On December 7, 1982, Charles Brooks Jr., convicted of murder, was injected with sodium pentathol at the state penitentiary in Huntsville, Texas, marking the first execution by lethal injection in the United States. Over the next decade, 32 states, the federal government, and the military would adopt lethal injection as a more humane alternative to the previous violent methods of execution like hanging or the electric chair.  Today, 26 of the 27 death penalty states rely on the very drugs used to help preserve life in hospitals across the United States to impose state-sanctioned death. 

This reliance proved its fallibility over past decades as major drug manufacturers started taking active steps to prevent their products from being used in executions. As they restricted distribution and severed supply chains, pharmaceutical companies — despite having no formal role in the legal system — began to function as de facto regulators of execution practices. As such, pharmaceutical companies' efforts to distance themselves from the death penalty unintentionally pushed states toward less-regulated pharmacies and experimental protocols, contributing to a far more secretive and increasingly unstable lethal injection system. 

Designing a “Humane” Execution

The standard protocol, developed in the late 1970s by Oklahoma’s Jay Chapman involved a three-drug sequence: (1) an anesthetic like sodium thiopental to render the prisoner unconscious; (2) pancuronium bromide, a paralyzing agent to suppress all voluntary muscle movement; (3) potassium chloride to stop the heart. 

By the 1980s, states started relying increasingly on established pharmaceutical manufacturers to provide standardized, high-quality compounds, reinforcing the notion that lethal injection was a medically controlled and predictable process. This dependence on regulated drug production, however, ultimately enabled future interventions by pharmaceutical companies to destabilize the very foundation upon which lethal injection protocols were built.

Pharmaceutical Companies Gain Control

Starting in the mid-2000s, and accelerating in the following decade, pharmaceutical companies around the world began taking increasingly deliberate measures to prevent their drugs from being used in executions — namely sodium thiopental. These decisions were driven primarily by ethical obligations, as pharmaceutical companies emphasized that their products were developed to treat patients and save lives.

In 2010, Hospira, the only domestic manufacturer of sodium thiopental, announced a production halt, and eventually discontinued Pentothal — the drug’s brand name — as it could no longer obtain a sufficient quantity of the drug’s active ingredient, catalyzing a shortage. A year later, Danish pharmaceutical company Lundbeck, said it would cease all shipments of sodium pentobarbital (brand name, Nembutal) intended for the death penalty. This came after the company received reports that Nembutal was replacing Pentothal in American executions during the execution drug shortage; a company spokesperson said: “This is fully against what we stand for. We are in the business of improving people’s lives.”

International pressure only intensified these efforts. By 2012, the European Union officially imposed export bans on drugs intended for capital punishment, effectively creating a major supply crisis across the United States. Moreover, domestic pharmaceutical companies also began imposing sweeping controls, ensuring their products would not be sold to correctional facilities or be redistributed for use in lethal injection — the last one being Pfizer in 2016. 

However, these decisions were also tied to growing reputational concerns as public awareness and international advocacy campaigns drew attention to the use of medical drugs in capital punishment. Reprieve, a United Kingdom-based human rights NGO, led the campaign to stop European companies from selling lethal injection drugs to the United States. Such movements also gained traction in the U.S., as members of the American Pharmacists Association and American Medical Association began voting against medical professionals’ participation in executions.

Although these corporate actions were not formal legal interventions, they effectively restructured the operational boundaries of the death penalty. As a result, what had once been a largely unexamined supply chain — where states could obtain anesthetics and other lethal injection drugs through standard medical distribution channels — became the focus of ethical scrutiny and corporate resistance. By controlling availability, pharmaceutical companies began functioning as gatekeepers of execution viability.

The drug shortage also revealed the extent to which the death penalty depended on cooperation from the pharmaceutical industry. When that cooperation was withdrawn, states were forced into a reactive and improvisational approach to executions, revealing how capital punishment now depended on corporate supply decisions outside the legal system. 

Compounded Uncertainty 

Interestingly, this intervention did not halt executions; instead, states began adjusting the conditions under which lethal injection continued to be operated, ultimately turning to compounding pharmacies.

Unlike large-scale manufacturers, compounding pharmacies produce customized or altered medications that are typically tailored to individual patient needs, thus operating under a different and generally less stringent regulatory framework as they are not subject to the same level of standardization, testing, and oversight as mass-produced, FDA-approved drugs. 

However, according to the Death Penalty Information Center, “some compounding pharmacies are more like drug manufacturers, producing large quantities of drugs that are copies or near-copies of commercially-available drugs,” eventually growing to play a significant role in allowing states to continue lethal injection executions. 

With a rapidly dwindling supply of vital execution drugs, states began relying on compounding pharmacies. In 2012, South Dakota acquired pentobarbital, an anesthetic, for the execution of Eric Robert. Not long after he was injected, he gasped heavily and his skin turned purple — a reaction described to be as “consistent with contaminated drugs,” according to the American Civil Liberties Union. A year later, Colorado’s Department of Corrections wrote to 97 compounding pharmacies in the state, asking for sodium thiopental in order to carry out an execution. This pattern continued for years: In 2014, Oklahoma executed Clayton Lockett with an untested protocol that did not render Lockett fully unconscious after he was injected with the anesthetic. The onlookers could see him writhe in pain, and his lawyer said it looked “like torture.”

Perhaps the most alarming was a 2018 investigation that found Texas was secretly obtaining execution drugs from Greenpark Compounding Pharmacy, which the Texas State Board of Pharmacy had cited for 48 violations between the years 2010 and 2018. Some of the violations included “keeping out-of-date drugs” as compounded drugs tend to have a much shorter shelf life, “using improper procedures to prepare IV solutions, and inadequate cleaning of hands and gloves.” 

As time passed, compounding pharmacies became a controversial necessity, and state legislatures began passing laws shielding the identities of drug suppliers from public disclosure, creating a decentralized and less accountable supply structure. In fact, all states that carried out executions between January 2011 and August 2018 had withheld information about the process to varying degrees, with Georgia even calling information about its executions a “state secret.” 

This nationwide transition into secretly adopting less-regulated products brought significant concerns about the quality and consistency of the substances being used, especially as states started seeing a rise in botched executions. According to research by Austin Sarat, a professor of political science at Amherst College, an estimated 3% of executions between 1890 and 1920 were botched. In contrast, nearly 35% of all executions in 2022 were “visibly problematic” primarily as a direct consequence of “failures to follow protocols, or defects in the protocols themselves,” demonstrating the consistent rise in the fallibility of lethal injection.

In a medical context, such inconsistencies would be unacceptable. But in the context of capital punishment, such secrecy and inaccuracy are almost normalized as states around the nation are likely to proceed with an execution using unreliable or improperly formulated drugs, ultimately resulting in an unnecessarily prolonged death. 

Constitutional Limits in an Unstable Execution System

The shift toward alternative drug sources and experimental protocols has not only altered the logistics of execution, but fundamentally destabilized the constitutional framework that governs the death penalty. This is particularly true under the Eighth Amendment’s prohibition on cruel and unusual punishment, as what was once framed as a controlled and predictable medical procedure has become an uncertain pharmacological experiment. 

In cases like Baze v. Rees (2008) and Glossip v. Gross (2015), the United States Supreme Court upheld lethal injection protocols while establishing a demanding standard for constitutional challenges. Prisoners must show not only that a method presents a substantial risk of severe pain, but also that a feasible and readily available alternative exists. This, in theory, would help prevent speculative claims. But it fails in practice: pharmaceutical companies have already restricted access to the safest known drugs, meaning that prisoners are often required to propose risky alternatives that states themselves are incapable of obtaining. As a result, the legal standard effectively shields evolving and potentially riskier execution methods from meaningful scrutiny. The U.S. Constitution also “does not require the avoidance of all risk of pain,” according to Supreme Court Justice Scalia. This, according to the Court, draws a line between “isolated errors” (when a corrections official errs or fails to follow protocol), and unnecessary pain and suffering, which is difficult to differentiate from pain that is the “inescapable consequence of death,” creating a legal loophole to avoid accountability.  

Also, when coupled with the states’ lack of transparency regarding the sources and composition of their drugs, courts are left to evaluate constitutional claims without full access to the relevant scientific evidence, effectively undermining judicial review. Without reliable information, courts cannot accurately assess whether a given method poses an unconstitutional risk of suffering, thus making the legal system a product of major corporations and state secrecy. 

An Additional Ethical Paradox

Moreover, the pharmaceutical restrictions that triggered the execution drug crisis also expose a deeper ethical contradiction: the attempt to reconcile a fundamentally medicalized method of execution with the ethical principles of the medical profession. Pharmaceutical companies and medical professionals have refused to participate in executions in order to uphold core ethical commitments to preserving life and preventing harm. Organizations like the American Medical Association prohibit physician participation in executions, emphasizing that medical expertise should never be used to facilitate death. Yet these efforts, while ethically consistent, have had unintended structural consequences for the death penalty itself. 

By cutting off access to regulated, pharmaceutical-grade drugs and removing medical expertise from the execution process, states were forced to rely on unreliable alternatives. As a result, executions are often carried out by underqualified personnel who use experimental drug combinations from compounding pharmacies, and consequently introduce serious “potential for pain and suffering” into the process — something that is now central to modern lethal injection practices. As such, a system that was once presented as medically controlled has become one defined by improvisation and uncertainty. 

States have only responded to these challenges by obscuring them. The expansion of secrecy laws shielding drug suppliers and execution protocols reflects an acknowledgement that the current system is harder to justify. As transparency decreases, so too does the ability of the courts, journalists, and the public to evaluate the ethicality of such execution practices, ultimately raising serious concerns about democratic accountability as the legal system continues to rely on incomplete or inaccessible information when assessing constitutional claims. 

Conclusion: How Corporations Reshaped the Architecture of Capital Punishment

As such, efforts to distance drug manufacturers and medicine from capital punishment has only destabilized the lethal injection execution system. Pharmaceutical companies, despite having no formal role in the legal system, became some of the most influential actors in reshaping the modern death penalty — ultimately transforming it from a medically legitimate procedure to a highly risky and controversial one. 

Ultimately, the crisis surrounding execution drugs exposes a deeper structural tension between medicine, corporations, and the power of the states. As pharmaceutical companies withdrew from participating in executions, they forced the death penalty into less-regulated territory, generating serious questions about whether lethal injection can continue to function as a constitutionally and ethically viable method of execution, and if corporations should be allowed such immense power to begin with — together exposing the fragile foundation upon which modern capital punishment rests.