Tablet Blog - The Uses and Abuses of Potassium Chloride

Here is the text of a blog I recently wrote for The Tablet:

Why British outcry at Oklahoma's botched execution rings tragically hollow

06 May 2014 by Tina Beattie

The persistent use of the death penalty in North America has brought widespread international condemnation, and never more so than with the so-called "botched execution" of Oklahoma death row inmate, Clayton Lockett. Lockett died of a heart attack some 43 minutes after the administration of a lethal injection using an experimental cocktail of drugs for the first time. Witnesses reported a prolonged struggle before the executioners drew the curtains on the death chamber.

The need to experiment with new combinations of drugs has arisen because some previously-used drugs are in short supply owing to a 2011 embargo by the European Union. This prevented European manufacturers from exporting drugs to the United States that might be used in lethal injections. In the past, this method of execution has used three drugs, including potassium chloride which stops the heart.

In 2010, The Guardian revealed that some British companies had been secretly exporting potassium chloride to America for use in executions. The outcry that followed prompted Britain to ban the export of drugs that might be used in lethal injections.

What has attracted little media attention is the fact that potassium chloride is used in this country to inject the foetal heart in cases of late abortion. The website of the Royal College of Obstetricians and Gynaecologists offers this advice:

For all terminations at gestational age of more than 21 weeks and 6 days, the method chosen should ensure that the foetus is born dead. This should be undertaken by an appropriately trained practitioner. Intracardiac potassium chloride is the recommended method and the dose chosen should ensure that foetal asystole has been achieved … Consideration can be given to abolishing foetal movements by the instillation of anaesthetic and/or muscle relaxant agents immediately prior to potassium chloride administration.

In Britain (excluding Northern Ireland), the time limit of 24 weeks for legal abortion is later than for most countries in western Europe, many of which allow abortion on demand but only during the first trimester. A legal loophole also means that abortions can be performed in Britain until birth in certain circumstances. Of the 190,972 abortions recorded in England and Wales in 2012, 91 per cent were performed in the first 13 weeks of pregnancy, but there were 160 abortions after the twenty-fourth week, of which 28 took place after the thirty-second week of pregnancy.

Few issues are as resistant to informed and reasoned debate as abortion, and any attempt to open up such a debate risks being hijacked by bitter polemicists on both sides. Yet wherever one stands on the legality and morality of abortion these are vital ethical issues. When there is such clear contradiction and denial as there is with regard to the uses and abuses of drugs like potassium chloride, it is in the public interest that such debate should be had, and that voices of reason should seek to be heard over the din of angry rhetoric. The question that will not go away is why the British public would be outraged at the use of a drug for the purposes of capital punishment, when one of our most prestigious medical organisations recommends its use for the purposes of killing a potentially viable baby.