Document ID: ./input/supremecourt_opinions/opinions/14pdf/14-7955_aplc.pdf
Page Number: 25

Cite as:  576 U. S. ____ (2015) 

21 

Opinion of the Court 

times  used  as  the  sole  relevant  drug  in  certain  medical 
procedures.  Dr.  Sasich  conceded,  for  example,  that  mid-
azolam might be used for medical procedures like colonos-
copies and gastroscopies.  App. 267–268; see also Brief for 
Respondents 6–8.5 

Petitioners  emphasize  that  midazolam  is  not  recom-
mended or approved for use as the sole anesthetic during 
painful surgery, but there are two reasons why this is not 
dispositive.  First,  as  the  District  Court  found,  the  500-
milligram dose at issue here “is many times higher than a 
normal  therapeutic  dose  of  midazolam.”  App.  76.  The 
effect of a small dose of midazolam has minimal probative
value about the effect of a 500-milligram dose.  Second, the 
fact that a low dose of midazolam is not the best drug for
maintaining  unconsciousness  during  surgery  says  little 
about  whether  a  500-milligram  dose  of  midazolam  is 
constitutionally  adequate  for  purposes  of  conducting  an 
execution.  We  recognized  this  point  in  Baze,  where  we 
concluded  that  although  the  medical  standard  of  care
might  require  the  use  of  a  blood  pressure  cuff  and  an
electrocardiogram  during  surgeries,  this  does  not  mean 
those  procedures  are  required  for  an  execution  to  pass 
Eighth Amendment scrutiny.  553 U. S., at 60. 

Oklahoma  has  also  adopted  important  safeguards  to
ensure  that  midazolam  is  properly  administered.    The 

—————— 

5 Petitioners’  experts  also  declined  to  testify  that  a  500-milligram
dose  of  midazolam  is  always  insufficient  to  place  a  person  in  a  coma 
and render him insensate to pain.  Dr. Lubarsky argued only that the
500-milligram  dose  cannot  “reliably”  produce  a  coma.  Id.,  228.  And 
when  Dr.  Sasich  was  asked  whether  he  could  say  to  a  reasonable 
degree  of  certainty  that  a  500-milligram  dose  of  midazolam  would  not
render someone unconscious, he replied that he could not.  Id., at 271– 
272.    A  product  label  for  midazolam  that  Dr.  Sasich  attached  to  his
expert  report  also  acknowledged  that  an  overdose  of  midazolam  can 
cause  a  coma.    See  Expert  Report  of  Larry  D.  Sasich,  in  No.  14–6244 
(CA10), p. 34.