Document ID: ./input/supremecourt_opinions/opinions/14pdf/14-7955_aplc.pdf
Page Number: 115

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

19 

SOTOMAYOR, J., dissenting 

“big  jump”  to  conclude  that  midazolam  would  be  effective 
to maintain unconsciousness throughout an execution.  Tr. 
369–370.  Indeed,  the  record  provides  no  reason  to  think 
that  these  procedures  cause  excruciating  pain  remotely
comparable  to  that  produced  by  the  second  and  third 
lethal injection drugs Oklahoma intends to use.

As for more painful procedures, the consensus was also
clear: Midazolam is not FDA-approved for, and is not used
as, a sole drug to maintain unconsciousness.  See App. 171
(Lubarsky),  262  (Sasich),  327  (Evans).    One  might  infer
from the fact that midazolam is not used as the sole anes­
thetic  for  more  serious  procedures  that  it  cannot  be  used 
for them.  But drawing such an inference is unnecessary, 
as  petitioners’  experts  invoked  sources  expressly  stating 
as much.  In particular, Dr. Lubarsky pointed to a survey 
article  that  cited  four  separate  authorities  and  declared
that  “[m]idazolam  cannot  be  used  alone  . . .  to  maintain 
adequate  anesthesia.”    Reves  318;  see  also  Stoelting  & 
Hillier  145  (explaining  that  midzolam  is  used  for  “induc­
tion of anesthesia,” and that, “[i]n combination with other 
drugs,  [it]  may  be  used  for  maintenance  of  anesthesia” 
(emphasis added)).

This  evidence  was  alone  sufficient,  but  if  one  wanted 
further  support  for  these  conclusions  it  was  provided  by 
the  Lockett  and  Wood  executions.    The  procedural  flaws
that  marred  the  Lockett  execution  created  the  conditions 
for an unintended (and grotesque) experiment on midazo­
lam’s  efficacy.  Due  to  problems  with  the  IV  line,  Lockett
was  not  fully  paralyzed  after  the  second  and  third  drugs 
were  administered.    He  had,  however,  been  administered 
more  than  enough  midazolam  to  “render  an  average  per­
son  unconscious,”  as  the  District  Court  found.    App.  57.
When  Lockett  awoke  and  began  to  writhe  and  speak,  he
demonstrated  the  critical  difference  between  midazolam’s 
ability  to  render  an  inmate  unconscious  and  its  ability  to
maintain the inmate in that state.  The Court insists that