Document ID: ./input/supremecourt_opinions/opinions/14pdf/14-7955_aplc.pdf
Page Number: 26.0

22 

GLOSSIP v. GROSS 

Opinion of the Court 

District  Court  emphasized  three  requirements  in  particu-
lar:  The  execution  team  must  secure  both  a  primary  and 
backup IV access site, it must confirm the viability of the 
IV  sites,  and  it  must  continuously  monitor  the  offender’s
level of consciousness.  The District Court did not commit 
clear  error  in  concluding  that  these  safeguards  help  to
minimize  any  risk  that  might  occur  in  the  event  that
midazolam  does  not  operate  as  intended.    Indeed,  we 
concluded in Baze that many of the safeguards that Okla-
homa  employs—including  the  establishment  of  a  primary 
and  backup  IV  and  the  presence  of  personnel  to  monitor 
an inmate—help in significantly reducing the risk that an 
execution  protocol  will  violate  the  Eighth  Amendment. 
Id., at 55–56.  And many other safeguards that Oklahoma
has  adopted  mirror  those  that  the  dissent  in  Baze  com-
plained were absent from Kentucky’s protocol in that case. 
For example, the dissent argued that because a conscious-
ness check before injection of the second drug “can reduce 
a risk of dreadful pain,” Kentucky’s failure to include that 
step  in  its  procedure  was  unconstitutional.    Id.,  at  119 
(opinion  of  GINSBURG,  J.).    The  dissent  also  complained 
that Kentucky did not monitor the effectiveness of the first
drug  or  pause  between  injection  of  the  first  and  second
drugs. 
Id.,  at  120–121.    Oklahoma  has  accommodated 
each of those concerns. 

B 
Petitioners  assert  that  midazolam’s  “ceiling  effect”
undermines  the  District  Court’s  finding  about  the  effec-
tiveness  of  the  huge  dose  administered  in  the  Oklahoma 
protocol.  Petitioners argue that midazolam has a “ceiling” 
above which any increase in dosage produces no effect.  As 
a result, they maintain, it is wrong to assume that a 500-
milligram dose has a much greater effect than a therapeu-
tic  dose  of  about  5  milligrams.    But  the  mere  fact  that 
midazolam  has  such  a  ceiling  cannot  be  dispositive.    Dr.