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Page Number: 24.0

20 

GLOSSIP v. GROSS 

Opinion of the Court 

lat[ions]’ ” from studies done about much lower therapeutic 
doses of midazolam.  See Brief for Petitioners 34 (citing Tr.
667–668; emphasis deleted).  But because a 500-milligram 
dose  is  never  administered  for  a  therapeutic  purpose,
extrapolation  was  reasonable.  And  the  conclusions  of 
petitioners’ experts were also based on extrapolations and
assumptions.  For  example,  Dr.  Lubarsky  relied  on  “ex-
trapolation of the ceiling effect data.”  App. 177.

Based on the evidence that the parties presented to the
District Court, we must affirm.  Testimony from both sides 
supports  the  District  Court’s  conclusion  that  midazolam 
can render a person insensate to pain.  Dr. Evans testified 
that although midazolam is not an analgesic, it can none-
‘insen-
theless  “render  the  person  unconscious  and 
sate’ during the remainder of the procedure.”   Id., at 294. 
In his discussion about the ceiling effect, Dr. Sasich agreed 
that as the dose of midazolam increases, it is “expected to
produce sedation, amnesia, and finally lack of response to 
stimuli  such  as  pain  (unconsciousness).” 
Id.,  at  243. 
Petitioners  argue  that  midazolam  is  not  powerful  enough 
to keep a person insensate to pain after the administration
of  the  second  and  third  drugs,  but  Dr.  Evans  presented 
creditable  testimony  to  the  contrary.    See,  e.g.,  Tr.  661 
(testifying  that  a  500-milligram  dose  of  midazolam  will 
induce  a  coma).4    Indeed,  low  doses  of  midazolam  are 
sufficient  to  induce  unconsciousness  and  are  even  some- 

—————— 

4 The  principal  dissent  misunderstands  the  record  when  it  bizarrely
suggests  that  midazolam  is  about  as  dangerous  as  a  peanut.    Post,  at 
15.  Dr.  Evans  and  Dr.  Lubarsky  agreed  that  midazolam  has  caused
fatalities in doses as low as 0.04 to 0.07 milligrams per kilogram.  App. 
217, 294.  Even if death from such low doses is a “rare, unfortunate side 
effec[t],”  post,  at  15,  the  District  Court  found  that  a  massive  500-
milligram  dose—many  times  higher  than  the  lowest  dose  reported  to
have  produced  death—will  likely  cause  death  in  under  an  hour.  App.
76–77.