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Page Number: 22.0

18 

GLOSSIP v. GROSS 

Opinion of the Court 

protocol  if  it  violates  the  Eighth  Amendment,  federal 
courts  should  not  “embroil  [themselves]  in  ongoing  scien-
tific controversies beyond their expertise.”  Baze, supra, at 
51.  Accordingly,  an  inmate  challenging  a  protocol  bears
the  burden  to  show,  based  on  evidence  presented  to  the
court, that there is a substantial risk of severe pain. 

A 
Petitioners attack the District Court’s findings of fact on
two main grounds.3  First, they argue that even if midazo-
lam is powerful enough to induce unconsciousness, it is too 
weak  to  maintain  unconsciousness  and  insensitivity  to 
pain  once  the  second  and  third  drugs  are  administered.
Second,  while  conceding  that  the  500-milligram  dose  of 
midazolam  is  much  higher  than  the  normal  therapeutic 
dose,  they  contend  that  this  fact  is  irrelevant  because 
midazolam  has  a  “ceiling  effect”—that  is,  at  a  certain 
point,  an  increase  in  the  dose  administered  will  not  have
any  greater  effect  on  the  inmate.    Neither  argument 
succeeds. 

The  District  Court  found  that  midazolam  is  capable  of 
placing a person “at a sufficient level of unconsciousness to 
resist  the  noxious  stimuli  which  could  occur  from  the 

—————— 

3 Drs. Lubarsky and Sasich, petitioners’ key witnesses, both testified
that  midazolam  is  inappropriate  for  a  third  reason,  namely,  that  it
creates  a  risk  of  “paradoxical  reactions”  such  as  agitation,  hyperactiv-
ity, and combativeness.  App. 175 (expert report of Dr. Lubarsky); id., at 
242, 244 (expert report of Dr. Sasich).  The District Court found, how-
ever,  that  the  frequency  with  which  a  paradoxical  reaction  occurs  “is
speculative” and that the risk “occurs with the highest frequency in low
therapeutic  doses.”  Id.,  at  78.    Indeed,  Dr.  Sasich  conceded  that  the 
incidence or risk of paradoxical reactions with midazolam “is unknown” 
and that reports estimate the risk to vary only “from 1% to above 10%.” 
Id., at 244.  Moreover, the mere fact that a method of execution might 
result  in  some  unintended  side  effects  does  not  amount  to  an  Eighth 
Amendment violation.  “[T]he Constitution does not demand the avoid-
ance of all risk of pain.”  Baze, 553 U. S., at 47 (plurality opinion).