Pharmacists aren’t just retailers, they’re medical professionals. And the professional organization to which they belong just made a big change to its ethical guidelines this week: to wit, that supplying drugs for use in executions is unethical. In a statement from the organization’s CEO, Thomas Menighan, the American Pharmacists Association explained: 

Pharmacists are health care providers and pharmacist participation in executions conflicts with the profession’s role on the patient health care team. This new policy aligns APhA with the execution policies of other major health care associations including the American Medical Association, the American Nurses Association and the American Board of Anesthesiology.

Pharmacists don’t take the Hippocratic Oath, swearing to do no harm—a fact that’s been mentioned in cases involving emergency contraception—but the idea that a health care provider would be providing drugs to assist in executions is one that’s been targeted by activists for some time. Most stories about APhA’s new policy use words like “discourage” to explain how the association feels about its members providing drugs to be used in executions, but the seriousness with which the organization intends to take violations of the ethical policy is unclear at the moment. In 2014 liberal blog ThinkProgress published a feature about the potential of the APhA taking such a step to end executions by lethal injection, noting the following: 

Almost all major medical associations — the American Medical Association, the American Public Health Association, the American Board of Anesthesiology, and the American Nurses Association — prohibit their members from assisting in executions. These professional associations believe that taking another person’s life against their will is a violation of the Hippocratic Oath, and can’t be reconciled with health workers’ ethical obligation to care for their patients. There can be stiff penalties for violating that. The American Board of Anesthesiology, which updated its policy in this area just four years ago, stipulates that members who participate in executions will lose their medical certification.

Whether APhA intends to revoke certification in the future for pharmacies like the anonymous source that provided a new supply of pentobarbital to Texas earlier this month is unclear at the moment; if the association can even identify the providers to implement such consequences is similarly unknown. That doesn’t make the move toothless, though—anti–death penalty activist Taren Stinebrickner-Kauffman noted to the Guardian that an end to lethal injection “may well be the outcome” of the policy, and states like Tennessee (which reinstated the electric chair as a backup) and Utah (which authorized the firing squad in the event that the drug isn’t available) seem prepared for a future in which execution drugs are no longer available by any means. 

The threat of losing professional certification that pharmacists spend time and money receiving is a serious one—more serious, presumably, than a little bit of PR fallout that the state has scrambled to help the compounding pharmacies that do provide the drugs avoid—and violating your profession’s stated ethical guidelines is never a good look for a health care provider. How all of this ultimately shakes out is yet to be determined, of course, but it’s another domino falling toward the end of lethal injection and the move toward a new means of execution in Texas. 

(AP Photo/Pat Sullivan, File)