I am implacably opposed to capital punishment. There are few issues on which I'm so certain. The state should not kill people. As I've said before, humanity is better than that.

It was only a few weeks ago that I learned that the European Union forbids the export of drugs used for killing prisoners in the USA through lethal injection. For perhaps the first time, I felt a real swell of pride at what seemed a surprisingly strong and principled stand. It is rare to see ethics translated to action on this scale.

But today, Owen Dyer's article in the BMJ (paywalled) has given me pause for thought. This excellently-written article discusses, in some detail, the difficulties drug shortages have caused for the lethal injection programme in several states.

Dyer's article talks through a number of horrendous botched executions, as well as the methods (some illegal) by which states have attempted to procure drugs for lethal injections. I found it a deeply thought-provoking piece. Towards the end, Dyer comes to this point:

Arkansas’ attorney general last year called the state’s capital punishment system “completely broken … it’s either abolish the death penalty or change the method of execution.”

Initiatives are now cropping up in state houses to return to more violent methods. These methods are not so far behind us as some imagine. The last execution by firing squad was in 2010, the last by gas chamber was in 1999, and the last hanging occurred in 1996. The last use of the electric chair was in 2013 in Virginia.

Is it better to bend our principles to supply drugs and assure a more humane death, or to withhold them and ensure a violent death?

The dilemma is complicated by the knowledge that violent methods have less public support, so may – or may not – bring about the end of capital punishment in the USA sooner than non-violent methods.

I tentatively lean in the direction of the greater good, and suggest that drugs are withheld. But it is certainly a complicated issue.

I recently had the pleasure of meeting Sir Simon Wessely – a renowned British psychiatrist. He’s exactly as lovely as he seems in his writing!

On the same day that I met Sir Simon, I had been discussing the challenges of publishing ‘lost’ clinical trials with someone else. I wish I’d discussed it with him, because then I could claim some sort of tangential influence on his decision to write my recommended read for this weekend: a blog post in which he describes a ‘lost’ trial involving him.

It is easy to claim that non-publication of trials may be result of deliberate decisions, such as a wish not to publicise negative results, and we know this does indeed happen. But probably more common is a more understandable and human sequence of events. A first attempt at publication fails. Teams break up. Some leave academic life and start families. Others move into busy clinical posts, or take on new demanding projects. And time marches on.

As you see, it adds a neat anecdotal riposte to the growing clamour of voices which seem to claim – intentionally or otherwise – that non-publication of trials is always a function of ‘evil’ people working for ‘big pharma’. It’s well worth a read.