Syringe.
With hundreds of inmates waiting to be executed and limited access to a key drug needed for lethal injections, Vietnam will now try to produce its own pharmaceuticals to carry out death sentences.
The move, announced by Public Security Minister Tran Dai Quang on Wednesday, stems from European controls on the exportation of barbiturates used in capital punishment.
The drug shortage generated much controversy in Vietnam, where officials complained that their attempt to introduce a less brutal execution technique only created a backlog of stressed-out death-row prisoners.
Some lawmakers last fall even suggested going back to Vietnam's old method: five-men firing squads.
Vietnam's new execution rules were introduced in 2011. The legislation, Decree 82, follows a protocol similar to that for lethal injections in the United States: first a dose of sodium thiopental, an anesthetic; then pancuronium bromide, a muscle relaxant; and finally potassium chloride, which stops the heart.
The change was presented as a more humane approach, to carrying out death sentences, although some Vietnamese lawmakers also praised injections as being cheaper and easier, psychologically, for executioners.
Because of its inability to obtain sodium thiopental, Vietnam now has five lethal-injection centres already built, but 532 inmates waiting on death row.
Their ranks are likely to grow, according to Amnesty International, since about 100 death sentences are imposed every year.
Vietnamese lawmakers last fall were told that some death-row prisoners died of illness while awaiting their sentence to be carried out, while others committed suicides or sought judgments to speed up their executions.
While not lethal, sodium thiopental is a key component because it renders the inmate unconscious, justifying the claim that it is a compassionate execution method.
Without it, the prisoner would remain lucid but unable to move while getting injected with potassium chloride, which causes excruciating pain, said Maya Foa, an investigator for the British human-rights group Reprieve.
Sodium thiopental is not produced in North America because it is no longer commonly used as an anesthetic. The drug is still made in Europe but exports began dwindling by 2011 because some European countries worried that it was used in executions.
Three months after Vietnam introduced Decree 82, the European Union put that worry into official form by amending its regulations, which already banned exports of products that could be used for capital punishment such as gallows and guillotines, to include sodium thiopental and other similar barbiturates.
The European export controls have had other repercussions. In Canada, for examples, some patients who are prone to side effects from other anesthetics could benefit from sodium thiopental but the drug is no longer available, even though there is no capital punishment here, said Rick Chisholm, a former president of the Canadian Anesthesiologists' Society.
Medical officials in Vietnam have said they would be able to produce barbiturates locally but needed legislative approval first.
Ms. Foa noted that the quantities of barbiturate needed for an execution are small – five grams per prisoner. "To set up a manufacturing plant for five grams would be absurd."
Vietnam could also rely on more artisanal production from a lab, but Ms. Foa said the output would have to meet high quality controls. Using unreliable anesthetics would defeat the claim that lethal injections are a more humane approach, she said.