The refusal by pharmaceutical giant Pfizer, Inc. to permit the further use of its drugs in lethal injections in the United States might see more of the 32 states with the death penalty (mostly in the South) return to using the electric chair, the firing squad and other discarded but more abhorrent modes of executing convicted criminals.

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Pfizer's move deprives death penalty states of the last and largest legal source of lethal injection drugs. Pfizer has heavily limited state's access to seven of its products sold under the generic names propofol, potassium chloride, pancuronium bromide, hydromorphone, rocuronium bromide, vecuronium bromide and midazolam.

Most of these drugs are normally used to stop the heart and brain as part of the popular "three-part cocktail" death penalty states use to kill convicted criminals. The drug midazolam, which Pfizer also makes, is used to sedate convicts prior to the intravenous injection of the heart and brain stopping drugs.

Pfizer said its distribution restriction limits the sale of these seven products to a select group of wholesalers, distributors and direct purchasers under the condition they won't resell these products to correctional institutions for use in lethal injections.

"Pfizer makes its products to enhance and save the lives of the patients we serve," said Pfizer in a statement. "Pfizer strongly objects to the use of its products as lethal injections for capital punishment."

In addition, Pfizer requires government purchasing entities to certify that products they purchase or acquire are to be used only for medically prescribed patient care and not for any penal purposes. Pfizer further requires these government purchasers certify the product they're buying is for "own use" and won't resell or otherwise provide the restricted products to any other party such as a prison.

"With Pfizer's announcement, all FDA-approved manufacturers of any potential execution drug have now blocked their sale for this purpose," said Maya Foa from Reprieve, a human rights advocacy group based in London.

"Executing states must now go underground if they want to get hold of medicines for use in lethal injection."

And death penalty states have indeed gone underground to source the lethal injection drugs they need. Some have even broken the law in the process. Late in 2015, shipments of sodium thiopental ordered by Texas and Arizona from an unapproved source in India were seized in airports by federal officials.

Ohio and Nebraska opted to buy a drug no longer available in the U.S. from abroad only to be told by the U.S. Food and Drug Administration that importing this drug is illegal.

But more ominous is the potential for more states to use the electric chair, the firing squad and the gas chamber for executions. These methods have been discarded as being too inhuman for taking the lives of people.

Tennessee in 2014 authorized prison officials to use the electric chair if lethal injection drugs are unavailable. In March 2015, Gov. Gary Herbert of Utah signed a bill into law approving firing squads when drugs can't be obtained, which should be the new norm because of Pfizer's action.

And in April 2015, Oklahoma made nitrogen gas its new backup method for executions. Prison officials in Louisiana have also recommended nitrogen gas be adopted as an alternative execution method.

TagsPfizer, death penalty, lethal injection, United States, midazolam, Maya Foa