In 'Curtains Down', you can swap out the prop gun for a real gun, which the actor playing the executioner will use to kill Alvaro D'Alvade for you.
There's even been statements that some of the people who went into the clinic came out as alcoholics due to there being nothing to do in the place but lie back and indulge. It's a safe house for mobsters laying low.
While the targets probably bribed the staff, 47 can carry in 4 syringes of unknown substance without being properly checked for them.