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Should Doctors Assist Executions?

by TChris

Physicians aren't supposed to harm their patients. Is it ethical for a physician to help the government kill a prisoner?

A plan for California to use an anesthesiologist to monitor the chemically induced demise of a condemned killer has ignited concerns that doctors have no business assisting executions. ... "Physicians are healers, not executioners," the national anesthesiology group said in a statement Wednesday. "The doctor-patient relationship depends upon the inviolate principle that a doctor uses his or her medical expertise only for the benefit of patients."

Drugs used in California executions "can cause excruciating pain, in violation of the Eighth Amendment ban against cruel and unusual punishment." A federal judge reviewing evidence of prior executions isn't convinced that inmates are rendered unconscious before they experience any pain. During the scheduled execution of Michael Morales on Tuesday, the judge wants California "to allow an anesthesiologist to observe and examine the inmate during the execution." That ruling has triggered a debate about using a doctor to assist the death of a healthy man.

The American Civil Liberties Union distributed a statement by Dr. Jonathan I. Groner, a surgery professor at the Ohio State University College of Medicine and Public Health, who likened the approach to the role of doctors in Nazi Germany.

"An anesthesiologist who enters the death chamber is clearly violating national and internationally established medical ethics," he wrote in a statement. "Not since Nazi physicians supervised the killing of mentally and physically disabled individuals ... have high-ranking physicians become so intimately involved in state-sponsored killing."

University of Pennsylvania bioethicist Arthur Caplan said involving a physician in an execution smacks of an attempt by the state to legitimize a controversial law enforcement tactic.

"There aren't many Western countries that have the death penalty, and there is a strong current in our society to do away with it," Caplan said. "You don't want it to seem more barbaric than it has to be. Having someone in a white coat nearby helps moot the moral criticisms made against you."

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  • Re: Should Doctors Assist Executions? (none / 0) (#1)
    by kdog on Fri Feb 17, 2006 at 06:36:58 AM EST
    I would think it kind of clashes with the oath..."do no harm" and all that.

    Re: Should Doctors Assist Executions? (none / 0) (#2)
    by Talkleft Visitor on Fri Feb 17, 2006 at 07:05:05 AM EST
    Let's ask a different question. Would it be okay to have a scientific investigation to see only if death by injection (or electricution) results in cruel amounts of pain. Not to assist, just to take data. If so, would it be okay for a doctor to take part in such a study, and if so, to take part in the death chamber, or only outside (by designing, advising, analyzing the data?) I am against the death penalty. And I am definitely against Nazi style medical experimentation. I am also against clueless courts making crap up on their own. But then too, I am against phoney baloney junk science stinking up those clueless courts making crap up on their own. (Bad divorce legal experiences, what can I say?)

    Re: Should Doctors Assist Executions? (none / 0) (#3)
    by Talkleft Visitor on Fri Feb 17, 2006 at 07:17:38 AM EST
    Then how can I be in favor of assisted suicide? As someone who is pro death penalty and pro assisted suicide I am confused by the logic. Someone, seriously, help figure this out.

    Re: Should Doctors Assist Executions? (none / 0) (#4)
    by owenz on Fri Feb 17, 2006 at 07:56:39 AM EST
    This is stupid. How is monitoring or easing the pain of a patient inconsistent with the Hypocratic Oath? After all, what's the real issue here? Inmates may be suffering excrutiating pain during executions. What role would the anesthesiologist play? Evaluate that pain - and possibly treat it. The inmate sure as heck won't have a problem with this. And if the inmate doesn't have a problem, who does? If society wants to kill wrongdoers, it should at least do so responsibly. Abstract arguments about a "physician's proper role" don't mean sh*t when the anesthesiologist could assist in reducing the brutality of the process. Who else is going to do it, a prison guard? The doctor is a big boy/girl. They know the score. The idea that they will be "tainted" by the process is childish and, quite frankly, stupid. If California citizens are uncomfortable with doctors assisting in executions, they should consider whether or not they really want to execute people. What they shouldn't do is stick their heads in the sand and pretend that some prison employee is more qualified to administer lethal medication than a doctor. If you want to kill people, at least do it right. If you're against the death penalty, please understand that arguing that doctors should not be present during executions plays directly into the hands of those who want the process to be as painful and brutal as possible. The participation of doctors simply drives home the reality of what is happening. If you're against the death penalty, you should be pushing for physician involvement.

    Re: Should Doctors Assist Executions? (none / 0) (#5)
    by Edger on Fri Feb 17, 2006 at 08:12:03 AM EST
    Christianity and Islam both promote the strange concept that upon your death you will be united once again with the source and ultimate ground of reality and existence, in a paradisical state of existence. If this is true, how can assisting in death, particularly to relieve pain, be considered "barbaric"? In light of the concept these religions promote it is also incredible and ultimately hypocritical that there is so much talk of death being a terrible event to be feared. Should it not be welcomed as ultimate reward by anyone professing these religions? The feeling of being an ego enclosed in a bag of skin separate from existence or "in" but not "of" the universe, and the weird idea that we can ever be separate from the ultimate ground of existence rather than being an expression of it, is in my opinion a hallucination fostered by these religions. A huge trick played on the human race. I think we do not come "into" the universe at birth, but rather come "out" of it. Analogous to an ocean "waving", or a tree "leaving", the universe "peoples". There is much more to this issue than there appears to be...

    Re: Should Doctors Assist Executions? (none / 0) (#6)
    by owenz on Fri Feb 17, 2006 at 08:26:43 AM EST
    "There aren't many Western countries that have the death penalty, and there is a strong current in our society to do away with it," Caplan said. "You don't want it to seem more barbaric than it has to be. Having someone in a white coat nearby helps moot the moral criticisms made against you."
    Wrong, wrong, and wronger. There is no "strong current in our society to do away with" the death penalty. Nor is there any evidence that reducing the brutality of executions by introducting doctors to the process will somehow increase support for the death penalty. A far stronger argument can be made that most death penalty supporters feed off of the pain and brutality of executions. A painful execution by burly prison guards in the dark of night is exactly what people want. Just look at Iran: they do their executions in front of cheering crowds. It's a revenge ritual. Beyond the logical inconsistencies of this guy's statement, think about the practical implications of what he's saying: let's make executions more brutal, then people won't support them. Ahem, where does that leave the condemned? As the gunea pig for this guy's misguided social theory, that's where. Bring the doctors into the process. Remove the ritual retribution fantasy. Remove the revenge. Clarify what is actually happening: the state is systematically, scientifically killing someone.

    Re: Should Doctors Assist Executions? (none / 0) (#7)
    by Che's Lounge on Fri Feb 17, 2006 at 08:54:10 AM EST
    If they go through with this I will file a formal complaint of malpractice and assault with the CA medical board. We should know the name of this "Doctor Mengele" and get his or her liscense revoked. This is murder. "Hey Doc, can't you turn my brown eyes blue?" It's not personal, it's professional. You want the medical profession to police it's own? Well here goes.

    Re: Should Doctors Assist Executions? (none / 0) (#8)
    by Talkleft Visitor on Fri Feb 17, 2006 at 09:16:47 AM EST
    CA Medical Board Washes Hands "We don't get involved in ethical violations." Hi folks - As soon as I learned of the ethically repulsive plan for physicians to actively participate in putting a human being to death I called the CA State Medical Board. The woman who answered the phone at the Board's complaint line (1-800-633-2322) told me the Board does not consider ethical violations, only violations of law. The Board sends out a quarterly report recounting all the disciplinary actions taken against physicians. Physicians in California have lost their licenses for consensual sexual relationships and consensual business deals with patients (and rightly so - those relations with patients are an abuse of the doctor-patient relationship). So the Board will pull someone's license for consensual sex with patients or sharing a business - but if the physician particpates in the extremely non-consensual act of deliberately ending the life of an unwilling person - well that doc is home free with the medical board. The person at the Board evinced no concern whatsoever for this matter or its implications for patients. The person at the Board did say that ethical matters may be referred to the physician's speciality medical society - which in this case would be the anesthesiologists. Of course, specialists are not obligated to join these societies. And the only way to report the two anesthesiologists who participate in the killing of the prisoner would be to know their names - which San Quentin will not release. So I have a question for the medical board - if cannabalism isn't illegal in California, and we have docs engaging in consensual cannabalism with patinet who survive the procedure - are those docs OK to practice in California? When the physicans who aided and abetted torture of human beings in Abu Gharaib, "Gitmo", or wherever come to California after military service, will the Board allow ex-torturers to start caring for patients? Hey - Alberto Gonzales tells us it's all legal - no criminal activity here. So if you call the medical board, maybe they can explain to you - if executioners can be doctors, why not torturers?

    Re: Should Doctors Assist Executions? (none / 0) (#9)
    by Al on Fri Feb 17, 2006 at 09:42:16 AM EST
    Increasingly, executions are presented as medical procedures. There are needles and tape and cotton wool and nurses, and now if the state gets its way, anesthesiologists. The presence of a medical doctor in an execution would have a very powerful effect of legitimizing the killing. Doctors are respected and trusted in society. For most people, a doctor can do no wrong. Therefore, if one is present at the execution, the killing must be OK. How considerate of the state to provide medical assistance to the person they are about to kill. All these dilemmas are created by the very existence of the death penalty. If you want these dilemmas to disappear, do away with the death penalty. It is pure revenge. It has absolutely no deterrent effect. Society is not in the least served by killing someone.

    Re: Should Doctors Assist Executions? (none / 0) (#10)
    by Che's Lounge on Fri Feb 17, 2006 at 10:36:28 AM EST
    Here is the ASA stand. They are deferring to the AMA's position, which is that it is unethical. However it remains to be seen whether they would revoke the credentials of a board certified anesthesiologist if they performed state sponsored killing.

    Re: Should Doctors Assist Executions? (none / 0) (#11)
    by Che's Lounge on Fri Feb 17, 2006 at 10:38:48 AM EST
    Not that ASA could do that necessarily. They may only be a society, which is not necessarily a regulating body. That's why the good doctor and I are going to the state of CA.

    Re: Should Doctors Assist Executions? (none / 0) (#12)
    by owenz on Fri Feb 17, 2006 at 10:42:42 AM EST
    "Increasingly, executions are presented as medical procedures. There are needles and tape and cotton wool and nurses, and now if the state gets its way, anesthesiologists ... The presence of a medical doctor in an execution would have a very powerful effect of legitimizing the killing."
    Huh? The killings are legitimate right now. The Supreme Court has held that the death penalty is constitutional. California has voters support the death penalty. There is nothing illegal or illegitimate about it. Are you people suggesting that we go back to the bad old days, when "Old Sparky" fried screaming inmates to death? Are you arguing that the move towards more humane treatments of condemned prisoners is counter-productive? Are you asserting that anti-death penalty advocates should want the procedure to be more painful to the condemned so as to "shock" the public out its support for the death penalty? Wake up, people. Making executions less painful is not a bad thing. The use of physicians to aid with pain relief for the condemned is going to matter to one person - the condemned. They're the ones who have to die. (And it makes average Americans squeamish, I don't see how that hurts the cause eiter.) If people are truly concerned with the death penalty, they should start by thinking about the the people being killed. If they are being slowly tortured to death, that should stop. Now. And if a doctor is the only way to stop it, so be it. The people who say that the death penalty should stay painful and brutal so that the public turns against it are just like the Nader supporters who thought George Bush's presidency would be a good thing, since "the people" would rise up and revolt under Republican policies. Life doesn't work that way.

    Re: Should Doctors Assist Executions? (none / 0) (#13)
    by jondee on Fri Feb 17, 2006 at 10:52:05 AM EST
    Havnt psychiatrists,(ie: doctors) been enabling executions for a while now? Im thinking "Dr.Death" in The Thin Blue Line.

    Re: Should Doctors Assist Executions? (none / 0) (#14)
    by kdog on Fri Feb 17, 2006 at 12:09:24 PM EST
    As someone who is pro death penalty and pro assisted suicide I am confused by the logic. Someone, seriously, help figure this out.
    I'm not confused. A terminally ill patient is choosing to die, and the assisting doctor is following the wishes of his patient and speeding up an impending event (the patients death). Someone on death row isn't choosing to die, but being sentenced. The doctor performing the execution is not following the wishes of the patient.

    Re: Should Doctors Assist Executions? (none / 0) (#15)
    by Al on Fri Feb 17, 2006 at 01:01:03 PM EST
    Owenz, I won't argue with you -- our standpoints are too far apart for that --, but I would like to point out something about the word "legitimize" that I used. By "legitimate" I mean that in someone's mind something is perceived to be OK. Someone who does not have a very strong position on the death penalty will see that there are doctors involved, and feel reassured that the execution is "OK", it's clean, it's painless, there are health professionals involved who know what they're doing. The doctors lend psychological legitimacy to the killing. Currently, the convict is put on a hospital gurney, and killed in a spotlessly clean room, totally reminiscent of a hospital room. It is all made to look like a medical procedure. It is obvious why. Imagine that convicts in the US were executed like in Saudi Arabia. There, they are taken to a public square and made to kneel. Then the executioner comes with an extremely sharp sword and severs their head with one blow. Blood is all over the ground, and a severed head rolls around. Do that once, and Americans, who are majoritarily healthy, decent folks, would be horrified that such a ghastly thing would be done to someone in their name. I won't go into the Iranian hangings. Only a very few, very sick individuals would tolerate such a thing in the United States. The interesting thing is that the Saudi method sounds like it's relatively painless. It is certainly very swift. But it is definitely barbaric, and unacceptable for Americans. A large part of the reason why the state can get away with putting so many people to death without causing general revulsion is that the method of killing is not perceived as barbaric. Until recently, death by injection seemed perfect, but then it became public that the convicts were actually conscious but unable to move while they were dying a very painful death. So people need to be reassured again that the method of execution is not barbaric, and the way to do that is to bring in doctors. This is why it's so important that medical doctors not be involved. That would not mean that the convicts in the future would die a painful death, if the judges react by stopping executions because they are truly cruel.

    Re: Should Doctors Assist Executions? (none / 0) (#16)
    by Talkleft Visitor on Fri Feb 17, 2006 at 05:51:25 PM EST
    The remarks in the comments are interesting. On some level, yes, it makes sense for doctors to ensure that a legal penalty is carried out as humanely as possible. For instance, should they treat the mentally ill, if such treatment will bring "sanity" that allows execution? I reckon yes. And, on some level, we can be demanding on the level of angels on the head of a pin to determine if the doctor is somehow involved on some level. Still, Al makes a good point too. It does "legitimize" the penalty. And, the doctor is directly taking part in the involuntary ending of a life. This has ethical problems. But, what is the ultimate until we do abolish capital punishment? Having non-medical personnel do this? I guess the basics are fairly straightforward, though current appeals re lethal injections suggest not quite so. Will not involving doctors harm the inmates? Is this a good thing?

    Re: Should Doctors Assist Executions? (none / 0) (#17)
    by Talkleft Visitor on Fri Feb 17, 2006 at 06:15:42 PM EST
    Why not just use some of the assisted suicide drugs? Don't they kill without "causing excruciating pain"? Jimbo

    Re: Should Doctors Assist Executions? (none / 0) (#18)
    by Che's Lounge on Sat Feb 18, 2006 at 09:07:49 AM EST
    Well the MD's shouldn't, and the prison staff CAN'T (obviously). Looks like the revenge lovers got nuthin.

    Re: Should Doctors Assist Executions? (none / 0) (#19)
    by Talkleft Visitor on Sat Feb 18, 2006 at 10:59:11 AM EST
    Well ideally ...

    Re: Should Doctors Assist Executions? (none / 0) (#20)
    by HK on Mon Feb 20, 2006 at 05:28:52 AM EST
    This is an interesting debate. The fact that the lethal injection issue is fraught with issues that cannot be reconciled epitomizes the lack of logic in the death penalty as a whole. As a writer and someone who has studied Law, my research has shown clearly that a moratorium was needed in order to address this and the many other inconsistancies in capital punishment. As a campaigner for the abolishion of the death penalty, I do not want medical professionals to participate in executions, thus violating their code of ethics and making the whole process more palatable for the general public and those who witness. As a close friend of Mike Morales, however, I am torn on this issue. I am distraught as it is and the idea that he may go through excruciating pain causes me much anguish. I do not want doctors to assist in his death, but nor do I want unqualified prison staff poking needles and tubes into him before putting him under physical and mental duress in a drawn out process that will eventually result in his death. Incidentally, I hope you have all read the Feb 17 Challenge to the lethal injection, available on the ACLU website. In this it is detailed that the CDRC suggested, as a solution to the question of whether Mike may be able to feel pain, 'to have the Warden poke Mr. Morales to see if he moved.' I kid you not...