Participation of medical professionals in American executions
Encyclopedia
Participation of medical professionals in American executions is a controversial topic, due to its moral and legal implications. The practice is proscribed by the American Medical Association
, as defined in its Code of Medical Ethics. The American Society of Anesthesiologists
endorses this position, stating "[lethal injections] can never conform to the science, art and
practice of anesthesiology".
In 2010, the American Board of Anesthesiologists, a member board of the American Board of Medical Specialties
, voted to revoke the certification of anesthesiologist
s who participate in executing a prisoner by lethal injection
. Board secretary Mark A. Rockoff defended the organization's policy, stating that participation in executions "puts anesthesiologists in an untenable position," and that physicians "can assuredly provide effective anesthesia, but doing so in order to cause a patient's death is a violation of their fundamental duty as physicians to do no harm."
In at least one case, the planned execution of Michael Morales
, the execution warrant
was stayed
indefinitely due to the objection of the contacted physicians to participate.
The topic was the subject of a 1992 review by the American Medical Association
, entitled Physician Participation in Capital Punishment.
cases discussing the constitutionality
of execution methods often involve testimony of medical professionals; one example of such a case being the 2008 Baze v. Rees
case, which affirmed the constitutionality of the three-drug lethal injection
protocol as a method of capital punishment
, despite claims that the single drug used for animal euthanasia
is more humane than the three-drug cocktail currently used.
One particular concern to opponents of physician participation in capital punishment is the role that health care providers have played in treating or reviving patients to render them fit for execution. In a 1995 Oklahoma case, death row inmate Robert Brecheen intentionally overdosed on sleeping pills hours before his scheduled lethal injection. He was immediately hospitalized and had his stomach pumped, before being returned to prison for his execution. In a similar 1997 case in Texas, David M. Long attempted suicide by drug overdose two days before his execution date and prison authorities flew him from an intensive care unit in Galveston, on a ventilator, accompanied by a full medical team, to the death chamber in Huntsville.
, Ángel Nieves Díaz
, and others. The only execution by lethal injection which failed to kill the condemned prisoner in United States occurred on September 15, 2009 in Ohio, when executioners attempted and then aborted the execution of Romell Broom
, leading to the implementation of a one-drug method. More than six decades earlier, on May 3, 1946, an unsuccessful attempt at the electrocution of Willie Francis
, then aged 17, led to an appeal to the U.S. Supreme Court
to reject a second attempt at electrocuting Francis, which failed by a 5-4 vote in Francis v. Resweber
, resulting in Francis' successful electrocution just over a year later, on May 9, 1947.
In many of these executions, the result of the error has been that executions have taken many times as long as they should done – in one case, the execution of Christopher Newton
, an execution took up to two hours to complete, fifteen times longer than average; ideally, executions should be completed within about eight minutes. Some have claimed that such executions may have induced excruciating pain, a possible violation of the Eighth Amendment
. This has been argued in the Supreme Court
case Hill v. McDonough
. Errors occurring in these botched executions include the incorrect placing of IV lines
, and injection of too little anaesthetic, reported in one study to have been consistent with awareness in 43% (21 executions) of the forty-nine executions in the study.
Since the reinstatement of capital punishment
in 1976, there have been, according to one study, forty-one possibly botched executions. On, January 7, 2008, the Supreme Court of the United States
heard oral argument
s in Baze v. Rees
, a case challenging the three-drug cocktail used for many executions by lethal injection
. The respondent's lawyer, Roy T. Englert, Jr., referred to the Death Penalty Information Center's list of "botched" executions. He criticized it because a majority of the executions on the list, according to respondent, "did not involve the infliction of pain, but were only delayed by technical problems (e.g., difficulty in finding a suitable vein)". However, the petitioners' attorney disagreed.
ruled 4-3 that the Medical Board cannot discipline doctors who participate in executions, stating that the statutes providing for lethal injection are superior to ethical guides.
, an ethical guide for the medical profession, albeit with no legal or constitutional value, which states:
American Medical Association
The American Medical Association , founded in 1847 and incorporated in 1897, is the largest association of medical doctors and medical students in the United States.-Scope and operations:...
, as defined in its Code of Medical Ethics. The American Society of Anesthesiologists
American Society of Anesthesiologists
The American Society of Anesthesiologists is an association of physicians, primarily anesthesiologists, that share a common goal of raising the standard of the medical specialty of anesthesiology and the improvement of patient care by fostering and encouraging education through research and...
endorses this position, stating "[lethal injections] can never conform to the science, art and
practice of anesthesiology".
In 2010, the American Board of Anesthesiologists, a member board of the American Board of Medical Specialties
American Board of Medical Specialties
The American Board of Medical Specialties is a non-profit physician-led umbrella organization for 24 of the 26 approved medical specialty boards in the United States...
, voted to revoke the certification of anesthesiologist
Anesthesiologist
An anesthesiologist or anaesthetist is a physician trained in anesthesia and peri-operative medicine....
s who participate in executing a prisoner by lethal injection
Lethal injection
Lethal injection is the practice of injecting a person with a fatal dose of drugs for the express purpose of causing the immediate death of the subject. The main application for this procedure is capital punishment, but the term may also be applied in a broad sense to euthanasia and suicide...
. Board secretary Mark A. Rockoff defended the organization's policy, stating that participation in executions "puts anesthesiologists in an untenable position," and that physicians "can assuredly provide effective anesthesia, but doing so in order to cause a patient's death is a violation of their fundamental duty as physicians to do no harm."
In at least one case, the planned execution of Michael Morales
Michael Morales
Michael Angelo Morales is a convicted murderer who was scheduled to be executed by the State of California at 7:30 p.m. on February 21, 2006...
, the execution warrant
Execution warrant
An execution warrant is a writ which authorizes the execution of a judgment of death on an individual...
was stayed
Stay of execution
A stay of execution is a court order to temporarily suspend the execution of a court judgment or other court order. The word "execution" does not necessarily mean the death penalty; it refers to the imposition of whatever judgment is being stayed....
indefinitely due to the objection of the contacted physicians to participate.
The topic was the subject of a 1992 review by the American Medical Association
American Medical Association
The American Medical Association , founded in 1847 and incorporated in 1897, is the largest association of medical doctors and medical students in the United States.-Scope and operations:...
, entitled Physician Participation in Capital Punishment.
Moral discussion
U.S. Supreme CourtSupreme Court of the United States
The Supreme Court of the United States is the highest court in the United States. It has ultimate appellate jurisdiction over all state and federal courts, and original jurisdiction over a small range of cases...
cases discussing the constitutionality
United States Constitution
The Constitution of the United States is the supreme law of the United States of America. It is the framework for the organization of the United States government and for the relationship of the federal government with the states, citizens, and all people within the United States.The first three...
of execution methods often involve testimony of medical professionals; one example of such a case being the 2008 Baze v. Rees
Baze v. Rees
Baze v. Rees, 553 U.S. 35 , was a United States Supreme Court case. The court agreed to hear the appeal of two men, Ralph Baze and Thomas Bowling, who were sentenced to death in Kentucky. The men argue that executing them by lethal injection would violate the 8th Amendment prohibition of cruel and...
case, which affirmed the constitutionality of the three-drug lethal injection
Lethal injection
Lethal injection is the practice of injecting a person with a fatal dose of drugs for the express purpose of causing the immediate death of the subject. The main application for this procedure is capital punishment, but the term may also be applied in a broad sense to euthanasia and suicide...
protocol as a method of capital punishment
Capital punishment
Capital punishment, the death penalty, or execution is the sentence of death upon a person by the state as a punishment for an offence. Crimes that can result in a death penalty are known as capital crimes or capital offences. The term capital originates from the Latin capitalis, literally...
, despite claims that the single drug used for animal euthanasia
Animal euthanasia
Animal euthanasia is the act of putting to death painlessly or allowing to die, as by withholding extreme medical measures, an animal suffering from an incurable, especially a painful, disease or condition. Euthanasia methods are designed to cause minimal pain and distress...
is more humane than the three-drug cocktail currently used.
One particular concern to opponents of physician participation in capital punishment is the role that health care providers have played in treating or reviving patients to render them fit for execution. In a 1995 Oklahoma case, death row inmate Robert Brecheen intentionally overdosed on sleeping pills hours before his scheduled lethal injection. He was immediately hospitalized and had his stomach pumped, before being returned to prison for his execution. In a similar 1997 case in Texas, David M. Long attempted suicide by drug overdose two days before his execution date and prison authorities flew him from an intensive care unit in Galveston, on a ventilator, accompanied by a full medical team, to the death chamber in Huntsville.
Botched executions
Possibly botched executions include those of Stanley WilliamsStanley Williams
Stanley Tookie Williams III was the co-founder of the Crips, a notorious American street gang which had its roots in South Central Los Angeles in 1969. In 1979 he was convicted of four murders committed in the course of robberies, sentenced to death, and eventually executed...
, Ángel Nieves Díaz
Ángel Nieves Díaz
Ángel Nieves Díaz was a Puerto Rican convict who was executed by lethal injection in Raiford, Florida. Nieves Díaz was convicted for shooting and killing the manager of a strip club in 1979...
, and others. The only execution by lethal injection which failed to kill the condemned prisoner in United States occurred on September 15, 2009 in Ohio, when executioners attempted and then aborted the execution of Romell Broom
Romell Broom
Romell Broom is an American convicted of murder, kidnapping, and rape. He was convicted in 1984 of abducting and killing Tryna Middleton, age 14, who was walking home from a football game in East Cleveland, Ohio. In 2003, Broom took up an offer from the state of Ohio for a DNA test to prove his...
, leading to the implementation of a one-drug method. More than six decades earlier, on May 3, 1946, an unsuccessful attempt at the electrocution of Willie Francis
Willie Francis
Willie Francis is best known for being the first recipient of a failed execution by electrocution in the United States. He was a black juvenile offender sentenced to death by electrocution by the state of Louisiana in 1945 for murdering Andrew Thomas, a Cajun pharmacy owner in St...
, then aged 17, led to an appeal to the U.S. Supreme Court
Supreme Court of the United States
The Supreme Court of the United States is the highest court in the United States. It has ultimate appellate jurisdiction over all state and federal courts, and original jurisdiction over a small range of cases...
to reject a second attempt at electrocuting Francis, which failed by a 5-4 vote in Francis v. Resweber
Francis v. Resweber
State of Louisiana Ex Rel. Francis v. Resweber, , is a case in which the U.S. Supreme Court was asked whether imposing capital punishment a second time, after it failed in an attempt to execute Willie Francis in 1946, constituted a violation of the United States Constitution...
, resulting in Francis' successful electrocution just over a year later, on May 9, 1947.
In many of these executions, the result of the error has been that executions have taken many times as long as they should done – in one case, the execution of Christopher Newton
Christopher Newton (criminal)
Christopher J. Newton was an American criminal whose 2007 execution by the state of Ohio motivated additional discussion about executions by lethal injection....
, an execution took up to two hours to complete, fifteen times longer than average; ideally, executions should be completed within about eight minutes. Some have claimed that such executions may have induced excruciating pain, a possible violation of the Eighth Amendment
Eighth Amendment to the United States Constitution
The Eighth Amendment to the United States Constitution is the part of the United States Bill of Rights which prohibits the federal government from imposing excessive bail, excessive fines or cruel and unusual punishments. The U.S. Supreme Court has ruled that this amendment's Cruel and Unusual...
. This has been argued in the Supreme Court
Supreme Court of the United States
The Supreme Court of the United States is the highest court in the United States. It has ultimate appellate jurisdiction over all state and federal courts, and original jurisdiction over a small range of cases...
case Hill v. McDonough
Hill v. McDonough
Hill v. McDonough , was a case decided by the United States Supreme Court challenging the use of lethal injection as a form of execution in the state of Florida. The Court ruled unanimously that a challenge to the method of execution as violating the Eighth Amendment to the United States...
. Errors occurring in these botched executions include the incorrect placing of IV lines
Intravenous therapy
Intravenous therapy or IV therapy is the infusion of liquid substances directly into a vein. The word intravenous simply means "within a vein". Therapies administered intravenously are often called specialty pharmaceuticals...
, and injection of too little anaesthetic, reported in one study to have been consistent with awareness in 43% (21 executions) of the forty-nine executions in the study.
Since the reinstatement of capital punishment
Gregg v. Georgia
Gregg v. Georgia, Proffitt v. Florida, Jurek v. Texas, Woodson v. North Carolina, and Roberts v. Louisiana, 428 U.S. 153 , reaffirmed the United States Supreme Court's acceptance of the use of the death penalty in the United States, upholding, in particular, the death sentence imposed on Troy Leon...
in 1976, there have been, according to one study, forty-one possibly botched executions. On, January 7, 2008, the Supreme Court of the United States
Supreme Court of the United States
The Supreme Court of the United States is the highest court in the United States. It has ultimate appellate jurisdiction over all state and federal courts, and original jurisdiction over a small range of cases...
heard oral argument
Oral argument
Oral arguments are spoken presentations to a judge or appellate court by a lawyer of the legal reasons why they should prevail. Oral argument at the appellate level accompanies written briefs, which also advance the argument of each party in the legal dispute...
s in Baze v. Rees
Baze v. Rees
Baze v. Rees, 553 U.S. 35 , was a United States Supreme Court case. The court agreed to hear the appeal of two men, Ralph Baze and Thomas Bowling, who were sentenced to death in Kentucky. The men argue that executing them by lethal injection would violate the 8th Amendment prohibition of cruel and...
, a case challenging the three-drug cocktail used for many executions by lethal injection
Lethal injection
Lethal injection is the practice of injecting a person with a fatal dose of drugs for the express purpose of causing the immediate death of the subject. The main application for this procedure is capital punishment, but the term may also be applied in a broad sense to euthanasia and suicide...
. The respondent's lawyer, Roy T. Englert, Jr., referred to the Death Penalty Information Center's list of "botched" executions. He criticized it because a majority of the executions on the list, according to respondent, "did not involve the infliction of pain, but were only delayed by technical problems (e.g., difficulty in finding a suitable vein)". However, the petitioners' attorney disagreed.
Legal implications
Several states which practice capital punishment, such as Georgia and Oregon, have laws forbidding sanctions against medical professionals participating in executions. The North Carolina Supreme CourtNorth Carolina Supreme Court
The Supreme Court of North Carolina is the state's highest appellate court. Until the creation of the North Carolina Court of Appeals in the 1960s, it was the state's only appellate court. The Supreme Court consists of six associate justices and one chief justice, although the number of justices...
ruled 4-3 that the Medical Board cannot discipline doctors who participate in executions, stating that the statutes providing for lethal injection are superior to ethical guides.
Proscription in the Hippocratic Oath
The practice is proscribed in the Hippocratic OathHippocratic Oath
The Hippocratic Oath is an oath historically taken by physicians and other healthcare professionals swearing to practice medicine ethically. It is widely believed to have been written by Hippocrates, often regarded as the father of western medicine, or by one of his students. The oath is written in...
, an ethical guide for the medical profession, albeit with no legal or constitutional value, which states:
Continuity of ethical discussion
Despite the constitutionality of lethal injection having been affirmed in Baze, the ethical discussion surrounding this topic seems unlikely to have been concluded, or, indeed, to be concluded any time in the near future.External links
- "Doctor, Reread Your Oath" Los Angeles TimesLos Angeles TimesThe Los Angeles Times is a daily newspaper published in Los Angeles, California, since 1881. It was the second-largest metropolitan newspaper in circulation in the United States in 2008 and the fourth most widely distributed newspaper in the country....
opinion piece criticizing physician involvement in executions - New England Journal of Medicine: Perspective Roundtable: Physicians and Execution (video) (available online)