Execution Doctors Unethical: Whether Hanging, Electrocution, Gas or Lethal Injectionl

     

There's hasn't been an execution in North Carolina for two years. Not that the state doesn't want to kill anyone. It's got 163 prisoners sitting on death row at Central Prison in Raleigh right now. But the state hasn't had a chance to kill anyone since August 2006. Down in North Carolina they are in the middle of a de facto moratorium on executions.

The execution shut-down happened because of a disagreement about the role doctors should play in a state killing. It finally reached the state Supreme Court last week. Well, that didn't seem to help any. In fact, there are a number of disagreeing factions involved in this dispute. I'm not talking about those that are fer versus those that are agin capital punishment. Apparently, no one is arguing that these 163 guys shouldn't be killed in the first place. Oh no. It's just who's gonna be involved in the killin' and then who's gonna have to make the final decision about who's involved. I wonder if it really comes down to just who wants to sleep good at night.

Excuset he sarcasm.  You do have to be alive to get to sleep, don't you. It's the ones they kill that get the Deep Sleep. No Ambien for them.

A LEGAL MORASS

The Associated Press calls it a "legal morass" (ahem). A morass is a soft wet area of low-lying land that sinks underfoot. If they were going to put you to night-night forever, any land underfoot would give you a sinking feeling, right?

A morass is also anything that entraps. And, a confused or complicated situation from which escape seems impossible -- unless you can figure out how to get the lawyers and doctors to keep arguing. Then try and get state legislators involved --- yes, more lawyers.

THE 'PRESENT' DOCTOR

The word "present" plays a big role in this debate.  Way back 99 years ago, when North Carolina was switching from hanging to the electric chair in 1909, executions were changed from the local level to the state capital. That's when the law was passed, so a medical authority would be able to certify the death to the locals, according to the Fayetteville Observer. Other than being present during executions and certifying the condemned  person had died, the law doesn't describe the doctor's role.

JUST DON'T 'DO' ANYTHING 

The North Carolina Department of Correction says that state law requires doctors to take part in executions. The N.C. Medical Board disagrees and says medical ethics against hurting patients bar doctors from doing anything more than certifying the death. Well, yes, the doctors have been doing more at executions.

Apparently starting in 2006,  doctors have monitored equipment that measures the condemned prisoner's brain waves, following a federal lawsuit questioning whether capital punishment violates the U.S. Constitution's ban on cruel and unusual punishment. The doc was supposed to warn if the inmate started to wake up from an unconscious state. If he were to wakeup, then he would suffer extreme pain from one of the drugs used to kill him and the state would be violating the Constitution. The executioners could increase the sedative dose used to keep the inmate unconscious during the injection of the painful, heart-stopping poison, based on the physician's observations.

It's that  level of participation, says the Medical Board, that violates the age old medical ethic "Do No Harm." At the beginning of 2007, the board told North Carolina physicians, whom they certify to practice, that should they do more than watch the execution and certify the death, they would face punishment. There haven't been any executions since then because no doctor in the state is willing to take part.

Last week during the state Supreme Court's discussions, Justice Ed Brady told the court that he looked up the word "present" in a Merriam-Webster dictionary and declared his dictionary read "actually involved," reported the Fayetteville Observer.  Additionally, Justice Brady asked the Medical Board lawyer why the lawmakers would require a doctor's presence if they didn't expect him to take part.

PHYSICIAN AS POTTED PLANT?

"Now a physician has got his education, his training and experience. If he's just standing there, or sitting like a potted plant, what's the purpose of that?"

Hey, we know from research that if a designated murderer (research assistant) walks into a room of potted plants and pulls one out of its pot by its roots, that later the potted plants that witnessed the murder physiologically react ("scream") when they see the murderous student again.

Justice Brady later asked whether having a doctor attend an execution would be like handing a loaded gun to someone who then fires it. Uh, if we're mixing metaphors, can a potted plant shoot a gun?

The Associated Press reported that even when the high Court rules on the role of doctors, it was not clear if state executions would resume. All sides -- attorneys of the state's medical licensing board, the state prison system and the court's justices-- agreed that the issue should be decided by lawmakers. However the North Carolina legislature has shown little inclination to deal with the issue. In the past two years, lawmakers filed at least two bills to address the physician's role and ensure that there would be no punishment by the medical for participation in an execution. What happened? No action was taken on either bill.

Last January, the New England Journal of Medicine printed an editorial, "Physicians And Execution," in which it made it very clear that medical doctors should never be involved in state killing. The history of lethal injection is particularly significant:

"Lethal injection was introduced in the United States in 1977 explicitly to sanitize executions, since the older methods --hanging, electrocution, and chemical gassing -- were considered to be inhumane.The three-drug regimen that is commonly used was proposed by an Oklahoma forensic pathologist, Dr. A. Jay Chapman, and adopted by the state legislature without any scientific or medical testing. Injected drugs, now used in all but 1 of 37 states in which capital punishment is legal, have been part of the increasing medicalization of executions and the enlistment of medical personnel to lend them apparent moral legitimacy.

Since 1977 the Oklahoma regimen has been used in approximately 900 executions, several dozen of which have been botched because of infiltration of intravenous lines, inadequate anesthesia, drug precipitation when solutions of sodium thiopental and pancuronium bromide are mixed, and other problems. In a vivid example, an inmate in Ohio in 2006 raised his head repeatedly during the execution and said, "It don't work."

It is definitely worth the time to read the entire editorial, just click on the above link to the New England Journal of Medicine.

In the end the editorial advises all responsible members of the medical profession when asked to assist in a state-ordered execution "remember the Hippocratic Oath and refuse to participate."

TO READ OTHER PHYSICIAN-ISSUE ARTICLES, CLICK HERE.

By Sharon McEachern