Lethal Injection on Trial

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Medical associations say the ethics of participating in the executions is clear. "The bottom line is that physicians are supposed to cure, not kill," says Dr. Priscilla Ray, chair of the Council on Ethical and Judicial Affairs at the American Medical Association (A.M.A.). "There are a number of doctors who are personally pro--death penalty. But we simply can't be involved in carrying it out." The A.M.A. can't do much to censure physicians who decide on their own to participate in executions. And almost all doctors involved in executions take great pains to conceal their identity--from hiding during the execution to requesting payment in cash so there's no check to trace back to the state. When doctors do admit to having helped the state execute an inmate, activists are there to make their life difficult. Dr. Arthur Zitrin, professor emeritus of psychiatry at New York University, has spent his retirement filing grievances against such doctors. An ethical grievance filed against the Georgia doctor who found High's good vein was eventually dismissed, but it did inspire the Georgia house of representatives to pass legislation in February that would protect the medical license of any doctor who participates in executions. A similar grievance filed by Zitrin and others against Kentucky Governor Ernie Fletcher, a licensed doctor who signed his first death warrant in November 2004, also failed, but Zitrin is unbowed. "Doctors should not be handmaidens to executioners," he says. "We have a responsibility to maintain life as long as there is a possibility to do so."

But other doctors quibble with that interpretation of the Hippocratic oath. In a certain light, a condemned prisoner whose death is imminent and assured could be viewed as a terminal patient. Then the doctors' palliative presence through the dying process takes on a nobler tone. Despite the A.M.A.'s objections, a survey published in 2000 by the Archives of Internal Medicine found that 43% of responding physicians felt it was acceptable for other doctors to inject lethal drugs as part of an execution.

Physicians have played a major role in the history of execution, but often with unintended consequences. Joseph-Ignace Guillotin was a pacifist doctor who thought beheading by ax was inhumane. And beginning with Oklahoma anesthesiologist Dr. Stanley Deutsch, who helped craft modern lethal-injection protocols 30 years ago, doctors have evolved the science of execution to the point where today they are the most qualified to carry out the sentence.

The rules are often vague about who monitors an execution if physicians are unwilling or unwanted. The surrogates range from nurse practitioners to prison guards, an inadequate replacement in the eyes of many. "If states were doing electrocutions, they would call in electricians," says Richard Dieter of the Death Penalty Information Center. "But lethal injection is a medical procedure. They need doctors."