I can’t understand the logic of state governments, on one hand, insisting that only physicians oversee lethal injection while, on the other hand, actively expanding scopes of practice for non-physician professionals.  Does the government believe that it takes eight years of medical training to successfully start an intravenous line and turn on a lethal concoction of drugs?  Are they so convinced that only a medical doctor can preside over an execution and not even solicit non-physician professionals?  Or, are they trying to find other uses for medical doctors’ skills now that they have begun to ‘dumb down’ health care across America?  Do public officials believe that only physicians are capable simultaneously of curing and killing, and not other allied health professionals with comparable skills of starting I.V.s and turning on a lethal cocktail infusion?   Why aren’t they pursuing nursing and physician’s assistant societies to see if they want to earn some extra cash fulfilling a ‘civic’ duty?  (Hint: don’t bother as they are ethically opposed as well.)

Do government officials think so little of its medical profession that they would expect the same physician who routinely executes condemned prisoners to then compassionately care for their loved ones?  Aren’t they concerned about these doctors becoming desensitized to the very essence of saving life above all, and of primum non nocere?  Do people really believe that giving ten times the safe dose of a drug for the purpose of killing a condemned person is, in some arcane way, practicing medicine?  Does society believe that any doctor has ever studied the effect of giving ten times the dose of a drug to a human being to reliably state that it accomplishes the intended purpose?

As an anesthesiologist, I’m puzzled because it is our specialty that is being ‘solicited’ and in some cases ‘conscribed’ to participate in lethal injection procedures and we have repeatedly gone on record to oppose any participation by our members.  Over the years, I, like most of my colleagues, have saved scores of trauma patients or gravely ill patients from dying during complex and emergency surgeries.  I have also experienced the despair, anguish and sadness of failing to save patients in these same critical situations.  Anyone who has ever used his or her skills, intuition, knowledge, compassion and adrenaline to do anything and everything to prevent the demise of a patient – only to watch them fade into death, will tell you that saving and killing by the same hand cannot be routinely and unemotionally delivered. 

I am sure that the executioners in the middle ages were not also the barber/surgeons.  I suspect that it was a separate ‘profession’ and the person delivering the axe did not have another full-time job. Perhaps, if society believes that capital punishment is an essential pillar of delivering justice in America, then non-medical experts should be specially trained to deliver that justice.  This solution is the only answer for the ‘humane’ delivery of capital punishment,. otherwise abandon the practice.

As long as state officials continue to cajole, authorize, demand, bully or beg medical and allied health professionals to participate in executions as though they were avocational pursuits, a national controversy will persist and expand.

Simply stated, the delivery of lethal injection in no way resembles the practice of medicine or health care; just like electrocution is not a subspecialty of electrical engineering.

In a society that puts a heavy emphasis on curative health care -- and tends to avoid dealing with death altogether -- it's not surprising that most people have little familiarity with hospice care. This is unfortunate, as hospice can make all the difference for families and patients facing the realities of a terminal illness. Part of the problem is that many Americans have an inaccurate view of what, exactly, hospice is. They mistakenly believe that it is only for cancer patients, or that they will have to incur extra expense to use it. But hospice is widely available and Medicare covers costs for 90 percent of those who use it. To learn more about what hospice is and why you should include it in your end of life planning, watch this week's video (embedded with this blog post) or read the full transcript of this week's program. I would also suggest that you watch a video at this site about a woman who decided to give up treatment at the end of life and accept her death.

Mike Magee