   | | Health Care Reform |  | | Story of the Week | January 23, 2008 | | The role of physicians in lethal injection | By Mike Magee, MD More than 3,000 U.S. citizens are living on “death row” in prisons, awaiting execution. They have each been there an average of just over 12 years since sentencing. As they languish, legal battles continue over the constitutionality of both the death penalty and the means of execution. And as these legal battles have escalated, it looks like physicians are being drawn into the controversy.
The death penalty itself is legal in 38 states, and since 1976, lethal injection has been the method of choice for execution 83% of the time. Today it is the preferred method in all states allowing execution.
The most widely used method of lethal injection involves three injections occurring in a sequence that induces a state of deep unconsciousness and freedom from pain, paralyzes the body's muscles and stops the heart from beating, leading to death.
While this approach to halting life, most would agree, is considerably more humane then other techniques such as death by hanging or electrocution, it is not without controversy. Legal challenges have revealed that the type, amount, and delivery of the drugs, as well as their effectiveness in doing what they are intended to do, varies from state to state, as does the supervision, speed and success of the procedure.
The question now on the table is: Could these lethal injections be more consistently and effectively applied under a physician’s guidance?
Some say yes, that the medicalization of the death penalty is a means to prevent needless pain and suffering associated with the death penalty. But others argue that doing so is a corruption of the historical values and established tenets of the profession of medicine – the central pledge of which is to “do no harm.” For more than three decades, the American Medical Association (AMA) has specifically prohibited physician involvement in executions -- and it recently revoked the AMA membership of a California physician who participated in an execution. In the words of the AMA: "The penal system, not the medical profession, is responsible for finding a way to perform executions.”
The only thing clear at this point is that the question will continue to be hotly debated in both state and federal courts.The U.S. Supreme Court has considered a case from Kentucky challenging lethal injection, poorly administered, as "cruel and unusual punishment." Initial hearings and comments by the Justices reflect conflict and sharply varying opinions on the question.
To learn more, watch this week’s video (embedded with this blog post) or read the full transcript, below. Then tell us how you feel: Should physicians or the medical community in general play any role in executions? If so, to what extent should they be involved?
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