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Participation of medical professional 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".[1]

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.[2]

Given the ethical conflicts involved, no physician, even if employed by the state, should be compelled to participate in the process of establishing a prisoner's competence to be executed if such activity is contrary to the physician's personal beliefs. Similarly, physicians who would prefer not to be involved with the treatment of an incompetent, condemned prisoner should be excused or permitted to transfer care of the prisoner to another physician.

American Medical Association, [2]


Moral discussion

"A physician, as a member of the profession dedicated to preserving life when there is hope of doing so, should not be a participant in a state execution."
American Medical Association[3]

U.S. Supreme Court 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.[4]

Botched executions?

Possibly botched executions include those of Stanley Williams, Ángel Nieves Díaz, and others. The only execution by lethal injection which failed to kill the condemned prisoner in United States history occurred on September 15, 2009 in Ohio, when executioners attempted and then aborted the execution of Romell Broom.

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.[5]

Since the reinstatement of capital punishment in 1976, there have been, according to one study, forty-one possibly botched executions.[6] On, January 7, 2008, the Supreme Court of the United States heard oral arguments 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)".[7][8] 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 Court 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 Oath, which states:

I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan.

However, the Hippocratic Oath has no legal or constitutional value; it is merely a professional ethical guide.

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.

Given the recent developments, it seems safe to suggest that the controversy over the constitutionality of lethal injection execution schemes will continue.

—Daniel S. Goldberg, J.D., Ph.D Student, [3]


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