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Doctors Who Participate in Executions Not Disciplined for Ethical Violations

By Matt Clarke

Since 1980, American Medical Association (AMA) policy has stated that it is a clear violation of medical ethics for physicians to participate in executions. The policy, which was last updated in 2005, contains a broad definition of "participation" which includes "consulting with or supervising lethal injection personnel." The American Society of Anesthesiologists adopted the AMA position, advising its members to avoid participation in lethal injections. The thinking is that professionals who are dedicated to the preservation of life so long as there is a hope of doing so should not participate in the ending of life.

Despite the AMA's clear-cut position, doctors are routinely involved in executions either supervising other medical personnel or taking an active role in injecting the lethal chemicals. In fact, a physician developed the three-drug lethal injection protocol that, until recently, was used by all death penalty states save one. Physicians also have a long history of involvement with executions dating back to at least the eighteenth century when Dr. Joseph Guillotine developed an execution machine. Doctors were also intimately involved in developing the most efficient methods of execution for the mass executions of the Nazi era.

Despite the involvement of doctors in hundreds of U.S. executions, no state medical board has ever disciplined a doctor for participating in an execution. There are several reasons for this. Only seven of the death penalty states have incorporated the AMA standards into their codes of medical ethics. Several states have a statutory mandate requiring the participation of a physician in executions making it virtually impossible to pursue disciplinary or legal action against the physicians who participate in executions. Other states have "shield laws" which explicitly remove medical board disciplinary jurisdiction for physicians participating in executions.

"There is this perception that many people, including judges, have that because of the AMA ethical code, doctors can't participate and won't participate in executions when the reality--and we've learned this through the legal cases that have been brought--is that doctors do participate and are willing to participate," said Ty Alper, associate director of the University of California, Berkley School of Law's Death Penalty Clinic and author of a January 2010 report published in the Journal of Medical Licensure and Discipline entitled "The Role of State Medical Boards in Regulating Physician Participation in Executions."

"The AMA guidelines are just that--guidelines--and not enforceable in most cases," Alper said.

Attempts to force medical boards to discipline execution doctors have thus far been unsuccessful. A group of California doctors lost a 1996 bid to force the medical board to discipline physicians who participated in executions. In 2005, some physicians tried the same thing in Georgia only to have their suit dismissed for lack of standing. The North Carolina Supreme Court threw out a medical board policy which would have disciplined doctors for involvement in executions despite a brief by the AMA supporting the policy.

The AMA has only revoked one physician's membership for participating in executions. But this had no effect on the doctor's medical license.

Thus far, only two death penalty states--Ohio and Illinois--have passed laws specifically prohibiting physician participation in executions. That may be the only way to prevent the practice as currently no state medical board is considering policies to punish doctors who participate in executions.

Source:, Journal of Medical Licensure and Discipline

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