Physician Participation in Executions

 

Lethal injection litigation has brought to light the issue of physician participation in executions. While the American Medical Association’s code of ethics prohibits the participation of physicians in executions, the AMA has no authority to discipline doctors who do choose to participate. Each individual physician must make his or her own ethical decision about whether to participate, and to what extent. 

 

Many doctors are willing to, and do, participate in executions. Thirty-four States have enacted laws that permit or require the presence or assistance of physicians in executions.   Atul Gawande, When Law and Ethics Collide – Why Physicians Participate in Executions, 354 New Eng. J. of Med. 1221, 1229 (2006). Eight states have enacted legislation stating that lethal injections are not a medical procedure in order to make doctors more comfortable participating.  Deborah W. Denno, The Lethal Injection Quandary: How Medicine Has Dismantled The Death Penalty, 76 Fordham L. Rev. 49 (2007) at 89.  Three states have legislated immunity for doctors who do participate in executions. Id. It should be noted that secrecy surrounding lethal injection protocols and administration, as well asstatutes protecting executioner confidentiality, have prevented a comprehensive understanding of the extent of physician involvement in executions. See Amicus Brief for the American Civil Liberties Union, the ACLU of Kentucky, and the Rutherford Institute. 

 

Despite limits on access to information on doctor participation, there are examples of the longstanding involvement of physician participation in lethal injection executions. These are a few of the many instances where physicians have participated in executions.  

 

• The first lethal injection protocol, and the model eventually adopted by most states, was developed by Dr. A. Jay Chapman in Oklahoma in 1977. Amicus Brief for the Fordham University School of Law, Lewis Stein Center for Law and Ethics at 16-20. 

• In Texas in 1982, Dr. Ralph Gray, the former Texas medical director, participated in the nation's first execution by lethal injection by examining the prisoner to determine the best injection site and pronouncing death.  Atul Gawande, When Law and Ethics Collide – Why Physicians Participate in Executions, 354 New Eng. J. of Med. 1221, 1229 (2006) at 1223.

• In Missouri, Dr. Doe overhauled the state’s lethal injection protocol and participated in executions by preparing drugs and inserting the IVs, and supervised executions. Amicus Brief for Michael Morales, Michael Taylor, et al, at 13-16.

• Dr. Carlo Musso acknowledged that he was present at executions in Georgia over a three year period. Atul Gawande, When Law and Ethics Collide – Why Physicians Participate in Executions, 354 New Eng. J. of Med. 1221, 1229 (2006) at 1228.

• In Oklahoma, a licensed physician is present in the execution chamber monitoring the execution, including the insertion of IV tubes and the administration of the fluids. See Malicoat v. State, 137 P. 3d 1234 (2006)

• At least two doctors, Dr. Mark Dershwitz and Dr. Derek Payne, assisted the State of Tennessee in the development of new lethal injection protocols, including advising the State on how the drugs work and recommending specific changes to the protocol.  See Harbison v. Little, 511 F. Supp.2d 872, 876 (M.D. Tenn. 2007).

• In Georgia, Dr. Sanjeeva Rao monitored executions and ordered the injection of additional chemicals when he deemed necessary. During one execution, he inserted a central line when nurses were unable to find a suitable vein. Adam Liptak, "Should Doctors Help With Executions? No Easy Ethical Answer", The New York Times, June 10, 2004. Ethics charges were brought against Dr. Rao, but the Georgia's Composite State Board of Medical Examiners ruled that he did not violate the state's medical practice act when he inserted the catheter into the condemned prisoner. Andis Robeznieks, "Ethics Charges Related to Executions Dropped", American Medical News, January 31, 2005.

In addition to these examples, many doctors, including anesthesiologists are willing to perform the tasks necessary to execute prisoners. One study found that 41% of doctors surveyed would participate in executions. Neil Farber et al., Physicians’ Willingness to Participate in the Process of Lethal Injection for Capital Punishment, 135 Annals of Internal Med. 884, 884-890 (2001).

 

Additional Information

 

Ty Alper, The Role of State Medical Boards In Regulating Physician Participation In Executions, Journal of Medical Licensure and Discipline, Vol 95 No 3 (2009).

 

Ty Alper, "The Truth about Physician Participation in Lethal Injection Executions," 88 N.C. L. Rev. 11 (2009)

 

Sawicki, Nadia N., "Doctors, Discipline, and the Death Penalty: Professional Implications of Safe Harbor Statutes" . Yale Law & Policy Review, Vol. 27, Fall 2008

 

Atul Gawande, When Law and Ethics Collide – Why Physicians Participate in Executions, 354 New Eng. J. of Med. 1221, 1229 (2006).

 

David Waisel M.D., "Physician Participation In Lethal Injection", Mayo Clinic Proceedings, September 2007.

 

Neil Farber et al., Physicians’ Willingness to Participate in the Process of Lethal Injection for Capital Punishment, 135 Annals of Internal Med. 884, 884-890 (2001).

 

Updated: February 2, 2010