In the execution chamber: Do doctors have a place -- at all?

Physicians' roles in legal injections are facing new challenges.

By Andis Robeznieks, AMNews staff. Oct. 25, 2004.

Years ago, prisoners condemned to death received a blindfold and a cigarette before they faced the firing squad. Today, they receive a dab of antiseptic on their arm before having a catheter inserted in preparation to receive a lethal three-drug cocktail.

First performed in 1982, lethal injection is the main method of execution in 37 of the 38 states with the death penalty. Of the 191 executions performed in the United States since 2001, 189 have been lethal injections. Now, a loose coalition of medical ethicists and death penalty opponents, increasingly concerned about the "medicalization" of executions, is making an uncoordinated but multipronged attack on the procedure.

Although it has not been directly involved in these efforts, the American Medical Association has a prominent role in this debate because of the long-standing opposition to physician involvement in executions written in the Association's Code of Medical Ethics. "The code is clear: The physician cannot play any role in an execution -- passive or active," said Michael Goldrich, MD, chair of the AMA Council on Ethical and Judicial Affairs.

First issued in 1980, the AMA policy does not take a stand on capital punishment itself but calls for keeping physicians out of the process. Lethal injection prohibitions apply to prescribing or administering tranquilizers as part of the execution; monitoring vital signs; rendering technical advice; selecting injection sites; starting intravenous lines; prescribing, preparing, administering or supervising the injection of drugs or their doses; inspecting, testing or maintaining lethal injection devices; and consulting or supervising lethal injection personnel.