Death penalty poses ethics quandary for doctors

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Some death penalty abolitionists in the United States have a new target - the doctors who help with lethal injections at executions, a complex ethical area in the fields of law and medicine.

In a move that some support as a strategy to help influence public opinion against capital punishment, a New York psychiatrist is working with lawyers who hope to charge doctors with professional misconduct for participating in executions.

Most states do not reveal whether doctors are present, but retired New York University psychiatry professor Arthur Zitrin has tracked down physicians in Georgia, Virginia and Illinois whom he wants to help oust on ethical grounds.

“The idea that physicians who have taken the Hippocratic Oath to take care of and preserve life, are taking part in executions is alarming and it is another sign that the death penalty tears at human rights,” said Michael Stark of the Campaign to End the Death Penalty.

Most Americans, 64 percent, support capital punishment, according to an October 2003 Gallup poll. However, the American Medical Association’s medical ethics code bars doctors from participating in a legally authorized execution.

Stark campaigned in Maryland to halt the execution of convicted rapist and murderer Steven Oken, 42, who was executed on Thursday night.

Oken lost a legal battle in which lawyers cited Maryland’s previous execution in 1998 when there was a leak of anesthetic and chemicals that killed the condemned man. Lawyers argued the state’s procedure was cruel and there was no certainty it could be carried out humanely.

MEDICAL QUALIFICATIONS

Some abolitionists argue that if prison staff are not qualified to insert the intravenous tubes and administer the deadly cocktail of three chemicals used in most states, the role of medical personnel becomes even more questionable.

But attorney Kenneth Baum, who also teaches medical ethics at Yale University, said doctors do not have the right to politicize executions by lethal injection, the most common form of carrying out the death sentence in the United States.

“If a physician wants to be there and the condemned person wants them to be there, the physician’s primary responsibility is to the patient,” said Baum, who opposes the death penalty but sees no conflict with his approval of doctors’ assistance.

“It is unacceptable for physicians to sacrifice a condemned inmate’s comfort during their final minutes for the sake of making a political stand,” he said.

He said that given that there were records of “botched” or prolonged executions, the condemned person deserved a doctor’s presence for what he believes has become a medical procedure. It involves insertion of an intravenous line and infusion of sodium thiopental, or sodium pentothal—a barbiturate to induce sedation; pancuronium bromide, or Pavulon to paralyze muscles; and then potassium chloride to stop the heart.

In May, the U.S. Supreme Court indicated in a ruling that in some circumstances, a doctor’s presence be required. This was the case of an Alabama death row inmate whose veins were so badly damaged by drug use that officials wanted to cut into part of his arm or leg to gain access to a vein.

In Oken’s case, Maryland prison authorities declined to disclose whether there was a doctor present at the execution.

Oken was the 747th person to be executed by lethal injection in the United States since the death penalty was reinstated in 1976, the Death Penalty Information Center said. The other 168 death sentences carried out were by electrocution, gas chamber, hanging and firing squad.

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