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Read what Public Citizen has to say about the biggest blunders and outrageous offenses in the world of public health, published monthly in Health Letter.

Outrage of the Month: Doctors in the Death Chamber — Participants Should Lose Their Licenses

Health Letter, June 2014

Sidney M. Wolfe, M.D.

The following invited commentary is reprinted with permission from The New York Times. It was originally posted on April 30, 2014, on the Times’ Room for Debate column, online at nytimes.com/roomfordebate, in response to the following question:

As a lethal mix of drugs left the murderer Clayton D. Lockett writhing and gasping before dying of a heart attack in the Oklahoma death chamber on the night of April 29, a doctor stood by to see if he had lost consciousness, and then died.

Doctors have participated in lethal injections since they were first used, even injecting prisoners, despite professional guidelines that proscribe this. Should they be allowed to participate in executions without being disciplined?

It is unfortunate when any physician, through negligence or ignorance, has a role in causing the death of a patient. But it is reprehensible when a physician deliberately participates, in any way, in the intentional killing of another human being by involvement in an execution.

Such action should swiftly result in the lifelong loss of the license to practice medicine.

Helping to kill a person violates the strictures of medical and ethical codes of professional organizations.

Medical licensing boards must lead the way in deterring such unacceptable doctor behavior. But the attitudes of too many physicians who are willing to participate explain why medical boards have not done so.

Lethal injection has become the almost exclusive form of capital punishment in the United States, as hanging, firing squads and electrocution were eliminated in the spirit of minimizing suffering.

The fact remains, however, that groups like the American Medical Association oppose participation and anesthesiologists can lose board certification for taking part in executions. Involvement perverts the duties and responsibilities that physicians have to heal, not to hurt.

Administering a lethal dose of drugs is the most serious violation of ethics, but merely being present to pronounce a patient dead still makes that physician complicit in someone's killing, as a necessary part of the death squad.

As long as so many physicians, albeit a minority, accept doctors' involvement in capital punishment, it is not likely that state legislatures will prohibit this as part of the medical practices that govern physician behavior. It will take bold efforts by physicians and legislators opposed to this state-ordered murder to convert our country, perhaps state by state, into one that is more civilized in this important respect.

Although there is no guarantee that disallowing physician participation will end capital punishment, it is a crucial step. Participating in the execution of a prisoner is not compatible with being licensed to practice medicine.

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