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The Ethics Behind Medical Professionals Assisting With Lethal Injections

“Death penalty by lethal injection has been all over the headlines for the past few months. The latest wave started with a botched execution last spring in Oklahoma when a technician couldn’t find the right vein, and continued with the refusal of some drug companies to allow their medications to be used in the lethal cocktail given to death row inmates… and just about every week, questions about the technique of lethal injections play a role in last-minute pleas to stay executions,” says host Barbara Lewis.

Despite objections from the American Medical Association, clinicians continue to assist with executions. Sound Medicine's bioethicist Dr. Eric Meslin unravels the ethics of capital punishment for medical professionals.  

Interview highlights

The ethical issue “Clinicians shouldn’t be involved in capital punishment. It’s against medical ethics. Their job is to help and heal; not to intentionally kill.” 

Why it's more complicated than that “If you believe that capital punishment should be conducted humanely, should be conducted so that it’s not cruel or unusual, to quote the Supreme Court decisions, then it makes sense…”

The comparison of death row inmates and terminally ill patients “It’s been written that anyone who’s essentially on death row might as well be terminally ill. First of all, I think that’s ethically disingenuous to anyone who’s terminally ill and who is suffering at the end of life, to equate them to someone who’s committed a capital offense and sitting in a prison as being equivalent. I think that’s just ethics bunk. And at the same time, I don’t think it’s correct to refer to people who are on death row as terminally ill anyway, irrespective of the comparison to real patients, because they can be there until they naturally die and that can be many, many years."

The medical experiment without consent "It does get a bit complicated, because if you believe that capital punishment, which is legal in the state in which it occurs should be carried out humanely and should be carried out using a lethal injection—which is a mixture of medicines usually to paralyze, to also make unconscious and to stop the heart—then you better be pretty darn sure those medicines have been tested for that purpose….Well we don’t have clinical trials underway in the nation’s prison system, where some death row inmates get one cocktail of medicines and another cohort of prisoners get another cocktail, and we see which one stops their heart better or more efficiently. This has been an experiment, a medical experiment, without consent, without ethical medical review. So it probably isn’t a surprise that the few times, granted there are a lot of executions in the United States but there are many more terminally ill patients in the United States then there are death row inmates. So we don’t have enough data, and it’s almost one of those ethically impossible studies to conduct. So every time someone gets one of these cocktails to end their lives in a prison system, it’s an experiment.

The pharmaceutical industry "They are being asked for their medicines for something that really wasn’t intended. In Europe, many of the pharmaceutical companies are reluctant to have their medicines shipped to the US to be used for this purpose. We are going to be in a real pickle when the methods that we thought were the most humane are no longer available.”