[Deathpenalty] death penalty news-----USA

[Rick Halperin]

March 21



USA:

Executions halted as doctors balk


After 897 executions by lethal injection over the past 25 years, the role
of doctors in carrying out the death penalty is surfacing as the latest
ethical issue to force a re-examination of capital punishment in the
United States.

A conflict between medical ethics and court orders that a doctor
participate in lethal injections has halted executions in California,
Missouri and North Carolina. But the ethical issue raised by doctors in
the death chamber lurks beneath the surface in most of the 37
capital-punishment states that sanction chemical execution, a mode of
death also facing separate constitutional challenges over whether it
unduly inflicts pain on prisoners.

The American Medical Association is adamant that it is a violation of
medical ethics for doctors to participate in, or even be present at,
executions. But recent court rulings have called for people with medical
expertise to assist in executions by mixing and injecting the lethal drugs
or monitoring the inmate's vital signs.

"That's the conundrum, right? The people who are best able to ensure that
the Eighth Amendment against cruel and unusual punishment is not going to
be violated are the people who want to have nothing to do with this," said
Deborah Denno, a professor at Fordham University School of Law and a
capital-punishment expert.

Lethal injection, in theory, provides a quiet death in which inmates
simply sleep and never awaken. First used in 1982, it was seen as a more
humane alternative to the gas chamber, electric chair, firing squad or
gallows. (Nebraska is the only of 38 states with the death penalty not to
use lethal injection; it still uses the electric chair.)

But personnel with little or no medical training at times have struggled
to find veins of inmates or have incorrectly administered the drugs. In
Florida, the December execution of Angel Diaz, who killed a topless club
manager, required 34 minutes  twice the usual time  and 2 lethal doses
because, on the 1st attempt, the needle missed the vein and went into soft
tissue. It was later revealed that the lead executioner had no medical
training whatsoever.

The death penalty is now on hold in 13 states, in 11 because of questions
over use of lethal injections. 3 of those moratoriums force a spotlight on
the largely hidden role of doctors in overseeing executions.

The sharpest debate over use of doctors in executing prisoners is shaping
up in North Carolina, where the state corrections department and the state
medical board are headed for a showdown over the board's declaration that
it will punish any doctor who participates in executions.

The fight in North Carolina is the 1st time a state medical board, a state
agency that licenses and disciplines physicians, willingly has pushed
itself into the debate. Months after a judge said a doctor must monitor a
death-row inmates vital signs to ensure there is no pain, the states
medical board in January said it would punish any doctor who did anything
more than observe executions. As a result, a judge has stayed five
executions.

The situation escalated March 6 when the North Carolina Department of
Corrections filed a lawsuit seeking to strip away the medical board's
power to punish physicians for assisting in executions. The corrections
department claimed that executions arent medical procedures and so arent
under the jurisdiction of the board.

In California, a federal judge in February 2006 ordered anesthesiologists
to be at the execution of Michael Morales, who killed and raped a
17-year-old girl, after hearing evidence that previous inmates still may
have been conscious when the final, heart-stopping drug in the lethal mix
was injected. But two anesthesiologists who agreed to be present later
backed out when they realized they might have to participate should
something go wrong. Morales execution was stayed.

In December, a federal judge found that Californias current
lethal-injection procedure is unconstitutionally cruel and unusual. Among
the reasons were lack of training for the execution team and improper
mixing of the anesthetic. While the judge ruled that a medical
professional wasnt required, he said the state's lethal-injection
procedures must ensure that enough anesthetic is given and provide a
reliable way to monitor the inmate's vital signs.

In Missouri, a lawsuit by inmate Michael Taylor, who killed and raped a
15-year-old honor student, exposed that a dyslexic surgeon was mixing the
lethal drugs, despite little training in anesthesiology, no written
execution protocol and little oversight. The judge called for a licensed
anesthesiologist to be used. The state then sent letters to 298 certified
anesthesiologists in Missouri and southern Illinois but could find no one
willing to participate.

In Maryland, where one inmate's lawyers demanded the state add a general
surgeon to the execution team, the state likewise said it wouldnt be able
to find doctors.

Although the AMA objects to doctors participation in executions, it cannot
punish doctors who disobey its advice. That power is left to state medical
boards, but no doctor yet has been punished for participating in an
execution.

However, a group of doctors led by Dr. Arthur Zitrin, a professor of
psychiatry at New York University School of Medicine, is suing to force
Georgia's medical board to punish three physicians who participated in
executions. The suit was dismissed by the trial court, but the state court
of appeals will hear oral arguments in April.

"I think physician participation is improper. I think it's unethical. I
think it violates the principles of medical ethics," Zitrin said. "Doctors
are committed to saving lives and providing health care, not killing
people."

Not all doctors agree with Zitrin, however. A 2001 survey published by the
Annals of Internal Medicine polled 413 doctors and found that 19 % were
willing to inject the lethal drugs. More were willing to perform other
acts that the AMA said would violate medical ethics, such as ordering the
lethal drugs, supervising those who inject the drugs, or placing IV lines.

Until recently, the extent of physician participation had been unclear to
the public. According to a 2005 article in The Journal of Legal Medicine,
17 states require physician participation in executions. The extent of
participation, however, is unclear. While Colorado and Georgia state that
physicians must participate "to the extent necessary," most of the states
call for doctors to declare death or simply be present  with other
potential duties unmentioned.

An additional 18 states allow for the participation of doctors, sometimes
by not explicitly prohibiting them, according to the article. Missouri's
execution protocols, for example, dont mention medical personnel, but the
recent court case revealed that a doctor had been filling syringes with
anesthetic.

Only 2 states  Illinois and Kentucky  forbid doctors from participating in
or attending executions.

States are confronting the physician dilemma in a variety of ways. Georgia
and Oklahoma recently enacted laws that forbid state medical boards from
punishing medical workers who participate in executions. The new Georgia
law would block Zitrin's attempts to punish doctors in future executions,
but his lawsuit still seeks penalties on doctors involved in executions
before the law took effect.

Bills in North Carolina and Tennessee also would forbid doctors from being
punished for participating in executions.

In South Dakota, the House recently passed a measure that would no longer
require a physician to be present at executions, at the request of
doctors. Although taking doctors out of the lethal injection process might
solve their ethical issues, it wouldn't solve those of the state, which
would still have to deal with the qualifications of the lethal-injection
team.

A Missouri bill would ensure that doctors who participate remain
anonymous. Newspapers that publish such a doctors name, for example, could
be charged with a misdemeanor.

(source: Stateline.org)