Should Medical Associations Be Allowed to
Sanction Physicians for Participating in Executions?
I have long marveled at the adamant efforts of many bioethicists and
physician leaders to prevent doctors from participating in
executions--while, ironically some of these same advocates promote the
propriety of doctors engaging in assisted suicide--which is no more a
legitimate medical act than execution. In North Carolina, the state
medical association went so far in trying to prevent doctor involvement
in executions that it threatened to make it a subject of professional
discipline--a policy now overturned by the state supreme court. From
The North Carolina Medical Board exceeded its
authority under state
law when it adopted policy threatening disciplinary action against
physicians who take an active role in executions, the Supreme Court of
North Carolina ruled in early May. The 4-3 decision appears to end the
board's policy barring doctors from participating in executions, the
only one of its kind in the country...
The board adopted its position in January 2007,
prompting a lawsuit
from the state's corrections department, which argued that the policy
deterred physicians from participating in executions. In 2007 the N.C.
medical board banned doctors from participating in executions. The
relevant state law, adopted in 1909, says a physician should be present
at the execution and "certify the fact of the execution."
In its policy, the board attempted to reconcile
standards and state law by saying physicians could be present at
executions in a professional role, but that "any verbal or physical
activity ... that facilitates the execution" might be grounds for
discipline. In the majority opinion, Associate Justice Edward Thomas
Brady wrote that for the medical board "to assert that the physician is
to merely occupy space in a nonprofessional capacity is simply
illogical and renders unintelligible the requirement that 'the surgeon
or physician of the penitentiary' be present."
The case's outcome is significant because an
announced in February 2007 said lethal injections should be
administered by personnel qualified to "administer the preinjections,
insert the IV catheter, and perform other tasks." The protocol says
"medical doctors" are among those "deemed qualified to participate in
the execution procedure." The purpose of the new protocol is to ensure
that condemned inmates do not suffer unnecessarily during the lethal
I think this is right, but only because it is a licensing board making
the determination that a physician could be punished for engaging in a
legal procedure that is not a medical act. I think voluntary medical
associations--such as the AMA--should have every right to exclude
physicians who participate in the non medical act of execution.
I also think that no doctor where assisted suicide is legal should be
professionally disciplined for engaging in that non medical act
(assuming the law is followed). However, voluntary associations should
be able to so exclude physicians. Yet, under the assisted suicide laws
of Oregon and Washington, even voluntary associations are prevented
from excluding or disciplining participating physicians--another way in
which the culture of death brooks no dissent. I think these laws
violate the First Amendment's right to free association and I hope that
one day a death doctor will be so sanctioned by a voluntary medical
association and the matter brought to the U.S. Supreme Court to
validate the right of the group to make that decision.
Contact: Wesley J. Smith
Date: May 18 2009
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