Physician participation in lethal injection executions

Zimmers, Teresa A.; Lubarsky, David A.

doi:10.1097/aco.0b013e3280895ab7

Cited by 14 publications

(13 citation statements)

References 14 publications

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“…23 Consistent with guidelines issued by the American Association of Anesthesiologists, none of the 298 board-certified anesthesiologists in Missouri were willing to comply with this request. 3,24 Regardless of the cause, absence of anesthesia would produce significant anxiety as a result of chemical paralysis and impending suffocation, as well as considerable pain from the infusion of concentrated potassium chloride. 1 The presence of pain and anxiety would go unnoticed secondary to the prisoner' s paralytic state and the lack of any requirements for the assessment of depth of anesthesia.…”

Section: Controversiesmentioning

confidence: 99%

“…2 Recently, lethal injection has become the most commonly used method of judicially authorized execution in the United States. 1,[3][4][5][6] The popularity of lethal injection as a means of execution is supported by a belief that it is a more humane method compared with other options. [3][4][5][6][7] Every execution conducted in the United States in 2005 involved lethal injection.…”

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confidence: 99%

“…The medical community continues to debate the ethics surrounding a "medicalized" method of execution that involves drug administration, as well as potential roles for health care professionals in the process. 3,6,[10][11][12]…”

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confidence: 99%

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Issues Surrounding Lethal Injection as a Means of Capital Punishment

2008

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Lethal injection as a method of state-sanctioned capital punishment was initially proposed in the United States in 1977 and used for the first time in 1982. Most lethal injection protocols use a sequential drug combination of sodium thiopental, pancuronium bromide, and potassium chloride. Lethal injection was originally introduced as a more humane form of execution compared with existing mechanical methods such as electrocution, toxic gassing, hanging, or firing squad. Lethal injection has not, however, been without controversy. Several states are considering whether lethal injection meets constitutional scrutiny forbidding cruel and unusual punishment. Recently in the case of Ralph Baze and Thomas C. Bowling, Petitioners, v John D. Rees, Commissioner, Kentucky Department of Corrections et al, the United States Supreme Court upheld the constitutionality of the lethal injection protocol as carried out in the Commonwealth of Kentucky. Most of the debate has surrounded the dosing and procedures used in lethal injection and whether the drug combinations and measures for administering the drugs truly produce a timely, pain-free, and fail-safe death. Many have also raised issues regarding the "medicalization" of execution and the ethics of health care professionals' participation in any part of the lethal injection process. As a result of all these issues, the future of lethal injection as a means of execution in the United States is under significant scrutiny. Outcomes of ongoing legislative and judicial reviews might result in cessation of lethal injection in totality or in alterations involving specific drug combinations or administration procedures.

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Section: Controversiesmentioning

confidence: 99%

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confidence: 99%

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Issues Surrounding Lethal Injection as a Means of Capital Punishment

2008

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“…The claim that the death penalty by lethal injection can be botched suggests that it can therefore be improved. The appeal for improvement in the name of humaneness succeeds in drawing physicians in, [16] by appealing to a sympathetic concern for the welfare of others. From the above considerations of ethics and cruelty, the argument in support of humanness fails for several reasons.…”

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confidence: 99%

The absence of cruelty is not the presence of humanness: physicians and the death penalty in the United States

Zivot

2012

Philos Ethics Humanit Med

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The death penalty by lethal injection is a legal punishment in the United States. Sodium Thiopental, once used in the death penalty cocktail, is no longer available for use in the United States as a consequence of this association. Anesthesiologists possess knowledge of Sodium Thiopental and possible chemical alternatives. Further, lethal injection has the look and feel of a medical act thereby encouraging physician participation and comment. Concern has been raised that the death penalty by lethal injection, is cruel. Physicians are ethically directed to prevent cruelty within the doctor-patient relationship and ethically prohibited from participation in any component of the death penalty. The US Supreme Court ruled that the death penalty is not cruel per se and is not in conflict with the 8th amendment of the US constitution. If the death penalty is not cruel, it requires no further refinement. If, on the other hand, the death penalty is in fact cruel, physicians have no mandate outside of the doctor patient relationship to reduce cruelty. Any intervention in the name of cruelty reduction, in the setting of lethal injection, does not lead to a more humane form of punishment. If physicians contend that the death penalty can be botched, they wrongly direct that it can be improved. The death penalty cocktail, as a method to reduce suffering during execution, is an unverifiable claim. At best, anesthetics produce an outward appearance of calmness only and do not address suffering as a consequence of the anticipation of death on the part of the condemned.

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“…[1][2][3] Some have proposed that through the administration of drugs and use of other clinically related paraphernalia (eg, needles, syringes, gurneys), justice officials effectively have ''medicalized'' capital punishment. [3][4][5] With regard to lethal injection, several professional issues exist specifically for pharmacists and health care professionals in general. Pharmacists will be expected to have an understanding of the clinical issues surrounding lethal injection because the process involves the administration of medications.…”

Section: Introductionmentioning

confidence: 99%

Lethal Injection as a Component of a Therapeutics Toxicology Module

Romanelli

2011

American Journal of Pharmaceutical Education

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Objective. To create and implement a required module that addresses both the clinical and ethical issues surrounding the use of lethal injection as a means of capital punishment. Design. As a component of a pharmacotherapeutics module in toxicology, pharmacy students were introduced to ethical and clinical considerations and controversies with the use of drugs as a means of capital punishment. Basic information was provided on the history of capital punishment and the origins of lethal injection. Pharmacotherapeutic limitations and challenges were presented in the context of clinical and ethical dilemmas. Assessment. Instructed material was assessed using block course examinations that had both objective and subjective components. Students were asked to synthesize information by both purposing a lethal injection reversal protocol and by acting as consults in the fictional design of more effective lethal injection protocols. Students provided formative and summative evaluations of the instruction through regular student liaison meetings and summative course evaluations. Conclusion. Lethal injection as a means of capital punishment in the United States is a controversial and ethically challenging topic on which pharmacists may be consulted and therefore should be knowledgeable about. Students positively evaluated this lethal injection module, which covered multiple clinical and ethical issues.

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Physician participation in lethal injection executions

Cited by 14 publications

References 14 publications

Issues Surrounding Lethal Injection as a Means of Capital Punishment

Issues Surrounding Lethal Injection as a Means of Capital Punishment

The absence of cruelty is not the presence of humanness: physicians and the death penalty in the United States

Lethal Injection as a Component of a Therapeutics Toxicology Module

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