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

Abstract

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.

Anesthetic Influence on Electroconvulsive Therapy: A Comprehensive Review

“…In addition, thiopental sodium was once used for lethal injection and is no longer available for use in the United States due to this association. 40 …”

The Emergence of Second‐Generation Lethal Injection Protocols: A Brief History and Review

“…The ethics of health care professionals' participation in executions have been debated extensively in the literature [56][57][58][59] and remain controversial whether considering first-or secondgeneration protocols. Physician and other health 1254 PHARMACOTHERAPY Volume 37, Number 10, 2017 professional groups have roundly declined to endorse the participation of members of their respective professions in lethal injection.…”

Nonconsensual withdrawal of nutrition and hydration in prolonged disorders of consciousness: authoritarianism and trustworthiness in medicine

“…A continuous infusion of barbiturates is a potent depressant of vital functions of the central respiratory center and the cardiovascular system. For the same reason, these medications can be administered rapidly as a bolus injection rather than by slow continuous infusion in active euthanasia and execution by lethal injection [ 42 ]. The RCP guidelines recommend general anesthesia to be administered in some cases “under the supervision of a consultant anaesthetist” (p. 84) [ 1 ].…”