Video: Execution case has national implications

updated 2/22/2006 7:24:23 PM ET 2006-02-23T00:24:23

For hundreds of years, doctors have been involved in executions. But their efforts to get out of this grisly business put them on a collision course this week with a federal judge who ordered that they assist in killing a California inmate.

“There’s been an attempt to medicalize executions all the way back to the French Revolution,” when Dr. Joseph-Ignace Guillotin invented the guillotine as a humane method of death, said University of Minnesota bioethicist Dr. Steven Miles.

“Doctors then got involved again in designing electrocution for the same reason in the United States,” he said. “The medical profession has been trying to dig itself out of this” ever since.

The most recent example is the case of Michael Morales, convicted of raping and murdering a teenage girl in California.

On its face, what doctors were asked to do might seem humane — ensure that Morales was adequately sedated before two painful drugs to end his life were injected. In fact, the judge ordered their participation after Morales’ lawyer argued that the inmate would suffer cruel and unusual punishment if not sedated properly.

However, two anesthesiologists refused to participate in the 12:01 a.m. Tuesday execution after learning they would be expected to tell prison officials whether Morales needed more sedation or possibly even give him more medication, thereby allowing the execution to proceed.

“They weren’t just going to observe,” which by itself would still violate medical ethics, said Dr. Priscilla Ray, a Houston psychiatrist who chairs the American Medical Association’s council on ethical and judicial affairs.

AMA opposes doctors’ role
The AMA and many other medical groups have long opposed doctors having any role in executions, including monitoring a prisoner’s vital signs or giving technical advice.

“They should not even certify death,” because if they find the patient has not died it would lead to more drugs or electrocution to kill the patient, Miles said.

“The ethical standard is pretty much universal,” said Leonard Rubenstein, a lawyer who is director of Boston-based Physicians for Human Rights. “It’s the same reason physicians can’t be involved in coerced interrogations,” or help certify prisoners as psychiatrically fit to be executed, he said.

It’s a voluntary rule and no doctors have been reprimanded or defrocked for taking part in executions, and few doctors do. In fact, most states have devised strategies to avoid involving doctors.

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Illinois, Texas find a way around it
Illinois, for instance, adopted a law saying that assisting death was not practicing medicine, thus freeing the state to hire non-physicians to do the job. Many states use “execution specialists” who are trained in how to start intravenous lines to administer lethal injections.

Texas has used such volunteers, many of whom have military training, for the 359 executions it has conducted since 1982, said Michelle Lyons, spokeswoman for the Texas Department of Criminal Justice.

Doctors are involved “very, very little” — only to pronounce a prisoner dead and not being present when the person was put to death, she said.

“Some states proceed without medical supervision or they require physicians to participate notwithstanding the ethical prohibitions,” said Rubenstein of Physicians for Human Rights. “The doctors who work for the corrections system are in a complete bind” if required to participate as a condition of employment, he said.

In California, the judge gave prison officials two options after the two anesthesiologists refused to assist: Find a doctor who would, or kill Morales with an overdose of sedatives instead of the three-drug combination that carries the possibility of pain.

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