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N. Carolina execution raises ethical concerns

A North Carolina man was executed by lethal injection  Friday by officials using a machine to ensure he did not suffer undue pain, a procedure that raised ethical questions about medical staff monitoring the death.
WILLIE BROWN
Willie Brown, seen in this undated photograph, was executed early Friday, for the 1983 killing of a woman during a convenience store robbery. AP file
/ Source: Reuters

A North Carolina man was executed by lethal injection  Friday by officials using a machine to ensure he did not suffer undue pain, a procedure that raised ethical questions about medical staff monitoring the death.

Willie Brown Jr., 61, was pronounced dead at 2:11 a.m. by Warden Marvin Polk at the state’s Central Prison, spokesman Keith Acree said. Brown had been sentenced to death for the 1983 killing of a convenience store clerk after a robbery.

Amid increased scrutiny of lethal injections across the country, a doctor and a registered nurse who routinely observe North Carolina’s executions employed a brain wave monitor to determine whether Brown was unconscious before he was injected with paralytic and heart-stopping drugs.

Brown’s execution was believed to be the first in the United States using the device. State officials purchased the machine after a judge ordered North Carolina to ensure Brown felt no pain.

In other states such as Florida and California, executions have been delayed while courts ponder whether lethal injections cause excessive pain.

North Carolina’s procedure, approved by U.S. District Judge Malcolm Howard, raised ethical questions for the doctor and nurse who watched over the machine from an observation room near the death chamber.

The American Medical Association’s code of ethics prohibits doctors from participating in executions and views the monitoring of a brain wave machine as relying on a physician’s skill and expertise, and therefore forbidden.

'Violates' medical oath
“The use of a physician’s clinical skill and judgment for purposes other than promoting an individual’s health and welfare undermines a basic ethical foundation of medicine --first, do no harm,” said Dr. Priscilla Ray, head of the association’s Council on Ethical and Judicial Affairs.

“Therefore, requiring physicians to be involved in executions violates their oath to protect lives and erodes public confidence in the medical profession.”

The association is not a regulatory body and cannot punish doctors.

The execution of an inmate in California was halted in February after San Quentin prison failed to find anesthesiologists willing to participate. A judge had ordered the presence of anesthesiologists to ensure the inmate’s death was painless.

Brown’s lawyers argued the methods used by North Carolina and 36 other states did not fully ensure inmates were unconscious before lethal drugs were injected.

If inmates were not fully sedated, they could experience an agonizing death, defense lawyers said. That could result in cruel and unusual punishment prohibited by the Eighth Amendment to the U.S. Constitution, they said.

Brown’s lawyers argued only medical professionals trained to administer anesthesia could ensure Brown was unconscious.

Howard ruled this week the brain wave monitor could be used instead. He also required the involvement of medical personnel for the execution to proceed.

State law has long required a physician to be present at executions. Their identities are confidential by law.

More than 2,000 people were known to have been executed around the world last year, the vast majority of them in China, Iran, Saudi Arabia and the United States, Amnesty International said Thursday.