Lethal injection is medicalising execution

BMJ 1998; 316 doi: (Published 31 January 1998) Cite this as: BMJ 1998;316:327
  1. Caroline White
  1. London

    Increasing numbers of doctors and other medical staff worldwide will be involved in state ordered executions if the preference for lethal injection continues to grow, warns Amnesty International in a new report.

    Lethal injection is widely perceived to be a more humane method of carrying out the death penalty, although well documented evidence clearly refutes this, says the report. Lethal injection is also thought to be more up to date and in keeping with developments in forensic medicine. Medical expertise is usually required at various stages of the process, conferring “the imprimatur of respectability on state activity and legitimising an illegal and unethical practice,” according to Dr James Welsh, coordinator of Amnesty's medical office and author of Lethal Injection: the Medical Technology of Execution.

    Last year China became the second country (the first was the United States) to carry out a judicial execution by lethal injection. It is thought that more than 20 people have been killed using this method since March and that it facilitates the alleged practice of kidney transplantations from the dead.

    Guatemala, the Philippines, and Taiwan have also recently introduced lethal injection, although no one has yet been executed in this way. In Guatemala lethal injection was introduced after a botched televised execution by firing squad in 1996. Over 400 people have been sentenced to death since 1994 in the Philippines after the death penalty was reinstated in 1993, in response to rising crime.


    The lethal injection chamber in Terra Haute, Indiana


    Lethal injection is the sole or alternative method of execution in 38 American states and seems to have speeded up the pace with which state execution is carried out, documents the report. It took less than five months for the last 35 executions to be carried out in the United States, all but two of which were by lethal injection, compared with nearly seven years for the previous 34 death sentences, only five of which were by lethal injection. In more than half of these American states, doctors are required by law to be present, and there is some evidence of coercion among those who refuse, says Dr Welsh.

    Several medical organisations have explicitly rejected the practice, including the World Medical Association and the International Council of Nurses. But, says Dr Welsh, there is a history of medical support for state executions. “Doctors need to ensure that their own professional association has a very clear stance on the issue, and as individuals they need to write to their governments condemning the practice.”

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