Intended for healthcare professionals

Education And Debate

Lethal injection: a stain on the face of medicine

BMJ 2002; 325 doi: (Published 02 November 2002) Cite this as: BMJ 2002;325:1026
  1. Jonathan I Groner (, trauma medical director
  1. Department of Surgery, Children's Hospital, Columbus, OH 43205, USA
  • Accepted 25 July 2002

The number of executions in the United States has increased as the acceptability of lethal injection has increased. Despite the opposition of professional organisations, healthcare professionals continue to participate. An American doctor describes parallels between America's use of lethal injection and Nazi Germany's “euthanasia” programme

The following shall be present … one (1) contract physician—(as designated by Health Services) to provide medical assistance during the execution process.1

On 6 November 2001, 45 year old prison inmate Jose High was led into a room at the Georgia Diagnostics and Classification Center in Jackson, Georgia, United States. The room would have looked familiar to a surgeon (or any doctor who performs procedures under sedation): it contained a trolley; cardiac monitor and defibrillator; medical equipment cabinets (including one for storing drugs); equipment stand; and the standard catheters, tubing, and sterile saline bags used to start intravenous lines. High lay down on the trolley, and a nurse tried to start a peripheral intravenous line. For more than 30 minutes, the nurse made several attempts to start the line at various locations, including High's right hand, right arm, right leg, and right foot. Finally, a doctor who worked under contract with the Georgia Diagnostics and Classification Center stepped in to help. He inserted a 7 French gauge, triple lumen, 20 cm long, central venous catheter into High's right subclavian vein. After the prison warden gave a signal, technicians injected thiopental sodium 6 g, pancuronium bromide 150 mg, and potassium chloride 360 mEq into High; this ended his life.

Summary points

Capital punishment continues to be used in the United States; almost all executions are now performed by lethal injection

Doctors have helped to develop “humane” execution methods

Lethal injection is unique because it simulates a medical procedure—the intravenous induction of general anaesthesia

Doctors' participation in lethal …

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