Intended for healthcare professionals


US anaesthesiologists are told not to take part in executions by lethal injection

BMJ 2010; 340 doi: (Published 04 May 2010) Cite this as: BMJ 2010;340:c2432
  1. Janice Hopkins Tanne
  1. 1New York

    The American Board of Anesthesiology, which certifies anaesthesiologists, has unanimously ruled that anaesthesiologists may not participate in capital punishment by lethal injection if they want to maintain their board certification.

    Major hospitals and medical centres require anaesthesiologists to be certified by the board, so loss of certification would make it difficult for many anaesthesiologists to work. The board has about 42 000 members.

    Mark Rockoff, the board’s secretary and spokesman, told the BMJ that the board issued its ruling in February after judges in some states suggested that they needed help from anaesthesiologists in preventing botched executions.

    There is no way of knowing whether anaesthesiologists have taken part in executions by lethal injection, because executioners usually remain anonymous. Likewise there is no way of knowing who may have performed lethal injections if an anaesthesiologist did not participate.

    “The board wanted to make it clear that [participating in an execution by lethal injection] was a violation of the anaesthesiologist’s responsibility as a physician to do no harm,” Dr Rockoff said. So far no doctors have been disciplined.

    Dr Rockoff is also an anaesthesiologist at the Children’s Hospital of Boston and a faculty member at Harvard Medical School.

    The board adopted the American Medical Association’s statement, which says, “A physician, as a member of a profession dedicated to preserving life when there is hope of doing so, should not be a participant in a legally authorized execution.”

    The AMA statement further says, “Physician participation in an execution includes . . . prescribing or administering tranquilizers and other psychotropic agents and medications that are part of the execution procedure; monitoring vital signs on site or remotely (including monitoring electrocardiograms); attending or observing an execution as a physician; and rendering of technical advice regarding execution.

    “In the case where the method of execution is lethal injection, the following actions by the physician would also constitute physician participation in execution: selecting injection sites; starting intravenous lines as a port for a lethal injection device; prescribing, preparing, administering, or supervising injection drugs or their doses or types; inspecting, testing, or maintaining lethal injection devices; and consulting with or supervising lethal injection personnel.

    The anaesthesiology board asks doctors who are applying for accreditation or for recertification to sign the board’s principles. They are not specifically asked whether they have participated in executions by lethal injection.

    Dr Rockoff said that the issue of participation in execution by lethal injection might arise if the association became aware through news reports or questions from members. If that happened, the issue would be referred to the association’s credentials committee.

    “I highly doubt that anaesthesiologists are involved,” Dr Rockoff said. “We are healers, not executioners.”

    The Washington Post, which reported the story on Sunday 2 May, said that about 35 of the 50 states perform executions and that most are done by lethal injection. The lethal injections usually include sodium pentothal, pancuronium bromide, and potassium chloride. Problems have occurred with some executions, with difficulty inserting catheters or because the prisoner experiences pain. Such botched executions have led to calls for anaesthesiologists to be involved.


    Cite this as: BMJ 2010;340:c2432

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