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Feature Death Penalty

Unwilling executioners?

BMJ 2011; 342 doi: (Published 06 June 2011) Cite this as: BMJ 2011;342:d3461
  1. Sophie Arie, freelance journalist
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Where and why do some doctors still participate in carrying out the death penalty? Sophie Arie reports

Lethal injection is now the main method of execution in China and the United States, the two countries that execute the highest numbers of people. But the widespread use of lethal injection—seen as a medical and therefore more humane method of execution than hanging, shooting, or electrocution—has meant that doctors have become more actively involved in carrying out the death penalty than they were in the past.

The medicalisation of executions has put doctors in an extremely difficult position. While in principle assisting in the killing of a person (whether legal or not) goes against the ethics of their profession, many decide, for religious or political reasons, that it is better to participate than not.

“With lethal injection, doctors moved into centre stage,” says Dr James Welsh, researcher and adviser at Amnesty International’s UK office. “Doctors had to think more about whether that’s what they went into medicine to do.”

Doctors’ involvement in the United States

In America, some 34 states currently allow the death penalty and over 80% of those use lethal injection. All except Kentucky state either require or permit doctors’ participation in executions ( State authorities go to some lengths to protect the identity of medical staff, who can be involved in different ways, from anaesthetising, injecting, and finding veins, to pronouncing and certifying death. Usually their participation is kept anonymous and they are often paid in cash.

Professional bodies such as the American Medical Association and the American College of Physicians have taken a common position since the early 1980s, when lethal injections were first used in the United States, against the involvement of doctors in carrying out the death penalty. “A physician, as a member of a profession dedicated to preserving life when there …

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