Let's get this part of the discussion out of the way. There is no disputing the fact that just about every person sentenced to death for murder caused his victim to experience some horrid combination of fear and pain.
It is only human to long for payback, to want to force the killer to endure at least a semblance of the misery he inflicted. Forgiveness in such a situation can seem like a luxury to be indulged in by saints.
Yet the punishments we as a society are prepared to inflict on even our most depraved killers cannot reliably balance these scales. We do not have people drawn and quartered, or burned alive, or subjected to any such process that we rightly have come to view as barbaric. Our Bill of Rights sets the base line: no punishments will be cruel or unusual.
Was it cruel to electrocute condemned killers, as North Carolina did for many years, or to gas them with cyanide, an option used here as recently as the mid-1990s? Not by standards of the time, apparently, but standards change. We now seem to be moving toward a consensus that to have one's life snuffed out, with foreknowledge of when existence will cease, is itself an adequate penalty for having violently taken another's life. There is no general demand to dispense a ration of gratuitous pain.
When the gas chamber gave way to lethal injection, the assumption was that anesthetizing prisoners and then killing them with toxic chemicals was far preferable -- no thrashing contortions, and respectably humane under the circumstances.
Then it began to dawn on people, here and in other states where lethal injection was used, that things could go wrong. An inmate on the gurney might actually experience severe pain -- without even being able to signal his plight because he was paralyzed.
The key call that has to be made boils down to this: Is the person unconscious or not? If not, the drugs that would kill him could also send him into agony.
Who better to make that call than a doctor? But the N.C. Medical Board now has decided that doctors, while they can attend, can't participate in executions, even though one is required by law to be present.
The "protocol" approved last week by the Council of State specifies that a doctor "shall monitor the essential body functions of the condemned inmate and shall notify the Warden immediately upon his or her determination that the inmate shows signs of undue pain or suffering." If the doctor gives the word, the prison warden is supposed to stop the execution.
Something tells us that this wasn't what the medical board had in mind. There's also the matter of the so-called BIS monitor.
North Carolina purchased a bi-spectral index monitor last year to gauge brain activity in inmates being executed. The aim was to satisfy a federal judge that inmates would be rendered unconscious before they were injected with the chemicals to paralyze their muscles and stop their heartbeats.
The device was made by Aspect Medical Systems of Newton, Mass. The company's vice president and medical director, anesthesiologist Scott D. Kelley, stated in an affidavit in April that the North Carolina buyers had indicated they planned to use the monitor for patient care, not in executions.
Kelley said the monitor's readings, to be reliable indicators of a person's level of consciousness, had to be interpreted along with other clinical signs, and that a doctor or nurse watching a monitor outside the death chamber might not be able to make accurate judgments.
Since then, as part of legal efforts to block executions that had been scheduled for this month, other doctors have submitted affidavits noting problems with the injection procedure.
For instance, with an inmate covered by a sheet and his hands wrapped in elastic gauze, as is the practice, it would be difficult to tell if the IV hook-ups were functioning properly. If the drugs were not injected into a vein -- as apparently occurred during a botched recent execution in Florida -- an inmate would face a protracted and painful death.
Alternatively, if a doctor called a halt and the execution turned into a resuscitation, an array of equipment and supplies would be needed for the inmate's life to be saved (so he could be killed at a later date!). Some doctors are skeptical that such a U-turn could be negotiated successfully. The inmate might be left in brain-damaged limbo.
The picture here is of an outrageously conflicted system entangling health professionals. The state cannot allow cruel amounts of pain when it executes someone, but it can't guarantee that won't happen unless doctors participate and thus breach professional ethics. If an unofficial death penalty moratorium is the result of this legal and ethical logjam, as Governor Easley suggests is the case, then that should be a relief for all concerned.