Moon suits: Florida goes to great lengths to protect doctors' anonymity

The Associated Press
Tuesday, August 28, 2007

JACKSONVILLE, Florida: At all Florida lethal injections, a man in a purple moon suit leans over the dying inmate to listen for a heartbeat and feel for a pulse. After a few seconds, he nods, and the witnesses are informed that the death sentence has been duly carried out.

The man is a doctor and the gear shields his identity — not just from the prisoner's family and friends, but from the American Medical Association, whose code of ethics bars members from participating in executions.

Most states take steps to shield the identities of doctors taking part in executions. Some draw curtains or remove the witnesses before the doctor emerges.

But death penalty experts say Florida is the only state that uses a moon suit to preserve the doctor's anonymity.

The practice, employed for about a year, reflects the strong passions surrounding the role of physicians in executions, and the conflicting pressures that prison officials around the country are increasingly feeling.

On the one hand, prison systems are facing demands from judges that they make sure executions by injection do not cause undue pain. At the same time, states are having difficulty recruiting doctors to oversee executions because of the medical profession's objections.

Some of those issues are likely to play out at a hearing in state court this week on a Florida Corrections Department plan aimed at avoiding another botched execution like the one last December of Angel Diaz.

A judge last month ordered the state to update its lethal injection protocol in light of the Diaz case. Diaz, who killed a Miami topless bar manager during a 1979 robbery, took 34 minutes to die — more than double the normal time — and needed an extra dose of drugs because the executioners mistakenly pushed the needles clear through his veins into his flesh.

The state is proposing to add more doctors, nurses, phlebotomists (people trained to draw blood) and other medical professionals to its lethal injection teams — something that is already done in some other states.

Under Florida's proposal, the doctors could be used to insert the intravenous lines and keep them flowing. A doctor or pharmacist would be responsible for buying and mixing the lethal chemicals.

However, department officials told The Associated Press that even though the plan allows greater participation, the doctors would still be used only to pronounce death.

The whole idea is offensive to the AMA.

"We are a profession dedicated to healing. Participation in an execution is an image of a physician with a dark hood," said Dr. Mark Levine, chairman of the AMA's Council of Ethical and Judicial Affairs.

Levine said doctors participating in executions must decide if they are "an instrument of the state or a member of a profession dedicated to preserving and protecting life. You can't be both."

The AMA and other medical groups can revoke membership for ethics violations, but they have no licensing authority in Florida or anywhere else. And membership in the AMA is not required to practice medicine.

But because of those objections, doctors at Florida executions wear plastic moon suits, similar to those used by hazardous materials teams, that cover them from head to toe. Goggles worn beneath the clear plastic face shield conceal the doctor's identity even further.

Florida has 381 men awaiting execution. Next up is Mark Dean Schwab, scheduled to die Nov. 15 for the 1992 kidnapping, rape and murder of a child.

Thirty-seven of the 38 states with capital punishment have adopted lethal injection. (Nebraska still uses the electric chair.) Many states use doctors and other medical professionals, though their duties vary.

Some, like Texas, have the doctor simply pronounce death. But Tennessee allows doctors to cut open an arm or a leg to find a suitable vein. Many use doctors because a court has ordered them to. In North Carolina, a debate over whether a doctor must monitor an inmate's level of consciousness has stopped executions.

In any case, most states try to shield the doctor's identity.

Missouri recently passed a law that will allow executioners to sue anyone who discloses their identity. That came after a St. Louis newspaper revealed the name of a doctor who had participated in dozens of executions. It reported that he had been sued more than 20 times for malpractice.

The doctor also said that he was dyslexic and occasionally altered the amount of anesthetic given to inmates.

Missouri officials said that without the law, it would be difficult to find a doctor with the expertise in anesthesia to assist in executions, as a federal judge there has demanded.

In Alabama and Ohio, a curtain is drawn after the execution so the doctor cannot be seen by the witnesses.

Bill Allen, a professor of bioethics in the University of Florida's College of Medicine, said he is not sure there is a solution that will satisfy those who want physicians barred from death chambers, because "doctors and medical professionals are the best trained to perform the functions to carry out a lethal injection."

"It's a fundamental conflict," Allen said.