Thursday 1 July 2010

Death Chambers: No Anesthesiologists Allowed

by Turi McNameeMay 23, 2010

It’s a somewhat unusual experience when a regulatory body feels the need to make a public statement saying that doctors should not kill people.

But that’s exactly what the American Board of Anesthesiology has done, stating that anesthesiologists are not to participate in capital punishment if they wish to be certified. It’s a statement that’s reminiscent of the American Medical Association’s opposition to physician involvement in capital punishment. But why are anesthesiologists in particular being singled out?

In a nation where capital punishment is constitutional while at the same time such punishment is not allowed to be cruel or unusual, stories of bungled executions make headlines and fill courtrooms. Truly there are some gruesome tales where the final exit more closely approximates a final flail. While not targeting anesthesiologists in particular, some have argued that such incidents could be prevented if a person with training in anesthesia were present. Certain judges have taken the matter a step further, ordering that an anesthesiologist be consulted for executions.

The anesthesiology board’s statement could, in effect, prevent that from happening. Board certification is a prerequisite for employment for most physicians. Unless an anesthesiologist was willing to walk away from standard practice entirely, states would have a hard time finding someone to fill the role of anesthesiologist attendant at executions. The other alternative would be to find an anesthesiologist who had lost his or her certification for other reasons, but if you think about it, would that really be an improvement over the present situation?

What remains to be seen is how this statement will play out legally. Several state medical boards that have tried to take action to discipline physicians who have participated in executions have found their decisions overturned by the Supreme Court, which has argued that such disciplinary action by a state-sanctioned group is in direct contradiction to state law that allows physicians to be present in the death chamber. Since the American Board of Anesthesiology is not state-based, such an argument might not apply to their certification requirements.

Personally, I'd no sooner participate in an execution than I would an infomercial for do-it-yourself appendectomy kits. But I wonder how many, if any, anesthesiologists feel strongly enough in favor of participation to risk their certification.

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