Tuesday, 23 January 2007

Law pushes physicians into an ethical conflict

Opinion - Editorials
Monday, January 22, 2007
Law pushes physicians into an ethical conflict

A state law that creates an ethical dilemma for doctors should be repealed.

The law requires "the surgeon or physician of the penitentiary" to attend each execution. The next one is scheduled for Friday.

American Medical Association policy, however, states that 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." Its definition of participation includes "attending or observing an execution as a physician."

The N.C. Medical Board doesn't go that far. In a new policy adopted last week, it prohibits physicians from "any verbal or physical activity ... that facilitates the execution ..." Violations would invite disciplinary action by the board, which has the power to suspend a physician's medical license.

The state board made its statement weaker than the AMA policy to avoid a conflict with North Carolina's law. But the law is in the wrong. It should not create a reason for physicians -- those employed by Central Prison, and possibly others -- to violate the ethical guidelines established by their leading professional organization, the AMA.

The law inevitably would get those physicians in trouble with the N.C. Medical Board as well. A doctor is required to attend an execution for one implied reason: in case something goes wrong. Lethal injection, the method of execution, involves the careful administration of drugs intended to render the inmate unconscious, immobilize his body and finally to stop his heart. Technicians can do the job and monitor the inmate's reactions, but they might not know how to handle an unexpected physical response. Legislators who wrote the law thought a physician should be on hand to help if needed.

A botched lethal-injection execution in Florida prompted then-Gov. Jeb Bush to suspend executions there late last year. Attorneys for condemned prisoners in North Carolina have asked the courts to order the presence of an anesthesiologist at executions here.

But, even if they are forced to attend, physicians still aren't allowed to participate. They can't do anything to directly cause the death of the condemned, or assist, supervise or contribute to the ability of anyone else to carry out the execution, the N.C. Medical Board policy says. That includes even "consulting with or supervising lethal injection personnel."

Physicians are required to certify death, but attending the execution isn't necessary for that job. If he or she can do nothing before that point without incurring professional sanctions, the physician's presence serves no valid medical or legal purpose. Under those circumstances, the law should not demand it.

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