I was told to approve a lethal injection, but it violates my basic medical ethics

We risk botched executions so long as they are conducted in a scientific vacuum and medical professionals operate devoid of any moral compass

The Guardian

Marc Stern

I peered through the small window of an otherwise solid steel door of the isolation wing of the prison, and saw a small man on his knees in front of his steel framed bed. He had committed many murders and was sentenced to life without the possibility of parole. Perhaps he was praying. Perhaps he was looking for a pencil. But that’s when it struck me: There might be a punishment worse than execution.

Other than a maximum of one hour per day when he could be escorted to a recreational cage outdoors, he would spend the next 10, 20, perhaps 30 years of his life in this very room – eight feet by 10 feet. He would have little contact with other human beings aside from officers and medical professionals. Forging a new friendship or hugging a loved one, if possible at all, would be rare, supervised and not likely spontaneous. His life would be restricted to the same 80 square feet – forever. . . [Full Text]

 

Redefining the Practice of Medicine- Euthanasia in Quebec, Part 6: Participation in Killing

Abstract

Redefining the Practice of Medicine- Euthanasia in Quebec, Part 6: Participation in Killing

It appears that, even where euthanasia or assisted suicide is legal, the majority of physicians do not actually provide the services.  However, by establishing a purported legal “right” to euthanasia, ARELC generates a demand that physicians kill their patients, despite the high probability that a majority of physicians will not do so.

Often for purely pragmatic reasons, euthanasia supporters do not usually insist that an unwilling physician should be compelled to personally kill a patient.  Thus, the difficulty created by the law can be addressed by administrative measures that connect patients looking for euthanasia with the minority of physicians willing to provide it.  Nonetheless, physicians who object to euthanasia for reasons of conscience will likely be expected to facilitate access to the procedure by helping the patient find a colleague willing to provide it.

However, objecting physicians not only refuse to kill patients, but also often refuse to do anything that they believe makes them morally responsible for the killing.  This includes actions that indirectly support or facilitate it.  Hence, it is likely that most of the attacks on freedom of conscience resulting from ARELC will be preciptated, not by a refusal to kill directly, but by this kind of refusal to participate indirectly in killing.

The Criminal Code demonstrates that a physician who refuses to facilitate the killing of a patient because he does not want to be a culpable participant in killing is acting well within well-established moral and legal norms reflected in our criminal law.  Further, the polices of professional medical organizations that forbid physician participation in capital punishment, torture, and female genital cutting indicate that it is not unreasonable for objecting physicians to refuse to facilitate euthanasia even indirectly.

On the contrary: refusing to participate, even indirectly, in conduct believed to involve serious ethical violations or wrongdoing is not aberrant behaviour.  It is the response expected of physicians by professional bodies and regulators in order to avoid physician complicity in such procedures. [Full Text]

Botched execution sparks outcry in US

Bioedge

Xavier Symons

Another botched execution in the USA has reignited debate over the death penalty. Arizona man Joseph Rudolph Wood took almost two hours to die after being injected with the drugs midazolam and hydromorphone. The two drugs are a new barbiturate combination being trialled in a number of US states.

According to witnesses, Wood gasped for air hundreds of times before succumbed to the drugs. “It was very disturbing to watch…like a fish on shore gulping for air”, said reporter Troy Hayden. “I counted 660 times that he gasped,” said Arizona Republic journalist Michael Kiefer.

Just two months ago BioEdge reported on a similar botched execution in Oklahoma.

Shortly after the execution, Arizona governor Jan Brewer issued a statement in which she ordered a full review of the execution process.

She was nevertheless adamant that the execution had been lawful and did not involve undue pain: “One thing is certain, however, inmate Wood died in a lawful manner and by eyewitness and medical accounts he did not suffer” her statement said.

The American Civil Liberties Union of Arizona issued a statement calling for a moratorium on executions. “What happened today to Mr. Wood was an experiment that the state did its best to hide,” Executive Director Alessandra Soler said.

The new drugs being used are intended to replace others that pharmaceutical companies now refuse to sell to US correctional facilities. The drug midazolam causes unconsciousness in a patient, while hydromorphone shuts down breathing and induces cardiac arrest.


cclicense-some-rightsThis article is published by Xavier Symons and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation to Bioedge. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

Embargo on lethal drug stops executions and assisted suicides in US

 Bioedge

Michael Cook

A shortage of a lethal drug is stopping both executions and assisted suicide in the United States. The supply of Nembutal, the drug of choice for executing prisoners in many American states and for assisted suicide in Oregon and Washington state, has dried up because its European manufacturer, the Danish company Lundbeck, refuses to supply it for use in executions. This has had an unintended consequence: patients in Oregon who want physician-assisted suicide cannot get it.

In a recent, widely-reported execution, the state of Oklahoma tried a three-drug cocktail as a substitute for Nembutal (also called pentobarbital or sodium thiopental) last month, but the prisoner, Clayton Lockett, appeared to die in great pain. So patients in Oregon are not going to be using that. A second-best drug, secobarbital, costs between US$1,500 and $2,300-more than five times pentobarbital and it is still hard to obtain.

The botched execution has dismayed lobbyists for assisted suicide because it suggests that a satisfactory substitute for Nembutal will be hard to find. According to the Wilamette Week, an Oregon newspaper, “Advocates would like to expand the policy across the country, and their concerns about bad publicity hampering that rollout appear to account for their reluctance to discuss Oregon’s shortage.”

The assisted suicide lobby, therefore, has turned to other solutions. Compassion & Choices (the rebranded Hemlock Society) has asked the Oregon Board of Pharmacy to allow a pharmacy to manufacture the drug from raw materials.

“Providing this service is important to Oregonians, and I’m very concerned about what appears to be a complete lack of availability of the drug we’ve historically used,” State Senator Elizabeth Steiner Hayward (who is also a doctor who dispenses assisted suicide prescriptions) told Wilamette Week. “What I’ve been told by the pharmacists is the drug is completely unavailable, and we should not prescribe it.”

The irony that one group lobbying against death is frustrating the work of another group lobbying for death was not lost on bioethics gadfly Wesley J. Smith. “It seems to me that if the drugs are wrong to use in lawful executions, they are also wrong to prescribe to people who want to kill themselves. Death-causing is death-causing, and that ain’t medicine,” he wrote in the National Review.

There are other ironies. It is widely acknowledged that it is against medical ethics for doctors to participate in executions. However, Oregon is one of the few states that mandates physician participation in an execution. And anticipating objections by a doctor’s colleagues, it has banned sanctions against him (or her) for participating in an execution.


Embargo on lethal drug stops executions and assisted suicides in USThis article is published by Michael Cook and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation to Bioedge. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

New execution protocol similar to doctor-assisted suicide recommended

New York Post

Lindsey Bever

Days after the botched execution of Oklahoma inmate Clayton Lockett, a bipartisan committee studying the death penalty has recommended a new one-drug lethal injection method to kill quickly and “minimize the risk of pain or suffering.”

The committee, formed by the Constitution Project long before the Lockett execution, urged states to administer an overdose of one anesthetic or barbiturate to cause death – the same method used in doctor-assisted suicides. (To read the report, click here.)

This method would replace a three-drug lethal injection protocol currently used by most states that employ the death penalty. . . [Full text]