The Oklahoma affair reveals the complicity of the medical profession in American executions

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Helping death states in the execution business is an unnoticed but lucrative side hustle for doctors and other medical professionals. This fact was made clear last Friday when reports surfaced that the state of Oklahoma was paying an unnamed doctor $15,000 for every execution he participated in, plus $1,000 for every day of training he provided to other members of the state enforcement team.

The doctor was recruited last year by Justin Farris, chief of operations for the Department of Corrections as Oklahoma prepared to resume executions after a 6-year hiatus.

According to the Death Penalty Information Center, “Under the agreement, the doctor was to receive approximately $130,000 during the 19-week period between October 28, 2021 and March 10, 2022, during which the State had programmed the executions of seven prisoners.

A rotten apple? Barely.

The common belief that doctors “cannot” participate in executions is wrong. What’s happening in Oklahoma shows they can – and they do.

Calling in doctors is a way to give modern forms of capital punishment – ​​particularly lethal injection – the trappings of a medical procedure. Others include the use of IVs, injectable medications, and EKGs. All of them create the illusion that the execution chamber resembles an ordinary operating room.

The truth is that no method of execution, including lethal injection, can ever live up to medical standards. Doctors are guided by an oath to “do no harm”, but the only purpose of the executioners these doctors help is to kill.

Doctors and medical personnel should not lend themselves to such cruel deception by participating when the state kills. This causes incalculable damage to the medical profession and it does not prevent horrible accidents of execution. But the involvement of doctors, nurses and emergency medical technicians lends an aura of legitimacy to the troubling practices surrounding lethal injection.

As shocking as the news from Oklahoma is, it reveals a familiar, if often overlooked, part of the history of executions in the United States. Oklahoma isn’t alone in relying on medical personnel to help with the execution. Today, execution laws or protocols in 17 death row states provide for some involvement of physicians in some part of the process.

But no doctor is, of course, obliged to help.

From the start, their willingness to participate in the execution process has been essential to the practice of lethal injection. And professional associations have been powerless to prevent medical personnel from participating in this process.

In 1977, when Oklahoma became the first state in the nation to adopt lethal injection as a method of execution, a physician played a key role. Dr. A. Jay Chapman, often called “the father of lethal injection, was the state’s chief medical examiner at the time. He designed the drug protocol that quickly became standard both in Oklahoma and across the country.

Chapman proposed that massive doses of two drugs be used. One, sodium thiopental, is an anesthetic, the other, pancuronium bromide, is a muscle relaxant that would paralyze the convict. Four years later, before the first lethal injection, he recommended the addition of a third drug, potassium chloride.

Chapman got involved in the business of lethal injections despite the fact that the Oklahoma Medical Association (OMA) said at the time that it would violate medical ethics.

Since then, other professional associations have followed the OMA in banning their members from participating in executions with the same limited success.

Several of these associations, including the American Medical Association (AMA), American Association of Anesthesiologists (ASA), and National Association of Emergency Medical Technicians (NAEMT), have issued public statements reminding members of their ethical obligation not to participate in the executions. .

The AMA explicitly prohibits physicians from “selecting injection sites for executions by lethal injection, starting intravenous lines, prescribing, administering or supervising the use of lethal drugs, monitoring vital signs, on site or remotely, and to declare the death”.

The ASA also prohibits anesthesiologists from assisting in executions. He notes that “although lethal injection mimics some technical aspects of the practice of anesthesia, capital punishment in any form is not the practice of medicine”.

The NAEMT states categorically that “Participation in capital punishment is inconsistent with the ethical precepts and goals of the EMT profession…EMTs and paramedics should refrain from participating in capital punishment and not participate in capital punishment. evaluation, supervision or control of the procedure or the prisoner; procuring, prescribing or preparing drugs or solutions; inserting the intravenous catheter; injecting the lethal solution; and/or assisting or assisting in the execution as as paramedic or paramedic.

Doctors and paramedics routinely ignore these warnings even though they risk penalties, including having their licenses revoked. They have assisted in hundreds of executions since the advent of lethal injection, but no one has ever been punished for it. Until there is effective professional discipline for the practice of medicine in the execution chamber, the charade will continue.

Some of those who challenge the ethical rules of their profession argue not only that medical personnel should be free to participate in the execution process, but that this is necessary to ensure that prisoners do not suffer unnecessarily.

Dr. Carlo Musso, called a “death row doctor” by The New York Times, said that “instead of carcinoma, this individual dies by court order”. He argues that “physician involvement and their ability to provide what he calls ‘end-of-life comfort measures’ helps keep our capital punishment system as humane as possible.”

Another doctor, Sandeep Jauhar, while acknowledging his opposition to capital punishment, wrote in a 2017 New York Times editorial that “Barring doctors from executions will only increase the risk that prisoners will suffer unduly. Participating in executions,” he continued, “does not make the doctor the executioner, just as providing comfort care to a terminally ill patient does not make the doctor the carrier of the disease.”

Dr. Jauhar may be right to say that doctors do not become executioners when involved in capital punishment. But as Musso notes, the medicalization of execution “probably…makes us more comfortable with capital punishment.”

That’s why death row states like Oklahoma are willing to pay a premium for doctors to attend their executions. But their involvement doesn’t just violate the standards of the medical profession – these doctors do something even worse: they profit from someone’s death. It is hard to imagine a more flagrant violation of ethical standards, for doctors or anyone else.

Austin Sarat is the William Nelson Cromwell Professor of Jurisprudence and Political Science at Amherst College. He is the author of numerous books on the death penalty in the United States, including “Horrible Spectacles: Botched Executions and the American Death Penalty.” Follow him on Twitter @ljstprof.

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