"Do No Harm" Means Just That

An editorial in this week's New England Journal of Medicine considers the role physicians should have in assisting the state in executing prisoners by lethal injection. They write:   "We are concerned that, regardless of its decision in Baze v. Rees, the Court may include language in its opinion that will turn again to the medical profession to legitimize a form of lethal injection that, meeting an appropriate constitutional standard, will not be considered 'cruel and unusual punishment.' On the surface, lethal injection is a deceptively simple procedure, but its practical application has been fraught with numerous technical difficulties. Without the involvement of physicians and other medical professionals with special training in the use of anesthetic drugs and related agents, it is unlikely that lethal injection will ever meet a constitutional standard of decency. But do we as a society want the nation's physicians to do this? We believe not."

The editorial looks ahead to the decision of the United States Supreme Court in Baze v. Rees, in which the Court must decide whether lethal injection in Kentucky constitutes cruel and unusual punishment and is thus unconstitutional. The cocktail used in Kentucky, according to medical experts, frequently results in agonizing and prolonged pain; indeed, it is outlawed for use by veterinarians in putting animals to sleep.

The executing states would love the medical profession to assist executioners in their unseemly business and a few of the Justices seem to welcome such a scenario in their questions posed at the January 7 oral argument in the case. Certainly, anesthesiologists could develop a cocktail and method that would avoid or at least limit the pain suffered by the condemned.

The authors in the NEJM cogently argue against such a practice. If physicians are to honor their oath and “Do No Harm,” they must resist calls to participate in the killing of prisoners, however heinous their crime.

Alan Milstein