In my last post, I discussed how the legal world has undermined medical ethics to justify physician and other caregivers involvement in lethal injection. In this post, I will expand on this by considering how the need to justify execution has resulted in the co-opting of compassion so strongly associated with normal medical practice.
In addition to legislative mandates, the law manipulates medicine more subtly as well through its selective use of nominally compassion-based arguments. Compassion is a central part of medical practice and ethics is in the context of physician attendance at execution deftly used to the opposite effect. Unlike the strategies addressed earlier in this work, appeals to compassion superficially appear to unite the law and medicine’s interests. As one law professor argues, “Death row inmates are people who have been sentenced to death, not torture. They are put to death via a procedure that involves dangerous prescription drugs and, often, complicated issues of venous access.” Consequently, he agrees that courts should require physician participation as “Good doctors can help ensure that, if the execution is going to be carried out, the individual does not suffer needlessly”. The statement that it is nearly impossible for lethal injection to be considered not cruel and unusual without participation by physicians presented earlier reinforces this argument. However, while it is true that if not done properly, the sequential three-drug cocktail to cause cardiac arrest can go awry at any stage this is not sufficient to justify physician participation. The compassion embodied by a desire to prevent these errors and unnecessary suffering comes at the cost of sacrificing central tenants of medical ethics. None of the drug protocols utilized for execution have ever been properly evaluated in animals before they were employed on humans. Consequently, while the evaluation of drug protocols and devices to be utilized to conduct executions resembles human subjects research, it wholly lacks the usual established protections. Medical professionals who participate in executions may be truly motivated by compassion, this defense of their participation is, however, a myopic one in which they wrongly paint themselves as passive participants in a situation over which they have no ethical involvement or responsibility.
The final way in which physician participation at execution-only serves to undermine the medical field while benefiting the legal one this paper will consider is the legitimacy granted to execution generated by trading on medicine’s reputation as a defender of the sanctity of life. Executions by lethal injection are carried out in a quasi-medical setting and give the impression that a medical procedure is being administered. Additionally, the doctor involved is undeniably using knowledge and skills attained during medical education and is recognized by society as possessing and using specific skills that are normally used to sustain and enhance life. By constructing a scene that is almost indistinguishable from the everyday practice of anesthesiologists when they “put a patient to sleep,” the procedure is granted a patina of respectability and compassion through association with the practice of medicine. As the Constitution Project explicitly states those practitioners involved should be those “responsible for performing functions in their day-to-day practice that are similar to those they will perform at the execution”. The only beneficiaries of this aegis of respectability, however, are those within the legal system seeking to minimize the perceived barbarity of execution. This is even conceded by legal scholars who acknowledge that “physician involvement in lethal injection can make capital punishment less grotesque, more palatable, and even routine”. The doctors involved certainly appear to feel far less comfortable than the legal scholars who publicly endorse their actions given their hesitancy with rare exceptions to openly reveal their actions.
This reality makes it difficult to argue against the fact that while the veneer of medical professionalism is being generated around executions central values of medical ethics are potentially being undermined.
 James K. Boehnlein, “Should Physicians Participate in State-Ordered Executions?” Virtual Mentor 15, no. 3 (March 01, 2013): 240-43. Accessed December 3, 2016. doi:10.1001/virtualmentor.2013.15.3.pfor3-1303.