Having considered my last posts it is my contention that advocates of physician participation in lethal injection cannot have it both ways, if the physician is acting in an official capacity they carry professional ethics and rules with them. Consequently, arguments like those suggesting professional standards may not apply to lethal injection because there is no established doctor-patient relationship should hold no water.
The physician who utilizes medical knowledge and skills in the context of the execution and is viewed by the corrections system, the state, and as society as functioning in a medical role. Consequently, the lack of such a therapeutic relationship in this context does nothing to lessen the doctor’s responsibility. In addition, the condemned prisoner is not able to consent to or refuse what would normally be a medical procedure conducted by a physician. This consent argument leads to another important point of discussion. Some who argue for a more permissive role for physicians in lethal injection do so with respect to the diversity of attitudes within the profession towards physician participation in assisted suicide and abortion. These proponents of deference to individual physician choice have a superficial strong argument regarding the apparent inconsistency between professional standards that sometimes view physician-assisted suicide favorably and physician participation in lethal injection unfavorably. This permissive argument breaks down in the context of consent. However, as has been established in lethal injection there is no consent by the condemned prisoner and there is no doctor-patient relationship as there is in physician-assisted suicide. Professional values in medicine undeniably evolve in dynamic interaction with social norms, however defining one’s professional role solely based on societal norms diminishes the individual professional responsibility to appropriately use the knowledge and skills attained during medical education and training. A physician, just like any other individual in society, is entitled to his or her own opinion on ethical issues however he or she is utilizing medical knowledge or skills as a physician in any social realm, professional ethical standards should apply. To present this argument at its most blunt terms ethics would “not prohibit physicians from participating in a firing squad (in their role as citizens), but it would prohibit their participation in lethal injections (in their role as physicians)”. In summary, when a physician is acting in a professional capacity and is unambiguously perceived as acting in such a role they must remain cognizant how the field of medicine has developed and defined appropriate norms regarding behavior in actions related to life and death and conform to these common standards to do otherwise compromise both the physician and their field.
History is replete with attempts by governments to co-opt the power and status of the medical profession for state purposes that conflict with the goals of medicine. For example, physicians have engaged in interrogations involving torture utilizing their professional skills to maximize the prisoner’s temporary suffering while minimizing the risk of permanent disability or death. Execution takes this subordination of medical skill to the state’s still further as it is axiomatically “the involuntary taking of the life of another human being, an act that can never be reconciled with the goals of medicine”. Considering this regardless of whether execution itself is justified it must never be perceived as a medical procedure. As I hope has been established the participation of physicians in execution sets a dangerous precedent by allowing the legal system undue influence over the medical field, undermining the professional right of medicine to govern its members and opening the door for the inappropriate exploitation of the positive social perceptions of medicine on behalf of punitive measures which potentially tarnish that very reputation. Consequently, physicians, should not take part in executions not only due to the enormous potential for individual violations of medical ethics but the potential undermining of the entire profession that participation facilitates.
 Leonard S. Rubenstein, “Roles of CIA Physicians in Enhanced Interrogation and Torture of Detainees.” Jama 304, no. 5 (August 04, 2010): 569-70. Accessed December 1, 2016. doi:10.1001/jama.2010.1057.