Capital Punishment

Debate over capital punishment has occurred for centuries and remains a volatile social, political, and legal issue. An individual’s opinion on capital punishment is the personal moral decision of the individual. However, as a member of a profession dedicated to preserving life when there is hope of doing so, a physician must not participate in a legally authorized execution.

1. Would directly cause the death of the condemned.
2. Would assist, supervise, or contribute to the ability of another individual to directly cause the death of the condemned.
3. Could automatically cause an execution to be carried out on a condemned prisoner. These include, but are not limited to:
4. Determining a prisoner’s competence to be executed. A physician’s medical opinion should be merely one aspect of the information taken into account by a legal decision maker, such as a judge or hearing officer.
5. Treating a condemned prisoner who has been declared incompetent to be executed for the purpose of restoring competence, unless a commutation order is issued before treatment begins. The task of re-evaluating the prisoner should be performed by an independent medical examiner.
6. Prescribing or administering tranquilizers and other psychotropic agents and medications that are part of the execution procedure.
7. Monitoring vital signs on site or remotely (including monitoring electrocardiograms).
8. Attending or observing an execution as a physician.
9. Rendering of technical advice regarding execution. And, when the method of execution is lethal injection:
10. Selecting injection sites.
11. Starting intravenous lines as a port for a lethal injection device.
12. Prescribing, preparing, administering, or supervising injection drugs or their doses or types.
13. Inspecting, testing, or maintaining lethal injection devices.
14. Consulting with or supervising lethal injection personnel. The following actions do not constitute physician participation in execution:
15. Testifying as to the prisoner’s medical history and diagnoses or mental state as they relate to competence to stand trial, testifying as to relevant medical evidence during trial, testifying as to medical aspects of aggravating or mitigating circumstances during the penalty phase of a capital case, or testifying as to medical diagnoses as they relate to the legal assessment of competence for execution.
16. Certifying death, provided that the condemned has been declared dead by another person.
17. Witnessing an execution in a totally nonprofessional capacity.
18. Witnessing an execution at the specific voluntary request of the condemned person, provided that the physician observes the execution in a nonprofessional capacity.
19. Relieving the acute suffering of a condemned person while awaiting execution, including providing tranquilizers at the specific voluntary request of the condemned person to help relieve pain or anxiety in anticipation of the execution.
20. Providing medical intervention to mitigate suffering when an incompetent prisoner is undergoing extreme suffering as a result of psychosis or any other illness. No physician should be compelled to participate in the process of establishing a prisoner’s competence or be involved with treatment of an incompetent, condemned prisoner if such activity is contrary to the physician’s personal beliefs. Under those circumstances, physicians should be permitted to transfer care of the prisoner to another physician. Organ donation by condemned prisoners is permissible only if:
21. The decision to donate was made before the prisoner’s conviction.
22. The donated tissue is harvested after the prisoner has been pronounced dead and the body removed from the death chamber.
23. Physicians do not provide advice on modifying the method of execution for any individual to facilitate donation.

Council Reports

Related Opinions

Patient-Physician Relationships

At the heart of medicine lie relationships founded in a “covenant of trust” between patient and physician in which physicians commit themselves to responding to the needs and promoting the welfare of patients.

Informed Consent

Informed consent to medical treatment is fundamental in both ethics and law. Patients have the right to receive information and ask questions about recommended treatments so that they can make well-considered decisions about care.

Confidentiality

Physicians have an ethical obligation to preserve the confidentiality of information gathered in association with the care of the patient. With rare exceptions, patients are entitled to decide whether and to whom their personal health information is disclosed.

Guidelines for Organ Transplantation from Deceased Donors

Organ transplantation is unique in that it involves two patients, donor and recipient, both of whose interests must be protected. Concern for the patient should always take precedence over advancing scientific knowledge.

Torture

Torture refers to the deliberate, systematic, or wanton administration of cruel, inhumane, and degrading treatments or punishments during imprisonment or detainment. Physicians must oppose and must not participate in torture for any reason.