World: Medical professionals break ethical oath with lethal injection

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4 Oct 2007
[International Secretariat]
Topic: Abolition of the Death Penalty
Doctors and nurses should not participate in executions ordered by the state in breach of their ethical oath, said Amnesty International in a new report today.
The report, Execution by lethal injection ? a quarter century of state poisoning looks at the legal and ethical implications of the use of the lethal injection across the world.

“Medical professionals are trained to work for patients’ well-being, not to participate in executions ordered by the state. The simplest way of resolving the ethical dilemmas posed by using doctors and nurses to kill is by abolishing the death penalty,” said Jim Welsh, Amnesty International’s Health and Human Rights coordinator.

Since 1982, at least 1,000 people were executed by lethal injection globally -- three in Guatemala, four in Thailand, seven in the Philippines, more than 900 in the USA and up to several thousands in China, where executions are a state secret.

In lethal injection executions, prisoners are commonly injected with massive doses of three chemicals: sodium thiopental to rapidly induce unconsciousness, pancuronium bromide to cause muscle paralysis, and potassium chloride to stop the heart.

Doctors have expressed concern that if inadequate levels of sodium thiopental are administered, the anaesthetic effect can wear off before the prisoner’s heart stops, placing them at risk of experiencing excruciating pain as the chemicals enter the veins producing cardiac arrest. Due to the paralysis induced by pancuronium bromide, they would be unable to communicate their distress to anyone.

For these reasons, these chemicals are not used by veterinary surgeons on animals for euthanasia. In Texas, the biggest user of lethal injection in the USA, the same drugs that are prohibited for use on cats and dogs because of the potential pain they might suffer are being used to execute.

Joseph Clark was executed in Ohio in December 2006. It took 22 minutes for the execution technicians to find a vein to insert the catheter. Shortly after the start of the injection, the vein collapsed and Joseph’s arm began to swell. He raised his head off the stretcher and said “it don’t work, it don't work”. The curtains surrounding the stretcher were then closed while the technicians worked for 30 minutes to find another vein.

“The use of lethal injection does not resolve the problems inherent to the death penalty: its cruelty; its irreversibility; the risk of executing the innocent; its discriminatory and arbitrary application; and its irrelevance to effective crime control,” said Jim Welsh.

“Governments are putting doctors and nurses in an impossible position by asking them to do something that goes against their ethical oath.”

In China, the world’s top executioner, many, executions by lethal injection are carried out in mobile vans. The windowless chamber at the back of the vans contains a metal bed on which the prisoner is strapped down. Once the needle is attached by the doctor, a police officer presses a button and an automatic syringe inserts the lethal drug into the prisoner’s vein. The execution can be watched on a video monitor next to the driver’s seat and can be videotaped if required.
“There is a global consensus within the medical profession that the involvement of health professionals in carrying out an execution, particularly by a method using the technology and knowledge of medicine, is a breach of medical ethics; yet health professionals are participating in such executions.”

“Professional bodies have recently spoken strongly about this abuse of ethics, but governments want to hide the identity of participating doctors to shield them from the scrutiny of professional colleagues,” said Jim Welsh.

Amnesty International calls on world leaders to abolish the death penalty and urges them to take the opportunity to begin with a vote for a moratorium at the current session of the United Nations General Assembly when it is voted on later in 2007.

A copy of “Execution by lethal injection ? a quarter century of state poisoning” will be available from 27 September on:

AI Index:POL 30/023/2007
4 October 2007