Lethal execution is the leading form of execution in the United States (Waisel 1073).  “The coroner declares that is was a little error. It’s not like the guy suffered.”  The coroner who stated this, had pronounced the prisoner dead after witnessing him convulse seven minutes after the drugs had been delivered. Physician assistance in executions will prevent errors that lead to unnecessary pain of the inmate. The existence of the death penalty depends on physicians. They have turned to medicine in a last effort to save the death penalty. Physicians have taken part in capital punishment for hundreds of years. The majority of states within the US either require or permit physician participation (Levy 263). Physicians have invented many of the products used to execute, as well as directly fed the life ending drugs into the prisoner. Dr. Carlos MacDonald and Dr. E.C. Spitzka introduced the electric chair in the 1800s, they were also in attendance of the first execution that used an electric chair. They gave the correct length of time to apply electricity and instructed how is was best and most effectively used. The guillotine was invented by a physician was who trying to find a way to make capital punishment more humane (Levy 263). There will be an ever-changing opinion of what is and is not humane. A small percentage of people would consider the guillotine to be humane in any way, but it was used for years. Lethal injection was introduced to, once again, make executions more humane. It was introduced by an anesthesiologist. The process presented was very similar to anesthesia. Pancuronium bromide, sodium thiopental, and potassium chloride were injected, with the goal to painlessly stop the person’s heart (Waisel 1073).  Physician participation in capital punishment is not a new idea. It is more prevalent now, because the common occurrence of botched lethal injections is running into issues with the Eighth Amendment. A physician’s assistance is needed during drug delivery. The drugs being administered are very dangerous drugs, there is no margin for error and the only way to prevent most errors is to have a physician involved. By looking at risk prevention, humane treatment, and still considering the opposing medical ethics code, we can see that physicians are needed to see though and complete executions. This is important because without a physician’s help lethal injections used for executions would be deemed unethical by the government. 

For lethal injection to be considered humane, physicians are needed to prevent unnecessary harm to the prisoner (Black). Since the start of lethal injection, several dozen executions have been botched leaving the prisoner in extreme pain. One man was able to lift his head, multiple times, during his execution and even said “It don’t work” (Curfman). Atul Gawande, states the six of the last eighth executed prisoners, in California, were still breathing when the person administering the drugs gave the paralytic. This could very well mean the executed prisoner was experiencing suffocation, a feeling like being buried alive (1221). J.D. Autry was executed through lethal injection. His execution took place without the presence of a physician. The people present “speculated” the drugs clogged the tubing, or the needle insertion was not done in the right place, thus causing a delay in the way the drugs were being released into the prisoner. J.D. Autry suffered for ten agonizing minutes (Levy 262). This situation shows why physicians are so necessary in executions. The technicians that were present at the time of the drug delivery just guessed what they thought went wrong. It was an either-or situation. They did not have the knowledge that was needed. They knew not how to fix the situation they got themselves into, and left the prisoner to suffer. The process should be done in a way similar to how Texas’s first state execution by lethal injection was carried out. A physician put in the IV, something they do on a daily bias, and injected the correct amount of sodium thiopental.  Before the prisoner could even finish five words, “Yeah, I can feel …”, he had passed out (Gawande 1227). The physician then completed the last two sets of injections and within three minute’s the prisoner was dead. A physician is trained in the medical field. They have a good sense for when something is going wrong. An anesthesiologist knows the signs of when the anesthetic, the first drug given, is working like it is supposed to. Sometimes they have to use a hands-on approach to test for reflexes. Just because there was suspension of breathing does not mean an adequate amount of sodium thiopental was administered. An average person would assume the opposite, and continue with the procedure. Administering the next drug that would cause muscle relaxation, preventing the prisoner from showing signs of pain. The third and final drug would then be given. This drug would cause burning and the feeling of suffocation if the very first drug was not administered properly (Waisel 1074). There is evidence that the lethal injection standards in the United States are lower than veterinary euthanasia or anesthetics performed in a medical facility (Zivot). This is not surprising when there is non-medical personal dealing with serious drugs. The uneducated personal are trying to inject sodium thiopental and pancuronium bromide in one line. The issue occurs when the two drugs are mixed they forms a precipitate, blocking the tube and ending up with a terribly wrong and painful execution which, not to mention, they have no clue how to undo or resolve the problem they just caused. The prisoner is to lay there and suffer until they finally die after being in agony for minutes. There is a similar problem when machines are used. During the drug delivery, the catheter gets clogged leaving the prisoner gasping for breath (Waisel 1074). Machines have never been a reliable source. A knowledgeable physician should be used in the place of untrustworthy machines. Allowing a physician to be present at an execution is a necessary part in order to ensure the execution will be performed with as little pain as possible to the prisoner. The mistakes the non-physicians are making are mistakes physicians could have easily prevented. Physicians are used to following protocol and procedures (1074). They learn and practice the steps they are supposed to take to properly complete a medical procedure. The non-physicians dealing with execution are coming in blindly. They do not think it will be that hard and just go for it, but when they realize something has gone wrong they do not know how to fix it, so they just push more drugs in or wait it out until the prisoner dies a slow painful death. The risk these facilities are taking, without the presence of a physician, is indescribable. It is so easy to ensure the execution goes right by having a physician in attendance. The chance of an execution going wrong with the presence of a physician is much lower than if a physician is not present. Not only should a physician be present to prevent unnecessary risk and pain but also to keep lethal injection in line under the Eighth Amendment.

A simple definition of the word humane is to show some form of compassion. For an execution to be considered humane it must be done in the most painless way possible. He government is trying to figure out if the current lethal injection system should be accepted under the constitution (Curfman). Gregory Curfman says that without physicians or other medical personal’s involvement, it is very unlikely that lethal injection will meet the constitutions ideal standard for humane treatment. When there is a problem with the drug delivery the only way for the situation to remain humane is to have a medical personal present to take charge, and prevent unnecessary pain to the prisoner. The previous forms of execution have since been deemed inhumane. Death by firing squad was used for years but is now said to be to bloody and unpredictable (Gawande 1222). “If doctors and nurses are removed, I don’t think [lethal injections] could be competently or predictably done” (Gawande 1226). The unpredictability of the firing squad was one of the reasons it is now considered inhume. As stated in the quote, lethal injection is just as unpredictable as a firing squad when a physician is not present. The outcome for each execution is different without a strict procedure to follow. The continued legal use of lethal injection depends on the participation of a physician. The only thing keeping lethal injection under the Eighth Amendment is the participation of physicians. “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” (Curfman). A main problem with lethal injection is the delivery of drugs, the drugs get clogged in the tubes because administer does not have the knowledge needed to be carrying out the execution. Knowing there is a more guaranteed way to smoothly and painlessly carry out the execution is what is making lethal injection questioned as constitutional (Waisel 1075). In the clip, Physicians and Execution — Highlights from a Discussion of Lethal Injection, Gawande interviews two doctors and a lawyer. The doctors go through strenuous amounts of schooling to be able to administer drugs, most not even as extreme as the ones used in lethal injection. They believe the people administering the drugs are not equipped, allowing for unexpected situations. The lawyer, Deborah Denno, states that the state has turned to medicine to save the death penalty. The government needs physicians to be involved in order to keep the situation humane, and have a chance to keep the death penalty legal. 

There is a strong argument on opposing the use of physicians in executions. “Physicians are healers, not executioners” (Gawande 1221). The American Medical Association is speaking out against the helping hand of physicians in lethal injection (Gawande 1221). The idea behind being a physician has never been to end someone’s life. Many of the medical groups such as, American Nurses Association (ANA), Society of Correlation Physicians, and American Medical Association (AMA), have acquired strict bans on physician involvement. Society of Correlation Physicians states that physicians cannot be involved in any way in an execution (Gawande 1223). Such organizations are worried that states requiring physician assistance in the same way are requiring physicians to violate some of their ethical obligations (Levy 270). One physician who had previously participated in an execution later discovered the AMA’s feeling towards physician participation and said, “Had he known of the AMA’s position, though, ‘I never would have gotten involved’” (Gawande 1225). Physicians respect their medical societies. Medical regulations make physicians participating in an execution unethical and can result in the revocation of their medical license. To make the situation easier for physicians some states, such as, Illinois and Kentucky, have decided to forbid the presence of a physician at an execution (Levy 267-268).  “Despite the fact that the majority of these laws utilize medicine to ensure the constitutionality of capital punishment, the official medical community is directly opposed to physician involvement” (Levy 267). The medical world acknowledges the use of medicine in lethal injection, but the need for their assistance cannot override the medical ethics they are bound to. The American Board of Anesthesiologists believes “we are healers, not executioners” (Stein). There is no way around this argument, they are supposed to be bound to their code of ethics. States have provided legal immunity to protect physicians who have patriated in executions. Several physicians have faced the challenge of losing their license, but none have fully lost their license yet. A loss of license would prevent the medical personal from working in most hospitals, along with other punishments (Stein). Some states require the assistance of physicians, which is a huge issue with the AMA, this mean physician are going to have to break medical code. The physicians do have the right to refuse to participate, so the ones involved are doing so willingly. When physicians do agree, they want their identity to be kept and most will deny interviews. They feel uncomfortable to talk about what they did (Gawande 1223). They know participating in an execution can ruin their reputation.

When considering the chance for error, the Eighth Amendment, and still taking into consideration the opposing views of the medical ethics codes, we can see that physicians make a huge difference in the way the executions are carried out. This is important because without a physician’s help executions would be deemed unethical by the government. There is a continuous struggle between government and medical ethics when discussing the necessity of physicians help in lethal injection. The government needs executions to stay within the Eighth Amendment, and physicians need to try and stay with their medical code. Physicians bring a sense of knowledge and control to the situation. Without the help of a physician when a complication occurs there is no one there to reverse or reset the situation. The inmate is to lie in agony until he or she slowly passes. A physician would have the execution under control and would have already accounted for mishaps. They have procedures they follow for all their other patients. They know all possible outcomes and are prepared for almost anything. Physicians take pride in their work and would have guidelines to follows for executions as well.  The humanness of lethal injection depends on the assistance of a physician. All precautions must be taken to prevent unnecessary pain. If these precautions are not taken, then execution will not fall under the Eighth Amendment, and the death penalty may become outlawed. The government has turned to medicine to save the death penalty. One way Legislation can get around executions being cruel and unusual punishment is with the help of physicians. Mishandled executions come when no physician is present. The prisoner is more susceptible to pain that could have been prevented with the input a physician. People who are participating in executions that are not physicians are playing the role of an anesthesiologist. Anesthesiologist go through many years of schooling to perfect their trade (Gawande).  The only way to save the death penalty is to allow the assistance of a physician. 
