Capital punishment ia a subject with major ethical undertones, widely debated in the United States, is to determine whether or not a physician or experienced medical personnel should be present at executions by lethal injection of persons condemned to capital punishment. This issue was discussed in a recent article published in JAMA (311; 2375-2376, 2014).

The article reported that a group of eminent legal professionals, known as the “Death Penalty Committee of the Constitution Project”, has published an extensive document with 39 recommendations that tackle many of the issues that arise in executions by lethal injection. The latter recommendations refer to the need (or not) to have a physician or qualified medical personnel supervise executions by lethal injection.

However, this recommendation runs contrary to the Ethical code of the North American Medical Association, which specifically prohibits doctors from being present at executions. This opinion is similar to that of many other medical and nursing associations. According to the study authors, no code of ethics in any country in the world approves participation by medical professionals in executions.

Others, however, believe that the participation of medical professionals in the execution is not contrary to medical ethics, and may even be obligatory.

In general, the authors consider that an execution is deciding about someone else’s life, an action that can never be considered as one of the aims of medical practice. Regardless of whether an execution is legally justified, it must never be considered as a medical procedure.

Be that as it may, the abovementioned document, “Constitution Project “, states that, although doctors cannot be forced to violate their ethical principles, medical staff should be present at executions, to take charge of all medically-related aspects of the procedure.

In summary, although some jurisdictions recommend the presence of a doctor at executions by lethal injection, physicians cannot be forced to do so, as this may run contrary to their professional and medical ethics.

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