Capital punishment in the United States is socially highly controversial, especially in two areas: participation of healthcare providers in the execution, and obtaining the drugs used in it.

Between 1976 — when the death penalty was reinstated — and 2015, 1,418 people were executed.

Thiopental has been the drug of choice in executions for three decades, but in 2009, its production was halted in the United States, with the result that it had to be acquired abroad.

For this reason, many states began to use phenobarbital. However, the Danish company that manufacture this drug has refused to distribute it if it is used for executions, so the State has had to resort to using other drugs, such as midazolam. Nonetheless, the problem continues.

Another difficulty in carrying out executions is the increasing reticence of healthcare providers to participate in them, an attitude reaffirmed by the Code of Ethics of the American Medical Association, which states that “A physician, as a member of a profession dedicated to preserving life when there is hope of doing so, should not be a participant in a legally authorized execution” (see HERE).

Non-physician healthcare providers are also reluctant to take part in the executions.

However, anaesthesiologist David Waisel says that it is honourable for physicians to minimise the pain of those condemned to death, so medical associations should allow doctors to participate in legally authorised executions.

JA Dodds ends the aforementioned article by stating that the participation of healthcare providers in the execution of prisoners violates the ethical principles of beneficence and autonomy, regardless of whether the healthcare provider is a physician or another healthcare professional.

As we can see, healthcare providers participation in executions remains an unresolved ethical issue.


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