Why should society allow the death penalty?

Doctors and the death penalty: secret helpers, courageous objectors

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Doctors have often been involved in developing supposedly more humane execution techniques. Since prisoners were "lethal injection", the death penalty has taken on a new medical dimension.


It should be quick, painless and humane. But the ritual begins days before the actual execution. The prisoner is transferred to death row. He is monitored around the clock to ensure that he does not end his life himself. On the eve of the execution, he received the executioner's meal and received the last visit from his family. The day of death is regulated almost to the minute. 45 minutes before the execution, the prisoner receives his execution clothes: the men blue jeans and a blue shirt, the women bra, underpants and dress. At least that is what the guidelines for lethal injection executions at San Quentin Prison in the US state of California provide. It also says there: Under the supervision of one of the two doctors present, the EKG electrodes are placed on the prisoner. He is led into the execution room and strapped to a chair. The electrodes are connected to the monitor, the doctor checks the function. A "qualified person" places the cannula. The infusion of a saline solution is started. A second infusion will be given in another part of the body in case the first is blocked. Then the "injection team" leaves the room. About ten minutes before the execution, the rest of the prison staff also leave, and the door is locked and sealed. The witnesses of the execution are only allowed to enter the auditorium if the saline infusions are running without problems. The execution begins on the orders of the prison chief. The barbiturate thiopental, the muscle relaxant pancuronium bromide and finally potassium chloride are injected one after the other. Only when the doctor declares the convicted dead is the injection of the deadly substances stopped.
"This execution ritual is cruel," says Dr. Kim Thornburn. The internist and staunch opponent of the death penalty worked as a prison doctor in San Quentin for eight years, until 1987. The argument that the "lethal injection" is a more humane method of execution does not accept them: "What is humane about killing? As doctors, we should not allow our medical methods to be used to kill." She herself started her service in San Quentin only on the condition that she did not have to attend executions. The fact that, as a doctor in the civil service, she also spoke out publicly against the death penalty is bad for her. A written warning and an entry in the personnel file were the result. In addition, it was passed over for years for upcoming promotions.
It is not only the San Quentin guidelines that attribute a role to doctors in the execution of prisoners. Of the 33 US states that use "lethal injection" either as the only or as an alternative method of execution, more than half stipulate that a doctor must be present at the execution. The American Medical Association (AMA) has spoken out strongly against medical participation in executions. The only conceivable role of the doctor is to confirm death. The doctor betrays his trust in society when he actively participates in the execution of death sentences. However, the association did not take a position on the death penalty per se. Various other US medical associations have joined the AMA position. The World Medical Association also condemns the participation of doctors in executions. The case of Dr. However, Kim Thornburn shows the conflicts that can arise when state legislation and medical ethical standards collide. "If your employer is the state, you are expected to do what the state tells you to do," Thornburn says. Again and again she hears from doctors who take the view: "Executions are legitimized by the state, so it is my duty to participate in them." Although Thornburn says there is great opposition to the participation of doctors in executions within the organized medical profession and especially among prison doctors, there is always someone from the prison administration who says: "I know someone who does it." If the prison doctors are not ready to take part in executions, they hire doctors from outside the system.
In 1982, Charles Brooks became the first nationwide prisoner to be "lethal injection" in Huntsville, Texas. Amnesty International reports that one of the doctors present monitored Brooks' vital functions during the execution and instructed the executioner - now known as the execution technician - to continue the infusion of the deadly substances for "a few more minutes." When Charles Walker died from "lethal injection" in 1990 as the first prisoner in Illinois, three doctors were involved in the execution: they gave Walker the medication before the execution, opened the venous line, and monitored his EKG in an adjacent room. This direct involvement in an execution sparked a storm of protest from leading medical professional organizations. Since then, the state of Illinois has protected its willing medical assistants from sanctions by guaranteeing them anonymity by law and paying them in cash if necessary.
"If it is not the doctors who take part in such executions, it is in any case semi-skilled personnel who have been given the appropriate medical knowledge," says former prison doctor Thornburn. Almost always, however, a doctor is on hand in the background in case something goes wrong during the execution. And that seems to be the case relatively often. The US Death Penalty Information Center documented more than 20 "problematic cases" between 1982 and 1997, cases in which it took up to 45 minutes for the "injection team" to find a suitable vein in which to perform a venous section had to be or the death row inmate suffered attacks of suffocation. However, according to Amnesty International, lethal injection has now become the most widely used method of execution in the United States. So far, more than 270 people have been killed in this way.
The development of the "lethal injection" is only one attempt in a historically long series to make executions "more humane". At the end of the last century, several "botched" hangings had attracted the public in the United States. New York State then set up a commission to recommend a more humane form of the death penalty. The panel included the dentist A. P. Southwick. In January 1888 the final report was available: The commission could not recommend death by hanging or the guillotine. Because the resistance of the medical profession became apparent, the injection of a lethal dose of cyanide was also discarded. The electric chair was ultimately the method of choice. Thomas Edison himself had affirmed that death from electricity is immediate. The first prisoner to be executed in this way was William Kemmler in 1890. In addition, Dr. Southwick: "We are living in a higher civilization from now on." There were always gruesome incidents when using the electric chair.
The discussion about lethal injection did not flare up again until the 1970s. After an unofficial moratorium, the US Supreme Court ruled in 1972 that the death penalty was unconstitutional because it was a cruel and unusual punishment. But as early as 1976 the court reversed its decision. With new death sentences being enforced and concerns about the constitutionality of the death penalty, Oklahoma Senator Bill Dawson asked the Director of the University of Oklahoma Anesthesia Department, Dr. Stanley Deutsch to make recommendations for an execution by injection of medication. The doctor's expertise was incorporated into the law with which the state legalized "lethal injection" as a method of execution in 1977.
In addition to the USA, China, Taiwan, Guatemala and the Philippines use this method. In China and Taiwan in particular, there is a danger that the doctor and the executioner will enter into an unholy alliance. There, the organs of executed people are used for transplantation. Lethal injection offers the "advantage" here that it does not injure any important organs. With a view to transplants, hospital doctors in Taiwan had already advocated shooting those sentenced to death not in the heart but in the head as early as 1989.
Amnesty International reports cases where Chinese courts have notified hospitals of upcoming executions and the convicts' medical records. Against this background, the organization fears that executions and their timing could be made dependent on the need for donor organs. The use of organs from executed organs for transplants does not seem to be a problem for at least some Chinese and Taiwanese doctors. They told the British Medical Association that organ donation enables the executed person to show remorse. The donor organs also saved human lives. In contrast, the Chinese Medical Association has denied participating in voluntary or uncontrolled organ donation. Whether voluntary or not, the process always involves the doctors deeper in the execution process. According to Amnesty International, it contradicts internationally recognized medical ethical standards and is a perversion of medicine when doctors use their medical knowledge for executions. Nevertheless, doctors have repeatedly contributed to the refinement of execution techniques: during the French Revolution, the doctor Dr. Joseph Guillotine the guillotine as a "more humane" alternative to the ax. In the 19th and 20th centuries, executioners often asked doctors how long their ropes should be: a rope that was too long often led to beheading, while a rope that was too short led to slow death by strangulation.
However, the participation of doctors in executions is not limited to the execution of the death penalty. It ranges from the medical or psychiatric expert work in the process to the care of the delinquents shortly before the execution. The American Medical Association has studied the ethical dimension of this indirect involvement in depth. The role of the psychiatrist gave her a particular headache. The need for psychiatric care among death row inmates, some of whom wait 15 years or more for their sentences to be carried out, is immense. This is confirmed by former prison doctor Kim Thornburn. When asked whether those condemned to death are also resuscitated after attempting suicide, she answered "yes" without hesitation. It was possible until literally the last minute that the person concerned would be pardoned. For the American Medical Association, the case is less clear. The question is whether the doctor is not helping to restore the ability to be executed in this way and is thus acting unethically. It is similar with the therapy of severe mental disorders, which improves the quality of life of the death row inmate, but brings him a good deal closer to the executioner. Ultimately, the AMA was unable to come up with a clear statement.
There are currently around 3,500 prisoners waiting to be executed in the United States. The executions of the brothers Karl and Walter LaGrand, which were carried out despite international protests, made headlines at the beginning of the year. Karl LaGrand died as a result of the "lethal injection", his brother Walter in the gas chamber. His agony is said to have lasted 18 minutes. While the American Medical Association places opposition or support for the death penalty at the moral discretion of the individual, for Amnesty International and other human rights organizations it means a violation of the most fundamental of all human rights, the right to life.
"There is no execution
the punishment for a particularly serious crime, but for a particularly bad lawyer. "This bitter statement comes from the human rights activist Stephen Bright. For him, the death penalty has nothing to do with justice. Statistics from the Death Penalty Information Center seem to prove him right: Race, social status, gender, and origin play a key role in the imposition of death sentences, and 75 people have been released from death row for innocence in the past 25 years, and there is no scientific evidence that the death penalty is a deterrent .
The doctor and lawyer Gregg
Bloche wrote in the Deutsches Ă„rzteblatt in 1996: "The participation of doctors in the death penalty is one extreme of a broad spectrum of activities that are expected of members of the medical professions in the service of the state and the public State and society to set meaningful limits to medicine. " Heike Korzilius

Doctors and the death penalty: secret helpers, courageous objectors

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