Physicians Should Desist From Aiding in Executions–reply

Abstract

I thank the readers and the authors of these and other letters for their interest in physician participation in capital punishment. I had the opportunity to make the ethical arguments,1Waisel D Physican participation in capital punishment.Mayo Clin Proc. 2007; 82: 1073-1080Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar and rather than reiterate those ideas, I will respond to some of the other issues that have come to the forefront. However, some of the letters misstate my comments, and I encourage readers to look at the published article (for example, I do not suggest that harms to public trust in the past make potential harms associated with physician participation in lethal injection acceptable; I do suggest that because these more widespread previous harms have been weathered, the argument that permitting physician participation in capital punishment will lead to a devastating loss of trust cannot legitimately be made because society has weathered far worse insults to trust). I am taken aback by what appears to be fear of discussing this topic. Forbidding the discussion of an idea is tantamount to acknowledging that the current standard can reign only through fiat. If the previous arguments hold water, then new proposals will not gain favor. But we should fear the circular reasoning that a policy or a code is unchallengeable truth because it has been codified by authorities. Voicing contrary opinions or different interpretations in a public forum because the author believes them to be in the public's best interest is a core value of professionalism, as is the earnest debate that might follow such opinions. In discussing this topic with others, it seems that some use the opposition to physician participation in capital punishment as a stalking horse for abolishing capital punishment. I understand the legal reasons for doing that. But I encourage presumptive leaders to speak with clarity and directness about their goals. Disingenuousness withers trust. Those who find capital punishment to be brutal, barbaric, and unjust should frankly seek elimination of the practice in the United States. Similarly, if physicians wish to consider themselves as leaders in society, then there is something attractive about having physicians do the “dirty work,” especially if practical reasons exist for physician participation. To claim that physicians are too special to do so permits physicians to wash their hands of the process. Being involved requires us to face reality and to fulfill our responsibility as members of society to address the issue (in this case, I imagine that this obligation can be fulfilled by seeking either to improve or to eliminate capital punishment). The vast majority of inmates who receive capital punishment have gotten the short end of the stick their entire lives. Needless suffering during execution is unconscionable for these most vulnerable members of society. I believe it can be concordant with medical ethos to permit physicians to use their administrative, research, and medical skills to minimize the harm of capital punishment to these individuals. Physicians Should Desist From Aiding in ExecutionsMayo Clinic ProceedingsVol. 83Issue 1PreviewTo the Editor: It was with a mixture of revulsion and consternation that I read and reread the commentary by Dr Waisel1 and the accompanying editorial by Drs Lanier and Berge.2 Full-Text PDF