Friday, March 22, 2013

Hi! I heal--and I kill


It is a dark moment when we conflate the notion of those who heal with those who kill.

In seventeen of the thirty-six states that administer the death penalty through lethal injection, execution of those on death row requires the presence of a doctor by law. In recent years, though, a number of medical groups, such as the American Medical Association, the Society of Correctional Physicians, and the American Board of Anesthesiologists, have censured such practices. The American Board of Anesthesiologists, for instance, began to revoke the license of any practitioner who acts as an accomplice in these executions. One of the primary reasons for this reaction is the fundamental role that doctrines such as the Hippocratic Oath play in the practice of medicine: “do no harm.” Since acting as an accomplice in the administration of fatal doses clearly goes against this tenet, many doctors feel that it violates the integrity of their profession.

The state laws requiring doctors for the management of the lethal injections often cite the importance of having a doctor’s medical knowledge to guard against messy complications in the procedure. However, it has been pointed out that adequately trained technicians would be just as capable of monitoring the process as doctors are. So if it actually is critical to have trained personnel on site, this task can be accomplished by some profession other than that of a doctor.

Why? the other side asks. Whether a doctor or anyone else in complicit in the execution is irrelevant to the final result, so the argument goes. However, in this case, the means are important. The stance just presented presupposes that there is nothing sacred about the concept of a doctor. But imagine asking a child to be participate at the execution. Sure, there are negative effects on the child’s health, so some might dismiss this example by saying that those harmful effects to the child are the reason this example is disturbing. The truth is, though, that even if the child were to suffer no negative effects, we would still be revolted by the prospect. There is something precious about certain stations in life, and, like childhood, the role of a doctor is something that we must guard carefully. A healer should have his function clearly delineated, whether or not a society believes in capital punishment. Thus, this question does not reduce to whether or not capital punishment is acceptable. While that is an important dilemma to pursue, the issue of whether doctors should participate in killings is separate, and also important to consider as a society. The function of a doctor is beautiful, and we should keep it that way.

Sources:
http://www.foxnews.com/opinion/2011/09/22/doctors-and-death-penalty-cases/
http://www.washingtonpost.com/wp-dyn/content/article/2010/05/01/AR2010050103190.html
http://deathpenalty.procon.org/view.answers.php?questionID=1003

2 comments:

Unknown said...

austenm, this is a very interesting argument in which you seem to argue that the very occupation of medicine is one that should have no part in capital punishment, regardless of its moral or legal permissibility. That being said, I find it to be gravely flawed for two reasons.

First, this argument seems to be based upon the assumption that authoritative traditions such as the Hippocratic Oath forbid the participation of doctors and healers in executions because such involvement violates the principle to “do no harm.” Wholly apart from whether or not we should consider the Hippocratic Oath to be binding on physicians today, I do not think that one can maintain that their participation in executions is morally impermissible unless capital punishment is also impermissible as well. After all, when we examine the phrase “do no harm,” we must ask ourselves precisely what kind of harm is in mind. By “harm,” do we mean mere physical pain? Of course, we do not; interpreting harm that broadly would mean that physicians are prohibited from carrying out countless painful but life-saving operations, which is absurd. Does harm refer to mere psychological harm? Again, it seems not, for no one would condemn a doctor who berates a patient for failing to maintain his or her health despite being instructed to do otherwise. It appears that the only reasonable way we can understand harm in the Hippocratic Oath is to refer to “pain inflicted unjustly or unnecessarily” or something very similar. The problem here, though, is that, if capital punishment is indeed permissible, that any pain resulting from an execution would *not* be inflicted unjustly or unnecessarily. Indeed, the standard justification for capital punishment arises from a view of punishment that emphasizes either retribution or deterrence, so such pains could never be unjust or unnecessary! So, physicians’ involvement in executions is wrong only if capital punishment is wrong as well.

Second, I do not think that your justification for the intrinsic sanctity of certain professions succeeds. First of all, I do not think that your comparison between the child and the doctor helps. Whereas childhood is a stage of one’s life, the medical profession is an occupation held by adults. So, even if the example of the child works, it does not establish what you want it to; at best, it only shows that certain periods of our lives have a unique value that should be protected. Moving to your example of the child, though, I must confess that it is not at all obvious that allowing a child to see an execution (again, assuming that executions are permissible) would be wrong if it could be known with certainty that the child would suffer no negative effects, either physical or psychological. To illustrate, it does not seem to be wrong to allow an intellectually precocious and mature child allow an execution since that child would be capable of understanding the nature of the punishment and mature enough not to suffer any adverse consequences from the experience.

Hence, I am not convinced that your argument works in the final analysis. If one wishes to defend the decisions taken by the American Medical Association and other major medical groups, one must call into question the moral legitimacy of capital punishment itself.

Unknown said...

The Hippocratic Oath is without a doubt an unquestioned and revered statement of the medical vocation. While few physicians question the authority and justice of the Hippocratic Oath, numerous disagreements arise with regard to interpretation. The modern version of this vow written by Louis Lasagna in 1964 does not contain the words “do no harm.” Though translations of the original version sometimes contain phrases similar phrases, many sections of the ancient version have been omitted because they have become obsolete. Furthermore, few medical cases have definitive solutions. Thus physicians must interpret the Hippocratic Oath on a case by case basis. It could even be argued at times that killing someone is beneficial to that individual or to society.

Regardless, at first glance it is understandable that medical personnel object to the ethics of a physician being present at an execution. But is there really that much of a difference between a doctor being in the room when an inmate dies and being in at home or in a hospital a couple miles away? Of course, no one would want a child to witness an execution even if it did not prove to be a traumatic experience. But the doctors who would be present are accustomed to death and are aware that lethal injections happen whether they are witnesses or not. It also seems unreasonable to claim that having a physician present “violates the integrity of the profession” because by the same logic assisting in an execution would violate the integrity of any person whose job does not normally entail such a task. Thus having a nurse or medical technician present would be equally unappealing. Are the ultimate functions of these professions less “beautiful” than ad doctor’s?

I should say that I fundamentally believe the death penalty should be banned. However, as long as it does exist, I think it is important that a fully qualified doctor be present. Having a physician in the room may provide some reassurance to the prisoner being executed. Doctors are present to ensure that the prisoner’s death is quick, painless, and as humane as possible. There are many historical incidents of mistakes being made in the administration of lethal injections. Such horrific episodes can lead to pain, outbursts, or even failure to die.

Ultimately, while it may be “[. . .] a dark moment when we conflate the notion of those who heal with those who kill,” I believe it is a dark moment anytime we kill without necessity.

http://guides.library.jhu.edu/content.php?pid=23699&sid=190964
http://classics.mit.edu/Hippocrates/hippooath.html