An “Online First” opinion piece from JAMA (free access) carries an argument, from a group of authors headed by Dr. Robert Truog of Harvard, that it is profoundly unethical for physicians to administer lethal injections to carry out capital punishment. Whatever one thinks of capital punishment, write Dr. Truog et. al., for physicians to administer the denoument violates a core ethical principle—that “the involuntary taking of the life of another human being…can never be aligned with the goals of medicine.” (Note that word involuntary.) For the state to commandeer physicians to this task is to usurp the nature, by definition, of a “profession,” which includes that it “defines and enforces its own ethical standards.” Those physicians who surreptitiously participate in executions should be disciplined by denial or revocation of board certification.
I am uneasy with capital punishment, but as a matter of public ethics continue to believe that it is justified in certain, limited circumstances. I do not intend to attempt a defense of that position now. But I agree with the argument of Dr. Truog and his colleagues here. I find that personally noteworthy because I am one who, on this blog, has expressed reservations of his treatment of medical futility and of the rules that should govern organ donation after cardiac death (DCD), as well, risking unprofessionalism by conflating, contra Margaret Mead, the roles of healer and executioner.
Mead’s assertion—found in other posts of mine and not repeated here—is, I think, a sounder ethical basis for asserting that physicians should not participate in execution by lethal injection, nor in calibrating torture in “enhanced interrogation,” or other actions. In those “other actions,” I would include physician aid-in-dying (aka physician-assisted suicide), overzealous steps to facilitate the harvesting of organs for transplantation, or siding, subtly or otherwise, with “society” or “the system and its costs” over against end-of-life treatment, as I argued last November 8 and this past February 6.
So, in the formulation of Truog et.al., that word “involuntary” is risky, the proverbial camel’s nose under the tent, it seems to me.
PS: I am late in posting today rather than yesterday—inexcusable, though I might plead family responsibilities this week. “Forgive me, Joe Kelley, for I have sinned.”