Doctors, the death penalty, and lethal injections: recent developments

Physicians should treat mentally ill death row inmates, even if treatment is refused

Competency to be executed evaluations are conducted with a clear understanding that no physician-patient relationship exists. Treatment however, is not so neatly re-categorized in large measure because it involves the physician's active provision of the healing arts. A natural tension exists between what practices may be legally permissible and what are ethically acceptable. We present an overview of the existing positions on this matter in the process of framing our argument.

The possible pain experienced during execution by different methods

The physiology and pathology of different methods of capital punishment are described. Information about this physiology and pathology can be derived from observations on the condemned persons, postmortem examinations, physiological studies on animals undergoing similar procedures, and the literature on emergency medicine. It is difficult to know how much pain the person being executed feels or for how long, because many of the signs of pain are obscured by the procedure or by physical restraints, but one can identify those steps which are likely to be painful. The general view has been that most of the methods used are virtually painless, and lead to rapid dignified death. Evidence is presented which shows that, with the possible exception of intravenous injection, this view is almost certainly wrong.

Why philosophers should offer ethics consultations

Considerable debate has occurred about the proper role of philosophers when offering ethics consultations. Some argue that only physicians or clinical experienced personnel should offer ethics consultations in the clinical setting. Others argue still further that philosophers are ill-equipped to offer such advice, since to do so rests on no social warrant, and violates the abstract and neutral nature of the discipline itself. I argue that philosophers not only can offer such consultations but ought to. To be a bystander when one's discipline does offer insights and methods of value discernment is pusillanimous. But this position requires a view of clinical medical ethics as one that arises out of the clinical practice of medicine, and not just from an application of general ethical principles to the practice of medicine. I conclude with some skills that trained philosophers can bring to the consultation service, and note that all consultations are in the form of recommendations that the patient, family, and physician are still free to accept or reject. Philosophers in the clinical setting do not make decisions.