Physician Participation in Executions: Time To Eliminate Anonymity Provisions and Protest the Practice

• Ethics, medical
• Physician role
• Capital punishment
• Attitude to death
• Lethal injection

In this issue, Farber and colleagues (1) have provided dramatic findings that warrant the attention of the profession. In their study, a large minority of physicians reported willingness to be personally involved in executions for capital cases. This image of a white-coated symbol of care working with or as the black-hooded executioner is in striking contrast to established physician ethics, which bar physicians from involvement with executions (2, 3). Farber and colleagues found that the most common rationale for physicians' willingness to participate was a sense of citizen obligation. This perception contrasts with the fact that the law goes out of its way to avoid obligating physician participation (4). It is also notable given decreasing public support for capital punishment as reports continue to emerge of executions of innocent or mentally ill people and of inadequate representation for death penalty defendants (5). Some U.S. political leaders and judges are promoting a moratorium on the death penalty, and a growing number of states are excluding mentally retarded persons (6, 7). Examination of the issue shows that medical involvement mostly serves to advance pro–death penalty political purposes, that traditional ethical positions opposing physician involvement are authentically derived and remain valid, and that physicians should take responsibility for reorienting the apparently confused minority.