Wednesday, August 29, 2007

Examining doctors' role in executions

Their identities are protected from inmates' families - and fellow physicians.

By Ron Word
Associated Press

JACKSONVILLE, Fla. - At all Florida lethal injections, a man in a purple moon suit leans over the dying inmate to listen for a heartbeat and feel for a pulse. After a few seconds, he nods, and the witnesses are informed that the death sentence has been duly carried out.
The man is a doctor and the gear shields his identity - not just from the prisoner's family and friends, but from the American Medical Association, whose code of ethics bars members from participating in executions.

Most states take steps to shield the identities of physicians taking part in executions. Some draw curtains or remove the witnesses before the doctor emerges.

But death-penalty experts say Florida is the only state that uses clothing more commonly associated with highly infectious diseases to preserve the doctor's anonymity.

The practice, employed for about a year, reflects the strong passions surrounding the role of physicians in executions, and the conflicting pressures increasingly felt by prison officials nationwide.

On the one hand, prison systems are facing demands from judges that they make sure executions by injection do not cause undue pain. On the other, states are having difficulty recruiting doctors to oversee them because of the profession's objections.

Some of those issues are likely to play out at a hearing in state court this week on a Florida Corrections Department plan aimed at avoiding a botched execution.

A judge last month ordered the state to update its lethal-injection protocol in light of the case of Angel Diaz last December. Diaz, who killed a Miami topless-bar manager during a 1979 robbery, took 34 minutes to die - more than double the normal time - and needed an extra dose of drugs because the executioners mistakenly pushed the needles clear through his veins and into his flesh.

The state is proposing to add doctors, nurses, phlebotomists (people trained to draw blood), and other medical professionals to its lethal-injection teams - something that is done in some states.

Under Florida's proposal, the doctors could be used to insert intravenous lines and keep them flowing. A physician or pharmacist would be responsible for buying and mixing the lethal chemicals.

Department officials told the Associated Press, however, that while the plan allowed greater participation, doctors would still be used only to pronounce death.

The whole idea is offensive to the AMA.

"We are a profession dedicated to healing," said Mark Levine, chairman of the Council of Ethical and Judicial Affairs. "Participation in an execution is an image of a physician with a dark hood."

Levine said doctors participating in executions must decide if they are "an instrument of the state or a member of a profession dedicated to preserving and protecting life. You can't be both."

Medical groups can revoke membership for ethics violations, but they have no licensing authority in Florida or anywhere else. And the AMA is simply a professional association, albeit one with a high profile; membership is not required to practice medicine.

But because of those objections, doctors at Florida executions wear plastic suits, similar to those used by hazardous-materials teams, that cover them from head to toe. Goggles worn beneath the clear plastic face shield conceal identity even further.

A middle ground might not be possible.

"It's a fundamental conflict," said Bill Allen, a bioethicist in the University of Florida's College of Medicine.

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