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Should Doctors Participate In Executions?


This is WEEKEND EDITION from NPR News. I'm Rachel Martin. The execution of a death row inmate in Oklahoma this past week has reignited the debate over the use of lethal injection in this country. According to reporters at the scene, Clayton Lockett writhed in pain after receiving the lethal combination of drugs. He had a heart attack 43 minutes later, and died. On Friday, President Obama called the execution, quote, "deeply troubling," and ordered the Department of Justice to review how the death penalty is applied across the country.

The Oklahoma execution has also raised a lot of questions about what kind of medical oversight happens in state executions. Is a medical professional always there to monitor how the inmate responds to the drugs? To talk more about this, we spoke with Ty Alper, a clinical professor of law at the University of California, Berkeley, who has represented death row inmates. And we asked him if participating in an execution, as some have argued, is a violation of medical ethics.

TY ALPER: Well, most medical associations - the American Medical Association and state-based medical associations - have ethical guidelines that prohibit the participation of doctors in executions. But it's important to keep in mind that those are just the guidelines of those medical associations. And the majority of doctors are not members of those associations. So the guidelines don't have any enforcement teeth.

MARTIN: Some in the medical community say that doctors who participate in state executions should actually lose their licenses. This past week, a man named Sidney Wolfe, a physician and consumer advocate, said, quote, "it's reprehensible when a physician deliberately participates in any way in the intentional killing of another human being by involvement in an execution." You, yourself, oppose the death penalty. Do you agree with him?

ALPER: I don't agree with him. I think - I am opposed to the death penalty, and I don't think that we should be executing people. But if we are, and particularly if we're going to do it by way of procedures that are shrouded in secrecy, that use experimental combinations of drugs that have never been used before, then we need to have competent medical personnel involved.

And I think that courts should require that qualified, competent medical personnel participate. That doesn't mean that any particular doctor should be forced to participate in an execution. But if a person is going to be executed, there should be qualified people on hand.

MARTIN: So at this point, that is not a mandate for every state. It's up to each state to decide whether or not they have some kind of medical oversight?

ALPER: That's correct. For the most part, courts have shied away from doing that, in part because states have successfully argued to courts that it's impossible to find doctors who are willing to do it. In fact, we know that doctors participate in all sorts of ways for a variety of reasons.

MARTIN: What are some of those reasons?

ALPER: I've never spoken with a doctor who has participated in an execution, but there have been interviews. And for the most part, the doctors who were willing to discuss it say that they view it, in a way, as similar to terminal illness. And they can relieve suffering, and that they feel that it's their duty to relieve suffering. I don't know if that's the case for all doctors who participate, so I think it runs the gamut why doctors participate. But they certainly do, in many cases.

MARTIN: A doctor was on hand during the execution of Clayton Lockett in Oklahoma. But his role in the events remains unclear, at this point. Do you think this is a case - from what you know - where a physician could have helped the situation?

ALPER: In the case of what happened in Oklahoma Tuesday night, we just don't know enough about what happened because everything about that execution was shrouded in secrecy. And it will take a truly independent review to determine what happened.

MARTIN: You talk a lot about the need to make sure that there are qualified medical professionals who are on hand during state executions. What are those qualifications? What does someone need to know in order to be effective in this role?

ALPER: To be simplistic about it, they need to be good doctors. They need to know what they're doing. They need to have the training and experience to perform the...

MARTIN: You think they need to be doctors; they need to be MDs.

ALPER: I don't think they necessarily need to be medical doctors. It depends on what they're doing. In the case of Clayton Lockett, we now know that the phlebotomist, who's not a medical doctor, was unable to find a peripheral IV line. And so the doctor had to come in and set what's called a femoral line, in the groin.

That's a much more difficult procedure, much more sensitive procedure. It's a painful procedure that has to be done, usually, by a qualified medical doctor. Again, we don't know exactly what went wrong in Oklahoma, but it appears that that central line may not have been set properly. So if a doctor is going to be called to do that particular task, he or she needs to be qualified to do it, and trained well to do it.

MARTIN: Ty Alper is a law professor at U.C.-Berkeley. Thanks so much for talking with us.

ALPER: Thank you, Rachel. Transcript provided by NPR, Copyright NPR.

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