Capital punishment was not always on the list of activities proscribed by the medical profession. It was a doctor, Joseph-Ignace Guillotin, who proposed a technologically advanced method during the French Revolution in the belief that it was more humane than hanging or the axe.

And despite the adamant opposition of the American Medical Association to participation in capital punishment, surprisingly, there are still doctors who feel that it is more altruistic to take part than abstain, especially when lethal injections are involved. Of 900 executions since 1977, 40 have been botched by incompetent staff. Last year the governor of Florida declared a moratorium on executions after a particularly gruesome death.

The most recent sighting of dissension is in the latest issue of the Mayo Clinic Proceedings. David Waisel, an anaesthetist at Boston Children’s Hospital and Harvard Medical School, argues acerbically that "the current AMA policy increases the chances of a botched execution". Absolute abstention, he contends, is nearly impossible, anyway, because physicians would have to train non-physicians to do the job.

Dr Waisel’s opponents worry that participation could debase the medical profession, erode its ethic of compassion and make it easier for doctors to collude in government-sponsored killing. But he maintains that even though his death is involuntary and not in his best interest, a condemned prisoner should be spared unnecessary suffering. In any case, in Oregon and in the Netherlands doctors already participate in killing patients.

There may be more sympathy for Dr Waisel’s forthright views amongst his colleagues than one might think. If the AMA were to reverse its stand, a 2001 survey indicated that about one doctor in five would be willing to participate.

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Michael Cook

Michael Cook edits BioEdge, a bioethics newsletter, and MercatorNet, an on-line magazine whose focus is human dignity. He writes from Sydney, Australia.

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