Post by MXB on Jun 10, 2006 2:15:53 GMT -5
ETHICS VS. EXECUTION
Local medical professionals agree assisting in death penalty violates code of conduct
By GUY KOVNER tHE PRESS DEMOCRAT
Local doctors and nurses say they must stick to their ethics and stay out of the execution chamber, even if it means crippling California's ability to carry out capital punishment
"We know where our moral compass directs us," said Michael Sexton of Novato, an emergency room physician and president of the 35,000-member California Medical Association.
No laws prevent a medical professional from participating in an execution by lethal injection, but Sexton and Deborah Burger, an Occidental nurse who heads the 65,000-member California Nurses Association, say such action is precluded by their ethical codes of conduct.
"Nurses are required to be patient advocates and do no harm," said Burger, a staff nurse at Kaiser Permanente in Santa Rosa.
The potential role of health care providers in carrying out California death sentences was highlighted in rulings this week by a San Jose federal judge that led to the state's postponing the execution of convicted rapist-murderer Michael Morales and, in effect, putting a moratorium on executions for at least two months.
That role is likely to be revisited when U.S. District Judge Jeremy Fogel takes up Morales' case again in early May, determining whether California's current lethal injection practices violate the Eighth Amendment ban on cruel and unusual punishment.
Patrick Broderick, dean of the Empire College School of Law in Santa Rosa, calls it "the most serious challenge to the death penalty in 30 years."
Sonoma County District Attorney Stephan Passalacqua declined to say whether the death penalty should be upheld. He said he is "awaiting the outcome" of the Morales case, which involves some "novel legal issues."
Sonoma County courts have convicted five of California's 650 condemned inmates. The state has by far the most Death Row inmates in the country.
Fogel put medical professionals in the cross hairs of the highly charged debate over capital punishment by ruling their involvement was needed to uphold Morales' right to be executed without "an undue risk of extreme pain."
Either an anesthesiologist must assure Morales is sufficiently sedated before injection of a paralytic and then a heart-stopping medication, the judge said, or a licensed medical professional must administer a fatal injection of only the sedative, sodium thiopental.
The state Department of Corrections conceded anyone still conscious during injection of the second two drugs would experience "excruciating pain," Fogel said in his Feb. 14 ruling.
In a tense, 24-hour period ending Tuesday night, the state failed to find the medical professionals required by the judge and the execution was postponed.
A spokesman for Attorney General Bill Lockyer said the state no longer is trying to meet Fogel's conditions - there is no imminent execution scheduled - and will focus its efforts on the May hearing in federal court.
California never has involved a medical professional in carrying out an execution, said Nathan Barankin, the spokesman.
Sexton of the medical association and Burger of the nurses union said no health care providers are needed at executions.
"An execution is not a medical procedure," Sexton said. Physician involvement in state-mandated executions would blur the line between lifesaver and life-taker and "threaten the trust the public has in physicians," he said.
The medical association also opposes physician-assisted suicide because it is a doctor's goal to "preserve life as long as possible," he said.
But Michael Gospe, director of medical ethics at Santa Rosa Memorial Hospital, said the ethical bar against taking a life by assisted suicide, euthanasia or capital punishment is not absolute.
Euthanasia is illegal in the United States and most other countries. Assisted suicide is legal in Oregon. Lethal injection is the preferred method in 35 of the 36 states that allow capital punishment.
"This is an individual matter that cannot be legislated," said Gospe, a retired gastroenterologist. "Each and every physician needs to come to his own conscious decision."
He said he personally finds capital punishment "morally intolerable," but there probably are California physicians who would give a lethal injection to a condemned inmate.
Sexton agreed such action is not illegal, and there would be no sanctions brought by the state Medical Board.
Gospe said he was mortified by the provision in Fogel's ruling that stipulated medical professionals involved in an execution could "wear appropriate clothing to protect their anonymity."
"It brings to mind the medieval executioner with the ax and the mask," he said.
Broderick, the law school dean, said Fogel is "highly unlikely" to change his mind about requiring the state to involve medical professionals in executions. In fact, that might be the "best outcome" the state can expect, Broderick said, because Fogel could also rule that lethal injection "in and of itself" is unconstitutional.
"Then, for all intents and purposes, we don't have the death penalty in California anymore," he said.
No matter how Fogel ultimately rules, the matter is likely to end up before the U.S. Supreme Court, legal experts say.
If the courts rule that medical professionals must assist in executions, Sexton said the burden will be on the state to meet that condition.
"It's not up to us to help the state decide how to conduct an execution," he said.
Burger said an untrained person could not administer a lethal injection, and she doesn't think any medical professionals would come forward.
"California might not be able to conduct any more executions," she said
Local medical professionals agree assisting in death penalty violates code of conduct
By GUY KOVNER tHE PRESS DEMOCRAT
Local doctors and nurses say they must stick to their ethics and stay out of the execution chamber, even if it means crippling California's ability to carry out capital punishment
"We know where our moral compass directs us," said Michael Sexton of Novato, an emergency room physician and president of the 35,000-member California Medical Association.
No laws prevent a medical professional from participating in an execution by lethal injection, but Sexton and Deborah Burger, an Occidental nurse who heads the 65,000-member California Nurses Association, say such action is precluded by their ethical codes of conduct.
"Nurses are required to be patient advocates and do no harm," said Burger, a staff nurse at Kaiser Permanente in Santa Rosa.
The potential role of health care providers in carrying out California death sentences was highlighted in rulings this week by a San Jose federal judge that led to the state's postponing the execution of convicted rapist-murderer Michael Morales and, in effect, putting a moratorium on executions for at least two months.
That role is likely to be revisited when U.S. District Judge Jeremy Fogel takes up Morales' case again in early May, determining whether California's current lethal injection practices violate the Eighth Amendment ban on cruel and unusual punishment.
Patrick Broderick, dean of the Empire College School of Law in Santa Rosa, calls it "the most serious challenge to the death penalty in 30 years."
Sonoma County District Attorney Stephan Passalacqua declined to say whether the death penalty should be upheld. He said he is "awaiting the outcome" of the Morales case, which involves some "novel legal issues."
Sonoma County courts have convicted five of California's 650 condemned inmates. The state has by far the most Death Row inmates in the country.
Fogel put medical professionals in the cross hairs of the highly charged debate over capital punishment by ruling their involvement was needed to uphold Morales' right to be executed without "an undue risk of extreme pain."
Either an anesthesiologist must assure Morales is sufficiently sedated before injection of a paralytic and then a heart-stopping medication, the judge said, or a licensed medical professional must administer a fatal injection of only the sedative, sodium thiopental.
The state Department of Corrections conceded anyone still conscious during injection of the second two drugs would experience "excruciating pain," Fogel said in his Feb. 14 ruling.
In a tense, 24-hour period ending Tuesday night, the state failed to find the medical professionals required by the judge and the execution was postponed.
A spokesman for Attorney General Bill Lockyer said the state no longer is trying to meet Fogel's conditions - there is no imminent execution scheduled - and will focus its efforts on the May hearing in federal court.
California never has involved a medical professional in carrying out an execution, said Nathan Barankin, the spokesman.
Sexton of the medical association and Burger of the nurses union said no health care providers are needed at executions.
"An execution is not a medical procedure," Sexton said. Physician involvement in state-mandated executions would blur the line between lifesaver and life-taker and "threaten the trust the public has in physicians," he said.
The medical association also opposes physician-assisted suicide because it is a doctor's goal to "preserve life as long as possible," he said.
But Michael Gospe, director of medical ethics at Santa Rosa Memorial Hospital, said the ethical bar against taking a life by assisted suicide, euthanasia or capital punishment is not absolute.
Euthanasia is illegal in the United States and most other countries. Assisted suicide is legal in Oregon. Lethal injection is the preferred method in 35 of the 36 states that allow capital punishment.
"This is an individual matter that cannot be legislated," said Gospe, a retired gastroenterologist. "Each and every physician needs to come to his own conscious decision."
He said he personally finds capital punishment "morally intolerable," but there probably are California physicians who would give a lethal injection to a condemned inmate.
Sexton agreed such action is not illegal, and there would be no sanctions brought by the state Medical Board.
Gospe said he was mortified by the provision in Fogel's ruling that stipulated medical professionals involved in an execution could "wear appropriate clothing to protect their anonymity."
"It brings to mind the medieval executioner with the ax and the mask," he said.
Broderick, the law school dean, said Fogel is "highly unlikely" to change his mind about requiring the state to involve medical professionals in executions. In fact, that might be the "best outcome" the state can expect, Broderick said, because Fogel could also rule that lethal injection "in and of itself" is unconstitutional.
"Then, for all intents and purposes, we don't have the death penalty in California anymore," he said.
No matter how Fogel ultimately rules, the matter is likely to end up before the U.S. Supreme Court, legal experts say.
If the courts rule that medical professionals must assist in executions, Sexton said the burden will be on the state to meet that condition.
"It's not up to us to help the state decide how to conduct an execution," he said.
Burger said an untrained person could not administer a lethal injection, and she doesn't think any medical professionals would come forward.
"California might not be able to conduct any more executions," she said