Jeffrey A. Singer
A doctor who intentionally performs cruel and medically unjustifiable procedures that cause pain and suffering could face criminal charges. If the patient dies, the doctor could face homicide charges. Apparently, those rules don’t apply to law enforcement.
On February 11, the Arizona Supreme Court approved a death warrant permitting the Arizona Department of Corrections to perform the state’s first execution by lethal injection since 2022. That year, Governor Katie Hobbs suspended executions pending an independent review of the process after several botched lethal injection attempts inflicted unnecessary and avoidable pain and suffering on the prisoners.
Last December, Governor Hobbs terminated the review and cleared the way for executions to resume. The governor claimed she lost confidence that the independent reviewer, retired US Magistrate Judge David Duncan, “will accomplish the purpose and goals of the Executive Order” she issued.
In a local television news interview, Duncan responded, “Maybe I was telling people what they didn’t want to hear. I mean, one of the things the governor said in her letter is that she was satisfied with the investigation that Dr. Thornell had conducted internally with respect to the ability to proceed with an injection. The problem with that is that’s an internal investigation. It’s exactly the opposite of an independent review.”
Virtually every health professional organization officially considers it unethical to participate in executions. For example, the American Medical Association Code of Ethics states:
Debate over capital punishment has occurred for centuries and remains a volatile social, political, and legal issue. An individual’s opinion on capital punishment is the personal moral decision of the individual. However, as a member of a profession dedicated to preserving life when there is hope of doing so, a physician must not participate in a legally authorized execution.
Even the American College of Correctional Physicians considers it unethical to participate in an execution:
Physicians who work with incarcerated people are likely to be called upon to participate in executions in some fashion. The incarcerated are clearly and directly our patients and our work is to care for their medical needs. ACCP members and all correctional medical providers have the strongest ethical imperative not to participate in executions in any way, including the direct or indirect supervision of other members of the health care team.
The American Pharmacy Association ethically precludes pharmacists from providing the drugs to perform lethal injection:
The American Pharmacists Association discourages pharmacist participation in executions on the basis that such activities are fundamentally contrary to the role of pharmacists as providers of healthcare.
Pharmacists are health care providers and pharmacist participation in executions conflicts with the profession’s role on the patient health care team. This new policy aligns APhA with the execution policies of other major health care associations including the American Medical Association, the American Nurses Association and the American Board of Anesthesiology.
So too does the association that represents compounding pharmacies.
Even if pharmacists were not ethically conflicted, the pharmaceutical industry would tie their hands. Over sixty pharmaceutical companies and distributors have made public statements against the “diversion of medicines to death row for use in capital punishment.” In some cases, they have successfully sued states for engaging in “subterfuge” and “clandestine” means to obtain their drugs.
So what are state correctional facilities to do? In many cases, they have resorted to obtaining drugs for lethal injection from underground sources. Investigative journalists exposed Idaho officials purchasing chemicals for cash in a parking lot. In 2015, the Food and Drug Administration halted Arizona and Texas from illegally purchasing drugs for lethal injection from overseas sources.
And because professional ethics precludes health care professionals from participating in executions, many corrections facilities use lab technicians, prison staff, or volunteers—many with no medical training—to insert intravenous catheters and perform the executions. A report in 2022 found one-third of all executions that year were botched. Most states, including Arizona, have laws that keep the executioner’s identity confidential.
Many executioners are using pentobarbital, a drug that the US Department of Justice recently rescinded from its federal prosecution protocol over concerns that it may cause “unnecessary pain and suffering.”
To avoid criticism, many states, including Arizona, have enacted secrecy laws, preventing the public from knowing the details of how they carry out their executions.
I have written about cops practicing medicine by dictating how doctors treat pain. While the cops may not be the ones who treat the pain, they call the shots. But with executions, their role escalates—they aren’t just dictating the procedure; they’re administering the shots. On March 19, they plan to execute Aaron Brian Gunches in Arizona.
Doctors who violate medical ethics face prosecution—when the state does it, they call it justice.