February 17, 2006
Statement attributable to:
Priscilla Ray, MD
Chair, AMA Council on Ethical and Judicial Affairs


"The American Medical Association (AMA) is alarmed that Judge Jeremy Fogel has disregarded physicians' ethical obligations when he ordered procedures for physician participation in executions of California inmates by lethal injection.

"The AMA Code of Medical Ethics addresses physician participation in executions involving lethal injection. These ethical obligations are set out in detail in ethical opinion 2.06 authored by the AMA Council on Ethical and Judicial Affairs. In part, it states:

An individual's opinion on capital punishment is the personal moral decision of the individual. A physician, as a member of a profession dedicated to preserving life when there is hope of doing so, should not be a participant in a legally authorized execution. Physician participation in execution is defined generally as actions which would fall into one or more of the following categories:

(1) an action which would directly cause the death of the condemned;
(2) an action which would assist, supervise, or contribute to the ability of another individual to directly cause the death of the condemned;
(3) an action which could automatically cause an execution to be carried out on a condemned prisoner.

Physician participation in an execution includes, but is not limited to, the following actions: prescribing or administering tranquilizers and other psychotropic agents and medications that are part of the execution procedure; monitoring vital signs on site or remotely (including monitoring electrocardiograms); attending or observing an execution as a physician; and rendering of technical advice regarding execution.

In the case where the method of execution is lethal injection, the following actions by the physician would also constitute physician participation in execution: selecting injection sites; starting intravenous lines as a port for a lethal injection device; prescribing, preparing, administering, or supervising injection drugs or their doses or types; inspecting, testing, or maintaining lethal injection devices; and consulting with or supervising lethal injection personnel.

"The use of a physician's clinical skill and judgment for purposes other than promoting an individual's health and welfare undermines a basic ethical foundation of medicine -- first, do no harm. Therefore, requiring physicians to be involved in executions violates their oath to protect lives and erodes public confidence in the medical profession.

"As the voice of American medicine, the AMA urges all physicians to remain dedicated to our ethical obligations which prohibit involvement in capital punishment."

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