Correspondence

Physicians and Execution

N Engl J Med 2008; 358:2182-2183May 15, 2008

Article

To the Editor:

In their editorial about physicians and executions, Curfman et al. (Jan. 24 issue)1 are correct that our profession has no place in the process of legal execution in this country. I would point out that growing public sentiment against executions has also been fueled by the introduction of DNA evidence into criminal trials and the subsequent realization that we are sometimes executing innocent people as well as the criminally guilty. Those of us in the medical profession have a long, inglorious history of contributing to the death of our fellow human beings through errors of omission and commission. Certainly, physicians, who should adhere to the dictum, “first, do no harm,” should reject participation in legal or any other type of execution.

Lawrence S. Bizer, M.D.
Albert Einstein College of Medicine, Bronx, NY 10461

1 References

1. 1

   Curfman GD, Morrissey S, Drazen JM. Physicians and execution. N Engl J Med 2008;358:403-404
   Full Text | Web of Science | Medline

To the Editor:

Curfman et al. state that as healers of the sick, physicians should not be involved in capital punishment and should remember the Hippocratic Oath. But a physician's job is not only to heal the sick — it is also to relieve suffering. When a patient is acknowledged to be terminally ill, the physician's role changes from an emphasis on cure to an emphasis on alleviation of the patient's pain and discomfort. A person whose life society has decided to terminate for the general good can likewise be regarded as terminally ill. Rather than end the person's life in a painful manner, it would be in line with a physician's role to offer advice on minimizing pain.

The original Hippocratic Oath also spoke out against facilitating any abortion, a dictum that our society no longer wholly observes. As long as society deems capital punishment a directive that is for the greater good, there should be no problem with a physician voluntarily offering to play a role in devising a more humane end.

Mark Weinblatt, M.D.
Winthrop University Hospital, Mineola, NY 11501
mweinbl@yahoo.com

To the Editor:

I am very pleased and encouraged to read the recommendation that physicians should not participate in executions. This is a moral stance with many positive implications, including avoiding a dual-loyalty conflict. Dual-loyalty conflict is a significant struggle in routine daily practice when the obligation to the patient is being balanced against loyalty to a third party, such as an insurer or employer. This conflict is all the greater when a physician enters a professional relationship with a person who is to be executed. Participation in executions, with its obvious harms, violates that obligation. By refraining from participation in executions, physicians also avoid a loyalty conflict with the state, which is paying for the physician's services. Thank you for this article and the discussions it will stimulate.

Robert M. Parke, M.H.Sc.
Humber River Regional Hospital, Toronto, ON M3N 1N1, Canada
bparke@hrrh.on.ca

To the Editor:

The Journal's editors add their voices to the chorus opposing physician involvement in the lethal injection of condemned criminals, arguing not that society should reject the execution of even abhorrent criminals but only that a “profession dedicated to healing the sick” should not be involved. They would exclude doctors from even voluntary assistance with a legal state function. To buttress their position, they ask us to “remember the Hippocratic Oath and refuse to participate.” Just which part of the oath do they wish us to remember? Swearing by Apollo and Asclepius, Hygeia and Panacea? Refusing to induce abortion in any woman? Refusing to “use the knife”? Or only the command never to give “a deadly drug” to anybody? Let us doctors put our cards on the table: either execution is a bad thing for society in general, and we, as health professionals and members of society, should stand wholly in opposition to it, or it is not bad, and doctors should be encouraged to use their expertise to reduce the suffering associated with what remains a legal action.

Francis A. Neelon, M.D.
3543 Rose of Sharon Rd., Durham, NC 27712
drneelon@ricediet.com