Masked, anonymous anesthesiologists go on strike, object to helping California kill a human being

Courtesy Clark County,
Nevada Prosecutor's website.

There's a Reuters story down below, but first you might want to read this. In 1928, 24 percent of physicians graduating from American medical schools swore to some form of the Hippocratic Oath; today nearly every graduating American physician swears to some form of it.

What a physician swears to in this oath is not subsequently legally binding in his/her practice. It has the status of ritual -- and a higher status only if the individual refuses to violate the oath he/she swore to.

Hippocrates was a Greek physician who lived from 470 to 510 BC.

It's hard to kill human beings legally. The Eighth Amendment to the Bill of Rights forbids Cruel and Unusual Punishment. States and the federal government used to hang and shoot people. (In Utah, the person to be executed could pick his/her preference, hanging or a firing squad.) Around the end of the 19th century, the Electric Chair (nicknamed "Old Sparky" in Florida) was introduced.

In 1924, Nevada introduced execution by cyanide gas -- the Gas Chamber. Like carbon monoxide, cyanide soaks up oxygen in the bloodstream so hemoglobin can't transport oxygen to the tissues -- a chemical suffocation. (AMY! Did I get that right?)

from http://www.richard.clark32.btinternet.co.uk/gascham.html

"The first person to die in Nevada's new gas chamber was Chinese born Gee Jong, on the 8th of February 1924, for the murder of Tom Quong Kee, a member of a rival gang. His lawyers had fought a long battle in the courts to show that gassing was "cruel and unusual punishment" and as such was illegal under the Eight Amendment to the American Constitution. The execution commenced at 9.30 a.m. when Gee Jong was led from a holding cell and secured to the chair within the chamber. He appeared to struggle a little after the gas was pumped in and then lapse into unconsciousness, but as no external stethoscope had been provided, he was left in the chamber for 30 minutes to ensure death."

After the U.S. Supreme Court declared the Death Penalty, as most states provided for it, unconstitutional, state legislatures who wished to keep legally killing human beings re-wrote their laws to pass the court's objections, and many state legislatures convinced themselves that the "uncruel, ununusual" method of execution was the lethal injection. In this State Fantasy, the person would just fall asleep, and suffer neither violence, anxiety nor pain.

Back here I wrote about having a recent medical procedure with a cocktail of anesthetics and analgesics that gave me an episode of total amnesia -- they tell me I was awake and conscious for twenty minutes, but I don't remember a thing about the episode. I suspect states trying to get around the C&U problem lethal injections are being criticized over are asking M.D. anesthesiologists or (non-M.D.) pharmacologists to design a new lethal injection cocktail that works a lot like my experience.

See Hippocratic Oath below, expect trouble.

States with a penchant for killing human beings are also pestered by other objections. They seem like Philosophy Class high school or college essay questions, but they actually come up quite frequently and generate ferocious legal battles.

1. What's the minimum IQ a person must have before you can execute him or her? In other words, if a state can try and convict a retarded person for murder, why can't they execute him/her?

2. What's the minimum age a person must be to be executed? Is that the age at which the crime was committed, or the age the person attains by the date of execution -- because the appeals process often takes a decade or two.

Many states allow their prosecutors the choice of trying children as minors in juvenile court, or as criminal felons in adult court. The traditional legal age of adulthood -- 18 or 21 -- is now very blurred regarding being tried or executed.

3. A court certifies a person was legally sane at the time he/she committed a murder, and sane enough to stand trial. The person is convicted and sentenced to death. While he/she awaits execution (nine years on Death Row might stress you out a little), he/she then goes insane, according to doctors who examine the person.

("Insane" is a legal, not a medical concept, but it's the Legal System that wants to kill you, not the Medical System.)

* Can the state execute an insane person? Why not?

* Can the state execute any person who, because of insanity or retardation, doesn't fully understand what's about to happen to him/her?

* Can the state force an insane person to take anti-insanity medicine to make him/her sane enough to understand what's about to happen, so the state can execute him/her? Why not?

Just for today, Vleeptron will skip the embarrassing problem of all the people on Death Row who are discovered to be (or to have been) innocent of the crime that put them on Death Row. Illinois still has the death penalty, but there's currently a governor-declared state moratorium on actual executions, because it turned out their Death Row was just infested with innocent people. (My guess is most Death Rows are just infested with people who did not commit the crime for which they were sentenced to death.)

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The Hippocratic Oath

I swear by Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods and goddesses, making them my witnesses, that I will fulfil according to my ability and judgment this oath and this covenant:

To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art -- if they desire to learn it -- without fee and covenant; to give a share of precepts and oral instruction and all the other learning to my sons and to the sons of him who has instructed me and to pupils who have signed the covenant and have taken an oath according to the medical law, but no one else.

I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.

I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art.

I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.

Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves.

What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about.

If I fulfil this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot.

Translation from the Greek by Ludwig Edelstein. From "The Hippocratic Oath: Text, Translation, and Interpretation" by Ludwig Edelstein (Johns Hopkins Press, 1943).

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Reuters
Tuesday 21 February 2006

Doctor walk-out
delays execution

by Carolyn Abate

SAN QUENTIN, California (Reuters) -- The execution of a California man was delayed for at least 15 hours early on Tuesday after two court-appointed anesthesiologists walked off the job over ethical concerns.

Michael Morales, whose attorney had recruited former Whitewater prosecutor Kenneth Starr to back his bid for clemency, had been scheduled to die at 12:01 a.m. PST [USA Pacific Coast time] for the rape and murder of a 17-year-old girl in 1981.

The execution could not take place after the doctors refused to be present to give the court-required certification that Morales, 46, was in fact unconscious before the lethal injection was given, thus minimizing the pain.

San Quentin State prison spokesman Lt. Vernell Crittendon said the execution was rescheduled for 7:30 p.m. PST on Tuesday. Without the doctors present, the state will need to alter the chemicals used in the execution.

"While we contemplated a positive role that might enable us to verify a humane execution protocol for Mr. Morales, what is being asked of us now is ethically unacceptable," the doctors said in a statement read by Crittendon.

Defense attorneys had claimed last week that the use of the lethal injection was cruel and unusual punishment, barred by the Constitution.

This prompted a judge to order prison officials to either alter the composition of the lethal chemicals used or make medical experts available to ensure unnecessary pain was not inflicted during the execution.

U.S. District Judge Jeremy Fogel had expressed concern that two of the three chemicals used in California, which should kill within a minute, sometimes took several minutes before stopping the condemned person's heart. The state then agreed to provide an unidentified anesthesiologist to attend the execution.

In a statement last week, Dr. Priscilla Ray, chairwoman of the American Medical Association Council on Ethical and Judicial Affairs, condemned the ruling that required the anesthesiologists present.

"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," she said. "Requiring physicians to be involved in executions violates their oath to protect lives."

Two last-minute appeals to the U.S. Supreme Court for a stay of execution failed late on Monday.

PUBLIC APPEALS

The weeks leading up to Morales' date for execution drew considerable public attention due to allegations of forged documents in a clemency petition filed by the defense team, and a federal judge's ruling that required doctors be on hand to make sure the execution was properly administered.

The scrutiny began when Morales' long-time attorney, David Senior, recruited former Whitewater prosecutor Starr to help in the appeal process. Starr is currently the dean of Pepperdine University Law School.

Even the judge who handed down the death sentence wrote a letter supporting the clemency bid.

Days after they filed a request for clemency with Gov. Arnold Schwarzenegger, San Joaquin County prosecutors accused Starr and Senior of submitting forged documents. The sworn statements of six jurors supporting the clemency bid and another statement from a prosecution witness recanting her testimony were proved to be forgeries by the prosecuting team.

Senior and Starr said they did not conduct the interviews that led to the questionable documents but relied on another attorney. They quickly withdrew the documents but pressed the clemency bid.

Schwarzenegger denied the request on Friday.

Morales is the 14th person to be put to death in California since the death penalty was reinstated in 1978.

© Reuters 2006. All Rights Reserved.

Reuters journalists are subject to the Reuters Editorial Handbook which requires fair presentation and disclosure of relevant interests.