US executions: fight, fudge, or fold?

Our ethical obligations to patients are sometimes overridden by the state, but as a profession we’re generally OK with this. Good medical practice doesn’t expect us to protect the confession of a murderer, or disobey the direction of a judge. But what would we do if the state required something of our profession that overrode our ethical judgement? Would we fight, fudge, or fold? ‘Returning violence for violence multiplies violence, adding deeper darkness to a night already devoid of stars. Darkness cannot drive out darkness: only light can do that..’(Martin Luther King Jr, 1963)

The US is the only G7 country that executes convicted criminals. There are 31 states that execute, and most require the participation of a licensed physician,¹ with doctors variably required to cannulate, titrate drugs, and judge effective progress, unconsciousness, and death.

American Medical Association (AMA) guidelines ban physician participation in execution but the AMA does not license doctors.² Doctors theoretically face being struck off by state medical boards for participating, but none has been. In …