To the Editor: In their editorial about physicians and executions,Curfman et al. (Jan. 24 issue)1 are correct that our professionhas no place in the process of legal execution in this country.I would point out that growing public sentiment against executionshas also been fueled by the introduction of DNA evidence intocriminal trials and the subsequent realization that we are sometimesexecuting innocent people as well as the criminally guilty.Those of us in the medical profession have a long, inglorioushistory of contributing to the death of our fellow human beingsthrough errors of omission and commission. Certainly, physicians,who should adhere to the dictum, "first, do no harm," shouldreject participation in legal or any other type of execution.
Lawrence S. Bizer, M.D. Albert Einstein College of Medicine Bronx, NY 10461
References
Curfman GD, Morrissey S, Drazen JM. Physicians and execution. N Engl J Med 2008;358:403-404. [Free Full Text]
To the Editor: Curfman et al. state that as healers of the sick,physicians should not be involved in capital punishment andshould remember the Hippocratic Oath. But a physician's jobis not only to heal the sick — it is also to relieve suffering.When a patient is acknowledged to be terminally ill, the physician'srole changes from an emphasis on cure to an emphasis on alleviationof the patient's pain and discomfort. A person whose life societyhas decided to terminate for the general good can likewise beregarded as terminally ill. Rather than end the person's lifein a painful manner, it would be in line with a physician'srole to offer advice on minimizing pain.
The original Hippocratic Oath also spoke out against facilitatingany abortion, a dictum that our society no longer wholly observes.As long as society deems capital punishment a directive thatis for the greater good, there should be no problem with a physicianvoluntarily offering to play a role in devising a more humaneend.
Mark Weinblatt, M.D. Winthrop University Hospital Mineola, NY 11501 mweinbl{at}yahoo.com
To the Editor: I am very pleased and encouraged to read therecommendation that physicians should not participate in executions.This is a moral stance with many positive implications, includingavoiding a dual-loyalty conflict. Dual-loyalty conflict is asignificant struggle in routine daily practice when the obligationto the patient is being balanced against loyalty to a thirdparty, such as an insurer or employer. This conflict is allthe greater when a physician enters a professional relationshipwith a person who is to be executed. Participation in executions,with its obvious harms, violates that obligation. By refrainingfrom participation in executions, physicians also avoid a loyaltyconflict with the state, which is paying for the physician'sservices. Thank you for this article and the discussions itwill stimulate.
Robert M. Parke, M.H.Sc. Humber River Regional Hospital Toronto, ON M3N 1N1, Canada bparke{at}hrrh.on.ca
To the Editor: The Journal's editors add their voices to thechorus opposing physician involvement in the lethal injectionof condemned criminals, arguing not that society should rejectthe execution of even abhorrent criminals but only that a "professiondedicated to healing the sick" should not be involved. Theywould exclude doctors from even voluntary assistance with alegal state function. To buttress their position, they ask usto "remember the Hippocratic Oath and refuse to participate."Just which part of the oath do they wish us to remember? Swearingby Apollo and Asclepius, Hygeia and Panacea? Refusing to induceabortion in any woman? Refusing to "use the knife"? Or onlythe command never to give "a deadly drug" to anybody? Let usdoctors put our cards on the table: either execution is a badthing for society in general, and we, as health professionalsand members of society, should stand wholly in opposition toit, or it is not bad, and doctors should be encouraged to usetheir expertise to reduce the suffering associated with whatremains a legal action.
Francis A. Neelon, M.D. 3543 Rose of Sharon Rd. Durham, NC 27712 drneelon{at}ricediet.com
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