By Alessandra Suuberg, Decency LLC
According to data from the Death Penalty Information Center (DPIC), in 2022 more than 2,000 prisoners were awaiting execution on death row in the United States.
As of December 31, 2022, the U.S. was among the countries retaining the death penalty, in contrast with 112 countries that had ended this practice for all crimes.
The following is a brief overview of the roles that medicine and medical professionals play in executions and the lives of individuals on death row.
Methods of Execution
Authorized methods of execution in the United States vary by state. These methods may include the following:
Lethal injection may entail a one-drug execution consisting of an overdose of pentobarbital. Alternatively, in the case of multi-drug executions, a sedative drug is administered, followed by a paralytic drug that stops the prisoner’s breathing, and finally potassium chloride, which stops the prisoner’s heart.
Lethal gas, which has included the use of cyanide gas or nitrogen gas, results in oxygen deprivation.
Electrocution is not the sole method of execution in any state today, according to DPIC.
Mississippi law additionally authorizes the use of a firing squad if nitrogen hypoxia, lethal injection, and electrocution are unavailable or held unconstitutional.
Discussions Surrounding Lethal Injection
Discussions surrounding lethal injection have included considerations of short-acting drugs, limited supply, drug side effects, contamination, and insufficient potency, which may lead to pain and other complications during executions.
In 2019, Jonathan Groner, a professor of surgery at the Ohio State University College of Medicine, opined in news coverage that the lethal injection drug landscape was “very, very unregulated, [and] very untested.”
In 2018, drug manufacturers and distributors had reportedly filed lawsuits “to distance themselves from capital punishment.” Companies had also reportedly placed limits on purchases of drugs for lethal injections, asked states to return some products, and stopped making a drug to avoid its use in executions.
Participation of Medical Professionals in Executions
According to James K. Boehnlein, MD, writing for the AMA Journal of Ethics in 2013, “[p]hysician participation is central to execution by lethal injection because medical knowledge and skills are integral to conducting the procedure effectively.”
Boehnlein provided an overview of arguments for and against physician participation in executions.
More recently, in 2019, Professor Deborah W. Denno at Fordham Law School addressed the medical community’s involvement in lethal injection, writing in the New England Journal of Medicine that doctors “share in the responsibility of addressing the shortcomings of execution methods.”
Voluntary Executions
According to the Death Penalty Information Center, at least 150 defendants, accounting for approximately 10% of all executions, have been “volunteers” waiving “at least part of their ordinary appeals” or “terminat[ing] proceedings that would have entitled them to additional process prior to their execution.”
In a recent example, in 2021 Mississippi executed volunteer David Cox, who filed court papers stating that he was “worthy of death” and wished to be executed.
Previous scholarship has addressed considerations of the relationship between volunteering for execution and suicide, struggling with mental illness, and/or substance abuse, and considerations related to the role of mental health professionals in evaluating competency for execution.
Healthcare on Death Row
Additional scholarship and news coverage have also addressed the provision of healthcare to individuals on death row, including mental health care.
Disclaimer: The information and opinions on this site do not include legal advice or the advice of a licensed healthcare provider.