Doctors to decide execution role

Helping in executions is unethical, says an N.C. Medical Board panel

RALEIGH -- The N.C. Medical Board could take a position as early as today on whether physicians may do anything more at executions than be present.

On Wednesday, the board's policy committee approved a position statement, which if adopted by the full board could be used to discipline any doctor who monitored an inmate's vital signs or brain-wave activity in any way to help the executioners.

"The discussion was very clear that it would be unethical for a physician observing the monitor to say or do anything that facilitates the execution," said Thom Mansfield, the board's legal director.

Any position adopted by the full board will still have to go through a lengthy review, involving public comment, before final approval.

The board took up the debate at the urging of half a dozen doctors after publicity about physicians' involvement in North Carolina's executions.

The involvement of doctors with the death penalty has been a controversial topic since two anesthesiologists refused to participate in a California inmate's execution earlier this year. A federal judge had required the doctors' presence to assuage concerns that the inmate might experience a painful death, thereby violating the constitutional ban on cruel and unusual punishment. Executions in California have since been derailed.

In April, a similar argument seemed to jeopardize the pending execution of Willie Brown Jr., a North Carolina death row inmate. A federal judge ordered prison officials to make sure Brown was unconscious during his execution before lethal drugs were injected. Prison officials proposed using a brain wave monitor to verify Brown's level of consciousness, which satisfied the judge.

Prison officials have revealed that a doctor and nurse stand in a room adjacent to the execution chamber where a heart monitor and a brain wave monitor are located. However, monitoring vital signs and brain-wave activity violates doctors' ethics code, according to the American Medical Association.

The N.C. Medical Board's policy committee members said Wednesday that they struggled with a position statement because there is a conflict between state law and the AMA's guidelines.

State law requires that a physician be present. But the AMA forbids a doctor to attend or observe an execution as a physician. The committee recommended a compromise: Adopt the AMA guidelines but recognize that state law requires a prison physician to be there. Mansfield said the board could not take away a doctor's license for actions required by state law.

That proposal didn't please at least one doctor.

"I don't like what you've come up with," Dr. Charles van der Horst, a UNC professor, told the policy committee. "It's a slippery slope."

Once a doctor is in the execution chamber, van der Horst said, the prison employees will begin to rely on the doctor's expertise. He cited an article in a medical journal that detailed interviews with doctors who said over time, they became more and more involved with executions. Van der Horst urged the committee to add a more explicit prohibition.

(Van der Horst's brother, Roger, is an editor at The News & Observer who oversees education coverage.)

A few hours later, in response to van der Horst's criticism, the policy committee added this line: "Any physician who engages in any verbal or physical activity that facilitates the execution may be subject to discipline."

The more explicit language pleased van der Horst, but not others.

"The N.C. Medical Board needs to take a strong stance against physicians' presence in the execution chamber," said Brian Elderbroom, associate director of the Common Sense Foundation, a progressive public policy center. "It's impossible to uphold those ethical standards while also condoning any presence of a medical professional."

Elderbroom also works with a statewide coalition working for a death penalty moratorium.