It may turn out, surprisingly, that the medical profession holds the key to ending this country's longstanding and dishonorable link to other nations that continue to shackle and kill some offenders. Capital punishment is horrifying and ineffective, and it's also beneath the international stature of the United States. Do we want to be at the same moral latitude as Libya, Iran and Iraq? Only two fully democratic and developed countries in the world -- the United States and Japan -- still employ capital punishment.

And executions are distasteful in any number of ways, even to those who carry them out. A recent New York Times article covered the emotional damage done to those who participate and the importance of "moral disengagement" for them. The prison system tries mightily to remove individual culpability from correction officers who handle the killing, but it's to no ultimate success.

Here's what that means: each aspect of an execution is handled by different people. Does the correctional officer who straps down the condemned man's left arm actually kill him? What about the officer who shackles his feet for the walk to the gurney? Or the one who puts the needles in his veins, or the ones who actually depress the syringes?

Which of these men actually kills the prisoner? Exactly -- it's impossible to say. It also allows these participants in the deaths to rationalize away their roles: "Hey, I only bought the chemicals; I didn't kill him."

In a cockeyed way, this makes sense in our system, in which "the people" convict and then carry out the execution. If no one person can be pinned down, then all of us are the executioners.

Well, I say, that's not acceptable -- I want no killing done in my name.

This is a system that allows the participants, from the correction officer to the governor, to hide behind the procedure and disclaim the fact of having executed the prisoner.

If capital punishment is good for our country, then why sanitize it to the extent it has been? If Gov. Mike Easley really believes in this, let him hand a loaded firearm to a lone shooter, who would put a bullet into the back of the neck of a bound, kneeling man. That's the way China has done it, and it was done in public, too. At least that system has the appearance of deterring other capital crimes.

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And there would be no question of what the prisoner was going through, unlike the issues recently raised by the use of the lethal injection. With cruder forms of execution -- gassing, shooting, electrocuting -- there is little question of the mechanism and cause of death. But lethal injection has raised some troubling issues, particularly on the question of whether the condemned is suffering pain during the course of dying. This is where the physicians might help spell the end of capital punishment.

In North Carolina, state law requires executions to be attended by doctors, who certify the death. But in doing so, they violate ethical guidelines of the profession.

In California, an execution was actually called off because the prison system could not come up with any physicians -- anesthesiologists in this case -- to monitor the death of Michael Morales.

The problem is whether the amounts and sequence of chemicals render the prisoner truly senseless, so that he does not suffer severe pain during the actual process of dying. Autopsies have found that in a number of cases, the amounts of chemicals in the body were not sufficient to induce this degree of unconsciousness and the prisoner, while motionless, would be in great pain.

If the prison system were genuinely concerned with administering a painless death -- the goal, after all, of lethal injection -- there is a way to achieve it. A "bispectral index" monitor can be used to assess, by analyzing an electroencephalogram, the depth of unconsciousness.

Increasingly common in surgery, the bispectral index could guide the administration of the fatal chemicals to ensure that enough are used.

Of course the correctional system knows these monitors exist -- their use was approved in 1996 -- but they do not employ them. And why not? I suspect their use would begin to bridge in a perverse and uncomfortable way the distance between the operating room and the death chamber and, in turn, the gap between physician and executioner.

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Doctors in California were absolutely right to refuse to participate, and the same is true for doctors in North Carolina. They must work to increase -- not shrink -- the gulf between them and capital punishment. With physicians' refusals to have anything to do with executions, the death penalty will become harder to carry out.

But more than that, those refusals will call further attention to the future of capital punishment and encourage all the states, and the United States, to join the majority of countries worldwide that ban execution as a means of punishment.

(Bob Kochersberger teaches journalism at N.C. State University. He can be reached at bobkochs@gmail.com)