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Appendix: Methods of Execution: by State
ALABAMA
Method of Execution: electrocution.
(Article 15-18-82 of Criminal Procedure; Punishment is to be inflicted
by electrocution.)
State Statute Regarding Physicians'
Role: Details of execution procedures to be determined by the Commissioner
of Corrections. "Persons who may be present;" (c) Two (2) physicians, including
the prison physician. In 1991 a bill to replace electrocution with lethal
injection was considered and rejected by the State Legislature. The bill
did not mention the role of medical personnel. (Article 15-18-84 of Criminal
Procedure.)
Department of Corrections Regulations
Regarding Physicians' Role: The Alabama Department of Corrections refused
to provide the regulations and refused to provide the grounds for its refusal
in writing. (Phone conversation on July 7, 1992 with Horace Lynn, Assistant
Counsel at the Department of Corrections.)
State Medical Society's Position:
The Medical Association of the State of Alabama doesn't have a policy on
physician participation in executions; they defer to the AMA. As the situation
has not arisen, they have neither sanctioned nor assisted members for participating
or not in an execution. They are not aware of whether or not state law
mandates physician involvement.
ARIZONA
Method of Execution: lethal gas
or lethal injection. (Article 13-704 of Criminal Code Title 13)
A. The penalty of death shall be inflicted
by an intravenous injection of a substance or substances in a lethal quantity
sufficient to cause death, under the supervision of the state department
of corrections. B. A defendant who is sentenced to death for an offense
committed before November 23, 1992 shall choose either lethal injection
or lethal gas at least twenty days before the execution date. If the defendant
fails to choose either lethal injection or lethal gas, the penalty of death
shall be inflicted by lethal injection.
State Statute Regarding Physicians' Role:
"Persons present at execution..." The superintendent of the state prison
shall invite a physician. (Article 13-705 of Criminal Code Title 13)
Department of Corrections Regulations
Regarding Physicians' Role:
The Department of Corrections' regulations
stipulate that a physician should be present to operate the heart monitor.
(Arizona State Prison Complex-Florence
Internal Management Procedure (IMP) 500 - "Execution Procedures": §5.5.3.)
State Medical Society's Position:
The Arizona Medical Association has no position on physician participation
in executions. As their interpretation of state law does not require physician
involvement, the issue of whether or not they sanction or assist members
who do or don't is moot.
ARKANSAS
Method of Execution: lethal injection.
(Article 5-4-617 of Survey of Arkansas Law - Criminal Procedure,
"Method of Execution" provides the following details: Punishment to be
inflicted "by continuous intravenous injection of lethal quality...until
the defendant's death is pronounced according to accepted standards
of medical practice." In addition, the 1987 statutes allow for those
defendants sentenced prior to July 4, 1983 to choose either electrocution
or lethal injection.)
State Statute Regarding Physicians'
Role: Specific details regarding witnesses and medical personnel are
determined by the Director of the Department of Corrections.
Department of Corrections Regulations
Regarding Physicians' Role:
The Department of Corrections provided
a one-page "Procedures for Executions;" the document stipulates that "a
death ruling will be made by the State Medical Examiner's Office following
the execution."
State Medical Society's Position:
The Arkansas Medical Society has a policy statement against medical participation
in executions but has no procedures to discipline those who do. The Society
interprets the state law as not requiring medical participation in executions.
CALIFORNIA
Method of Execution: lethal gas
or lethal injection. (Assembly Bill 2405-Amendment to Article 3604 of Penal
Code). Punishment of death shall be inflicted by the administration
of a lethal gas or by an intravenous injection of a substance or substances
in a lethal quantity sufficient to cause death. Persons sentenced to death
shall have the opportunity, as specified, to elect to have the punishment
imposed by lethal gas or lethal injection. This choice shall be made in
writing. If a person under sentence of death does not choose either lethal
gas or lethal injection within 10 days, the penalty of death shall be imposed
by lethal gas.
State Statute Regarding Physicians'
Role: "The warden of the State Prison where execution (takes place)
must be present and must invite the presence of two physicians..."
(Article 3605 "Witness to Execution".)
Department of Corrections Regulations
Regarding Physicians' Role:
The state execution procedures, provided
by the Department of Corrections, stipulate the presence of the Chief Medical
Officer and one additional physician. For their role, as per the regulations,
see "Legal Perspective." (San Quentin Institution Procedures.)
State Medical Society's Position:
The California Medical Association opposes medical participation in executions,
has a procedure to discipline those who disobey and to assist those who
need assistance as a result of their refusal to participate. The Association
interprets the state statute as requiring physicians to participate in
executions.
COLORADO
Method of Execution: lethal injection.
(Article 16-11-401 of Colorado Revised Statutes, 1989 Supplement,
"Method;" Death Penalty to be inflicted by lethal injection.)
State Statute Regarding Physicians'
Role: The execution shall be performed in the appointed room or place..."by
a person selected by the Executive Director (of the Department of Corrections)
and trained to administer intravenous injections.... Death shall be pronounced
by a licensed physician or coroner according to accepted medical standards."
(Article 16-11-402 of Colorado Revised Statutes, 1989 Supplement,
"Implements.")
A physician shall be present. (Article
16-11-404 of Colorado Revised Statutes, 1989 Supplement, "Witnesses.")
Immediately after the execution, a postmortem
examination shall be made by the attending physician. (Article 16-11-405
of Colorado Revised Statutes, 1989 Supplement, "Record and certificate
of execution.")
Department of Corrections Regulations Regarding
Physicians' Role:
We were unable to obtain a copy of the
regulations. According to a letter from the Executive Director of the Colorado
Department of Corrections, "documents governing the process to be put into
place and activated to conduct an execution are confidential to the Department
and made available only to those who have a 'need to know.'" (June 9, 1992
letter from Frank O. Gunter.) Our subsequent letter and phone messages
requesting the legal grounds for confidentiality went unanswered.
State Medical Society's Position:
The Colorado Medical Society does not have a policy regarding physician
participation in executions, but they are looking into it. They are unaware
of state law regarding this issue.
CONNECTICUT
Method of Execution: electrocution.
State Statute Regarding Physicians'
Role: The warden of the Correctional Institution in Somers appoints
the executioner. "The following persons may be present...the physician
of the Connecticut Correctional Institution, Somers..." (Article 54-100
of Criminal Procedure, "Electrocution.")
Department of Corrections Regulations
Regarding Physicians' Role: According to a letter from the Department
of Corrections, the State of Connecticut does not have departmental regulations
regarding executions, due to the fact that the last execution in the state
took place in 1960. (June 19, 1992 letter from Leo C. Arnoe.)
The State Medical Society's Position:
The Connecticut State Medical Society does not have a position on physicians'
participation in execution and is not aware of the law's requirements.
DELAWARE
Method of Execution: lethal injection.
(Article 4209 (f) of Delaware Code Revised 1974-1988 Supplement,
"Method and imposition of sentence of death" specifies lethal injection
as the mode of execution and states: "The administration of the required
lethal substances...shall not be construed to be the practice
of medicine and any pharmacist or pharmaceutical supplier is authorized
to dispense drugs (to the Commissioner of the Department of Corrections)
without prescription. If lethal injection is held to be unconstitutional
or infeasible, punishment is to be inflicted by hanging.)
Department of Corrections Regulations
Regarding Physicians' Role:
The Delaware Department of Corrections
Policies and Procedures stipulate that in the case of execution by lethal
injection, a physician or physicians confirm death. If the execution is
by hanging, the procedure is that the physician(s) will determine that
death has occurred after the inmate dropped through the trap. (Department
of Corrections, State of Delaware, Policies and Procedures Number 750,
Execution Procedures.)
Our letter to the Delaware Department
of Corrections went unanswered. Following repeated phone messages, we were
eventually told that the information was confidential. We requested to
receive the denial in writing with the citation of legal grounds for the
confidentiality. We have not received this information. A copy of the document
was obtained through further research.
State Medical Society's Position: The
Medical Society of Delaware does not have a policy statement on the role
of physicians in executions, but it defers on this issue to the American
Medical Association.
FLORIDA
Method of Execution: electrocution.
(Article 922-10 of Criminal Procedures and Corrections, "Execution
of Death Sentence;" inflicted by electrocution and overseen by the warden
of the State Prison, who designates the executioner.)
State Statute Regarding Physicians'
Role: "A qualified physician shall be present and announce when death
has been inflicted." (Article 922-11 of Criminal Procedures and Corrections,
"Regulation of Execution" (2).)
NOTE: A bill to replace electrocution
with lethal injection was considered and rejected by the State Legislature
in 1991.
Department of Corrections Regulations Regarding
Physicians' Role:
The Florida State Prison Operating Procedure,
provided to us by the Florida Department of Corrections, specifies that
a physician and a physician's assistant are to be among the five people
(in addition to the condemned person) present in the execution chamber
immediately prior and throughout the execution. An additional physician
is in the witness room. (Florida State Prison Operating Procedure.) For
more details, see: "Legal Perspective."
State Medical Society's Position:
The Florida Medical Association does not have a policy regarding physician
participation in executions. They defer to the AMA on this issue, but are
not necessarily in agreement. They neither sanction nor assist members
who do or don't participate in executions. They are aware of state statutes
regarding physician involvement.
GEORGIA
Method of Execution: electrocution.
State Statute Regarding Physicians'
Role: At least three executioners, two physicians "to determine when
death supervenes" and electricians are required to attend. (Article 17-10-41
of Criminal Procedure, "Persons required to be present at executions.")
Executioners and attending physicians
certify execution to the court clerk. (Article 17-10-42 of Criminal
Procedure, "Preparation and filing of certification." Article 17-10-44
of Criminal Procedure, "Death chamber apparatus, etc.," describes
what is needed to carry out execution by electrocution.)
Department of Corrections Regulations Regarding
Physicians' Role:
We were unable to obtain regulations.
Our repeated written and phone messages to the effect were ignored. (Letters
on June 4 and July 20, 1992, phone calls on June 26, July 16, and July
20.)
State Medical Society's Position:
The Medical Association of Georgia has no policy statement on physicians'
role in executions because the Society defers on this issue to the position
taken by the American Medical Association.
IDAHO
Method of Execution: lethal injection.
State Statute Regarding Physicians'
Role: [Death is] inflicted by lethal injection "until death is pronounced
by a (licensed) physician in accordance with accepted medical standards."
The statute contains language claiming that lethal injection is "not a
medical procedure" and that chemicals can be dispensed to the Director
of the Department of Corrections without a prescription. In addition, the
Director is given a role in determining the mode of execution; if it is
deemed that lethal injection cannot be administered in a "reasonable" manner
(i.e. without causing suffering) a firing squad will be used. Finally,
"infliction of punishment by lethal injection shall not be construed to
be the practice of medicine." (Article 19-2716 of Idaho Code - 1987
Revision, "Infliction of Death Penalty.")
Department of Corrections Regulations
Regarding Physicians' Role:
The Department of Corrections informed
us that there was no administrative policy on the department level due
to the fact that the last execution was carried out in 1957. There exists,
however, a detailed, confidential execution guide of the Idaho Maximum
Security Institution, which is where executions orders would be carried
out. According to the letter, the document is protected from public disclosure
by Idaho Code section 9-340 (35). (July 2, 1992 letter from Karol T. Phillips,
Sr. Administrative Assistant, State of Idaho Department of Corrections.)
State Medical Society's Position:
The Idaho Medical Association has no policy statement on physicians' role
in executions because the Society defers on this issue to the position
taken by the American Medical Association.
INDIANA
Method of Execution: electrocution.
(Article 35-38-6-1 of Criminal Law and Procedure, Manner and time
of execution; Punishment is to be inflicted by electrocution. The warden,
or persons designated by the warden, shall serve as executioner(s).)
State Statute Regarding Physicians'
Role: "Who may be present" includes the prison physician. (Article
35-38-6-6 of Criminal Law and Procedure.)
State Medical Society's Position:
The Indiana State Medical Association does not have a policy regarding
physician participation in executions; they defer to the AMA on this issue.
Though the issue has yet to arise, it would be up to the county and state
medical boards to determine whether or not to sanction or provide support
to a member who did or did not violate this policy. They interpret the
law as not requiring physician involvement and are themselves opposed to
physician involvement.
ILLINOIS
Method of Execution: lethal injection.
(Article 119-5 of Criminal Law and Procedure, "Execution of Death
Sentence;" (a) Inflicted by lethal injection until death is pronounced
by a licensed physician according to accepted medical standards.
State Statute Regarding Physicians'
Role: Execution is to be conducted in the presence of two (2) physicians
who, along with other witnesses, shall certify that the execution has taken
place. The identity of executioners and other participants shall remain
confidential. (Article 119-5 of Criminal Law and Procedure, "Execution
of Death Sentence;" (d), (e).)
Department of Corrections Regulations
Regarding Physicians' Role:
The Illinois Department of Corrections
Execution Procedure, received from the Department, refers to "a medically
trained person," "a Health Care Unit Member," and "qualified health care
personnel," ascribing them specific roles.
State Medical Society's Position:
The Illinois State Medical Society has a policy against physician participation
in executions. They wouldn't necessarily sanction a member who participated
in an execution, but would provide support for a member who declined to
do so. Their interpretation of the law is that a physician is required
to pronounce death.
KENTUCKY
Method of Execution: electrocution.
(Article 431.220 of Kentucky Penal Code, "Execution of Death Sentence;"
punishment inflicted by electrocution.)
State Statute Regarding Physicians'
Role: "Persons who may attend executions" includes the physician of
the penitentiary. (Article 431-250 of Kentucky Penal Code.)
Department of Corrections Regulations
Regarding Physicians' Role: Kentucky has not executed an inmate since
1962. According to a letter from the Commissioner of Corrections, a new
set of procedures was being drafted as of July 92.
State Medical Society's Position:
The Kentucky Medical Association does not have a policy regarding physician
participation in executions. They feel they would probably defer to the
AMA on this issue. Disciplinary matters are referred to a judicial committee;
they would probably provide support to a member who declined to participate
in an execution. They are not aware of state law regarding physician involvement.
LOUISIANA
Method of Execution: lethal injection.
(Article 569 of Revised Statutes, "Place for execution; manner of
execution;" Every sentence executed on or after September 15, 1991 shall
be carried out by lethal injection.) State Statute Regarding Physicians'
Role: No licensed health care professional "shall be compelled to
administer a lethal injection." (Article 569 of Revised Statutes,
"Place for execution; manner of execution;" (c).)
Executions are to take place in the presence
of the coroner of the parish of West Feliciana or his deputy and a physician
summoned by the warden of the state penitentiary at Angola.
Department of Corrections Regulations Regarding
Physicians' Role:
The regulations provided by the Department
of Public Safety and Corrections list a physician as one of the four people
to be present in the execution room during the execution. One of the four
people is "a competent person selected by the warden to administer the
lethal injection." (Department of Public Safety and Corrections -Department
Regulation No. 10-25: §G(2).)
State Medical Society's Position:
Unofficially, the Louisiana State Medical Society is against physician
participation in executions. They don't necessarily defer to the AMA on
this issue. They would not sanction a member who participated in an execution;
they might provide assistance to one who declined to do so. They interpret
the law as not requiring physician involvement.
MARYLAND
Method of Execution: lethal gas.
(Article 27,73 of Annotated Code of the Public General Laws of Maryland,
"Death Chamber, conduct of executions;" punishment is to be inflicted by
lethal gas....)
State Statute Regarding Physicians'
Role: Punishment is to be...conducted by the warden or his designee,
in the presence of "...the physician of the penitentiary or his assistant..."
(Article 27,73 of Annotated Code of the Public General Laws of Maryland,
"Death Chamber, conduct of executions.")
Department of Corrections Regulations
Regarding Physicians' Role:
According to a fax message from the Executive
Assistant at the Maryland Department of Public Safety and Correctional
Services, the state of Maryland does not have departmental procedures for
executions.
State Medical Society's Position:
The Medical & Chirurgical Faculty of the State of Maryland defers to
the AMA on the issue of physician participation in executions. They would
both discipline and assist members who either participated or declined
to participate in an execution. Maryland does not require physician involvement
in executions.
MISSISSIPPI
Method of Execution: lethal injection
or lethal gas. (Article 99-19-51 of Criminal Procedures, "Infliction
of sentence;" punishment is inflicted by lethal injection or by lethal
gas.)
State Statute Regarding Physicians'
Role: Lethal injection "shall not be construed to be the practice of
medicine or nursing." Pharmacists may dispense drugs to the state executioner
without a prescription. (Article 99-19-53 of Criminal Procedures,
"Execution of death sentence.")
The commissioner secures the presence
of at least one, but not more than two physicians. The executioner, Commissioner
and physicians prepare and sign the death certificate. (Article 99-19-55
of Criminal Procedures, "Witnesses, certificate of execution...;"
(2) and (3).)
Department of Corrections Regulations Regarding
Physicians' Role:
Despite a written request and repeated
phone messages left with the office of the Commissioner of the Department
of Corrections, we were unable to obtain either a copy of the regulations
or an explanation of why our request was ignored.
State Medical Society's Position:
The Mississippi State Medical Association does not have a policy regarding
physician participation in executions; they defer to the AMA. They would
provide support to a member who declined to participate butprobably would
not discipline him or her because they interpret state law as only requiring
a physician to declare death.
MISSOURI
Method of Execution: lethal gas
or lethal injection. (Article 546.720 of 1990 Cum Pocket Part, "Manner
of Execution," Punishment of death shall be by administration of lethal
gas or by means of the administration of lethal injection.
State Statute Regarding Physicians'
Role: The chief administrative officer of the correctional institute
shall "invite the presence of a physician." (Article 546-740 of 1990
Cum Pocket Part, "Witnesses.")
Department of Corrections Regulations
Regarding Physicians' Role:
The Director of the Department of Corrections
in his June 25, 1992 letter stated that copies of regulations governing
executions "will not be forwarded" for "reasons of safety for staff and
inmates." In his letter, he provided some of the details of the existing
departmental document. According to his summary, "the inmate is placed
on a gurney and the IV is set or put into place by medical staff... The
heart and other vital signs are monitored electronically by a medical staff
person. The inmate is pronounced dead by a physician, and the blinds to
the witness viewing area are closed."
A recently published book provides a few
more details as to the nature of a physician's involvement. The physician
is present in the execution chamber and monitors the dying inmate's heart
from behind a screen, located about a foot away from the gurney. (Stephen
Trombley, "The Execution Protocol," Crown Publishers, New York 1992. Caption
under a photograph depicting the execution chamber.)
State Medical Society's Position: The
Missouri State Medical Association does not have a policy regarding physician
participation in executions; they defer to the AMA. If a member acted in
contravention of this policy, they would consider it an ethics violation
and proceed accordingly; they would assist members who declined to participate
in executions. Such an occasion has yet to arise. Their interpretation
of the law is that Missouri mandates physician participation.
MONTANA
Method of Execution: hanging or
lethal injection. (Article 46-19-103 of Criminal Procedure, "Execution
of the Death Sentence," (3); Punishment is to be inflicted by hanging or,
at the election of the defendant, by lethal injection...)
State Statute Regarding Physicians'
Role: Punishment is to be inflicted..."until a licensed physician pronounces
that the defendant is dead according to accepted standards of medical practice."
The warden selects the executioner. Executions by lethal injection must
be carried out by a person "trained to administer the injection." This
person "need not be a physician, registered nurse or licensed practical
nurse..." (Article 46-19-103 of Criminal Procedure, "Execution of
the Death Sentence;" (3), (5), and (6).)
Department of Corrections Regulations
Regarding Physicians' Role:
A June 15 letter from the Department of
Corrections stated that "Montana corrections regards its executions procedures
manual as a confidential document." Our written request for the grounds
for the confidentiality, followed by repeated phone messages, were never
answered.
State Medical Society's Position:
The Montana Medical Association has a policy that a physician not be compelled
to participate in an execution, but it is not in writing. A situation has
not yet arisen where the society has either sanctioned or supported a member
for participating or not in an execution. They are unaware of state law
regarding physician involvement.
NEBRASKA
Method of Execution: electrocution.
(Article 25.29-2532 of Criminal Procedure, "Mode of inflicting punishment;"
punishment is inflicted by electrocution. The Warden, or, in the case he
is incapacitated, the Deputy Warden serves as the executioner, unless the
warden designates a "competent" executioner (witnesses, physicians, and
pronouncement of death are not mentioned).)
Department of Corrections Regulations
Regarding Physicians' Role:
Despite repeated written and phone requests
addressed to the Director of the Department of Correctional Services, we
were unable to obtain a copy of the regulations governing executions.
State Medical Society's position:
The Nebraska Medical Association has no policy statement on physicians'
role in executions.
NEVADA
Method of Execution: lethal injection.
(Article 176.355 of Revised Statutes Volume #7, "Execution of Death
Penalty;" (1) Judgement is to be inflicted by lethal injection.)
State Statute Regarding Physicians'
Role: The Director of the Department of Prisons selects the lethal
chemicals after consulting with the state health officer.The Director
must invite a competent physician to be present at the execution.
(Article 176.355 of Revised Statutes Volume #7, "Execution of Death
Penalty;" (2)(b),(d).)
Department of Corrections Regulations
Regarding Physicians' Role:
The Director of the Department of Corrections
in his June 16 letter refused to provide us with a copy of Nevada's regulations
governing executions, "due to confidentiality." Our written and telephone
requests for providing the basis for the confidentiality have been ignored.
State Medical Society's Position:
The Nevada State Medical Association does not have a policy regarding physician
participation in executions. As the issue has not arisen in Nevada for
a long time, they believe they would defer to the AMA. As they interpret
the law to not require physician involvement (though a physician may be
invited to attend), the question regarding sanction or providing
a member with assistance is moot.
NEW HAMPSHIRE
Method of Execution: lethal injection.
(Article 630:5 XIII. of 1989 Criminal Supplement, "When the penalty
of death is imposed..." punishment is inflicted by lethal injection...until
death is pronounced by a licensed physician "according to accepted standards
of medical practice...")
State Statute Regarding Physicians'
Role: Lethal injection is performed by a person selected by the commissioner
and trained to administer the injection. This person "need not be a physician,
registered nurse, or licensed practical nurse..." Lethal injection "shall
not be construed to be the practice of medicine..." Pharmacists are authorized
to dispense the drugs to the commissioner without a prescription. (Articles
630:5 XV. and XVI. of 1989 Criminal Supplement.)
Department of Corrections Regulations
Regarding Physicians' Role: According to a June 10, 1992 letter from
the Commissioner of the Department of Corrections, New Hampshire, a state
where the most recent execution took place in 1939, does not have regulations
for the administration of executions.
State Medical Society's Position:
The New Hampshire Medical Society is opposed to physician participation
in executions. Though the situation has yet to arise, a member who contravenes
the Society policy would be dealt with by its jurisprudence committee and
possibly dropped from the society, while a member who declined to participate
in an execution would receive the society's assistance. Their interpretation
of the law is that it does not require physician involvement.
NEW JERSEY
Method of Execution: lethal injection.
(Article 2C:49-2 of Criminal Justice Code, Administration of punishment;
punishment is inflicted by lethal injection.)
State Statute Regarding Physicians'
Role: Prior to the injection of lethal substances, "the person shall
be sedated by a licensed physician, registered nurse, or other qualified
personnel..." (Article 2C:49-2 of Criminal Justice Code, Administration
of punishment.)
Lethal injection "shall not be construed
to be the practice of medicine..." Pharmacists are authorized to dispense
drugs to the commissioner without a prescription. The commissioner must
designate persons who are "qualified to administer injections and who are
familiar with medical procedures, other than licensed physicians,
as executioners. (Article 2C:49-3 of Criminal Justice Code, "Determination
of substances and procedure..." (a), (b).)
"Persons authorized to be present;" includes
two licensed physicians. (Article 2C:49-7 of Criminal Justice Code.)
Immediately after the execution an examination
of the body shall be made by the licensed physicians attending the execution.
(Article 2C:49-8 of Criminal Justice Code,
"Examination and report; certificate.")
Department of Corrections Regulations
Regarding Physicians' Role:
According to a staff member at the office
of the Assistant Commissioner, Division of Adult Institutions, New Jersey
does not have departmental regulations and procedures on capital punishment.
State Medical Society's Position:
The Medical Association of New Jersey has a policy statement against physicians'
participation in executions. The Society has developed procedures to discipline
its members who violate the policy and procedures to assist members who
refuse to participate in executions.
NEW MEXICO
Method of Execution: lethal injection.
(Article 31-14-11 of New Mexico Statutes 1978 Volume #6, "Punishment
of Death; how inflicted;" manner of inflicting punishment is lethal injection;
execution is supervised by the Warden of the State Penitentiary.)
State Statute Regarding Physicians'
Role: The warden must invite the presence of a physician." (Article
31-14-15 of New Mexico Statutes 1978 Volume #6, "Who may be present.")68
Department of Corrections Regulations
Regarding Physicians' Role:
According to a June 12, 1992, letter from
the office of the Secretary of the Corrections Department, New Mexico has
no procedures for executions, due to the fact that the most recent execution
took place in 1960.
State Medical Society's Position:
The New Mexico Medical Society has no policy statement on physicians' role
in executions because the Society defers on this issue to the position
taken by the American Medical Association.
NORTH CAROLINA
Method of Execution: lethal gas
or lethal injection. (Article 15-187 of Criminal Procedure, "Death
by lethal gas or drugs;" states: "Death by electrocution is hereby abolished...Lethal
gas is substituted therefor, except that the defendant chooses lethal injection..."
(defendant must choose five (5) days prior to execution date). 15-187 amended
in 1983 as follows: "Warden may obtain and employ the drugs necessary to
carry out the provisions of this act...")
State Statute Regarding Physicians'
Role: Witnesses include the surgeon or physician of the penitentiary.
(Article 15-190 of Criminal Procedure, "Who shall be present...")
The warden and surgeon or physician of the penitentiary certify the fact
of execution. (Article 15-192 of Criminal Procedure, "Certificate
of death.")
Department of Corrections Regulations
Regarding Physicians' Role: The Department of Corrections Research
File, in the chapter entitled "Methods of Execution in North Carolina"
states that when lethal injection is used, "a physician, whose sole function
is to pronounce the inmate dead, watches from the control room. After five
to ten minutes, he goes to the inmate, listens for heart sounds, checks
his pupil response and pronounces him dead. The physician leaves the chamber,
the witnesses are escorted to the elevators and the body is removed." When
asphyxiation by lethal gas is used, "a heart monitor is attached to the
inmate which can be read in the control room by a staff member and a physician."(Department
of Corrections Research File: "Methods of Execution in North Carolina.")
State Medical Society's Position:
The North Carolina Medical Society has a policy statement against physicians'
participation in executions. The Society has not developed procedures to
discipline its members who violate the policy nor procedures to assist
members who refuse to participate in executions.
OHIO
Method of Execution: electrocution
or lethal injection. (Article 2949.22 of Crimes-Procedure, "Execution
of the Death Sentence;" punishment is inflicted by electrocution or lethal
injection. The warden or his deputy shall be the executioner.)
State Statute Regarding Physicians'
Role: Physicians of the penitentiary shall be present [at executions].
(Article 2949.25 of Crimes-Procedure, "Attendance at execution;"
(d).)
Department of Corrections Regulations
Regarding Physicians' Role:
According to a document provided by the
Ohio Department of Rehabilitation and Correction, at the execution of the
death penalty, as witnesses in or about the vicinity of the execution chamber
are included, among others: "Such number of physicians of the institution
where the execution is to be conducted as the superintendent thinks necessary."
(Department of Rehabilitation and Correction Rule No. 5120-9-54: "Attendance
at execution.")
State Medical Society's Position:
The Ohio State Medical Association has no policy statement on physicians'
role in executions because the Society defers on this issue to the position
taken by the American Medical Association.
OKLAHOMA
Method of Execution: lethal injection.
(Article 1014 of Crimes & Punishments Title 21 681 to 930, "Manner
of Inflicting Punishment of Death" is by lethal injection administered
"...until death is pronounced by a licensed physician according to accepted
standards of medical practice." State Statute Regarding Physicians'
Role: The Warden must invite the presence of a physician. (Article
1015 of Crimes & Punishments Title 21 681 to 930,"Persons who
may be present.")
Department of Corrections Regulations
Regarding Physicians' Role:
Our letter to the Director of the Oklahoma
Department of Corrections requesting a copy of the departmental regulations,
followed by several phone calls, was ignored. The Department of Corrections
Policy Statement No. OP-090901: "Procedures for the Execution of Inmates
Sentenced to Death" was quoted, however, in a recent British book. The
document states: The Chief Medical Officer of the Penitentiary, or the
Medical Director of the Department [of Corrections], or a physician designated
by the Warden must be present [at the execution; and after the catheter
has been inserted] the examining physician shall inspect the catheter and
monitoring equipment and determine that the fluid will flow into the vein...
The execution shall be by means of a continuous, intravenous administration
of a lethal quantity of sodium thiopental combined with either tubo-curarine
or succinylcholine chloride or potassium chloride which is an ultrashort-acting
barbiturate combination with a chemical paralytic agent. The Department
Medical Director shall order a sufficient quantity of the substance...
(Passage cited in: British Medical Association, Medicine Betrayed: The
Participation of Doctors in Human Rights Abuses, 1992, p. 112.)
State Medical Society's Position:
The Oklahoma State Medical Association has no policy statement on physicians'
role in executions because the Society defers on this issue to the position
taken by the American Medical Association.
OREGON
Method of Execution: lethal injection.
(Article 137.473 of Oregon Revised Statutes Vol #3 Penal Code Chapter
131-170, "Means of inflicting death; place and procedures; acquisition
of lethal substance;" (1) Punishment is inflicted by lethal injection...)
State Statute Regarding Physicians'
Role: (1) ...the superintendent shall "invite the presence of one or
more physicians..." (2) The person administering the injection "shall not
thereby be considered to be engaged in the practice of medicine." (3)(a)
Pharmacists may provide the lethal substances upon written order of the
Director of the Department of Corrections accompanied by a copy of the
court's judgement of death. (Article 137.473 of Oregon Revised Statutes
Vol #3 Penal Code Chapter 131-170, "Means of inflicting death; place
and procedures; acquisition of lethal substance.")
Department of Corrections Regulations
Regarding Physicians' Role:
According to the regulations provided
by the Oregon Department of Corrections, "the selection of the executioner(s)
will be the joint responsibility of the superintendent and the health services
manager of the Oregon State Penitentiary. (a) All medically-related issues
relating to lethal injection shall be the responsibility of the Oregon
State Penitentiary health services manager. The document further stipulates
that the Oregon State Penitentiary health services manager{superintendent}
will identify one or more physicians who will be responsible for observing
the execution process and examining the condemned after the lethal substance(s)
has been administered to ensure that death has been induced. The superintendent
shall be present at the execution and shall invite the presence of: One
or more physicians as identified above... And finally the document states:
"The intravenous administration of the chemicals will be maintained until
death is pronounced by the licensed physician(s)." (Capital Punishment
(Death by Lethal Injection)": OAR 291-24-005 through OAR 291-24-095.)
State Medical Society's Position:
The Oregon Medical Association has a policy statement against physicians'
participation in executions. The Society has developed procedures to discipline
its members who violate the policy and procedures to assist members who
refuse to participate in executions.
PENNSYLVANIA
Method of Execution: lethal injection.
(Article 2121.1 of Penal & Correctional Inst., "Method of execution;"
Punishment is inflicted by lethal injection...)
State Statute Regarding Physicians'
Role: Punishment is inflicted... until death is pronounced by a licensed
physician. Lethal substances are approved by the Department of Corrections.
(Article 2121.1 of Penal & Correctional
Inst., "Method of execution.")
Department of Corrections Regulations
Regarding Physicians' Role:
Claiming confidentiality, Pennsylvania
declined to provide regulations regarding executions.
State Medical Society's Position:
The Pennsylvania Medical Society has no policy statement on physicians'
role in executions because the Society defers on this issue to the position
taken by the American Medical Association.
SOUTH CAROLINA
Method of Execution: electrocution.
(Article 24-3-530 of Code of Laws of South Carolina, "Method;" punishment
is inflicted by electrocution. Execution is directed by the Commissioner
of the Department of Corrections.)
State Statute Regarding Physicians'
Role: "Witnesses" mentions "necessary staff." "Certification" states
"Executioner and the attending physician shall certify the fact of such
execution to the (court clerk)." (Articles 24-3-550 and 24-3-560 of Code
of Laws of South Carolina.)
Department of Corrections Regulations
Regarding Physicians' Role:
Two physicians are included among the
individuals that will be present when an execution is carried out (one
in the execution chamber and one in the witness area). (The Department
of Corrections' "Execution Procedures" paragraph 6.c.) The regulations
stipulate that "...the Director of the Division of Health Services will:
(1) Ensure that physicians are present during the execution to certify
that the execution was carried out." The warden will "request physician
to confirm death after electrical sequence... The inmate will be pronounced
dead by the physician. (South Carolina Dept. of Corrections Policy No.
1500.31 (15/31) - "Execution Procedures.")
State Medical Society's Position:
The South Carolina Medical Association does not have a policy regarding
physician participation in executions; in general, they defer to the AMA.
The issue of sanctioning or supporting a member who has participated or
declined to participate in an execution has yet to arise. They do not believe
state law requires physician involvement.
SOUTH DAKOTA
Method of Execution: lethal injection.
(Article 23A-27A-32 of Criminal Procedure, "Place and Manner of
Execution;" Punishment is inflicted by lethal injection...)
State Statute Regarding Physicians'
Role: Punishment is inflicted..."until the convict is pronounced dead
by a licensed physician according to accepted standards of medical practice."
The executioner must be trained to administer intravenous injections; the
executioner "need not be a physician, registered nurse or licensed practical
nurse." The procedure "may not be construed to be the practice of medicine..."
Pharmacies can dispense drugs to the Warden without prescription. (Article
23A-27A-32 of Criminal Procedure, "Place and Manner of Execution.")
"...the Warden shall also arrange for
the attendance of the prison physician and two other licensed physicians
of the state." (Article 23A-27A-34 of Criminal Procedure, "Persons
Attending.")
Department of Corrections Regulations Regarding
Physicians' Role: According to a letter from the Department of Corrections,
South Dakota, whose most recent execution took place in 1947, does not
have regulations for the administration of executions.
State Medical Society's Position:
The South Dakota State Medical Association has no policy statement on physicians'
role in executions.
TENNESSEE
Method of Execution: electrocution.
(Article 40-23-144 of Tennessee Code Annotated Volume 7, "Death
by electrocution.")
State Statute Regarding Physicians'
Role: "Witnesses" includes the prison physician. (Article 40-23-116
of Tennessee Code Annotated Volume 7.)
Department of Corrections Regulations
Regarding Physicians' Role:
In a July 30, 1992, letter, the Commissioner
of the Tennessee Department of Corrections informed us that "In order to
sustain the security and integrity of the institution, I regret that I
am unable to send you more specific information regarding executions."
State Medical Society's Position:
The Tennessee Medical Association does not have a policy regarding physician
participation in executions. The issue has yet to have been addressed and
they are unaware of state law on the subject.
TEXAS
Method of Execution: lethal injection.
(Article 43.14 of Texas Criminal Laws, "Execution of Convict;" punishment
is inflicted by lethal injection.)
State Statute Regarding Physicians'
Role: Those "Present at execution" includes two physicians, including
the prison physician.
(Article 43.20 [804] of Texas Criminal
Laws.)
Department of Corrections Regulations
Regarding Physicians' Role: The "Texas Department of Corrections Procedures
for the Execution of Inmates Sentenced to Death" states: "A medically trained
individual (not to be identified) shall insert an intravenous catheter
into the condemned person's arm and cause a neutral saline solution to
flow." After the prisoner completes his/her last statement, the designee(s)
of the Director "...shall induce by syringe substance and/or substances
necessary to cause death. This individual(s) shall be visually separated
from the execution chamber by a wall and locked door, and shall also not
be identified." The attending physician(s) shall stand with the witnesses.
State Medical Society's Position:
The Texas Medical Association has a policy statement opposing doctors'
participation in executions.
UTAH
Method of Execution: firing squad
or lethal injection. (Article 77-19-10 of Utah Criminal Code, "Judgement
of death - location and procedures" (1), (2), and (3); The death warrant
specifies the method of execution...)
State Statutes Regarding Physicians'
Role: If judgement is to be carried out by shooting, the executive
director selects a five-person firing squad of "peace officers." If the
judgement is to be carried out by lethal injection, the executive director
must select two or more persons "trained in accordance with accepted medical
practices to administer intravenous injections..." Death shall be pronounced
by a licensed physician "according to accepted medical standards."
(Article 77-19-10 of Utah Criminal
Code, "Judgement of death - location and procedures" (2) and (3).)
The executive director "shall cause a
physician to attend the execution." (Article 77-19-11 of Utah Criminal
Code, "Who may be present...")
Department of Corrections Regulations Regarding
Physicians' Role:
The Utah Department of Corrections declined
to provide us with regulations detailing the execution process. At our
request, the Assistant Director of the Department cited the Utah Code Annotated
63-2-304 (a) (11) as the basis for confidentiality.
State Medical Society's Position:
The Utah Medical Association has a policy statement opposing doctors' participation
in executions and procedures for disciplining doctors who participate in
executions and to assist those who refuse.
VIRGINIA
Method of Execution: electrocution.
(Article 53.1-233 of Code of Virginia, "Method;" punishment is inflicted
by electrocution and is conducted by the Director or one or more of his
designees.)
State Statutes Regarding Physicians'
Role: Those present include the physician employed by the Department
or his assistant. (Article 53.1-234 of Code of Virginia, "Who to
be present.")
The physician shall perform an examination
to determine that death has occurred; the physician's death certificate
is appended to the Director's certification. (Article 53.1-235 of Code
of Virginia, "Certificate of execution.")
Department of Corrections Regulations Regarding
Physicians' Role:
The Deputy Director of Virginia Department
of Corrections stated in a July 7, 1992 letter that "information which
is related to security procedures or the release of which could jeopardize
institutional security or client confidentiality will not be provided to
your organization." On these grounds, the warden of Greensville Correctional
Center, the institution where executions are carried out, declined toprovide
us with regulations regarding executions. He did state in his letter that
the "attending physician pronounces the inmate deceased approximately five
minutes upon the completion of the process."
State Medical Society's Position:
The Medical Society of Virginia does not have a policy on physician participation
in executions; they defer to the AMA. It is up to a committee to determine
if a member has committed a breach of ethics; if so, there is the possibility
the member will be expelled. The Society might support a member who declined
to participate; there is no policy in place to do so at this time. They
do not believe state law requires physician involvement, the current execution
procedure being electrocution.
WASHINGTON
Method of Execution: lethal injection
or hanging. (Amendment to Article 10.95.180 of Criminal Procedure.)
The punishment of death shall be inflicted by intravenous injection of
a substance or substances in a lethal quantity sufficient to cause death
and until the defendant is dead, or at the election of the defendant, by
hanging the neck until the defendant is dead.
State Statutes Regarding Physicians'
Role: Punishment is...to be supervised by the superintendent of the
state Penitentiary; "until death is pronounced by a licensed physician."
(Article 10.95.180 of Criminal Procedure, Method; (1).)
Department of Corrections Regulations
Regarding Physicians' Role:
A physician is among the staff members
required/permitted to attend the execution. The physician will determine
if death has occurred. B. The physician and coroner will: 1. Make pronouncement
of death. 2. Sign the death certificate.
Appendix B - DEATH BY LETHAL INJECTION
states that as soon as the inmate has elected lethal intravenous injection,
a physical examination will be conducted to determine any physical problems
that may affect the execution process. A copy of this examination along
with any recommendations will be forwarded immediately to the designated
associate superintendent. (Department of Corrections Policy No. 01.100.)
State Medical Society's Position: The
Washington State Medical Association's policy is that physician participation
in a legally authorized execution be discouraged. They would sanction a
member who acted in contravention of this policy, but such a situation
has yet to arise. They would probably support a member who declined to
participate. They do not believe state law requires physician involvement.
WYOMING
Method of Execution: lethal injection.
(Article 7-13-904 of Wyoming Statutes 1977, "Method of execution;"
Punishment is inflicted by lethal injection...)
State Statutes Regarding Physicians'
Role: Punishment is inflicted...until death is pronounced by a licensed
physician "according to accepted standards of medical practice." "Administration
of the injection does not constitute the practice of medicine."
"Witnesses" include (ii) two (2) physicians,
including the prison physician. (Article 7-13-908 of Wyoming Statutes
1977.)
Department of Corrections Regulations Regarding
Physicians' Role:
The Director of Wyoming Department of
Corrections, in a June 15, 1992 letter stated that the departmental policies
and procedures regarding executions are confidential and may not be publicly
released. Our follow up request to cite the grounds for this confidentiality
went unanswered.
State Medical Society's Position:
The Wyoming Medical Society has no policy statement on physicians' role
in executions because the Society defers on this issue to the position
taken by the American Medical Association.
68
A document issued by the Medical Director of the Office of Health Services
of the Corrections Department prohibits any health care professional working
in the Corrections Department to participate in any part of the execution
procedure. (Standard of Care, Topic: Executions, Number: 86/11/02)
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