Kentucky Governor, Ernie Fletcher, M.D., recently signed the death warrant ordering the execution of Thomas Clyde Bowling, 51, on November 30, 2004. Participation by physicians in the execution of prisoners is considered an aberrant form of medical practice by the American Medical Association, the American College of Physicians, the American Public Health Association and many other health professional organizations.
In March, 1994, the AMA issued a "fatwah" to state medical licensure boards to treat physician participation in the execution of prisoners as a cause for professional discipline. The AMA Code of Medical Ethics proscribes a physician from playing an active or passive role in state executions. This is more than a passive involvement. The Code provides, in part, " a physician as a member of a profession dedicated to preserving life when there is hope of doing so should not be a participant in a legally authorized execution."
Physicians in Kentucky are required by the Kentucky state licensure board to adhere to the AMA ethical guidelines. A number of physicians, including 86 year old retired NYU psychiatrist, Arthur Zitrin, are calling for the removal of Governor Ernie's medical license. This would lead to the unseemly prospect of a sitting governor of a state being hauled before a state professional licensing board for discipline resulting from the legal performance of his gubnatorial duties. It is an interesting thought, but it won't happen.
Execution by legal injection does seem more humane in a way. It is at least more aesthetically pleasing. An observer is generally not faced with the vision of burning flesh or eyeballs popping out of the skull as a result of clumsy efforts at dispatching a human life. Lethal injections are more clinical and controlled. They occur ina quasi-operating room environment with the soon to be dispatched stapped to the "altar" like an early Aztec offering. When the curtain is raised for the observers (Yes, there is an element of theater here), the prisoner has already been connected to the agency of death by the insertion of needles into her arm connecting her with several lintervenous drips. (They carefully use an antiseptic swipe before inserting the needles so as not to cause an infection.) One of the drips connects to a harmless saline drip. The others are more lethal. One connects to a dose of sodium thiopental which will render the patient unconscious. Another leads to a dose of pansurmonium which will relax the prisoner's muscles to prevent involuntary movement.
The last releases potassium chloride. This is an anesthetic overdose which will precipitate immediate cardiac and respiratory arrest. The beauty is that if sodium thiopental does not do the job to completely induce a state of unconsciousness, no observers will ever know because the prisoner will be paralyzed and unable to move anyway.
In 1977, Oklahoma became the first state in the union to adopt lethal injection as the favored form of execution. Despite the overall statistical lead of the State of Texas in the number of executions, Oklahoma still holds the per capita capital lead. It also holds the distinction for having executed the most women in a given year. In 2001, it executed three women, including a client and friend of mine, Lois Nadean Smith.
Nadean Smith embraced her death with dignity and peace. She had an unwavering faith that who was on her way to meet the Lord in heaven and had no fear of death. Her only concern was the effect it would have on her family and her lawyers. She was convinced that her role was to help comfort the two women execucted before her and when they were gone she was ready to go. A doctor in a brown corduroy sport coat nervously twisted his stethoscope in his hands. He looked as queasy and uncomfortable as the warden of Mabel Bassett Women's penitentiary, who came to know and respect Nadean Smith over the years of her incarceration.
The participation of doctors in the machinery of death seems more disturbing than the crusade of someone like Dr. Jack Kevorkian, M.D., who is serving time for assisting in the 1998 suicide of Thomas Youk who was slowly and torturously expiring of amyatrophic lateral sclerosis, ("Lou Gehrig's disease"). What is perhaps even more disturbing is the failure of a governor to at least take a hard and careful look at the death cases that come before them rather than engaging in the trend to wash their hands from responsibility in the solvent of the "will of the people."
Many people believe that capital cases are carefully scrutinized for error at every level of appeal in state and federal courts and that the likelihood of a miscarriage of justice is remote. Unfortunately that is not the case. Most of these cases are passed from one court to another with a hot potato rubber stamp, with judges frequently going great distances to find identified error as "harmless," in order to implement the people's will.
Mr. Bolling, who will die on November 30, was convicted of a double murder based entirely on circumstantial evidence. He is mildly retarded and denies ever having met the victims. There is no evidence that he knew the victims and there is no evidence of motive. There was no robbery. One of the victims was known to have turned in a drug dealer to law enforcement agencies just prior to his murder. An associate of the drug dealer was known to have had access to Mr. Bowling's automobile, which was the principal connection between Mr. Bowling and the murder because of the matching of paint and glass at the scene. It can't or shouldn't be a satisfying experience for the governor. Some of his political opponents have been less than charitable remarking that he finds it easier to keep his pledge of no new taxes than his Hippocratic Oath.
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