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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 October 6; 335(7622): 690.
PMCID: PMC2001080

Doctors who help give lethal injections should be punished, says Amnesty

Doctors and other healthcare staff who take any part in executions by lethal injection should be punished by their professional bodies, says the human rights organisation, Amnesty International.

In a report published to mark 25 years of the use of this method of execution, Amnesty says that leading professional organisations should push harder to outlaw the practice. The organisation opposes any form of capital punishment.

The practice is condoned in only six countries. But despite an overall fall in the numbers of lethal injections in four of these, it has become the execution method of choice in the United States, says the report.

There have been 919 such executions in the US since the method became legal in 1977 to the end of July this year. More prisoners are executed in China than anywhere else in the world, and the country increasingly views lethal injection as a more modern approach than death by shooting, says the report.

There are no official figures, but about 40% of executions are thought to use this method, with possibly thousands carried out to date, says the report.

As a procedure that involves a degree of medical expertise, lethal injections put pressure on doctors to take part, “raising serious ethical and human rights issues,” says Amnesty.

Doctors may also feel the need to help when poorly trained prison staff bungle the procedure, says the report.

It cites nine botched US cases of lethal injection since 2000, including one in 2001, in which the prisoner was pronounced dead 69 minutes after the execution had begun.

Virtually all codes of professional conduct that consider the death penalty oppose the participation of healthcare professionals.

But, says the report, “there is little commitment to take action when individuals disregard these ethical principles.” No doctor has so far been disciplined for taking part, it says.

And professional bodies are not doing enough to educate their members, says the report.

A 2001 survey published of 1000 members of the American Medical Association found that a “significant number” were prepared to inject a prisoner with poison, and only 3% were aware of the association's guidelines on the issue. The guidelines say that a doctor, 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 authorised execution.

Deborah Denno, of New York's Fordham University School of Law, said that some doctors argued that it was unethical to stand by and do nothing while a prisoner was clearly suffering. “If doctors think they will be tempted to help out, they can refuse to be present,” she countered.

Last week, the North Carolina Medical Board lost its battle with the Department of Corrections to be allowed to punish doctors taking part in lethal injections. “If every medical board did that, it would send out a very powerful message that the profession doesn't like it,” said Professor Denno.


Execution by Lethal Injection: A Quarter of a Century of State Poisoning is available at

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