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Chicago - A botched lethal injection in Oklahoma this week has renewed a debate on whether doctors should be banned from executions - or required to participate to make the process more humane.
Some of the nation's 32 death penalty states mandate doctor participation - including Oklahoma - but critics say what happened there proves a doctor's presence can't guarantee the process will go smoothly.
"Physicians have an ethical and moral responsibility to remain as far from the execution chamber as possible," said Dr. Jonathan Weisbuch of Phoenix, a death penalty opponent. He calls what happened in Oklahoma torture. "How dare they experiment on a living human being," Weisbuch said.
In Oklahoma on Tuesday, the execution team struggled to find a suitable vein for injecting the lethal drugs and a vein collapse prevented the drugs from working properly. Clayton Lockett, a convicted murderer, writhed before the execution was called off. He died later of apparent heart attack. According to witnesses and a letter from the state's prisons chief, a physician checked the IV line, checked to see if Lockett was unconscious and reported that not enough drugs had been given to kill him - all violations of the American Medical Association's ethics policy.
The AMA says it's unethical for doctors to be involved except in a peripheral way. That's one reason why the number and identities of physicians who do participate are shrouded in secrecy. Dr. Ardis Dee Hoven, the AMA's president, issued a statement Friday regarding Lockett's execution.
"No matter how one feels about capital punishment, it is disquieting for physicians to act as agents of the state in the assisting, supervising or contributing to a legally authorized execution," Hoven said. "The American Medical Association is troubled by continuous refusal of states to acknowledge the ethical obligations of physicians that strictly prohibit involvement in capital punishment."
Weisbuch says the Oklahoma case underscores why an execution moratorium is needed. He plans to ask the AMA to lobby for a ban at the group's policymaking meeting next month in Chicago. Similar attempts have failed. But whether Lockett's execution, execution drug shortages and concerns about their effectiveness will sway the AMA this time remain to be seen.
The group's endorsement might deter some physicians from participating, but whether it would influence pro-death penalty politicians is uncertain.
Richard Dieter, executive director of the Death Penalty Information Center, an advocacy group critical of how capital punishment is usually carried out, said doctors' participation in executions often pits the medical profession against the judicial system. "Lawsuits say this is a medical procedure being done by guards - it could go wrong," Dieter said. "Courts want assurances" that condemned inmates won't suffer, he said.
Yet even if doctors don't feel bound by AMA policy - only about 20 percent of U.S. physicians are AMA members - many strongly adhere to their oath to do no harm.
Dieter said states' execution protocols often don't specify what role doctors play, and they're often updated, so it's difficult to quantify the number of doctors involved. Dieter said his organization doesn't keep tabs.
Here are some examples of current execution rules:
• Texas says unspecified members of "the drug team" inject the drugs, and a physician enters the death chamber when the execution is over, "to examine the offender, pronounce the offender's death, and designate the official time of death."
• North Carolina says a doctor will monitor the condemned inmate "and immediately notify the warden of any signs of undue pain or suffering."
• Kentucky's mandate says, "No physician shall be involved in the conduct of an execution except to certify cause of death provided that the condemned is declared dead by another person."
Dr. Neil Farber, a University of California, San Diego internist and educator, said surveys he did more than a decade ago found that almost 20 percent of doctors would be willing to perform lethal injections.
Farber said it's likely Lockett's execution will change some minds.
"I sure hope so," he said. "Whether a physician supports or is opposed to the death penalty, I think it is something society needs to address."