Participation of medical professionals in American executions is a controversial topic, due to its moral and legal implications. The practice is proscribed by the American Medical Association, as defined in its Code of Medical Ethics. The American Society of Anesthesiologists endorses this position, stating that lethal injections "can never conform to the science, art and practice of anesthesiology".
In 2010, the American Board of Anesthesiologists, a member board of the American Board of Medical Specialties, voted to revoke the certification of anesthesiologists who participate in executing a prisoner by lethal injection. Board secretary Mark A. Rockoff defended the organization's policy, stating that participation in executions "puts anesthesiologists in an untenable position," and that physicians "can assuredly provide effective anesthesia, but doing so in order to cause a patient's death is a violation of their fundamental duty as physicians to do no harm."
In at least one case, the planned execution of Michael Morales, the execution warrant was stayed indefinitely due to the objection of the contacted physicians to participate.
The topic was the subject of a 1992 review by the American Medical Association, entitled Physician Participation in Capital Punishment.
Moral discussion
U.S. Supreme Court cases discussing the constitutionality of execution methods often involve testimony of medical professionals; one example of such a case being the 2008 Baze v. Rees case, which affirmed the constitutionality of the three-drug lethal injection protocol as a method of capital punishment, despite claims that the single drug used for animal euthanasia is more humane than the three-drug cocktail currently used.
One particular concern to opponents of physician participation in capital punishment is the role that health care providers have played in treating or reviving patients to render them fit for execution. In a 1995 Oklahoma case, death row inmate Robert Brecheen intentionally overdosed on sleeping pills hours before his scheduled lethal injection. He was immediately hospitalized and had his stomach pumped, before being returned to prison for his execution. In a similar 1999 case in Texas, David M. Long attempted suicide by drug overdose two days before his execution date and prison authorities flew him from an intensive care unit in Galveston, on a ventilator, accompanied by a full medical team, to the death chamber in Huntsville.
A survey of physicians was conducted concerning the ethics of engaging in eight actions considered by the AMA to constitute participation in capital punishment, and therefore deemed unethical for physicians. The eight actions were (a) administration of lethal drugs, (b) starting intravenous lines for such drugs, (c) maintaining or inspecting lethal injection devices, (d) ordering lethal drugs, (e) supervising the administration of lethal drugs, (f) selecting injection sites, (g) monitoring vital signs during the execution, and (h) determining death. According to the findings, "Eighty percent indicated that at least 1 of the disallowed actions was acceptable, 53% indicated that 5 or more were acceptable, and 34% approved all 8 disallowed actions. The percentage of respondents approving of disallowed actions varied from 43% for injecting lethal drugs to 74% for determining when death occurred."
Botched executions
Possibly botched executions include those of Stanley Williams, Ángel Nieves Díaz, and others. The only execution by lethal injection that failed to kill the condemned prisoner in the United States occurred on September 15, 2009, in Ohio, when executioners attempted and then aborted the execution of Romell Broom, leading to the implementation of a one-drug method. More than six decades earlier, on May 3, 1946, an unsuccessful attempt at the electrocution of Willie Francis, then aged 17, led to an appeal to the U.S. Supreme Court to reject a second attempt at electrocuting Francis, which failed by a 5–4 vote in Francis v. Resweber, resulting in Francis' successful electrocution just over a year later, on May 9, 1947.