NEW VOICES: American Medical Association, EMT Association Say Participation in Executions Violates Medical Ethics

Both the American Medical Association (AMA) and the National Association of Emergency Medical Technicians (NAEMT) recent­ly issued pub­lic state­ments remind­ing mem­bers of their eth­i­cal oblig­a­tion not to par­tic­i­pate in legal­ly autho­rized exe­cu­tions. As courts and leg­is­la­tures through­out the coun­try con­tin­ue to strug­gle with ques­tions relat­ed to lethal injec­tion pro­ce­dures, AMA pres­i­dent William G. Plested III not­ed that AMA pol­i­cy clear­ly pro­hibits med­ical pro­fes­sion­als from par­tic­i­pat­ing in exe­cu­tions because it ​“erodes pub­lic con­fi­dence in the med­ical pro­fes­sion.” The NAEMT issued a posi­tion paper stat­ing that mem­ber par­tic­i­pa­tion in exe­cu­tions is for­bid­den because it ​“is incon­sis­tent with the eth­i­cal pre­cepts and goals of the EMS profession.” 

In his state­ment for the AMA, Plested not­ed:

The American Medical Association is trou­bled by con­tin­u­ous refusal of many state courts and leg­is­la­tures to acknowl­edge the eth­i­cal oblig­a­tions of physi­cians, which strict­ly pro­hib­it physi­cian involve­ment in a legal­ly autho­rized exe­cu­tion. The AMA’s pol­i­cy is clear and unam­bigu­ous — requir­ing physi­cians to par­tic­i­pate in exe­cu­tions vio­lates their oath to pro­tect lives and erodes pub­lic con­fi­dence in the med­ical pro­fes­sion.

A physi­cian is a mem­ber of a pro­fes­sion ded­i­cat­ed to pre­serv­ing life when there is hope of doing so. The use of a physi­cian’s clin­i­cal skill and judg­ment for pur­pos­es oth­er than pro­mot­ing an indi­vid­u­al’s health and wel­fare under­mines a basic eth­i­cal foun­da­tion of med­i­cine — first, do no harm.

The guide­lines in the AMA Code of Medical Ethics address physi­cian par­tic­i­pa­tion in exe­cu­tions involv­ing lethal injec­tion. The eth­i­cal opin­ion explic­it­ly pro­hibits select­ing injec­tion sites for exe­cu­tions by lethal injec­tion, start­ing intra­venous lines, pre­scrib­ing, admin­is­ter­ing, or super­vis­ing the use of lethal drugs, mon­i­tor­ing vital signs, on site or remote­ly, and declaring death.

As the voice of American med­i­cine, the AMA urges all physi­cians to remain ded­i­cat­ed to our eth­i­cal oblig­a­tions that pro­hib­it involve­ment in capital punishment.

(AMA Press Release, ​“AMA: Physician Participation in Lethal Injection Violates Medical Ethics,” July 17, 2006)

The NAEMT posi­tion statement stated:

The National Association of Emergency Medical Technicians (NAEMT) is strong­ly opposed to par­tic­i­pa­tion in cap­i­tal pun­ish­ment by an EMT, Paramedic or oth­er emer­gency med­ical pro­fes­sion­al. Participation in exe­cu­tions is viewed as con­trary to the fun­da­men­tal goals and eth­i­cal oblig­a­tions of emer­gency med­ical ser­vices.
…

Historically, the role of EMTs and para­medics has been to pro­mote, pre­serve and pro­tect human life. NAEMT’s EMT Oath is based on the basic prin­ci­ples of sav­ing life, respect for human life and the non-inflic­tion of harm to all recip­i­ents of emer­gency med­ical ser­vice care. The EMT Oath is a guide for the EMT and para­medic code of con­duct and stip­u­lates that the EMT or para­medic ​“fol­low that reg­i­men which, accord­ing to my abil­i­ty and judg­ment, I con­sid­er for the ben­e­fit of patients and abstain from what­ev­er is dele­te­ri­ous and mis­chie­vous.” The oblig­a­tions to res­cue, save and pre­serve life are part of the essen­tial trust rela­tion­ship that the EMT and para­medic have with all peo­ple in a com­mu­ni­ty and should not be breached even when legal­ly sanc­tioned.

Participation in cap­i­tal pun­ish­ment is incon­sis­tent with the eth­i­cal pre­cepts and goals of the EMS pro­fes­sion.

NAEMT strong­ly oppos­es to all forms of par­tic­i­pa­tion, by what­ev­er means, whether under civ­il or mil­i­tary legal author­i­ty.

EMTs and Paramedics should refrain from par­tic­i­pa­tion in cap­i­tal pun­ish­ment and not take part in assess­ment, super­vi­sion or mon­i­tor­ing of the pro­ce­dure or the pris­on­er; procur­ing, pre­scrib­ing or prepar­ing med­ica­tions or solu­tions; insert­ing the intra­venous catheter; inject­ing the lethal solu­tion; and/​or attend­ing or wit­ness­ing the exe­cu­tion as an EMT or Paramedic.

The fact that cap­i­tal pun­ish­ment is cur­rent­ly sup­port­ed in many seg­ments of soci­ety does not over­ride the oblig­a­tion of EMTs and Paramedics to uphold the eth­i­cal man­dates of the pro­fes­sion.

NAEMT rec­og­nizes that endorse­ment of the death penal­ty remains a per­son­al deci­sion and that indi­vid­ual EMTs and para­medics may have views that are dif­fer­ent from the offi­cial posi­tion of the pro­fes­sion. Regardless of the per­son­al opin­ion of the EMT or para­medic on the appro­pri­ate­ness of cap­i­tal pun­ish­ment, it is a breach of the foun­da­tion­al pre­cepts of emer­gency med­ical ser­vices, and a vio­la­tion of the EMT Oath, to par­tic­i­pate in tak­ing life of any person.

(NAEMT Position Statement on EMT and Paramedic Participation in Capital Punishment, June 9, 2006) 

See New Voices and Methods of Execution.