Officials liked this method. Because it borrowed from established anesthesia techniques, it made execution like familiar medical procedures rather than the grisly, backlash-inducing spectacle it had become. (In Missouri, executions were even moved to a prison-hospital procedure room.) It was less disturbing to witness. The drugs were cheap and routinely available. And officials could turn to doctors and nurses to help with technical difficulties, attest to the painlessness and trustworthiness of the technique, and lend a more professional air to the proceedings.
My students' answers didn't exhibit any philosophical resistance to the idea of greatness. It's not that they had been primed by their professors with complex arguments to combat genius. For the truth is that these students don't need debunking theories. Long before college, skepticism became their habitual mode. They are the progeny of Bart Simpson and David Letterman, and the hyper-cool ethos of the box. It's inane to say that theorizing professors have created them, as many conservative critics like to do. Rather, they have substantially created a university environment in which facile skepticism can thrive without being substantially contested.
Why are my students describing the Oedipus complex and the death drive as being interesting and enjoyable to contemplate? And why am I coming across as an urbane, mildly ironic, endlessly affable guide to this intellectual territory, operating without intensity, generous, funny, and loose?
"Tell me, Socrates, have you got a nurse?"
"Why do you ask such a question," I said, "when you oughtrather to be answering?"
"Because she leaves you to snivel, and never wipes your nose: shehas not even taught you to know the shepherd from the sheep."
Salem Village had a very colorful history before the famous witch trials. It was notexactly known as a bastion of tranquillity in New England. The main reason was its 600plus residents were divided into two main parts: those who wanted to separate fromSalem Town, and those who did not. The residents who wanted to separate from SalemTown were farming families located in the western part of Salem Village. Those whowanted to remain a part of Salem Town were typically located on the eastern side of Salem Village--closest to Salem Town. The residents who wished to remain a part ofSalem Town were economically tied to its thriving, rich harbors.
Sometimes, however, we will be wrong — as I think the doctors and nurses are who have used their privileged skills to make possible 844 deaths by lethal injection thus far. We each should then be prepared to accept the consequences. Unlike Dr. Musso, however, nearly all these doctors and nurses have sought to keep their actions hidden in order not to face the consequences. In the final analysis, I think this is what makes their actions seem particularly troubling. We cannot blame them for their impulse to hide. But we cannot admire them either.
The four physicians and the nurse I spoke to all acted against long-standing principles of their professions. Their actions have made our ethics codes effectively irrelevant in society. Yet, it must be said, most took their moral duties seriously. It is worth reflecting on this truth as well.
The doctors' and nurse's arguments for competence and comfort in the execution process do have some force. But however much they may wish to be there for an inmate, it seems clear that the inmate is not really their patient. Unlike genuine patients, an inmate has no ability to refuse the physicians' “care” — indeed, the inmate and his family are not even permitted to know the physician's identity. And the medical assistance provided primarily serves the government's purposes — not the inmate's needs as a patient. Medicine is being made an instrument of punishment. The hand of comfort that more gently places the IV, more carefully times the bolus of potassium, is also the hand of death. We cannot escape this truth. The ethics codes seem right.
There is little doubt that lethal injection can be painless and peaceful, but as courts have recognized, this requires significant medical assistance and judgment — for placement of intravenous lines, monitoring of consciousness, and adjustments in medication timing and dosage. In recent years, medical societies have persuaded two states, Kentucky and Illinois, to pass laws forbidding physician participation in executions. Nonetheless, officials in each of these states intend to continue to rely on medical supervision, employing nurses and nurse-anesthetists instead. How, then, to reconcile the conflict between government efforts to ensure a medical presence and our ethical principles forbidding it? Are our ethics what should change?
Three weeks after speaking to me, he told me to go ahead and use his name. It is Dr. Carlo Musso. He helps with executions in Georgia. He didn't want to seem as if he was hiding anything, he said. He didn't want to invite trouble, either. But activists have already challenged his license and his membership in the AMA, and he is resigned to the fight. “It just seems wrong for us to walk away, to abdicate our responsibility to the patients,” he said.
His group took the contract, and he has been part of the medical team for each execution since. The doctors are available to help if there are difficulties with IV access, and Dr. D considers it their task to ensure that the prisoner is without pain or suffering through the process. He himself provides the cardiac monitoring and the final determination of death. Watching the changes on the two-line electrocardiogram tracing, “I keep having that reflex as an ER doctor, wanting to treat that rhythm,” he said. Aside from that, his main reaction is to be sad for everyone involved — the prisoner whose life has led to this, the victims, the prison officials, the doctors. The team's payment is substantial — $18,000 — but he donates his portion to the children's shelter where he volunteers.
My conversations with the physicians and the nurse I had tracked down, however, rattled both of these views — and no conversation more so than one I had with the final doctor I spoke to. Dr. D is a 45-year-old emergency physician. He is also a volunteer medical director for a shelter for abused children. He works to reduce homelessness. He opposes the death penalty because he regards it as inhumane, immoral, and pointless. And he has participated in six executions so far.