ABSTRACT In a recent issue of this journal, David Silver and Gerald Dworkin discuss the physicians' role in execution by lethal injection. Dworkin concludes that discussion by stating that, at that point, he is unable to think of an acceptable set of moral principles to support the view that it is illegitimate for physicians to participate in execution by lethal injection that would not rule out certain other plausible moral judgements, namely that euthanasia is under certain conditions legitimate and that (...) organ‐donation surgery is sometimes permissible. This article draws attention to some problems in the views of Silver and Dworkin and suggests moral principles which support the three moral views just mentioned. (shrink)

Gerald Dworkin has argued that it is inconsistent with the proper ends of medicine for a physician to participate in an execution by lethal injection. He does this by proposing a principle by which we are to judge whether an action is consistent with the proper ends of medicine. I argue: (a) that this principle, if valid, does not show that it is inconsistent with the proper ends of medicine for a physician to participate in an execution by lethal injection; (...) and (b) that this principle is not valid, and this is because it mistakenly views the promotion of patient autonomy as one of the proper ends of medicine. Rather, I propose, we should view respect for a patient's autonomy as a constraint on the pursuit of the proper ends of medicine, rather than as one of the proper ends itself. With this revised understanding of the proper ends of medicine, we can conclude that it is inconsistent with the proper ends of medicine for a physician to participate in an execution by lethal injection. (shrink)

The United States Supreme Court recently ruled that execution by a commonly used protocol of drug administration does not represent cruel or unusual punishment. Various medical journals have editorialized on this drug protocol, the death penalty in general and the role that physicians play. Many physicians, and societies of physicians, express the opinion that it is unethical for doctors to participate in executions. This Target Article explores the harm that occurs to murder victims' relatives when an execution is delayed or (...) indefinitely postponed. By using established principles in psychiatry and the science of the brain, it is shown that victims' relatives can suffer brain damage when justice is not done. Conversely, adequate justice can reverse some of those changes in the brain. Thus, physician opposition to capital punishment may be contributing to significant harm. In this context, the ethics of physician involvement in lethal injection is complex. (shrink)

Book reviewed in this article: Principles of Biomedical Ethics. By Tom L. Beauchamp and James F. Childress.

An argument against the participation of physicians in capital punishment by means of lethal injection.

To circumvent objections that the death penalty was “cruel and unusual punishment” and therefore a violation of the Eighth Amendment to the Constitution, advocates proposed lethal injection and the involvement of physicians to overcome the negative perceptions associated with the death penalty, and to increase public acceptability of the practice. Initiated in 1982, lethal injection is now the primary method of execution in 37 of the 38 states with the death penalty. “To be exact, this method has been used to (...) kill 788 of the 956 men and women who have been executed in the United States since 1976, when the death penalty was reinstated by the Supreme Court.” More recently, of the 191 executions performed in the United States since 2001, 189 have been by lethal injection.This “medicalization” of the death penalty has ignited a debate, by those within the medical profession and by others outside it, about the appropriateness of physicians participating in executions. (shrink)

Over the course of its first seven editions, Principles of Biomedical Ethics has proved to be, globally, the most widely used, authored work in biomedical ethics. It is unique in being a book in bioethics used in numerous disciplines for purposes of instruction in bioethics. Its framework of moral principles is authoritative for many professional associations and biomedical institutions-for instruction in both clinical ethics and research ethics. It has been widely used in several disciplines for purposes of teaching in the (...) classroom, during conferences, etc. (shrink)

Cover -- Half Title -- Title -- Copyright -- Dedication -- Contents -- Acknowledgments -- 1 Preliminaries -- 1.1 What Normative Ethics Is -- 1.2 What Normative Ethics Is Not -- 1.3 Defending Normative Theories -- 1.4 Factors and Foundations -- PART I FACTORS -- 2 The Good -- 2.1 Promoting the Good -- 2.2 Well-Being -- 2.3 The Total View -- 2.4 Equality -- 2.5 Culpability, Fairness, and Desert -- 2.6 Consequentialism -- 3 Doing Harm -- 3.1 Deontology -- (...) 3.2 Thresholds -- 3.3 The Scope of the Constraint -- 3.4 Doing and Allowing -- 3.5 Intending Harm -- 4 Other Constraints -- 4.1 Lying -- 4.2 Promises -- 4.3 Special Obligations -- 4.4 Conventions -- 4.5 Duties to Oneself -- 5 Further Factors -- 5.1 Demanding Too Much -- 5.2 Options -- 5.3 Rights -- 5.4 Interaction -- PART 2 FOUNDATIONS -- 6 Teleological Foundations -- 6.1 Foundational Theories -- 6.2 Egoism -- 6.3 Virtues -- 6.4 Act Consequentialism -- 6.5 Rules -- 7 Deontological Foundations -- 7.1 Contractarianism -- 7.2 Universalizability -- 7.3 The Ideal Observer -- 7.4 Reflection -- 7.5 Foundational Pluralism -- 7.6 Possibilities -- Suggested Readings -- References -- About the Book and Author -- Index. (shrink)