Post by Maggie on Sept 8, 2006 6:44:07 GMT -5
A physician is willing to help Georgia with executions
By Jeremy Kohler
ST. LOUIS POST-DISPATCH
08/12/2006
Dr. Carlo Musso sees little difference between a terminally ill patient and a death-row inmate. In the case of the second, he said, a death sentence is the illness.
The government, not he, could cure the second by abolishing the death penalty, he said.
So, Musso does what he can to help inevitable deaths happen without pain. He says his actions conflict neither with medical ethics nor his own opposition to state-sanctioned killing.
Musso does a job which most medical societies, including the American Medical Association, ban their members from doing. He said he has participated in about five executions in his home state of Georgia.
Musso, who treats inmates at Georgia's county jails, said his only role at executions so far has been to pronounce death. He said he would be willing to do more, even assist a nurse with an intravenous line, if asked. But he would not give the lethal injection because he does not want to be the executioner.
Unlike most other physicians who participate in U.S. executions, Musso chooses not to hide his identity - even after anti-execution activists sought to have his predecessor's medical license revoked. He said he has exposed himself to criticism from death-penalty foes, but that he has also received letters from medical students commending his bravery.
For more than a decade, Missouri corrections officials got help from a surgeon who hid his identity. A Post-Dispatch story July 30 disclosed he was Dr. Alan Doerhoff of Jefferson City, a general surgeon whose privileges have been suspended by two hospitals and who had been reprimanded by the state Board of Healing Arts for hiding his malpractice lawsuit history.
Musso first allowed his name to be used in March in a New England Journal of Medicine article exploring physician involvement in executions. He said he's proud of what he does.
"When it comes to your profession, either you don't try to hide what you do or you choose not to do it," he said. "I've made my choice to speak out about my participation and to get involved in the debate over the ethical and moral choices we make."
Federal courts have required this year that three states give physicians roles in the process, and some experts believe many of the other 34 states that use lethal injections could face similar requirements. Two of those states, Illinois and Kentucky, specifically ban participation by doctors. MORE
Execution doctor stays secret
Behind the mask of the Mo. execution doctor
Doctors forced in the middle of a constitutional battle
The rulings have rankled medical societies such as the American Medical Association, which have repeatedly reminded members that participation in executions - however slight - could violate medical ethics.
The AMA, with about 300,000 members, is the nation's biggest medical association. It does not license or discipline doctors. AMA membership is not a requirement of practicing medicine. But the association serves a voice of organized medicine and its code of ethics serves as a guide for local and state medical societies.
Even pronouncing death is a slippery slope for physicians, according to AMA guidelines. In theory, a doctor could examine an inmate who was presumed dead and find signs of life. In such a case, he would find himself in a conflict between the state's duty to take the life and his duty to try to revive the inmate.
States hoping to continue executions might have to recruit doctors like Musso.
"It's different when you're there at the bedside," he said. "It's not a political issue at that point. The issue is the state is going to execute that individual regardless of what you believe."
Finding doctors willing to work at executions is proving hard in Missouri. U.S. District Judge Fernando Gaitan, in Kansas City, ordered prison officials to enlist an anesthesiologist to oversee lethal injections. Last month, the president of the Missouri Society of Anesthesiologists reminded members of their ethical obligation to avoid even ancillary tasks at executions.
Missouri prison officials wrote to nearly 300 anesthesiologists, but none volunteered for the job. Missouri finally appealed Gaitan's order to the 8th Circuit Court of Appeals in St. Louis, saying his order effectively amounted to an execution ban.
Many would participate
Despite Missouri's lack of success in finding an execution doctor, there is reason to think that many doctors would, in fact, be willing to participate in executions, and that doctors as a group are not uniformly opposed.
A study of American physicians published in 2000 found that 54 percent of doctors would condone a colleague's participation in executions.
A related study in 2001 found that 41 percent of doctors were willing themselves to perform most tasks at an execution that are disallowed by the American Medical Association. Nearly one in five said they would even be willing to administer the lethal drugs themselves.
The results surprised even the researchers, said Dr. Neil J. Farber, co-author of the study, an internist and professor at Christiana Care Health System in Wilmington, Del., who said the findings were "upsetting." He suggested those doctors were putting support of the death penalty ahead of their medical duty.
"The second thing was basically that they felt a duty to society to be involved," he said. "So you have physicians not feeling very concerned about individuals, but about their duty to society."
So where are those doctors now?
Farber said he thinks recent publicity concerning death-penalty appeals has dissuaded doctors from being involved.
He said few physicians he encountered during his previous studies were aware of ethical guidelines concerning executions. He suggested that a new study might indicate less willingness to participate.
"It's clear that the physicians who are involved are looked down upon by society," he said. "People are saying that physicians should not be involved."
A doctor steps down
Some execution doctors whose identities were revealed have suffered blistering criticism.
Arthur Zitrin, a retired psychiatrist and death penalty opponent from New York, filed suit last July in Georgia's Fulton County to try to force the state Composite Board of Medical Examiners to punish doctors who help with state executions.
Zitrin previously tried unsuccessfully to get the board to revoke the license of Dr. Hothur V. Sanjeeva Rao, a doctor who helped the state carry out lethal injections. The medical board refused to investigate Rao, who quit working at executions, opening the door for Musso. Rao has declined to speak with media in Georgia and did not return a phone message seeking an interview.
Zitrin said he was not involved in any action against Musso.
"I think that physicians should not be agents of the state's punitive operatus," he said. "It's not an appropriate or an acceptable social position for physicians to take."
On the contrary, Musso said, it would be unethical to walk away from a dying patient.
"I've heard from medical students, e-mailing me and thanking me for having the courage to speak out," he said. "They agree that the water is muddy when it comes to the right thing to do."
jkohler@post-dispatch.com 314-340-8337
www.stltoday.com/stltoday/news/stories.nsf/stlouiscitycounty/story/0D30CAC213CD1F26862571C8006FD70A?OpenDocument
By Jeremy Kohler
ST. LOUIS POST-DISPATCH
08/12/2006
Dr. Carlo Musso sees little difference between a terminally ill patient and a death-row inmate. In the case of the second, he said, a death sentence is the illness.
The government, not he, could cure the second by abolishing the death penalty, he said.
So, Musso does what he can to help inevitable deaths happen without pain. He says his actions conflict neither with medical ethics nor his own opposition to state-sanctioned killing.
Musso does a job which most medical societies, including the American Medical Association, ban their members from doing. He said he has participated in about five executions in his home state of Georgia.
Musso, who treats inmates at Georgia's county jails, said his only role at executions so far has been to pronounce death. He said he would be willing to do more, even assist a nurse with an intravenous line, if asked. But he would not give the lethal injection because he does not want to be the executioner.
Unlike most other physicians who participate in U.S. executions, Musso chooses not to hide his identity - even after anti-execution activists sought to have his predecessor's medical license revoked. He said he has exposed himself to criticism from death-penalty foes, but that he has also received letters from medical students commending his bravery.
For more than a decade, Missouri corrections officials got help from a surgeon who hid his identity. A Post-Dispatch story July 30 disclosed he was Dr. Alan Doerhoff of Jefferson City, a general surgeon whose privileges have been suspended by two hospitals and who had been reprimanded by the state Board of Healing Arts for hiding his malpractice lawsuit history.
Musso first allowed his name to be used in March in a New England Journal of Medicine article exploring physician involvement in executions. He said he's proud of what he does.
"When it comes to your profession, either you don't try to hide what you do or you choose not to do it," he said. "I've made my choice to speak out about my participation and to get involved in the debate over the ethical and moral choices we make."
Federal courts have required this year that three states give physicians roles in the process, and some experts believe many of the other 34 states that use lethal injections could face similar requirements. Two of those states, Illinois and Kentucky, specifically ban participation by doctors. MORE
Execution doctor stays secret
Behind the mask of the Mo. execution doctor
Doctors forced in the middle of a constitutional battle
The rulings have rankled medical societies such as the American Medical Association, which have repeatedly reminded members that participation in executions - however slight - could violate medical ethics.
The AMA, with about 300,000 members, is the nation's biggest medical association. It does not license or discipline doctors. AMA membership is not a requirement of practicing medicine. But the association serves a voice of organized medicine and its code of ethics serves as a guide for local and state medical societies.
Even pronouncing death is a slippery slope for physicians, according to AMA guidelines. In theory, a doctor could examine an inmate who was presumed dead and find signs of life. In such a case, he would find himself in a conflict between the state's duty to take the life and his duty to try to revive the inmate.
States hoping to continue executions might have to recruit doctors like Musso.
"It's different when you're there at the bedside," he said. "It's not a political issue at that point. The issue is the state is going to execute that individual regardless of what you believe."
Finding doctors willing to work at executions is proving hard in Missouri. U.S. District Judge Fernando Gaitan, in Kansas City, ordered prison officials to enlist an anesthesiologist to oversee lethal injections. Last month, the president of the Missouri Society of Anesthesiologists reminded members of their ethical obligation to avoid even ancillary tasks at executions.
Missouri prison officials wrote to nearly 300 anesthesiologists, but none volunteered for the job. Missouri finally appealed Gaitan's order to the 8th Circuit Court of Appeals in St. Louis, saying his order effectively amounted to an execution ban.
Many would participate
Despite Missouri's lack of success in finding an execution doctor, there is reason to think that many doctors would, in fact, be willing to participate in executions, and that doctors as a group are not uniformly opposed.
A study of American physicians published in 2000 found that 54 percent of doctors would condone a colleague's participation in executions.
A related study in 2001 found that 41 percent of doctors were willing themselves to perform most tasks at an execution that are disallowed by the American Medical Association. Nearly one in five said they would even be willing to administer the lethal drugs themselves.
The results surprised even the researchers, said Dr. Neil J. Farber, co-author of the study, an internist and professor at Christiana Care Health System in Wilmington, Del., who said the findings were "upsetting." He suggested those doctors were putting support of the death penalty ahead of their medical duty.
"The second thing was basically that they felt a duty to society to be involved," he said. "So you have physicians not feeling very concerned about individuals, but about their duty to society."
So where are those doctors now?
Farber said he thinks recent publicity concerning death-penalty appeals has dissuaded doctors from being involved.
He said few physicians he encountered during his previous studies were aware of ethical guidelines concerning executions. He suggested that a new study might indicate less willingness to participate.
"It's clear that the physicians who are involved are looked down upon by society," he said. "People are saying that physicians should not be involved."
A doctor steps down
Some execution doctors whose identities were revealed have suffered blistering criticism.
Arthur Zitrin, a retired psychiatrist and death penalty opponent from New York, filed suit last July in Georgia's Fulton County to try to force the state Composite Board of Medical Examiners to punish doctors who help with state executions.
Zitrin previously tried unsuccessfully to get the board to revoke the license of Dr. Hothur V. Sanjeeva Rao, a doctor who helped the state carry out lethal injections. The medical board refused to investigate Rao, who quit working at executions, opening the door for Musso. Rao has declined to speak with media in Georgia and did not return a phone message seeking an interview.
Zitrin said he was not involved in any action against Musso.
"I think that physicians should not be agents of the state's punitive operatus," he said. "It's not an appropriate or an acceptable social position for physicians to take."
On the contrary, Musso said, it would be unethical to walk away from a dying patient.
"I've heard from medical students, e-mailing me and thanking me for having the courage to speak out," he said. "They agree that the water is muddy when it comes to the right thing to do."
jkohler@post-dispatch.com 314-340-8337
www.stltoday.com/stltoday/news/stories.nsf/stlouiscitycounty/story/0D30CAC213CD1F26862571C8006FD70A?OpenDocument
