THE AMERICAN BOARD OF ANESTHESIOLOGY, INC. A Member Board of the American Board of Medical Specialties 4208 Six Forks Road, Suite 900, Raleigh, North Carolina 27609-5753 Phone: (866) 999-7501 Fax: (866) 999-7503 Website: www.theABA.org Commentary (4/2/10) Anesthesiologists and Capital Punishment The majority of states in the United States authorize capital punishment, and nearly all states utilize lethal injection as the means of execution. However, this method of execution is not always straightforward (1), and, therefore, some states have sought the assistance of anesthesiologists (2). This puts anesthesiologists in an untenable position. They 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. For decades the American Medical Association (AMA) has been opposed to physician involvement in capital punishment on the grounds that physicians are members of a profession dedicated to preserving life when there is hope of doing so (3). Effective February 15, 2010, the American Board of Anesthesiology (ABA) has incorporated the AMA’s position on capital punishment into its professional standing requirements for all anesthesiologists who are candidates for or diplomates of the ABA (4). Thus, anesthesiologists may not participate in capital punishment if they wish to be certified by the ABA. What constitutes participation is clearly defined by the AMA’s policy. The ABA has not taken this action because of any position regarding the appropriateness of the death penalty. Anesthesiologists, like all physicians and all citizens, have different personal opinions about capital punishment. Nonetheless, the ABA, like the AMA, believes strongly that physicians should not be involved in capital punishment. The American Society of Anesthesiologists has also supported the AMA’s position in this regard (5), as have others (6). Patients should never confuse the practice of anesthesiology with the injection of drugs to cause death. Physicians should not be expected to act in ways that violate the ethics of medical practice, even if these acts are legal. In conclusion, the ABA’s policy on capital punishment is intended to uphold the highest standards of medical practice and encourage anesthesiologists and other physicians to honor their professional obligations to patients and society. Mark A. Rockoff, MD Secretary, ABA Board of Directors President Steven C. Hall, MD Chicago, IL Vice President Glenn P. Gravlee, MD Aurora, CO Secretary Mark A. Rockoff, MD Boston, MA Treasurer Douglas B. Coursin, MD Madison, WI J. Jeffrey Andrews, MD San Antonio, TX David L. Brown, MD Cleveland, OH Daniel J. Cole, MD Phoenix, AZ Deborah J. Culley, MD Boston, MA Brenda G. Fahy, MD Lexington, KY Cynthia A. Lien, MD New York, NY James P. Rathmell, MD Boston, MA Mark A. Warner, MD Rochester, MN ____________ Executive Staff Mary E. Post, MBA, CAE Executive Director, Administrative Affairs References 1. Black L, Sade RM. Lethal injection and physicians: State law vs. medical ethics. JAMA. 2007; 298(23):2779-81. 2. Gawande A. When law and ethics collide: Why physicians participate in executions. N Engl J Med. 2006;354(12):1221-9. 3. American Medical Association Code of Medical Ethics, Opinion E-2.06 - Capital Punishment (June 2000). (Accessed March 9, 2010, at http://www.ama-assn.org/ama/pub/physicianresources/medical-ethics/code-medical-ethics/opinion206.shtml) 4. American Board of Anesthesiology professional standing policy: Anesthesiologists and capital punishment. (Accessed February 15, 2010, at http://www.theABA.org/Home/notices#punishment) and Newsletter of the American Society of Anesthesiologists 2010; 74(3): 49 (ASA Newsletter will be available online after April 1, 2010 at: http://www.asahq.org/Newsletters/NL%20Portal/march10.html) 5. Guidry OF. Message from the President: Observations regarding lethal injection. Newsletter of the American Society of Anesthesiologists. August, 2006. (Accessed March 9, 2010, at http://www.asahq.org/Newsletters/2006/08-06/guidry08-06.html) 6. Truog RD, Brennan TA. Participation of physicians in capital punishment. N Engl J Med 1993; 329: 1346-1350.