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The American Board of Anesthesiologists has determined that any member who participates in a legal execution faces expulsion. From the official notice:

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.

I have absolutely no objection to kicking out a doctor that violates his association’s ethical rules.  But it is curious.  If doctors should not kill as part of their professional capacity- -and that’s certainly a reasonable maxim—they should not kill in any context.  The directive should also be applied by the ABA—and the AMA, for that matter—to kick out any doctor assisting suicides or engaging in euthanasia.  Otherwise, all I see is cowardice, posturing, and hypocrisy in this. After all, the Hippocratic Oath explicitly bans participating in assisted suicide but is silent about executions.

The assisted suicide laws in Oregon and Washington prohibit such professional sanctions.  But in my view, since these groups are voluntary associations, such prohibitions are profoundly unconstitutional as they eviscerate the right of free association.  I just wish affected medical associations had the guts to drive that point home.

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