April/May96
Physicians, Reflect: Primum
Non Nocere
by Pierre Duterte, M.D.
A PHYSICIAN CANNOT ESCAPE the essential principle: Primum
non nocere ('First and foremost is not to harm or injure'). How can
we reconcile the death penalty with medical practice? To accept the death
penalty means accepting involvement in it. For me, this is impossible. Lethal
injection can only be performed with the help of physicians: passively-by
preparing drugs, training the staff; actively-by setting up the IV
line, checking the killing machine, supervising the execution.
The medicalization of execution reflects a stage of our evolution. During
"barbaric" times, you were stoned to death, fed to lions. In the
middle ages, you were hanged, burned and in Europe guillotined (to try to
make it look more "humane). In industrial times, you benefited from
the magic of electricity. We are now at the medical stage. What will be
the future mode of execution? Ecological?
For a long time physicians compromised themselves with the "humanitarian"
excuse, like the French Dr. Guillotin, famous for his "fresh blow on
the nape of the neck." With lethal injection, there is a mockery of
medicine: the gurney, white sheets, leather strap, bladder catheter, anus
catheter, IV drip, and sometimes the site of execution made to resemble
an operating theater! Some states execute in old hospitals!
If there is an anesthesia, it is for the public and the media, to make them
proud of their own "humanity," satisfied with this medicalization,
this humanization of barbarity. All is as clean as an IV! Death is like
undergoing anesthesia! But when you read about all the failures of this
method, you must admit there is nothing really humane in this. And killing
by any means is not "humane." The way you get killed is not the
important thing. We just feel a little less guilty by letting the state
put to sleep forever, in our name, one of its citizens.
Although the death penalty and euthanasia have nothing in common, as some
people believe, it is interesting to note the paradox. Euthanasia is illegal
nearly everywhere in the world, but sometimes compatible with ethics, whereas
the death penalty is legal in some places in the world, but totally incompatible
with ethics.
The death penalty has nothing in common with the practice of medicine in
the broad sense of the term. A doctor involved with lethal injection is
prostituting his knowledge to serve the state.
We as physicians, as human beings, must refuse to let ourselves be corrupted
by this "humanitarian" excuse. Ethics applies worldwide. There
is a time when a physician is not allowed to hide or put his mind at ease
behind law.
Pierre Duterte works in a French association taking care of refugees,
victims of torture or repression in their homeland. He writes to death
row prisoners and prisoners in general population in quite a number of states
in the U.S. He has been to the Texas death row twice.