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Prison Physician Weighs His Role in Executions

Last week, a U.S. doctor and two nurses were charged with murdering four seriously ill patients who were trapped with hundreds of others in a flood-damaged, sweltering New Orleans hospital after hurricane Katrina. In addition to the ethical issues involved in that case, there are also renewed questions about the ethics of physicians and nurses participating in the execution of inmates sentenced to death in U.S. prisons.

Capital punishment has been outlawed by 85 countries, including most of the major western nations, but the United States allows execution as a punishment for murder.

Some executions are carried out with a lethal dose of sedative drugs administered intravenously, which means medical professionals must be involved in the process. But doctors and nurses take a professional oath to "do no harm," and many ethicists have questioned whether ending the life, even of a violent felon, violates their oath.

Carlo Musso is a physician in Georgia who provides health care to inmates. After years of working in the correctional system, Musso says he got a request to participate in the execution of a condemned prisoner. "My original thoughts were how horrible it must be for a physician to take care of an inmate on death row and then after years participate in the execution of his patient," he says.

Musso told a New England Journal of Medicine interviewer that the first thing he did was witness an execution, an event that made him very sad. That was until he realized the execution was an end-of-life issue. "And at that point I felt that it was my duty to make sure if someone was going to die, that he die or she die in the most humane way possible, with the least amount of pain and suffering. And that this overwhelming duty that I felt outweighed any other issue or conflict I had in my mind at that time," he says.

Musso's role in the few executions he has been involved in has been in pronouncing an inmate's death.

Nurses fill syringes with the lethal drugs and insert intravenous tubes. Prison employees administer the drugs that cause death. Musso says he would do anything except inject the drugs. "I feel it is my duty that if this patient is going to die, my duty is to make sure that if he dies, he dies in a painless manner. However, I would not play the role of the executioner. I would not actually be the causation of his death," he says.