It's About the Killing, Not the Pain

By Joan Ryan, San Francisco Chronicle, Feb. 23, 2006

Opinion

At the risk of losing my bleeding-heart-liberal membership card, I really don't care if Michael Morales suffers when he is put to death at San Quentin State Prison, whenever that might be. For the torture he inflicted on 17-year-old Terri Winchell 25 years ago, he deserves every second of the 10 to 15 minutes of horrible pain he might feel as the lethal cocktail of drugs spreads through his body.

So the debate sparked by Tuesday night's postponement of Morale's execution seems a little off point.

Two anesthesiologists, hired to ensure Morales a painless death, refused at the last minute to participate, forcing the execution to be postponed until after a May 2 court hearing. At issue is how, with physicians unwilling oversee the killing, the state Department of Corrections can make sure the prisoner is unconscious and thus free of pain while he dies. A federal judge in San Jose ruled last week that the execution could proceed only with that assurance.

The debate, playing out on talk radio and blogs, is how to put someone to death in a humane way, or if it's even necessary to find a humane way. But any debate over what's inhumane about the death penalty ought to be about the death part. Isn't the death itself a bit more critical, ethically speaking, than the manner in which the death is brought about?

That's why I find the death penalty proponents' reaction to the anesthesiologists' decision so intriguing. Few seem angered or outraged, as far as I can tell. They seem to accept the doctors' commitment to preserving life, not taking it. It seems reasonable, even to those who support the death penalty, that doctors would see killing a fellow human being as beyond the bounds of ethical behavior.

What's so different about the rest of society? Why is killing a fellow human being not beyond the bounds of our own ethical behavior? Some might say the difference is that doctors take a professional oath not to kill. But participating in an execution would not get them arrested or likely lead to a loss of their medical license. They choose not to participate because it's wrong to take a life, even of lowly murderers like Morales.

Dr. Guy Micco is co-director of the Center for Medicine, the Humanities and Law at UC Berkeley and a clinical professor. He once headed the ethics committee at Alta Bates Hospital. He says the American Medical Association ought to come right out and oppose the death penalty instead of just discouraging its doctors from participating.

"The AMA should take stand that says, 'We don't want physicians to participate not only because we don't want them to get their hands dirty but because we think the work of killing is wrong,' '' Micco said.

"I'm all for getting all the psychopaths off the streets, but we've got to stop this. The death penalty in and of itself is cruel and unusual. There are too many problems with it. I hope this latest debate puts the very idea of the death penalty on our plates again, not only about the participation of physicians but the inhumanity of killing.''

Folks will try to make the analogy to abortion and accuse the medical organizations of being hypocritical. How, they'll ask, can doctors find executing criminals so abhorrent but have no ethical problem with performing abortions? For people who believe a pre-viable fetus is a human being, the analogy is apt. I respect that point of view. But it is a personal belief, and neither the law nor most medical associations share it.

And some also will make the comparison to physician-assisted suicide. Most medical organizations denounce physician-assisted suicides, but doctors who support it see a clear distinction between carrying out an execution and helping end the life of a terminally ill patient. One patient has consented, the other has not.

"The state is in a real bind,'' says David Magnus, director of the Stanford Center for Biomedical Ethics. "It has to come up with a painless way of killing without physicians involved.''

One of his students had a suggestion. Since doctors can't participate and since they are not practiced in methods of euthanasia anyway, why not hire veterinarians? They are the experts in putting living creatures to death.

"Maybe they could have the veterinarians train people to carry out the executions,'' Magnus said.

I couldn't tell if Magnus was serious or if he was making a point. Personally, I think if we're going to have a death penalty, we ought do away with the gurney and white sheets and IV needles. It's so civilized and sanitized. I'm all for carrying out capital punishment by beheading people with a really sharp sword. It's quick, cheap and as perfectly primitive as the sentence itself.

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E-mail Joan Ryan at joanryan@sfchronicle.com. Joan Ryan's column will run Thursdays while she is on assignment.

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