In a survey published in the Archives of Internal Medicine (2000;160:2912-6), an overwhelming majority of physicians (74%) said it is acceptable for doctors to pronounce an executed inmate dead. This practice is frowned upon by most medical organizations. Almost half of respondents — 43% — said there is nothing wrong with doctors actually injecting condemned inmates with lethal drugs.

Groups such as the American Medical Association, American College of Physicians and American Psychiatric Association clearly oppose any participation by members in executions. Today, most of these deaths result from lethal injection.

The AMA, for example, is opposed to having physicians pronounce an executed inmate dead. If the inmate is still alive, the AMA argues, the physician might have to advise the executioner to repeat the procedure or increase the dosage. (The AMA Council on Ethical and Judicial Affairs differentiates between pronouncing the death of an executed inmate, which it opposes, and certifying death after the inmate has been pronounced dead by someone else.)

Dr. Neil Farber, chief of general internal medicine at the Christiana Health Care System in Wilmington, Delaware, and lead author of the survey, told CMAJ he was "surprised and troubled" by the results. "We didn't expect there would be this many physicians condoning their colleagues' involvement in these practices."

The findings were based on 482 responses to 1000 questionnaires mailed to a random national sample of doctors from all specialties.

Asked to explain the paradox of having doctors' organizations oppose involvement in capital punishment while individual doctors appear to condone it, Farber responded: "I guess doctors are people too. It appears as if they rely more on personal and societal values when making these judgements than on their professional ones."