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RESOLVED, That the North Carolina Medical Society supports the following position of the American Medical Association regarding physician involvement in capital punishment and the individual. A physician, as a member of a profession dedicated to preserving life when there is hope of doing so, should not be a participant in a state execution. “Physician extension of this position to those who may perform services as agents of physicians:

  1. An individual’s opinion on capital punishment is a personal moral decision. However, participation in execution is defined generally as actions that would fall into one or more of the following categories: (a) an action that would directly cause the death of the condemned; (b) an action that would assist, supervise, or contribute to the ability of another individual to directly cause the death of the condemned; (c) an action that could automatically cause an execution to be carried out on a condemned prisoner.
  2. Physician participation in an execution includes but is not limited to the following actions: prescribing or administering tranquilizers and other psychotropic agents and medications that are part of the execution procedure; monitoring vital signs on site or remotely (including monitoring electrocardiograms); attending or observing an execution as a physician; and rendering of technical advice regarding execution or the means of execution.
  3. In the case where the method of execution is lethal injection, the following actions by the physician would also constitute physician participation in execution: selecting injection sites; starting intravenous lines as a port for a lethal injection device; prescribing, preparing, administering, or supervising injection drugs or their dose or types; inspecting, testing or maintaining lethal injection devices; consulting with or supervising lethal injection personnel.
  4. The following actions do not constitute physician participation in execution: (a) testifying as to medical history and diagnoses or mental state as they relate to competence to stand trial, testifying as to relevant medical evidence during trial, testifying as to medical aspects of aggravating or mitigating circumstances during the penalty phase of a capital case, or testifying as to medical diagnoses as they relate to the legal assessment of competence for execution; (b) certifying death provided that the condemned has been declared dead by another person not under the direct supervision of a physician; (c) witnessing an execution in a totally non-professional capacity; (d) witnessing an execution at the specific voluntary request of the condemned person, providing that the physician observes the execution in a non-physician capacity and takes no action which would constitute physician participation in an execution; and (e) relieving the acute suffering of a condemned person while awaiting execution, including providing tranquilizers at the specific voluntary request of the condemned person to help relieve pain or anxiety in anticipation of the execution.
  5. Physicians should not determine legal competence to be executed. A physician’s medical opinion should be merely one aspect of the information taken into account by a legal decision maker such as a judge or hearing officer. When a condemned prisoner has been declared incompetent to be executed, physicians should not treat the prisoner for the purpose of restoring competence unless a commutation order is issued before treatment begins. The task of re-evaluating the prisoner should be performed by an independent physician examiner. If the incompetent prisoner is undergoing extreme suffering as a result of psychosis or any other illness, medical intervention intended to mitigate the level of suffering is ethically permissible. No physician should be compelled to participate in the process of establishing a prisoner’s competence or be involved with treatment of an incompetent, condemned prisoner if such activity is contrary to the physician’s personal beliefs. Under those circumstances, physicians should be permitted to transfer care of the prisoner to another physician.
  6. Organ donation by condemned prisoners is permissible only if (1) the decision to donate was made before the prisoner’s conviction, (2) the donated tissue is harvested after the prisoner has been pronounced dead and the body removed from the death chamber, and (3) physicians do not provide advice on modifying the method of execution for any individual to facilitate donation.

(Resolution 27-1983, adopted 5/7/83) (revised, Report FF-1993, Item 4, adopted as amended 11/7/93) (revised, Report H-2003, Item 3 #26, adopted as amended 11/16/03) (reaffirmed, Report N-2008, Item 2-2, adopted 10/19/2008) (revised, Report G-2013, Item 1-1, adopted 10/26/2013)
(technical correction, Board Report-2019, Page 5, Item 2-22, adopted 7/27/2019)