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Capital Punishment and the Responsible Pharmacist
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CAPITAL PUNISHMENT and the Responsible Pharl11acist By GEORGE
ethal injection as a particular method of capital punishment first started in Oklahoma, and other states followed soon after. Since the Federal government is not constitutionally delegated the power to specify the method of capital punishment to be employed, the states have reserved this power for themselves. Acting under this doctrine of federalism' the various states presently use five different methods of administering capital punishment: hanging, firing squad, electric chair, gas chamber, and now, lethal injection.I The reason for using new technology-whether injection or something else-to execute convicted criminals is generally the same as it has always been-to provide a humane method of killing condemned prisoners, one that is presumably less painful than a previous method. It was for humane reasons that a physician invented the guillotine,2 that New York gave us the electric chair, and Nevada contributed the gas chamber. 3 Curiously, however, Oklahoma justified its lethal injection program with the twin arguments that it would be both more humane and a cost-effective alternative to reconstructing its electric chair or building a gas chamber.
L
J.
PERCHAK
There have already been notable attempts at involving pharmacists in capital punishment via injectioD,as though the pharmacist were some kind of ,death care provider.' considered the most humane. In the past, an 1887 commission definitely favored electrocution over chemical methods. 4 Even Thomas Edison supported the use of electricity for executions..5 Today, lethal injection appears to have made a comeback as the most humane method: electricity no longer enjoys the popularity it once had. Nonetheless, the import of all this
has been to try and somehow make the killing of condemned criminals reasonably acceptable. Socially, the less the act of capital punishment horrifies the public, the greater likelihood of it continuing. And, constitutionally, the less violation there is of the Eighth Amendment's ban on cruel and unusual punishment, the less fear of interference from the courts. But regardless of which method of execution may be currently considered more humane, or the social and constitutional impact of that method, capital punishment essentially remains what it has always been from a moral viewpoint-a condemnable system of legalized retribu tion. Variations in the means employed to reach the same end do not appreciably alter an insoluble moral dilemma: that taking any convicted criminal's life only adds a second wrong to the first wrong
Inconsistencies A closer look at the history of these macabre innovations, however, reveals that there have been some inconsistencies in the arguments about which particular method should be
George]. Perchak is a licensed pharmacist and a member of the American Pharmaceutical Association.
6
American Pharmacy Vol. NS25, No.7, July 1985/406
committed by the criminal. No one has the moral authority to execute a human being. When one kills killers, it is still murder. It does not stand to reason that, as one commentator has put it, "Capital punishment is ... a controversial issue itself, but the question of using 'prescription drugs' to carry out the process of execution is a completely separate and distinct matter."6
Special Concerns However, lethal injection per se does pose special concerns to pharmacists, since the procedure entails requesting-or conscripting-their services. There have already been notable attempts at involving pharmacists in capital punishment via injection, as though the pharmacist were some kind of "death-care provider" whose expertise should be integrated into the process. Cases in point include the proposed legislation requiring the Dean of the Arkansas College of Pharmacy to provide appropriate consulting services to the director of the department of corrections, and the Connecticut department of corrections' attempt to get professional advice on the agents to be used in lethal injection from the Drug Information Center at the University of Connecticut Health Center.
Official Policies Some pharmacy organizations have responded by adopting official positions on the issue. The American Pharmaceutical Association adopted the following policy in 1985: 1. The American Pharmaceutical Association opposes the use of the term drug" for chemicals used in lethal injections. 2. The American Pharmaceutical Association opposes the laws and regulations which mandate the participation of pharmacists in the process of execution by lethal injection. The American Society of Hospital Pharmacists' policy states: 1. A decision by a pharmacist to participate in the use of drugs in capital punishment is one of individual conscience. /I
American Pharmacy Vol. NS25, No.7, July 1985/407
A responsible pharmacist must consider that what he dispenses might become the means by which an execution takes place. 2. Pharmacists, regardless of who employs them, should not be put at risk of any disciplinary action, including loss of their jobs, because of refusal to participate in capital punishment. Both these policy statements do not prevent an individual from availing himself of his personal liberty to participate in capital punishment, nor do they have the wisdom to morally condemn such participation.
Personal Responsibility However, individual pharmacists can still personally condemn lethal injection, and all of the other methods of capital punishment. For my part, moral law dicates that human life must be our highest value, and since capital punishment clearly negates that value, it is a moral atrocity. The legalization of this punitive process does not in any way redeem it. In addition to not providing consultation or information services for this process, or actually participating, pharmacists need to be more aware of the less obvious ways that they might inadvertently become a party to an act of capital punishment. For example, the medical director of Oklahoma's correction department can order his supplies from a pharmacy near the state prison, and those supplies may become the lethal tools of an execution. 3 A responsible pharmacist must consider that what he dispenses might be the means by which an execution takes place, and therefore, by natural extension, the pharmacist could in some way figure in that execution. One must safeguard against the practice of indiscriminately dispen-
sing products without giving thought or care as to how they will be used. Not taking those safeguards invites involvement, tacit approval, and blame. Likewise, it would be unethical to author an article on, say, the toxicokinetics involved with an execution, or any other subject that might lend itself to promoting the act, even if it is done in the belief that such work will result in a humane execution. The same prohibition applies to research in this area that would have similar negative consequences. The probable results of one's work should always be given considerati~ before it is initiated. If the foreseeable outcome of that research is not very likely to be used in the service of mankind, and will instead be abused, then it should be abandoned.
Maintaining Integrity Pharmacy is a life-giving profession. To maintain the integrity of that heritage, pharmacists need to consider their actions carefully and confer moral character to their professional responsibilities. Lesser standards of conduct are unacceptable, and the profession must be maintained at the highest level possible. It may be that the lethal injection issue in particular has sensitized pharmacists to capital punishment. Reflecting on only that single issue, however, is not enough. While particular care should be given to all the immediate professional considerations, .condemning the whole notion of capital punishment is also justifiably a part of our obligation, as is warning other pharmacists away from any involvement whatsoever. If policy statements fall short of this obligation, then individuals must rise to the occasion and speak out. D
References 1. T. O . Finks, The Journal of Legal Medicine , 4, 384 (1983).
2. D. B. Weiner, Journal of the American Medical Association, 220, 85 (1972) . 3. P. Malone, "Death Rowand the Medical Mode!," The Hastings Center, vol. 9, 1979. 4. ] . M. Bleyer, Medical Legal Journal, 5, 425 (1887) . 5. N. P. Brown, Medical Legal Journal, 6, 386 (1888) . 6. E. G. Feldmann, Journal of Pharmaceutical Sciences, 73, 1189 (1984).
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CAPITAL PUNISHMENT and the Responsible Pharl11acist By GEORGE
ethal injection as a particular method of capital punishment first started in Oklahoma, and other states followed soon after. Since the Federal government is not constitutionally delegated the power to specify the method of capital punishment to be employed, the states have reserved this power for themselves. Acting under this doctrine of federalism' the various states presently use five different methods of administering capital punishment: hanging, firing squad, electric chair, gas chamber, and now, lethal injection.I The reason for using new technology-whether injection or something else-to execute convicted criminals is generally the same as it has always been-to provide a humane method of killing condemned prisoners, one that is presumably less painful than a previous method. It was for humane reasons that a physician invented the guillotine,2 that New York gave us the electric chair, and Nevada contributed the gas chamber. 3 Curiously, however, Oklahoma justified its lethal injection program with the twin arguments that it would be both more humane and a cost-effective alternative to reconstructing its electric chair or building a gas chamber.
L
J.
PERCHAK
There have already been notable attempts at involving pharmacists in capital punishment via injectioD,as though the pharmacist were some kind of ,death care provider.' considered the most humane. In the past, an 1887 commission definitely favored electrocution over chemical methods. 4 Even Thomas Edison supported the use of electricity for executions..5 Today, lethal injection appears to have made a comeback as the most humane method: electricity no longer enjoys the popularity it once had. Nonetheless, the import of all this
has been to try and somehow make the killing of condemned criminals reasonably acceptable. Socially, the less the act of capital punishment horrifies the public, the greater likelihood of it continuing. And, constitutionally, the less violation there is of the Eighth Amendment's ban on cruel and unusual punishment, the less fear of interference from the courts. But regardless of which method of execution may be currently considered more humane, or the social and constitutional impact of that method, capital punishment essentially remains what it has always been from a moral viewpoint-a condemnable system of legalized retribu tion. Variations in the means employed to reach the same end do not appreciably alter an insoluble moral dilemma: that taking any convicted criminal's life only adds a second wrong to the first wrong
Inconsistencies A closer look at the history of these macabre innovations, however, reveals that there have been some inconsistencies in the arguments about which particular method should be
George]. Perchak is a licensed pharmacist and a member of the American Pharmaceutical Association.
6
American Pharmacy Vol. NS25, No.7, July 1985/406
committed by the criminal. No one has the moral authority to execute a human being. When one kills killers, it is still murder. It does not stand to reason that, as one commentator has put it, "Capital punishment is ... a controversial issue itself, but the question of using 'prescription drugs' to carry out the process of execution is a completely separate and distinct matter."6
Special Concerns However, lethal injection per se does pose special concerns to pharmacists, since the procedure entails requesting-or conscripting-their services. There have already been notable attempts at involving pharmacists in capital punishment via injection, as though the pharmacist were some kind of "death-care provider" whose expertise should be integrated into the process. Cases in point include the proposed legislation requiring the Dean of the Arkansas College of Pharmacy to provide appropriate consulting services to the director of the department of corrections, and the Connecticut department of corrections' attempt to get professional advice on the agents to be used in lethal injection from the Drug Information Center at the University of Connecticut Health Center.
Official Policies Some pharmacy organizations have responded by adopting official positions on the issue. The American Pharmaceutical Association adopted the following policy in 1985: 1. The American Pharmaceutical Association opposes the use of the term drug" for chemicals used in lethal injections. 2. The American Pharmaceutical Association opposes the laws and regulations which mandate the participation of pharmacists in the process of execution by lethal injection. The American Society of Hospital Pharmacists' policy states: 1. A decision by a pharmacist to participate in the use of drugs in capital punishment is one of individual conscience. /I
American Pharmacy Vol. NS25, No.7, July 1985/407
A responsible pharmacist must consider that what he dispenses might become the means by which an execution takes place. 2. Pharmacists, regardless of who employs them, should not be put at risk of any disciplinary action, including loss of their jobs, because of refusal to participate in capital punishment. Both these policy statements do not prevent an individual from availing himself of his personal liberty to participate in capital punishment, nor do they have the wisdom to morally condemn such participation.
Personal Responsibility However, individual pharmacists can still personally condemn lethal injection, and all of the other methods of capital punishment. For my part, moral law dicates that human life must be our highest value, and since capital punishment clearly negates that value, it is a moral atrocity. The legalization of this punitive process does not in any way redeem it. In addition to not providing consultation or information services for this process, or actually participating, pharmacists need to be more aware of the less obvious ways that they might inadvertently become a party to an act of capital punishment. For example, the medical director of Oklahoma's correction department can order his supplies from a pharmacy near the state prison, and those supplies may become the lethal tools of an execution. 3 A responsible pharmacist must consider that what he dispenses might be the means by which an execution takes place, and therefore, by natural extension, the pharmacist could in some way figure in that execution. One must safeguard against the practice of indiscriminately dispen-
sing products without giving thought or care as to how they will be used. Not taking those safeguards invites involvement, tacit approval, and blame. Likewise, it would be unethical to author an article on, say, the toxicokinetics involved with an execution, or any other subject that might lend itself to promoting the act, even if it is done in the belief that such work will result in a humane execution. The same prohibition applies to research in this area that would have similar negative consequences. The probable results of one's work should always be given considerati~ before it is initiated. If the foreseeable outcome of that research is not very likely to be used in the service of mankind, and will instead be abused, then it should be abandoned.
Maintaining Integrity Pharmacy is a life-giving profession. To maintain the integrity of that heritage, pharmacists need to consider their actions carefully and confer moral character to their professional responsibilities. Lesser standards of conduct are unacceptable, and the profession must be maintained at the highest level possible. It may be that the lethal injection issue in particular has sensitized pharmacists to capital punishment. Reflecting on only that single issue, however, is not enough. While particular care should be given to all the immediate professional considerations, .condemning the whole notion of capital punishment is also justifiably a part of our obligation, as is warning other pharmacists away from any involvement whatsoever. If policy statements fall short of this obligation, then individuals must rise to the occasion and speak out. D
References 1. T. O . Finks, The Journal of Legal Medicine , 4, 384 (1983).
2. D. B. Weiner, Journal of the American Medical Association, 220, 85 (1972) . 3. P. Malone, "Death Rowand the Medical Mode!," The Hastings Center, vol. 9, 1979. 4. ] . M. Bleyer, Medical Legal Journal, 5, 425 (1887) . 5. N. P. Brown, Medical Legal Journal, 6, 386 (1888) . 6. E. G. Feldmann, Journal of Pharmaceutical Sciences, 73, 1189 (1984).
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