Lethal injection isn't a medical procedure. Stop involving medical professionals | Opinion

Imagine you’re suffocating − desperately trying to breath − feeling like you’re being buried alive. The force you’d exert to attempt breathing would literally suck water into the air sacks of your lungs. This is exactly what’s seen at autopsy in the lungs of 77% of prisoners after execution by lethal injection.

When Gov. Bill Lee temporarily halted executions this year to investigate our lethal injection process, I breathed a sigh of relief. As a practicing physician in Tennessee for the past 25 years, I rely on medications to heal disease and ease suffering. Regardless of what any of us feel about the death penalty, we should all oppose our state’s use of medicines in executions − a practice that impersonates a complicated medical procedure in a poorly monitored setting. This too often results in botched executions and simultaneously imposes psychological harm for the health care professionals and others involved.

There is a pervasive myth that lethal injection is a medical procedure, but this couldn’t be more wrong. In the late 1970s, it was originally touted as involving “no pain, no spasms, no smells or sound – just sleep, then death.” But this was a falsehood created by someone with no scientific training. The drugs listed in Tennessee’s lethal injection protocol, and the quantities used in an execution, are based upon experimentation and speculation − not the art and practice of medicine. And a string of horrific scenes in execution chambers, in Tennessee, Alabama and other states, have made clear that condemned prisoners often experience agonizing deaths.

Although many executing states’ laws make clear that lethal injection is not the practice of medicine, most execution protocols − including Tennessee’s −require some degree of medical participation: a doctor, nurse and/or emergency medical technician.

Since its inception, the medical community has wanted nothing to do with lethal injection. With clarity and consistency, over 30 health care associations, from the American Medical Association to the American Society of Anesthesiologists, have uniformly adopted the stance that the medical community should not participate in executions because it fundamentally violates our core commitment to preserve life. Similarly, pharmaceutical companies and pharmacists won’t supply their life-saving medicines for use in executions.

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The burden placed on those involved in performing executions is immense. Correctional staff are charged with carrying out an execution by lethal injection for which they are medically ill-equipped, particularly when an execution goes wrong − which is becoming the rule, rather than the exception.

In July, Joe James Jr. was repeatedly cut with a scalpel as Alabama Department of Corrections staff tried to establish an IV line for three hours − the longest lethal injection execution in American history. In Arizona, struggling staff were instructed by the prisoner himself where to insert the deadly IV line. In Oklahoma, executioners missed Clayton Lockett’s vein, causing the drugs to bubble under his skin. The blood-soaked physician and paramedic froze, uncertain whether to resuscitate him or find some other way to kill him.

It recently came to light that Tennessee is not testing its lethal injection drugs correctly. Asking staff to administer poor-quality drugs is yet another unethical component of this approach to imposing capital punishment. Other potential consequences include the risk of criminal liability from dispensing lethal injection drugs without a valid medical prescription and the toll on the mental health of those who participate in taking the life of another person.

I think we can all agree that our hard-working doctors, nurses and corrections staff deserve better − subjecting them to trauma and liability in the pursuit of lethal injection is unconscionable.

The governor made the sound, sensible decision to put executions on hold so we can investigate the current protocol and its efficacy. As Tennesseans, we must ask ourselves why we are so invested in a method pretending to be medicine − at such a detrimental expense to those who are directly involved.

When I graduated from medical school, I took an oath of primum non nocere (first, do no harm), and I would be breaking my oath to you or anyone else if I ever intentionally used medications to harm someone. The target principle of medicine is not merely benevolence, or wishing good. It must remain something much more: beneficence. Doing good. Lethal injection is a flawed construct, and more tinkering will not fix it. It is wrong for those in the medical profession to be involved, and we must be left out of it.

Dr. Wes Ely is a professor of medicine and critical care at Vanderbilt University and the Nashville VA. His writing represents his own opinion and not that of his employers. He is co-director of the Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center at www.icudelirium.org and author of "Every Deep-Drawn Breath", a work of narrative nonfiction from which 100% net proceeds are donated into an endowment for COVID-19 survivors and their families. Dr. Ely has no financial conflicts of interest with the topics reported in this guest column. He may be found on Twitter and TikTok @WesElyMD.