As far as verbal or written directives, it is still outside of scope to administer such things. I guess there's the lengthy argument of what is in and out of scope. Technically, IV Medication administration is within the scope, so it is allowed. Until protocols come up for "Lethal Injection", it shouldn't be done by EMT's. Regardless of what a Doctor orders, we are still limited by protocols.
I never said any other way was perfect. Sure, mistakes happen. The idea was to remove any aspect from an EMT's hands. Isolate and deny. Isolate those who do it [to on-healthcare providers], and deny entry to any EMT who wants to.
Either way, it is still a consequence of the healthcare provider. And no one can say, 100% definitively, that any patient passed over in a MCI would be dead or not. So, is it safe to say that if the EMT is providing care to someone else, that it is acceptable to contradict the Hippocratic Oath, and cause further harm by not treating a patient?
I guess what I'm trying to point out is to watch your gatekeepers. Medicine, overall, will want to deny approval or isolate anything dealing with the death penalty. Why? We obviously don't want to be associated with death, and dealing death. It's dirty, people fear it, and we'd look bad. We already have enough of those issues. But change the taste to a MCI, and we openly admit that it's acceptable to allow people to die.
So, What is it?
I don't know. MCI is an essential tool. There's no changing that. Being active in the Death Penalty? That's something that would be incredibly easy to shove off onto someone else, and free the hands of medicine with.