Should EMS be involved in capital punishment?

[DwayneEMTP]

http://www.naemt.org..._positions.aspx

"Participation in capital punishment is inconsistent with the ethical precepts and goals of the EMS profession."

What do you think?

Should EMS personnel be allowed to make their own moral/ethical decisions concerning being involved in the taking of a life when the unique situation of capital punishment is involved?

If an EMT can be prevented from participating in a legally sanctioned killing while off duty, as in a state sanctioned execution, should they then also be disallowed from using lethal force to defend themselves and/or others based on the same 'do no harm' ethos?

If a physician, who is held to the same or perhaps higher standard of morals and ethics, is allowed to participate, then doesn't it become a no brainer that inclusion of EMS personnel is a given?

I'm hoping that we can get into the spirit of exploring the morals and ethics of EMS and go beyond "I would never do that as I'm tasked with preserving life and not taking it!" as I'm also a human being and have a family to support. So perhaps my stance changes if I get $10,000/execution? $50,000?

I look forward to your thoughts!

Dwayne

Edited to repair formating, no contextual changes made.

Edited November 24, 2010 by DwayneEMTP

[HERBIE1]

http://www.naemt.org..._positions.aspx

"Participation in capital punishment is inconsistent with the ethical precepts and goals of the EMS profession."

What do you think?

Should EMS personnel be allowed to make their own moral/ethical decisions concerning being involved in the taking of a life when the unique situation of capital punishment is involved?

If an EMT can be prevented from participating in a legally sanctioned killing while off duty, as in a state sanctioned execution, should they then also be disallowed from using lethal force to defend themselves and/or others based on the same 'do no harm' ethos?

If a physician, who is held to the same or perhaps higher standard of morals and ethics, is allowed to participate, then doesn't it become a no brainer that inclusion of EMS personnel is a given?

I'm hoping that we can get into the spirit of exploring the morals and ethics of EMS and go beyond "I would never do that as I'm tasked with preserving life and not taking it!" as I'm also a human being and have a family to support. So perhaps my stance changes if I get $10,000/execution? $50,000?

I look forward to your thoughts!

Dwayne

Edited to repair formating, no contextual changes made.

Good question, and sure to generate some interesting debate.

Well, what about the physician who is present at executions? Aren't they violating their Hippocratic oath simply by being there?

The only person who can sign a death certificate is a doctor, so by law they must be part of the process in some way. Do they need to be present at the actual execution- maybe not. Anyone can be trained to place EKG leads on a patient to confirm asystole, but wouldn't a trained medical professional- EMT, nurse, or doctor must be present to assess an absence of pulse and spontaneous respirations? Would simply confirming death be somehow considered as facilitating that death?

From a moral/ethical standpoint, I guess the provider must decide for themselves if they want to participate in the process if they know it will be part of their required duties. In a sense, anyone involved in an execution is merely carrying out a sentence that has already been decided by the legal system. They are not the ones who determine that a person will die, but merely the instruments who carry out a predetermined fate.

Personal opinion- I would have no problem doing this, and yes, I am pro capital punishment, given the right circumstances. I suppose being against the death penalty might be a deal breaker for most.

[DwayneEMTP]

...Well, what about the physician who is present at executions? Aren't they violating their Hippocratic oath simply by being there?

So it's ok then for me to march my Jews into the gas chamber as long as the guard before me did the same?

The only person who can sign a death certificate is a doctor, so by law they must be part of the process in some way. Do they need to be present at the actual execution- maybe not. Anyone can be trained to place EKG leads on a patient to confirm asystole, but wouldn't a trained medical professional- EMT, nurse, or doctor must be present to assess an absence of pulse and spontaneous respirations? Would simply confirming death be somehow considered as facilitating that death?

Awesome question, and I have no friggin' idea.

...From a moral/ethical standpoint, I guess the provider must decide for themselves if they want to participate in the process...

Here is where we begin to disagree. If we are to accept the definitions of morals as:

mo·ral·i·ty (m -r l -t , mô-). n. pl. mo·ral·i·ties. 1. The quality of being in accord with standards of right or good conduct. ...

www.thefreedictionary.com/morality

then we can agree to here still, as it is possible for me to believe that it is morally acceptable to kill in the name of justice where another may not. But, if we are to accept the definition of ethics as:

1. ( used with a singular or plural verb ) a system of moralprinciples: the ethics of a culture.

2. the rules of conduct recognized in respect to a particularclass of human actions or a particular group, culture, etc.:medical ethics; Christian ethics.

http://dictionary.re...m/browse/ethics

Doesn't it then remove the decision from the grasp of the individual and place it in the hands of the body responsible for the development of the ethical guidlines of the group, in this case prehospital care providers?

Particularly following joint statements such as this...(Plested at the time of this speech was President of the AMA. I believe this to be relatively current but couldn't find a date on the page or document excerpts.)

http://www.deathpena...o.org/node/1775

In his statement for the AMA, Plested noted:

The American Medical Association is troubled by continuous refusal of many state courts and legislatures to acknowledge the ethical obligations of physicians, which strictly prohibit physician involvement in a legally authorized execution. The AMA's policy is clear and unambiguous — requiring physicians to participate in executions violates their oath to protect lives and erodes public confidence in the medical profession.

...if they know it will be part of their required duties. In a sense, anyone involved in an execution is merely carrying out a sentence that has already been decided by the legal system. They are not the ones who determine that a person will die, but merely the instruments who carry out a predetermined fate.

But is that the public perception? And if there is a paramedic 'soul' so to speak, is it bruised by such behavior?

...Personal opinion- I would have no problem doing this, and yes, I am pro capital punishment, given the right circumstances. I suppose being against the death penalty might be a deal breaker for most.

I'm not morally opposed. I would, in the most beastly manner and with joy in my heart beat to death an intruder or one responsible for damage to my family. And that is not exagerating for effect. But as long as facts such as this, Post-mortem DNA tests have shown that some people were innocent of the crimes for which they were executed. Since 1973, 90 people waiting with death sentences have been fortunate enough to have lawyers and reporters intervene to demonstrate their innocence. (http://historymatters.gmu.edu/d/5420) exist, then I will be opposed to the death penalty.

For the record, I'm making my argument based on what appears to be morally and ethically sound grounds as it applies to my sensibilities. As with abortion I'm in no way confident that what may prove to be right for me must also then be right for all. I'll never be part of aborting a child, but I can't pretend that I, in my uterusless state, are qualified to decide for everyone.

I'm excited to hear the thoughts of all...

Dwayne

[HERBIE1]

So it's ok then for me to march my Jews into the gas chamber as long as the guard before me did the same?

Awesome question, and I have no friggin' idea.

Here is where we begin to disagree. If we are to accept the definitions of morals as:

mo·ral·i·ty (m -r l -t , mô-). n. pl. mo·ral·i·ties. 1. The quality of being in accord with standards of right or good conduct. ...

www.thefreedictionary.com/morality

then we can agree to here still, as it is possible for me to believe that it is morally acceptable to kill in the name of justice where another may not. But, if we are to accept the definition of ethics as:

1. ( used with a singular or plural verb ) a system of moralprinciples: the ethics of a culture.

2. the rules of conduct recognized in respect to a particularclass of human actions or a particular group, culture, etc.:medical ethics; Christian ethics.

http://dictionary.re...m/browse/ethics

Doesn't it then remove the decision from the grasp of the individual and place it in the hands of the body responsible for the development of the ethical guidlines of the group, in this case prehospital care providers?

Particularly following joint statements such as this...(Plested at the time of this speech was President of the AMA. I believe this to be relatively current but couldn't find a date on the page or document excerpts.)

http://www.deathpena...o.org/node/1775

In his statement for the AMA, Plested noted:

The American Medical Association is troubled by continuous refusal of many state courts and legislatures to acknowledge the ethical obligations of physicians, which strictly prohibit physician involvement in a legally authorized execution. The AMA's policy is clear and unambiguous — requiring physicians to participate in executions violates their oath to protect lives and erodes public confidence in the medical profession.

But is that the public perception? And if there is a paramedic 'soul' so to speak, is it bruised by such behavior?

I'm not morally opposed. I would, in the most beastly manner and with joy in my heart beat to death an intruder or one responsible for damage to my family. And that is not exagerating for effect. But as long as facts such as this, Post-mortem DNA tests have shown that some people were innocent of the crimes for which they were executed. Since 1973, 90 people waiting with death sentences have been fortunate enough to have lawyers and reporters intervene to demonstrate their innocence. (http://historymatters.gmu.edu/d/5420) exist, then I will be opposed to the death penalty.

For the record, I'm making my argument based on what appears to be morally and ethically sound grounds as it applies to my sensibilities. As with abortion I'm in no way confident that what may prove to be right for me must also then be right for all. I'll never be part of aborting a child, but I can't pretend that I, in my uterusless state, are qualified to decide for everyone.

I'm excited to hear the thoughts of all...

Dwayne

We could argue morality and ethics all day. Very subjective topic, and as such, there is no right or wrong answer in that regard. I would toss a doctor in with a medic, at least in terms of only being PRESENT at the execution. They did not decide a person must die, but merely are ensuring that a legally mandated sentence has been carried out. Is the person who administers the lethal injection, throws the switch, or hits a lever to release the cyanide capsules actually KILLING someone? Not in a legal sense of that word.

If the AMA or any EMS organization ever BANS their people from participating in an execution, than I suggest they can easily find willing replacements who could then be trained to fill their roles. Again- all the doctor needs to do is sign the death certificate.

As we veer off on a tangent-

I agree that you need to be as close to 100% certain as possible of the guilt of someone in order to put them to death. I also agree that mistakes have been made in the past, but this was also long before technology and DNA studies existed. I would have no problem saying that from this day forward, whenever a capital case comes up, DNA tests MUST be performed, as well as any other confirmations currently available- including confessions, CSI technology, physical evidence, eyewitnesses- build a solid case based on irrefutable proof. Call me a barbarian, but I simply feel there are some crimes that require the ultimate penalty. Not life in prison, no solitary confinement- in certain cases, the crime is so horrific, that the only "civilized" punishment is to forfeit your life.

Anyone who has been accused/convicted before this arbitary time will never see the light of day. Prison for life, with no chance of parole- just in case there was a mistake made.

[Lone Star]

It's my understanding of the duties of the EMT/Medic involved is to only place the catheter, to ensure that venous access is achieved, and that all medically accepted practices for venous access are adhered to.

Just because the inmate is condemned to death, it does not mean that the State can just slam a needle into their arm by someone with no medical training or background. The complications of extravasation would be tantamount to cruel and unusual punishment.

That being said, since the initiation of an IV is considered within the medical scope of practice, it only stands to reason that the person gaining venous access be a member of the medical community.

The EMT/Medic/Physician present is not the State sanctioned Executioner. They are not the ones that are charged with releasing the chemicals that directly cause the death of the condemned inmate. They aren’t going to be the ones activating the trap door in hangings, they aren’t going to be the one to give the order to fire to the firing squad; and they will not be the one pulling the switch for “Ol’ Sparky”.

One must then consider how simply initiating intravenous access by medically accepted standards and practices is considered to be directly violating the Code of Ethics.

The actions of the EMT/Medic would be the same actions that are used in the field to save lives. The only difference here is that there will be someone else releasing chemicals into the IV that are designed to end a life. The EMT/Medic’s actions are not what directly caused the death of the condemned.

Just because the inmate is condemned to death doesn’t disqualify them from having medical procedures initiated and monitored by properly trained medical personnel.

My personal views on capital punishment are irrelevant in this discussion.

[emtannie]

I read the initial post, and the link to it, and really really wanted to add to this thread, but when I started typing, every sentence I typed was followed with a “yeah but…”

So, here goes.

Should EMS personnel be allowed to make their own moral/ethical decisions concerning being involved in the taking of a life when the unique situation of capital punishment is involved?

We make moral/ethical decisions every day. Some of those may not be what others would deem appropriate, so why should this be any different? For example: today is the fourth shift in a row that you have been called to the same residence for the same person for the same problem which does not need an ambulance. You are abrupt and do not show empathy to the patient. You did your job, but did you do it to the level of compassion you could have, and ethically “should” have? Probably not.

So, let's extrapolate that to the case of capital punishment. You make a personal decision whether to be involved in it. Whether others see it as appropriate or ethical is their decision. You and only you have to sleep with the decision you made today.

If an EMT can be prevented from participating in a legally sanctioned killing while off duty, as in a state sanctioned execution, should they then also be disallowed from using lethal force to defend themselves and/or others based on the same 'do no harm' ethos?

Hmmm…. I don’t consider those two events as equal. The legally sanctioned killing was a product of the legal system, and if you agree with the legal system, you have to support the decisions and the process that got that person there. If someone were to attempt to cause me or mine harm, I would do my best to beat them into a bloody pulp to protect myself and my family/friends. Should someone deliberately attempt to cause harm to me or a member of my family, I would have no qualms about using lethal force if necessary to protect myself or them.

If a physician, who is held to the same or perhaps higher standard of morals and ethics, is allowed to participate, then doesn't it become a no brainer that inclusion of EMS personnel is a given?

Here, I am unclear as to the role of the physician – does the doctor administer the lethal dose, or does someone else? Does the doctor only determine time of death? For the sake of discussion, if the doctor does administer the lethal dose, then they are doing harm to that patient, and violating their code of ethics. If they are only confirming death, they are not.

It could be said that the doctor is not standing by the medical code of ethics by allowing the execution; however (see where the “yeah but” stuff comes in here?) the doctor did not make the decision to sentence that person to the death penalty. Does the code of ethics mean that anyone in the medical field should be against the death penalty as a whole? Hmmmmm – I sense a big debate there, and a quagmire of “if I can put a criminal to death for a crime, why can’t I put a terminally ill patient to death to relieve their suffering?”…

I'm hoping that we can get into the spirit of exploring the morals and ethics of EMS and go beyond "I would never do that as I'm tasked with preserving life and not taking it!" as I'm also a human being and have a family to support. So perhaps my stance changes if I get $10,000/execution? $50,000?

So, just thinking out loud here (or typing out loud?) if I am tasked with preserving life, could it be seen that I am preserving lives by allowing capital punishment? Follow me here… Criminal Joe has been convicted of doing some very nasty things, and has been sentenced to die by lethal injection. By killing Criminal Joe, the legal system is saving itself hundreds of thousands of taxpayer dollars since they don’t have to house and feed that person for the next 20, 30 or 40 years, and protecting those who could potentially be victims of Criminal Joe in the future. Those are tax dollars that could go to put a roof over a homeless person’s head, or shelter a battered family, so, using a ripple effect theory, I can say that I am saving others by having this person put to death.

Yeah but…. What if Criminal Joe really wasn’t guilty, and the legal system made a mistake? Isn’t it better to pay those hundreds of thousands of dollars so that he is still alive? Hmmmm – a quandary…

I am trying very hard to leave my personal views on capital punishment out of this discussion.

Dwayne, I hope that I have added discussion and thought to your thread, and haven’t just wandered aimlessly through it….

[island emt]

In days gone by , it was possible for an innocent person to be arrested , tried & convicted for a violent crime they did not commit.

Today not so much thanks to all of the technology and science.

In the old days a cop would take a report that a man had raped a woman and the first guy they saw that was reasonably close to the description given by the victim is who they arrested.

Have there been cases of innocent people put to death in the past ? Undoubtedly.

Will there be innocent people put to death in the future? probably a very minor chance thanks to science, video cameras on every streetcorner and new technology.

How many innocent people are murdered by gang bangers or drunk drivers every day?

How many members of the military are killed in wars each day?

How many ids are starving today as we as a nation gorge ourselves on more food than some see in a whole month?

Just a few thoughts for your philosophical viewing and random thoughts to ruminate on.

Back to question #1. Yes I would stick the needle in and push the switch to administer the drugs to terminate life of a convicted criminal.

[BEorP]

If a physician, who is held to the same or perhaps higher standard of morals and ethics, is allowed to participate, then doesn't it become a no brainer that inclusion of EMS personnel is a given?

Physicians are prohibited from participating in executions in the AMA's Code of Medical Ethics. See: http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion206.shtml

"An individual’s opinion on capital punishment is the personal moral decision of 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 legally authorized execution. Physician participation in execution is defined generally as actions which would fall into one or more of the following categories: (1) an action which would directly cause the death of the condemned; (2) an action which would assist, supervise, or contribute to the ability of another individual to directly cause the death of the condemned; (3) an action which could automatically cause an execution to be carried out on a condemned prisoner."

[BEorP]

double post

Edited November 25, 2010 by BEorP

[croaker260]

It's my understanding of the duties of the EMT/Medic involved is to only place the catheter, to ensure that venous access is achieved, and that all medically accepted practices for venous access are adhered to.

Just because the inmate is condemned to death, it does not mean that the State can just slam a needle into their arm by someone with no medical training or background. The complications of extravasation would be tantamount to cruel and unusual punishment.

That being said, since the initiation of an IV is considered within the medical scope of practice, it only stands to reason that the person gaining venous access be a member of the medical community.

The EMT/Medic/Physician present is not the State sanctioned Executioner. They are not the ones that are charged with releasing the chemicals that directly cause the death of the condemned inmate. They aren’t going to be the ones activating the trap door in hangings, they aren’t going to be the one to give the order to fire to the firing squad; and they will not be the one pulling the switch for “Ol’ Sparky”.

One must then consider how simply initiating intravenous access by medically accepted standards and practices is considered to be directly violating the Code of Ethics.

The actions of the EMT/Medic would be the same actions that are used in the field to save lives. The only difference here is that there will be someone else releasing chemicals into the IV that are designed to end a life. The EMT/Medic’s actions are not what directly caused the death of the condemned.

Just because the inmate is condemned to death doesn’t disqualify them from having medical procedures initiated and monitored by properly trained medical personnel.

My personal views on capital punishment are irrelevant in this discussion.

This is pretty much my view exactly. After all, I would hate for the inmate to get a cellulitis from a crappy IV stick, or suffer undue pain from a misplaced catheter and delayed action of the medications/lethal injection.