Law and Ethics for Medical Careers 3rd Edition

1
Law and Ethics for Medical Careers 3rd Edition

• Capital Punishment (10)

2
The Case

• A physician practices medicine in a state where
  capital punishment is legal. In addition, the
  laws in this state say capital punishment is
  exempt from the statutory definition of the
  practice of medicine.

3
The Case, continued

• The physician wonders if the decision to
  participate in legal executions is therefore left
  to the individual practitioners.

4
Laws and Ethics in Conflict

• Recently several states have brought medical
  ethics in conflict with state laws.

5
Laws and Ethics in Conflict, continued

• State legislatures have contended that the act of
  execution is separate from the practice of
  medicine.
• Physicians are being asked to apply their medical
  skills as agents of the state, not as members of
  the medical profession.

6
What Do You Think?

• Are ethical principles governed by laws?

• Are minimum standards met by laws or by
  principles of ethics?

7
What Do You Think?

• Are laws or ethics developed on moral guidelines?
• Do you think physicians should ethically
  participate in legal executions? Why or why not?

8
Considerations

• Ethical principles are not governed by laws.

• A law is a rule made and enforced by a governing
  body.

9
Considerations, continued

• Ethics are based on high standards of conduct and
  the differences between right and wrong.
• Most laws are intended to protect the public by
  establishing minimum standards.

10
Council on Ethical and Judicial Affairs

• Opinion 2.06 in the Code of Medical Ethics states
  that physician participation in capital
  punishment is unethical, even when a physician is
  acting in an advisory capacity.

11
Competency Assessments

• Physicians may be asked to provide assessments
  for
• Medical competence, which is the ability to make
  decisions regarding medical treatment.
• Competence for execution, which is a legal
  concept used to determine if the execution
  should be carried out.

12
What Do You Think?

• Do you think a physician may ethically perform
  these assessments? Both? Only one? Explain
  your answer.

13
What the Experts Say

• Physicians may ethically provide assessments of
  medical competence. This pertains to treatment,
  and they may act as agents of the state in this
  manner.

14
What the Experts Say, continued

• Evaluating competence for execution is a legal
  matter. It is the duty of the court to determine
  from the best information available whether an
  execution should be carried out.

15
What if...

• If a convicted patient becomes incompetent and
  the execution cannot be carried out, what is the
  physicians responsibility?

16
What if

• Which option would be in the patients best
  interest?
• Being treated to return to competence and be
  executed.
• Not being treated and remaining incompetent for
  execution.

17
What the Experts Say

• It is not in the patients best interest and
  therefore unethical to treat condemned prisoners
  in order to restore them to competence.

18
What the Experts Say, continued

• Exceptions to this would include
• A commendation order converting the sentence to
  life imprisonment without the possibility of
  parole.
• Extreme suffering by the prisoner.

19
The Experts Summary

• Physicians should always act within the law, but
  they should not perform activities that violate
  the basic tenets of their profession to which
  they have dedicated their lives. The ethics of
  the medical profession were developed primarily
  for the benefit of the patient.
• Ethics Forum, American Medical News, April 28,
  1997.