It was a matter of life and death in the Wake County Superior Courthouse earlier this year as state officials and the North Carolina Medical Board clashed over the role of physicians in administering executions.
The conflict continued Friday when the board announced it would appeal a court ruling that it had exceeded its authority by prohibiting doctors from participating in capital punishment. The announcement came after nearly a year of wrangling between the state and the board over medical ethics and the death penalty.
"It's a question of who decides what the ethical standards are for physicians--doctors or the state," Duke law professor James Coleman said.
Last January, NCMB adopted a policy stating that "physician participation in capital punishment is a departure from the ethics of the medical profession." The policy was struck down in court because it contradicted the state law that requires a doctor to oversee every execution.
Until this ruling, the board's decision-the first of its kind in the country-effectively put a freeze on executions in the state.
Peggy Robinson, a representative from the board and an assistant professor in the Duke physician assistant program, declined to comment for this story.
The case sits at a contentious intersection between law and medical ethics, said Dr. Ross McKinney, director of Duke's Trent Center for Bioethics, Humanities and History of Medicine and vice dean for research at the School of Medicine.
"The question is, do you want to have a death penalty?" he said. "The issue is if you should fight it directly or if a peripheral approach is better."
The board's policy was first challenged in March when the North Carolina Department of Correction filed suit contending that state law requiring doctors to oversee executions superseded the board's authority. The ruling in the case, handed down by Judge Donald Stephens last month, stated that executions were not a medical procedure and the board had no jurisdiction for preventing physicians from participating.
The decision has triggered widespread conflict in and out of the medical community.
"When you're asked to infuse [intravenous drugs] and produce a biological effect, that's certainly a medical procedure in my mind." McKinney said. "But some physicians will say that it is more humane to administer lethal injection than other methods of execution and so are willing to participate."
Doctors take an oath to preserve life at all costs and should not be allowed to oversee executions, said Dr. Robert Cook-Deegan, director of the Duke Institute for Genome Science and Policy's Center for Genome Ethics, Law and Policy.
"If the state decides it wants to continue to have the death penalty, then it's just going to have to find a different way to do it that doesn't require physicians," he said.
Samson Mesele, a junior and copresident of the Duke's chapter of the American Civil Liberties Union, also attested to the importance of maintaining the board's autonomy.
"The ACLU believes the death penalty is a form of cruel and unusual punishment," he said, "But the real issue here is that only the medical board has the right to constrain the behavior of doctors."
But sophomore William Payne, a member of Duke College Republicans, said members of the board should respect the court's ruling.
"The people of North Carolina have backed capital punishment as the ultimate recourse in the justice system," he said, "The board doesn't have the power to stop it."
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