IMA and the role of doctors in capital punishment

By Poojil Tiwari

In October 2017, the Indian Medical Association (IMA) invoked the World Medical Association (WMA) resolution and asked for its doctors to be excused from participating in the execution of capital punishment. Krishan Kumar Aggarwal, president of the IMA said in his statement, “No doctor should be present during the process of execution. This would be a violation of medical ethics and should be deemed professional misconduct.”

Role of medical professionals in status quo

In 2012, the WMA passed a resolution which stated that it was illegal for medical professionals to partake in capital punishments in any capacity or “during any step of the execution process including its planning and the instruction and/or training of persons to perform executions.” According to The Code of Criminal Procedure (1989), the method of capital punishment to be followed in India is death by hanging. Medical professionals are primarily required for two reasons: to authenticate a person as “fit to be executed” and to witness the hanging and vouch for the death of the individual. Furthermore, they are required to provide their medical expertise in order to optimise the procedure to make it as painless as possible. This includes monitoring the vital signs of a person during the execution process and determining the exact drop of the height with respect to the age, weight and height of the convict.

Internationally, the debate between ethics and justice has been rife in recent times with the WMA incorporating ‘The Physician’s pledge’ into their Geneva Declaration on October 14, 2017. The pledge advocates against the participation of physicians in the process of capital punishment stating that it is “incompatible with a physician’s role as healer.”

Juxtaposing legal with ethical

The issue with the active participation of medical professionals such as doctors and nurses in convict executions is that it conflicts with their role of a ‘healer’ in the society. The arguments made by the WMA and other related medical bodies is simple. The Hippocratic oath taken by doctors enunciates “do not harm” as the fundamental principle of being a doctor. Therefore, it goes against the ethics of a doctor to use their medical knowledge to contribute in administering the death penalty to an individual.

The American Medical Association in its 1992 Code of Medical Ethics said, “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 authorised execution.” While there is no particular law that mandates the involvement of doctors in carrying out the death penalty, it has become an issue of state practice by virtue of it being the general norm. Therefore, the issue becomes that by refusing to participate in capital punishment, the medical community is evading their duty towards the state and is, thereby, obstructing justice. The medical community has, time and again, said that conducting the execution is a technical process as opposed to a medical one. Such executions should be performed by technicians trained in carrying out capital punishment.     

Ethical conflict in India

In countries where capital punishment is given by hanging, the doctor virtually conducts the execution. India’s stance on the involvement of doctors in capital punishment is unique, to say the least. Most national and international health bodies are against the use of doctors to provide a ‘certification of death’ after the execution. The rationale behind this is that even in a scenario wherein the convict is found alive upon inspection, the doctor is not allowed to revive the individual which again conflicts with their duties as doctors. However, the statement given by the IMA president specifically outlines that doctors can be called upon to examine the body post the execution for certification of death. Therefore, it would seem that the IMA president’s statement only calls for the cessation of the active participation of doctors during the execution.   

Death by hanging

Many countries use other methods, such as lethal injections, for execution where the doctor administers the injection. Therefore, IMA’s aversion to participating in capital punishment also warrants examination of the death-by-hanging method. The process of the death penalty should ideally be optimised to ensure a painless and quick death. However, even in the best case scenario, the person being hanged suffocates to death in at least a minute long process. This only contributes to the drawing out of the moral dilemma of the doctors while also violating the dignity and human rights of the convict. In 2003, the Law Commission had proposed shifting to lethal injections as the method to deliver the death penalty. However, this would only pronounce the role of the medical professionals in the process by making them the literal executioner.     

Research is still ongoing on the legal obligations that the medical community may have with respect to their participation in capital punishments. However, it is clear that India needs to take a look into its existing capital punishment mechanism. 

Photo Credit: Ben Sutherland via Visualhunt.com / CC BY