End the use of lethal injection in the United States
The Issue
To: William K. Marshall III, director of the Federal Bureau of Prisons
Gaining popularity as humane, lethal injection has become the most common execution method used in the country. Unfortunately, this is often not the case, as medical professionals are not involved in its development nor administration (Hassan et al., 2024a; Sawicki, 2022; Peters, 2025). Physician participation would temper these concerns (Sawicki, 2022, p. 27), but as organizations in the field note, there are important ethical problems.
According to Black and Sade (2007, 2780), “healing the sick and alleviating suffering is the primary role of physicians in US society” (Sawicki, 2022, p. 20). Intentionally causing death can arguably align with this duty, like by providing relief to those in pain and distress close to death. Physician presence can alleviate even non-physical suffering in executions, but not always.
Despite approximately 14,000-15,000 murders occurring each year, few result in the death penalty due to the influence of outside factors determining capital punishment — location, judge, prosecutor, case notoriety, even demographics (Braswell et al., 2023, p. 205). “Many offenders are poor and cannot attract the best defense attorney available”, Braswell et al. (2023, p. 202) points out, while “data show more punitive treatment in cases with white victims” especially in “cases involving black defendants” compared to “all other defendant/victim racial combinations” (p. 204).
African Americans’ suspicion of the medical community (Corr et al., 2025, p. 86), due to history including but not limited to the Tuskegee syphilis study, and their constituting over 40% of the death row population (Braswell et al., 2023, p. 204), might mean assuming comfort from physician presence during executions is incorrect. Involvement may harm the already-strained relationships certain (fellow) minority groups have with the medical community.
No execution method “can minimize the mental stress and fear of upcoming death” (Hassan et al., 2024a, p. 4485). An individual faces minimal comfort in being punished at all, whatever and by whoever it may be. Rockoff et al. (2024) critique arguments favoring physician involvement in lethal injection executions on the basis of mistaken analogies to physician aid-in-dying. Those sentenced to death have no consent privilege, unlike competent free adults who can choose to “refuse lifesaving treatment regardless of the [success likelihood]” (Sawicki, 2022, p. 24).
Moral and pragmatic differences exist between killing someone relatively healthy in an execution, versus a person already close to medical death (not a sanctioned one) or incurability, per physician-assisted dying. Physicians function as criminal justice system members from an internal standpoint, because this practice is explicitly undeniably a punishment, not based on the good of the patient, unlike physician aid-in-dying. They carry out passed-down judgment as moral agents of the state, not caring medical professionals.
Its nature does not focus on the patient’s well-being (even if trying to ease discomfort); rather, physicians are acting for the interests of the client (the government), not the patient (the condemned), which defies the profession’s ethical sensibility. “If physicians are viewed as facilitators of death,” state Black and Levine (2008, 113—114), “patients might not believe that their physicians are always acting in their best interests” (not the state’s) and “erode the trust necessary for the medical profession to function in society” (Sawicki, 2022, p. 21).
Physicians’ role cannot be removed entirely from executions: monitor vital signs and determine time of death (LeGraw & Grodin, 2002, 410—1), oversee nonprofessionals (Sawicki, 2022), conduct preliminary screening of the convict specifically related to its implementation and steps directly taken before the execution (like preparing syringes during and immediately after the procedure) (Hassan et al., 2024b). However, it should be reduced as much as possible.
LeGraw and Grodin (2002, 419) state that medicine “has a significant and unavoidable commitment to nonmaleficence [meaning] that even if medical professionals refused to participate in lethal injection, the procedure itself would still be unethical, since it is inherently a medical procedure” (Sawicki, 2022, p. 23). Physicians historically have been involved in executions, but this situation is unique: lethal injection cannot be undertaken adequately by non-professionals.
The only ethical manner to executing lethal injection is considerable health-care professional participation (Sawicki, 2022, p. 29), but LeGraw and Grodin (419) argue “the use of a medical procedure to execute human beings is, by itself, a violation of medical ethics and human rights” (Sawicki, 2022, p. 21).
Please sign this petition urging U.S. lawmakers, the judicial system, and stakeholders to reevaluate reliance on lethal injections and explore more-ethical alternatives. Make your voice heard and help drive change towards aligning practices aiming for greater integrity in the criminal justice system, medical community, and their actors.
References
Braswell, M.C., McCarthy, B.R., & McCarthy, B.J. (2023). Justice, crime, and ethics (11th ed.). Anderson Publishing.
Corr, C. A., Corr, D. M., & Doka, K. J. (2025). Death & dying, life & living (9th ed.). Cengage.
Hassan, A., Verma, A., Anuragi, P. K., Sharma, M., & Naniwal, U. (2024a). The science of execution: A review of contemporary methods and their implications for human dignity. Frontiers in Health Informatics, 13(3), 4479–4487. https://healthinformaticsjournal.com/index.php/IJMI/article/view/394
Hassan, A., Verma, A., Sharma, M., Gupta, D., & Kumar, N. (2024b). The paradox of healing and harm: Physician participation in lethal injection executions in the United States. Library Progress International, 44(3), 15202–15212. https://doi.org/10.48165/bapas.2024.44.2.1
Peters, A. B. (2025). The American experiment as a violation of jus cogens norms: Capital punishment, state secrecy, & a novel way to kill. Washington University Global Studies Law Review, 25(1), 245–282. https://journals.library.wustl.edu/globalstudies/article/id/9191/
Rockoff, M. A., Van Cleve, W., & Van Norman, G. A. (2024). Anesthesiologists and capital punishment. Anesthesiology Clinics, 42(4), 715–732. https://doi.org/10.1016/j.anclin.2024.02.007
Sawicki, S. K. (2022). Health-care professionals and lethal injection: An ethical inquiry. The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine, 47(1), 18–31. https://doi.org/10.1093/jmp/jhab040
Photo by Ian Talmacs on Unsplash
3
The Issue
To: William K. Marshall III, director of the Federal Bureau of Prisons
Gaining popularity as humane, lethal injection has become the most common execution method used in the country. Unfortunately, this is often not the case, as medical professionals are not involved in its development nor administration (Hassan et al., 2024a; Sawicki, 2022; Peters, 2025). Physician participation would temper these concerns (Sawicki, 2022, p. 27), but as organizations in the field note, there are important ethical problems.
According to Black and Sade (2007, 2780), “healing the sick and alleviating suffering is the primary role of physicians in US society” (Sawicki, 2022, p. 20). Intentionally causing death can arguably align with this duty, like by providing relief to those in pain and distress close to death. Physician presence can alleviate even non-physical suffering in executions, but not always.
Despite approximately 14,000-15,000 murders occurring each year, few result in the death penalty due to the influence of outside factors determining capital punishment — location, judge, prosecutor, case notoriety, even demographics (Braswell et al., 2023, p. 205). “Many offenders are poor and cannot attract the best defense attorney available”, Braswell et al. (2023, p. 202) points out, while “data show more punitive treatment in cases with white victims” especially in “cases involving black defendants” compared to “all other defendant/victim racial combinations” (p. 204).
African Americans’ suspicion of the medical community (Corr et al., 2025, p. 86), due to history including but not limited to the Tuskegee syphilis study, and their constituting over 40% of the death row population (Braswell et al., 2023, p. 204), might mean assuming comfort from physician presence during executions is incorrect. Involvement may harm the already-strained relationships certain (fellow) minority groups have with the medical community.
No execution method “can minimize the mental stress and fear of upcoming death” (Hassan et al., 2024a, p. 4485). An individual faces minimal comfort in being punished at all, whatever and by whoever it may be. Rockoff et al. (2024) critique arguments favoring physician involvement in lethal injection executions on the basis of mistaken analogies to physician aid-in-dying. Those sentenced to death have no consent privilege, unlike competent free adults who can choose to “refuse lifesaving treatment regardless of the [success likelihood]” (Sawicki, 2022, p. 24).
Moral and pragmatic differences exist between killing someone relatively healthy in an execution, versus a person already close to medical death (not a sanctioned one) or incurability, per physician-assisted dying. Physicians function as criminal justice system members from an internal standpoint, because this practice is explicitly undeniably a punishment, not based on the good of the patient, unlike physician aid-in-dying. They carry out passed-down judgment as moral agents of the state, not caring medical professionals.
Its nature does not focus on the patient’s well-being (even if trying to ease discomfort); rather, physicians are acting for the interests of the client (the government), not the patient (the condemned), which defies the profession’s ethical sensibility. “If physicians are viewed as facilitators of death,” state Black and Levine (2008, 113—114), “patients might not believe that their physicians are always acting in their best interests” (not the state’s) and “erode the trust necessary for the medical profession to function in society” (Sawicki, 2022, p. 21).
Physicians’ role cannot be removed entirely from executions: monitor vital signs and determine time of death (LeGraw & Grodin, 2002, 410—1), oversee nonprofessionals (Sawicki, 2022), conduct preliminary screening of the convict specifically related to its implementation and steps directly taken before the execution (like preparing syringes during and immediately after the procedure) (Hassan et al., 2024b). However, it should be reduced as much as possible.
LeGraw and Grodin (2002, 419) state that medicine “has a significant and unavoidable commitment to nonmaleficence [meaning] that even if medical professionals refused to participate in lethal injection, the procedure itself would still be unethical, since it is inherently a medical procedure” (Sawicki, 2022, p. 23). Physicians historically have been involved in executions, but this situation is unique: lethal injection cannot be undertaken adequately by non-professionals.
The only ethical manner to executing lethal injection is considerable health-care professional participation (Sawicki, 2022, p. 29), but LeGraw and Grodin (419) argue “the use of a medical procedure to execute human beings is, by itself, a violation of medical ethics and human rights” (Sawicki, 2022, p. 21).
Please sign this petition urging U.S. lawmakers, the judicial system, and stakeholders to reevaluate reliance on lethal injections and explore more-ethical alternatives. Make your voice heard and help drive change towards aligning practices aiming for greater integrity in the criminal justice system, medical community, and their actors.
References
Braswell, M.C., McCarthy, B.R., & McCarthy, B.J. (2023). Justice, crime, and ethics (11th ed.). Anderson Publishing.
Corr, C. A., Corr, D. M., & Doka, K. J. (2025). Death & dying, life & living (9th ed.). Cengage.
Hassan, A., Verma, A., Anuragi, P. K., Sharma, M., & Naniwal, U. (2024a). The science of execution: A review of contemporary methods and their implications for human dignity. Frontiers in Health Informatics, 13(3), 4479–4487. https://healthinformaticsjournal.com/index.php/IJMI/article/view/394
Hassan, A., Verma, A., Sharma, M., Gupta, D., & Kumar, N. (2024b). The paradox of healing and harm: Physician participation in lethal injection executions in the United States. Library Progress International, 44(3), 15202–15212. https://doi.org/10.48165/bapas.2024.44.2.1
Peters, A. B. (2025). The American experiment as a violation of jus cogens norms: Capital punishment, state secrecy, & a novel way to kill. Washington University Global Studies Law Review, 25(1), 245–282. https://journals.library.wustl.edu/globalstudies/article/id/9191/
Rockoff, M. A., Van Cleve, W., & Van Norman, G. A. (2024). Anesthesiologists and capital punishment. Anesthesiology Clinics, 42(4), 715–732. https://doi.org/10.1016/j.anclin.2024.02.007
Sawicki, S. K. (2022). Health-care professionals and lethal injection: An ethical inquiry. The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine, 47(1), 18–31. https://doi.org/10.1093/jmp/jhab040
Photo by Ian Talmacs on Unsplash
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Petition created on March 6, 2026