Does nursing exist? No easy answer for New York Times article

June 10, 2004 -- "Should Doctors Help With Executions? No Easy Ethical Answer," a lengthy article by Adam Liptak in today's New York Times, discusses health care practitioner participation in U.S. executions. It includes numerous descriptions of the conduct, opinions, and ethical responsibilities of named physicians, but only one passing reference to a nurse (not named) who "spent 39 fruitless minutes stabbing needles" into a condemned former drug addict before a named physician inserted a central line that could carry the lethal injection.

The Times piece describes the participation of one Georgia physician in executions in great detail. It also quotes five different named physicians, some repeatedly. These physicians express different opinions as to the ethical implications of physician participation in executions and discuss attempts to prevent it. The story also discusses the effect of judicial decisions and legislation on physician participation in executions, as well as the relevance of the Hippocratic oath and the American Medical Association's code of ethics, which specifically forbids physician participation.

If not for the passing, contemptuous reference to the "stabbing" nurse, we might conclude that the New York Times simply had no idea that nurses also participate in executions and that they confront these same ethical dilemmas. In fact, some nurses do participate, although since at least 1994 the American Nurses Association has maintained that it violates nursing ethics. The International Council of Nurses and at least one state nursing association have taken similar positions. In fact, the nature of execution by lethal injection--now the predominant form in the U.S.--is such that nursing would be a more relevant profession for this discussion. It is nurses who typically give injections, monitor vital signs and patient pain, and generally advocate for appropriate pain relief for patients. This makes all the more glaring the lack of any discussion of nursing--and all the more comic the quote attributed to Dr. Kenneth Baum that physicians should participate in executions because "inserting the I.V....infusing medicine...monitoring vital signs [and] declaring death" are all "the practice of medicine." Of course, each of these but the last is more the province of nursing than medicine.

It may be that those responsible for this piece do not know that nurses are licensed, autonomous professionals. Nurses have nursing licenses, and they are subject to nursing ethics, not medical ethics. It also seems likely that those responsible for the article do not know that most of the health care issues arising in a condemned person's final minutes would fall more within the province of nursing--and with sources like Dr. Baum, it's not hard to see why. As it happens, though Dr. Baum completed a joint J.D./M.D. program at Yale in 2001, since 2001 he has practiced as a litigation attorney defending complex health-related tort cases for a corporate law firm in New Haven, and we have found no indication that he has practiced medicine. His article on physician participation in executions was published in the same year as his graduation from medical school.

We encourage supporters to let those responsible for this article know that they have not gotten the whole story, that they should have consulted with nursing ethicists on these issues, and that their piece has contributed to the public erroneous impression that nurses are marginal players in the health care arena.

See Adam Liptak's article "Should Doctors Help With Executions? No Easy Ethical Answer" in the June 10, 2004 issue of the New York Times.

Please send your letter to author Adam Liptak at liptaka@nytimes.com, the New York TImes editor at letters@nytimes.com and please send a copy to the Center at letters@truthaboutnursing.org