Law and ethics

April 12, 2007 -- Today The Sun-News (Myrtle Beach, SC) ran a short Associated Press piece reporting that some North Carolina nurses are seeking to bar nurses from participating in executions in the state. Although the state's medical association was reportedly able to bar physicians from such participation simply by issuing an ethics policy--effectively halting the state's capital punishment system and provoking a lawsuit by the state--the state's nursing board says it can't make such a move without a change to the Nursing Practice Act. Although the piece might have pursued these issues further, we thank the Sun-News and the AP for highlighting them.

"Some nurses want ban on execution role" says that Raleigh nurse Cynthia Gallion has sponsored a petition urging the North Carolina board of nursing to "adopt an ethics policy prohibiting [nurses] from participating in executions." Galliano is quoted as saying that such participation "is clearly against our code of ethics." Although the article does not follow this up, Galliano appears to be correct. [See ANA code of ethics provisions 1.1, 2.1, 2.2, 4.1, 4.2, 4.3, 5.1, 5.3, 5.4, 6.1, 6.2, 8.2, 9.1, 9.4] However, nursing board spokesperson David Kalbacker says the board can't discipline a nurse for taking part in an execution without a change in the Nursing Practice Act. The piece does not pursue why that might be. But it does say that the state medical board apparently faced no such impediment when it issued an ethics policy earlier in the year threatening to sanction any physician who played such a role. Apparently, that move led the state attorney general to sue the medical board; the piece does not report the status of that litigation. But it's not hard to imagine that the nursing board does not wish to be subject to a similar legal action. In any case, Gallion reportedly plans to take the issue to the state legislature.

The piece also notes that the North Carolina Nurses Association "once barred nurses from participating in executions," which presumably means once had an ethics policy against it. But the association reportedly changed that policy in 2003, and it now "leaves the decision up to the individual nurse," while opposing prisons requiring that their nurses participate as part of their jobs. Although the presence of nurses is reportedly not required at executions, nurses "have been present at the past several executions." (Presumably physicians are required, or the medical association's move would not have halted the state's executions, though the piece does not say so explicitly.)

The piece might have discussed why the nursing board says its legislative situation differs from that of the medical board. And it might have addressed why health workers might find it unethical to participate in executions. In fact, this issue is a controversial one nationwide. In any case, we thank the Sun-News and the AP for covering the issue.

See the article "Some nurses want ban on execution role: Petitioners want lawmakers to add to ethics policy" from the April 12, 2007 edition of the Sun-News.

The Associated Press

"Some nurses want ban on execution role: Petitioners want lawmakers to add to ethics policy"

RALEIGH, N.C. - A group of nurses who have asked their licensing board to adopt an ethics policy prohibiting them from participating in executions must take their case to the legislature, a spokesman for the N.C. Board of Nursing said.

A few nurses are urging the board to follow the example set by the state medical board, which in earlier this year threatened to punish any physician who participates in an execution.

"It is clearly against our code of ethics," said Raleigh nurse Cynthia Gallion, who has collected more than 80 signatures on a petition urging the nursing board to act.

But David Kalbacker, a spokesman for the nursing board, said the board can't discipline a nurse who takes part in an execution unless lawmakers amend the Nursing Practice Act so that it prohibited such an action.

"We have to make a legislative change," Kalbacker said. "We can't make an announcement."

Such a change to the state's Medical Practice Act wasn't required for the medical board, which has the power under state law to discipline doctors who fail to comply with its ethics policies.

Gallion said she plans to ask the board to approach the legislature, but she may be out of time.

The deadline for the introduction of legislation has passed in the Senate.

In the House, the deadline is April 18, less than a week away.

The medical board's declaration that any doctor who participates in an execution violates medical ethics and could face sanction triggered a series of legal actions that effectively shut down the state's capital punishment system. The state attorney general's office tried and failed to resolve the dispute outside of court, and later sued.

The N.C. Nurses Association, a professional organization that does not license and discipline nurses, once barred nurses from participating in executions.

But the group changed that policy in 2003 and now leaves the decision up to the individual nurse.

It does, however, oppose prison officials requiring that nurses participate in executions as part of their jobs.

The issue has arisen again and been referred to the commission on standards and practices, which next meets April 30, said Tina Gordon, the association's executive director.

State law does not require that a nurse attend an execution.

However, court records and depositions from prison officials indicate that at least two nurses have been present at the past several executions.