Unethical to involve doctors

The time has come for us to hang the convicted in the Nirbhaya rape case. At this time, it is also important to discuss the involvement of doctors in the process. The World Medical Association (WMA) provides ethical guidance to physicians through its Declarations, Resolutions and Statements. The same is adopted by CMAAO Asian Countries including Indian Medical Association.

WMA first adopted its resolution on physician participation in capital punishment in 1981, which then amended in 2000 and 2008. The revised Declaration of Geneva was adopted by
the World Medical Association General Assembly on October 14, 2017, in Chicago.

There is a universal agreement that physicians must not participate in executions as it is incompatible with the physician’s role as healer. The use of a physician’s knowledge and clinical skill for purposes other than promoting health, wellbeing and welfare undermines a basic ethical foundation of medicine. The WMA Declaration of Geneva states: “I will maintain the utmost respect for human life”, and “I will not use my medical knowledge to violate human rights and civil liberties, even under threat.”

As citizens, physicians have the right to form views about capital punishment based on their individual moral beliefs. As members of the medical profession, they must uphold the prohibition against participation in capital punishment. Therefore, the World Medical Association affirms that it is unethical for physicians to participate in capital punishment, in any way, or during any step of the execution process, including its planning and the instruction and training of persons to perform executions. It also requests that its constituent members advise all physicians that any participation in capital punishment as stated above is unethical, and urges its constituent members to lobby actively national governments and legislators against any participation of physicians in capital punishment.

Even the MCI ethics appendix reaffirms this— 1) I solemnly pledge myself to consecrate my life to service of humanity. 2) Even under threat, I will not use my medical knowledge contrary to the laws of Humanity... 11) I shall abide by the code of medical ethics as enunciated in the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations 2002.

But according to the Delhi jail manual, point 23 prescribes that the Jail Medical Office has to issue a certificate that the person is medically fit for hanging and that a doctor must be present at the execution.The medical officer will have to determine if the convict is physically fit to be hanged, to check the length of the rope as proportionate to the convict’s body. After the hanging, a doctor will have to certify death. However, the body remains suspended for half an hour, and only after this period is the Medical Officer allowed to declare death. Therefore, as per the Jail Manual, doctors are required at every step of the execution to monitor vital signs of convicts during the process of execution, look for signs of life and then pronounce death. The same is unethical as per WMA, CMAAIO. The Indian Medical Association (IMA) wrote in the past to the Medical Council of India (MCI) demanding that the participation of doctors in the process of capital punishment be scrapped.

In a letter to the then MCI president, when I was the National President in 2017 of IMA, I wrote, “the presence of physicians at the time of execution was a violation of medical ethics”.
I also wrote that IMA holds the view that no doctor should be present during the process of execution. This is a violation of medical ethics and therefore amounts to professional misconduct. I also wrote “that the amended WMA Declaration of Geneva The Physicians Pledge was adopted by the WMA General Assembly on October 14, 2017, in Chicago. All the policies and resolutions of the WMA are accepted by member National Medical Associations, making India a signatory to all the policies and resolutions adopted by the body (WMA). We, therefore, request you to implement the WMA Resolution on Physician Participation in Capital Punishment as a guideline for doctors in the country”. There is no law which mandates the presence of a doctor at the time of capital punishment.

Such requirements are only present in the Jail manual. Doctors can be called to testify death but cannot asked to testify their fitness or be present at the site of execution.

(The writer is the president of the Confederation of Medical associations of Asia and Oceania and Heart Care Foundation of India)