Jacob M. Appel


The purpose of this paper is to merge two largely separate bodies of writing on the subject of psychiatric participation in capital punishment. Much has already been written from the perspective of legal academics regarding the rights of prisoners to be free from unwanted medical care if the purpose of providing such care is to render them fit for execution. Medical ethicists have also written much on the degree to which physicians, and specifically psychiatrists, may participate in facilitating the death penalty before they become so complicit as to violate accepted standards of professional ethics. Surprisingly, these two fields of inquiry have developed in relative isolation. What this essay seeks to do is to examine the relationship between these two bodies of thought and to explore the following question: What impact do the ethical limits of psychiatric practice have on the application of capital punishment? Two other questions naturally follow: 1) Do ethical limitations on psychiatric participation create a “bottleneck” that will, in practice, make executions impossible; and 2) Are there ways of meeting the constitutional rights of condemned defendants that would allow for execution without the participation of medical professionals? In order to answer these questions, a brief exploration of evolving medical attitudes toward capital punishment is necessary.