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Governor or physician?

Thomas Mayo at HealthLawProf Blog raises questions about whether a physician, who also happens to be a Governor, violates medical ethics by signing an inmate's death warrant.

The Kentucky Board of Medical Licensure says that Gov. Ernie Fletcher, who is a physician, did not violate medical ethics when he authorized the execution of an inmate on the state's death row, despite the AMAs prohibition of physicians from participating in executions. "The committee, which examined the issue at the request of four death-penalty opponents, said Fletcher was acting as governor, not as a doctor, when he signed a Nov. 8 death warrant for Thomas Clyde Bowling."

After reading Mayo's post and looking at the information he links to, I think the Board got it right. Yes, we should worry when docs avoid their ethical responsibilities by trying to remove their "physician" hats at convenient times. But we should also avoid falling into the trap of defining the person by their profession. The AMA's code of medical ethics doesn't completely define the ethical obligations of every human being who happens to have chosen the profession of medicine.

Ernie Fletcher may be a physician, but he's also pursuing another profession. If Fletcher had refused to sign the death warrant, would he have been violating his ethical responsibilities to Kentucky's citizens as Governor? Those obligations come from Kentucky law and the promises he may have made to the citizenry before he was elected, and have nothing to do with medical ethics. It's crucial that a person be able to set aside his role as a physician, because otherwise he might find it difficult to do anything else in his life ethically.

I knew an emergency doc once who also served as a reserve police officer. He couldn't have done that job well if the code of medical ethics had attached to his person 24/7. Conversely, he couldn't have been an ethical physician if he was bound to treat patients with the ethics of a cop.