Sunday, May 3, 2009

Hippocrates and the Hangman



"Many that live deserve death. And some that die deserve life. Can you give it to them? Then be not too eager to deal out death in the name of justice, fearing for your own safety. Even the wise cannot see all ends."

Gandalf, The Fellowship of the Ring


Granted, when it comes to the question of capital punishment, those on death row tend in their character to be more like Gollum (for whom Frodo desires death in this Tolkien quote) than like Socrates faced with the hemlock in Jacques-Louis David's famous painting. And it is noteworthy as regards the quote that contemporary America endeavors to give (deserved) life to those fated to die every bit as aggressively as it seeks to give (deserved) death to those otherwise fated to live after committing heinous crimes. In this respect capital punishment is a grim mirror image of the out-of-control medical-industrial complex. Even the wise...

This came to mind after a recent local story in which the Supreme Court of North Carolina decided (4-3!) that the state medical board cannot in fact discipline physicians who participate in executions (i.e. by monitoring vital signs to insure that the inmate is "not suffering"). Death sentences, which had been on hold for a couple of years because of this question, can presumably start up again.

It took me years to decide where I came down on the question of the death penalty. I used to be for it, as I've always had a healthy respect for evil as a real force in the world, and as Tolkien wrote, in terms of abstract justice there are people who have done things so awful that they deserve to die. However, in an odd parallel to the question of the possible rationality of suicide, I think that the absoluteness of death precludes, in practice, the ethically justifiable intentional taking of life for any reason but direct and obvious self-defense (any society-wide deterrent effect of capital punishment is debated, and is definitely not direct and obvious).

Capital punishment, like suicide, is a declaration that this particular person's life cannot be considered worth living; in an execution the state effectively commits suicide on another's behalf, conflating vengeance and penance. In this sense it is richly ironic that those on death row are not permitted to commit suicide, and indeed may not be considered "competent" for execution if they are suicidal. Both execution and suicide are acts of dreadful certainty: "By the permanence of this act I affirm that I (or we, the state) cannot possibly be mistaken, that things could never come to be different, whether through additional evidence or altered perception." Playing God, indeed, although to do so with someone else's life is rather different, isn't it, than to do so with one's own?

What physician would want the job of monitoring an execution? I suppose it could be a deeply ethical act, inasmuch as the about-to-be-executed are, by definition, those who have had every human right stripped from them--except for the right to freedom from inflicted physical agony. Another irony, as Atul Gawande's recent New Yorker article painfully described, is the regular use of long-term solitary confinement, which arguably inflicts emotional distress far more horrific than the physical pain someone could undergo during lethal injection. What is the difference? Well, there are media and family representatives observing an execution, but in a solitary cell, not so much. Very discreet.

I always come back to Oliver Cromwell's (paraphrased) admonition, "I beseech you, in the bowels of Christ, consider that you may be mistaken." Suicide means blinding oneself to the possibility of the ultimate error. Execution leaves this possibility open, but removes the option of ever rectifying it. Eventually the civilized world will view capital punishment much in the way it views slavery, as beyond the pale (much of the world does already actually, we just haven't joined it yet).

9 comments:

rvitelli said...

Solitary confinement isn't always about punishment. It's often used for prisoners who wouldn't be able to function in regular association with other prisoners. Mentally ill prisoners often end up in solitary because there's no place else to put them.

Retriever said...

"What physician would want the job of monitoring an execution? I suppose it could be a deeply ethical act, inasmuch as the about-to-be-executed are, by definition, those who have had every human right stripped from them--except for the right to freedom from inflicted physical agony."

I can't imagine any physician who could bear to do this. Then, again, I can't imagine any physician who could bear to perform abortions, and yet plenty do. Many perform fancy footwork to define the unborn as not human and therefore not deserving the right to live.

I like the Cromwell quote. The main reason I am (mostly) against capital punishment. Better to let a hundred villains live than execute one innocent one. Us ferocious evangelical Christians really believe that stuff about going out to save that one lost sheep to rescue it, and leaving the 99 others to do so.

However, in a society where poor children cannot get a decent education, live in rat infested buildings, and get substandard if any medical care, I find it obscene that we spend so much money on condemned killers. According to this interview with a former warden if St, Quentin, it costs 90,000 dollars more per year (over and above what it costs to keep a prisoner in the general population) to keep someone on death row. Presumably this reflects not only the more guards, tighter security, but also the cost of all those appeals, etc.

There are times when I cruelly wonder if a firing squad wouldn't be more merciful than a life of near solitary confinement, and would certainly cost society less money. Who benefits from spending more money keeping dangerous criminals for decades at public expense to keep them away from hurting the general public? Even the regular prison costs more per prisoner than college for the average kid per year.

I have no answers,but yet again it does seem to me odd that people weep over cruelty to murderers and torturers and rapists, but can be quite oblivious to the plight of the chronically mentally ill, or the frail elderly living on cat food, or abused kids. Odd that the able-bodied criminals draw such sympathy.

Retriever said...

Dog leapt up and bumped keyboard before I could add this link:

http://www.latimes.com/news/opinion/la-oe-woodford2-2008oct02,0,4155306.story

Anonymous said...

'it does seem to me odd that people weep over cruelty to murderers and torturers and rapists, but can be quite oblivious to the plight of the chronically mentally ill, or the frail elderly living on cat food, or abused kids. Odd that the able-bodied criminals draw such sympathy.'

Retriever, to be human is to sympathise. Sympathy for those condemned to suffer the depravities of the human condition is morally reflexive; it appeals to the deepest and most primal of human instincts. It is the social creature's prison; an irresolute given that entangles our consciences together and deems humanity a stricken collective - a pull of the string here inevitably pains the psyche there.

Torture is a concentrated eternal present blind to everything extraneous/immaterial to the pure experience in question. It only invites emotional response. It doesn't balance the probabilities of deservedness. It hurts like hell to endure, and it's morally repulsive to witness (unless youre a sadist, of course). Sympathy is above religiosity.

Actually, I can't comprehend the infernal retributive willingness of family members to witness executions - is it really the only way to gain 'closure' ? Who's the human and who's the beast? It seems to me like condescending to a deeper level of passive depravity. There's just something about the the whole catered (apparently these 'events' come replete with food & refreshments - to dampen that gnawing feeling in the pit of the audiences' guts which some mistake for hunger) tragic drama that reviles me...regressively medieval.

I'm not so concerned about the 'absoluteness' of death, only the methods of it's cruel handmaidens - those that still deign to call themselves human in spite of...

Irrevocability scars many life choices - we live and die by its sword. So be it. We can only live among its ruins and call it art.

Some bloodthirsty avengers would rather be stabbed in the back by 'justice' than let a criminal roam safely among their children. HOw's that for sacrifice in the name of...

'Moral contempt causes greater indignity and harm than any crime'

Retriever said...

Eloquent,Anonymous,and you are right. Agree with most of what you wrote. Particularly about the avengers. I've never understood the desire to witness another's suffering "for closure" either. And about irrevocability.


I worked on human rights cases and legislation against torture in youth, so I;m not the ogre you might think from my exasperation at the injustice of spending more on imprisoning than educating or treating a person.

I am really just mulling over the related issue of how being merciful towards our enemies, and trying honestly to give offenders a second chance (a good thing, something demanded of the Christian) can be balanced against protecting potential victims of theirs and preventing future acts of violence.

Good piece by Dalrymple on evil here: http://www.newenglishreview.org/custpage.cfm/frm/38224/sec_id/38224

Novalis said...

If I came across as high-minded in this post, I didn't mean to. I have never even considered doing prison or forensic psychiatry precisely because I do not relish being around offenders. Over the years in general practice contexts I have met numerous individuals with criminal histories, and I have rarely found them to be anything but evasive and disingenuous about their own responsibilities. But perhaps it is partly because of this personal moral distaste of mine that I bend over backward in insisting on our ethical duties toward them.

I can't resist a morbid clinical note, from my past ECT experiences. Some years ago, the much talked about execution of Timothy McVeigh (the Oklahoma federal building bomber) happened to fall on an ECT day. We didn't have our usual anesthesiologist that day, but instead a truly odious man who, as he was drawing up the meds for the procedure, observed out loud (patient still awake of course) that the meds (barbiturate plus paralytic) were the same as those employed in lethal injection.

Of course, in ECT these are followed by life-preserving oxygenation rather than the lethal potassium chloride of an execution; this is no minor detail, but may have been lost on the unfortunate patient that day. I ended up complaining about that anesthesiologist several times, and he was rarely assigned to ECT. (I'm happy to say though that the procedure went fine as it always did the eight years I did them).

Anonymous said...

I think we're all inclined to make judgements - unfortunately a lot of them are prejudiced, and stereotypical. Unfortunately some stereotypes are true.

Some people are inconsolable; others are irremediable. - Should they jump or should they be pushed? Sometimes peace is very painful to hold. Too many wars to be waged.

Retriever, on a lighter note (of the black comedy variety), a film called 'The Young Poisoner's Handbook' was made about Graham Young - the young psychopath from the evil article you mentioned. Now that's entertainment!

Retriever said...

Well, Anonymous, there is lots of great comedy about death....Arsenic and Old Lace (my favorite, as I could always relate to Cary Grant's happy cry "I'm not a Brewster, I'm the son of a sea cook" as I always hoped that I was adopted...). Then what about "Kind Hearts and Coronets" where the same Alec Guinness plays all the parts and the villain murders everyone between him and the title...Or the Monty Python skit on the plague "I'm not dead yet....you soon will be."
Great blackcomedy for the anti-war types in "Oh What a Lovely War" about WWI (from my youth back when the dinosaurs roamed the earth). BlackAdder on WWI is pretty good too. And don't even get me started on the great comic material on us witless evangelicals! You would like the Wittenburg Door online. It's very liberal, and funny. To the religious life as The Journal of Polymorphous Perversity is to the psychiatric profession.

fraise said...

Interesting read -- but a major argument against capital punishment wasn't mentioned, though I can understand why in the context of your particular approach in your post. And it does fit with what you say, too -- that argument being, there have been more than 130 death row inmates found innocent. *Innocent*. How on earth can we live with the possibility of killing innocent people?
Stats:
http://www.deathpenaltyinfo.org/innocence-and-death-penalty

"Even the wise cannot see all ends" -- and even a decent justice system doesn't always incarcerate the actual guilty party.