The abortive execution of convicted Tennessee murderer Christa Pike last week was not just a reminder of the violent nature of capital punishment. No matter how one views the death penalty, the grisly details of this tragic incident should — to use a phrase coined by Supreme Court Justice Felix Frankfurter — shock the conscience. As troubling have been the subsequent efforts to sustain her life, when she will be subjected to a lethal injection once more.
A physician and a veterinarian, respectively, we have both often treated critically ill patients. However, only one of us has legally ended the lives of a sizable proportion of them. As ethicists in our respective fields, we believe that animal euthanasia may offer useful insight into capital punishment.
For pets, the process of imposing death is relatively straightforward. Companion animal euthanasia is a therapeutic intervention to mitigate suffering; when conducted properly, the process spares the subject both fear and pain. It is typically performed when a beloved animal struggles with life-limiting disease. The term “euthanasia” derives from the Greek “euthanatos,” or easy death, and this ethos shapes the entire enterprise.
Veterinarians are legally, professionally, and (for the majority) morally mandated to end profound clinical suffering in accordance with well-established, evidence-based protocols. Complications are rare and botched interventions even rarer. The process may only be performed by a licensed professional, or, less frequently, by a highly trained technician.
The euthanasia drug, pentobarbital, must be pure and non-compounded. As a result of numerous safeguards to ensure a pain-free passing for pets, most pet owners report highly positive euthanasia experiences.
In contrast, the various legal methods of human execution — from hanging to electrocution to gassing — are neither peaceful nor painless. Can one imagine euthanizing a cat or dog on the gallows or in the electric chair? Doing so would certainly be a violation of veterinary ethics and possibly the basis for criminal charges.
According to the Death Penalty Information Center, 3.15% of all executions and 7.2% of those using lethal injection from 1890 to 2010 were considered “botched,” as were an estimated 7.4% of cases since 2021. To any veterinarian, these results would be considered an ethical crisis.
Although multiple factors have played a role in these failed executions, the most significant cause is lack of clinical expertise. Effective execution requires both knowledge and skills. In the hands of a trained expert such as Charles-Henri Sanson, the royal executioner of Paris during Louis XVI’s reign, even this morally fraught role needs professionalism and technical excellence.
Yet since the American Medical Association Code of Ethics explicitly forbids physician participation in capital punishment, executions are rarely, if ever, performed by expert clinicians. Rather, the state may employ executioners with limited technical expertise and often no experience in basic anatomy or medical care.
Publicly available information from the Pike case, for instance, suggests that the drug may have been of dubious quality and extravasated during administration by Tennessee prison employees. Pentobarbital that leaks from the vessels causes agonizing pain.
While we both strongly oppose capital punishment, we also believe that physicians may have an appropriate role to play in mitigating pain and suffering during state-sanctioned executions — especially if the alternative is another tragedy like that of Pike. To do so is not to endorse capital punishment. Rather, doing so may reflect one of the core duties of both physicians and veterinarians: To mitigate suffering whenever possible.
Appel is director of ethics education and a psychiatrist at Mount Sinai. Mani is a small animal veterinarian in Massachusetts.