The global landscape of capital punishment is witnessing a disturbing surge, challenging the moral and ethical frameworks that underpin modern healthcare practice. As executions rise in frequency, especially in a handful of countries, the medical community finds itself at a critical crossroads. Bharat Malkani, a scholar of law at Cardiff University, presents a compelling argument in The BMJ, urging healthcare professionals to vocally oppose involvement in capital punishment. His appeal underscores the inherent conflict between the role of medical professionals—as guardians of life and wellbeing—and participation in state-sanctioned executions.
Recent data from Amnesty International reveal a striking increase in the number of executions worldwide. Despite a global decrease in the number of countries executing individuals, those that do practice capital punishment have escalated their execution rates drastically. In 2024 alone, at least 1,518 executions were recorded, a significant rise from 1,153 in 2023. This marks the fourth consecutive year of rising execution numbers and the highest tally since 2015, when 1,634 executions were reported.
The majority of these executions are concentrated in just three countries: Iran, Saudi Arabia, and Iraq. Iran accounted for at least 972 executions in 2024, with Saudi Arabia conducting at least 345, and Iraq at least 63. Notably, Saudi Arabia has already executed over 241 people in 2025, raising concerns about a new peak in capital punishment practices. China, though a known executioner, maintains secrecy regarding its official numbers, but it is believed to carry out thousands annually, a critical blind spot in global human rights monitoring.
One of the most alarming aspects of this trend is the extension of capital punishment to offenses traditionally considered minor, as well as the targeting of individuals critical of government authority. For example, the execution of Saudi journalist Turki al-Jasser, known for exposing corruption within the Saudi royal family, highlights the political dimensions of state executions. Such cases represent a direct affront to justice and freedom of speech, magnifying concerns about the use of the death penalty as a tool for political repression.
Additionally, there are troubling reports of individuals with mental illnesses and intellectual disabilities being sentenced to death, a practice that starkly violates international legal standards. These violations signal systemic ethical breaches within the judicial systems administering capital punishment, challenging the fundamental human rights principles enshrined in global conventions.
Central to the discourse is the role of medical professionals in executions, which raises profound ethical dilemmas. The involvement of doctors in administering lethal injections or other aspects of the death penalty contradicts the very essence of medical ethics, rooted in the preservation of life and the alleviation of suffering. Despite clear prohibitions by organizations such as the American Medical Association (AMA), some physicians still participate in state executions, reflecting a disconcerting dissonance between professional ethics and legal mandates.
In some jurisdictions, legal systems compel healthcare workers to partake in executions, forcing professionals to navigate untenable moral and legal conflicts. This coercion exacerbates the ethical crisis, undermining the autonomy of medical judgment. In response, the World Medical Association has issued calls to abolish any form of physician involvement in executions, advocating a principled stance in defense of human rights and professional integrity.
The surge in executions occurs amid a broader global shift towards authoritarianism and increasingly punitive law enforcement policies. This political backdrop diminishes hopes for an immediate global cessation of capital punishment. Yet, Malkani emphasizes the indispensability of persistent activism and advocacy efforts highlighting the injustice, immorality, and inhumanity inherent in state-sanctioned death penalties.
Healthcare professionals possess a unique and influential platform owing to society’s respect for their expertise and ethical commitments. Their opposition to capital punishment can wield considerable influence in abolitionist movements. By refusing complicity in executions and articulating the incompatibility of the death penalty with medical ethics and human rights, medical practitioners can become pivotal agents of change.
The ethical challenge posed to the medical community is complex but imperative. Beyond individual conscience, institutional reforms and international cooperation are necessary to reinforce the rejection of physician participation in executions. Medical ethics codes worldwide must be actively enforced, and legal protections must be strengthened to shield healthcare workers from compulsion in capital punishment processes.
This rising trend in executions underscores the urgency for intensified global scrutiny and coordinated responses. It is crucial to foster dialogues that integrate human rights, medical ethics, and legal frameworks to dismantle the apparatus enabling such state violence. The medical community’s proactive engagement can catalyze broader social and political reforms, advancing the movement toward abolition and reaffirming the sanctity of life.
In conclusion, the surge in global executions represents not only a challenge to human rights but a profound test to medical ethics and professional responsibility. Healthcare professionals’ opposition to capital punishment is vital in confronting the practice’s fundamental inhumanity and the violation of the right to life. This stance is not merely moral but grounded in the core principles of medicine, requiring unwavering commitment and courageous advocacy in the face of rising authoritarianism.
Subject of Research: Not applicable
Article Title: Medical opposition to capital punishment is needed as executions surge
News Publication Date: 1-Oct-2025
Web References: http://dx.doi.org/10.1136/bmj.r2017
References: Amnesty International reports; American Medical Association code of medical ethics; World Medical Association resolutions
Image Credits: Not provided
Keywords: Medical ethics, capital punishment, executions, human rights, physician participation, legal ethics, abolition, authoritarianism
