death penalty

Indian Medical Association asks that doctors be excused from participating in execution of convicts

The Indian doctors’ body has joined its global counterpart in declaring that participating in death penalty processes is against medical ethics.

Earlier this month, the World Medical Association updated the Hippocratic oath to include a statement that it is against medical ethics for doctors to participate in capital punishment. On Tuesday, the Indian Medical Association joined its global counterpart and asked the Medical Council of India to include a statement to this effect in India’s code of medical ethics.

The World Medical Association first adopted its resolution on physician participation in capital punishment in 1981, which it then amended in 2000 and 2008, The resolution states that “it is unethical for physicians to participate in capital punishment, in any way, or during any step of the execution process, including its planning and the instruction and/or training of persons to perform executions.”

The World Medical Association in 2008 had asked all its member bodies which includes the Indian Medical Association to “lobby actively national governments and legislators against any participation of physicians in capital punishment.”

Dr KK Aggarwal, president of the Indian Medical Association, said “By asking doctors to certify if a person is fit enough to be hanged, the government is forcing us to violate our medical ethics. By certifying someone fit, we are pushing them towards execution.”

At the same time, medical ethics experts have raised the question of why the association has decided to raise the issue at this time, especially when it has remained silent on other ethical violations.

The doctor’s role

According to India’s Code of Criminal Procedure, 1898, the method of capital punishment for convicts sentenced to death is hanging. According to the National Crime Records Bureau, 1,303 capital punishment verdicts were announced between 2004 and 2013. Three convicts have been executed during this period.

Doctors have two primary responsibilities in execution. First, they are expected to certify a person “fit to be executed”. Second, doctors are expected to witness the hanging and certify the death of the convict.

When screening someone for fitness for hanging, doctors are supposed to check whether the convict is pregnant if female and look for any diseases. “The reason for certifying someone fit for hanging is to ensure that his death is a result of hanging and nothing else,” said Dr SM Patil, police surgeon with the Maharashtra government.

According to the jail manual, a medical officer (doctor), executive magistrate and superintendent have to sign the execution report which gives details of the name of the prisoner and the time and location of death by hanging. The manual also elaborates on the role of the medical officer in deciding the length of the drop as per the height, weight of the convict.

In 1995, a two judge bench of the Supreme Court while deciding on a petition said that ‘‘a convict shall remain hanging only till he is declared dead by a medical officer.”

In a paper on the role of the medical profession on capital punishment, forensic doctor RK Bansal wrote, “as a result of this little known judgment, a doctor must periodically examine the person after hanging to look for signs of life. If the person is found alive, the doctor is to ask the hangman to continue – to order hanging to death instead of resuscitating.”

Writing in the Indian Journal of Medical Ethics in 2003, human rights lawyer Vijay Hiremath pointed out that death by hanging does not meet standards laid down by the Supreme Court for the execution of death penalty – that it should be as quick and simple as possible, that the act of execution should produce immediate unconsciousness passing quickly into death, that it should be decent and should not involve mutilation.

“There have been several cases reported where hanging has not immediately resulted in a broken neck and thus the convict is left to slowly strangle to death. This strangling results in the convict’s eyes popping almost out of his head, his tongue swelling up and protruding from his mouth. In cases where the neck is in fact broken, the rope often tears large portions of the convict’s flesh and muscle from that side of the face where the noose is. In many cases, the convict will end up urinating on himself and defecating before death. The prisoner remains dangling from the end of the rope for 8-14 minutes before a doctor climbs up a small ladder and listens to his heartbeat with a stethoscope and pronounces him dead.”

— Law commission report proposes lethal injection for the death penalty, Indian Journal of Medical Ethics

Dr Anup Surendranath, director of the Centre on the Death Penalty at National Law University in Delhi, said “The law does not authorise the convict to suffer. The law only authorises death, not a painful death.”

The Centre on the Death Penalty undertakes research on death penalty administration and works to ensure that all death row convicts have adequate legal representation.

In fact, in 2003 the Law Commission suggested moving to lethal injection instead of hanging as the method of execution. This means that a doctor will have a more crucial role in the execution process because he or she will have to administer the injection.

Being ethical or obstructing justice?

Aggarwal and his colleagues have consulted legal experts to understand if there is any statute that binds doctors to participation in capital punishment. “We don’t think there are any legal provisions which can force us to perform executions,” said Aggarwal.

Doctors working as medical officers in jails are expected to follow the jail manual which demands their participation in the execution. “Someone inserted all these duties of doctors in the jail manual. We have to find if it has any legal backing,” said Aggarwal.

However, some doctors do not agree with the World Medical Association’s stand on capital punishment and its support by the Indian Medical Association. “By not participating in executions, doctors will obstruct the course of justice,” said Dr GS Grewal, former president of Punjab Medical Council. “The IMA is undermining the law of the country by refusing to participate in an execution ordered by the court.”

As the Indian Medical Association urges the government to excuse them from the process of execution, legal experts said that it raises questions about the nature of capital punishment.

Members of the Indian Medical Association themselves said that their opposition to the involvement of the medical fraternity in the process of execution does not necessarily mean they do not support capital punishment.

“It is on the government and the courts if they want to execute a convict,” said Aggarwal. “What we are saying is that as doctors, we cannot be a part of it. Medical ethics clearly says that doctors should do no harm.”

Surendranath said that doctors are important stakeholders in the process of execution and that by raising an ethical red flag on the process of execution, doctors are clearly influencing the debate surrounding the torturous nature of capital punishment.

Meanwhile, the Indian Medical Association will wait to see if the Medical Council of India will agree to its request.

“Currently, we cannot take action against any doctor who participates in capital punishment,” agreed Aggarwal. “We want the Medical Council of India to adopt the resolution which will give the resolution some legal backing.”

Patil who works closely with doctors posted in government prisons in Maharashtra said doctors are bound by the jail manual to fulfill their roles in executions. “They are doing their duty,” he said.

Is this really about ethics?

Dr Amar Jesani, editor of the Indian Journal of Medical Ethics pointed out that the Indian Medical Association seems to have woken up to this ethical conflict rather late given that the World Medical Association passed the resolution first in 1981.

Moreover, he said, “If the Indian Medical Association’s opposition is out of real conscientiousness, they should also take up other issues where doctors are involved in human rights violations.”

He indicated that doctors participate in pseudo-scientific procedures like lie detection tests used during interrogation. “There are also instances where doctors are involved in inciting communal violence. The Indian Medical Association should look at these aspects of human right violations too.”

The president of the World Medical Association is Dr Ketan Desai who was elevated to the post in 2016 despite having been arrested in 2010 on bribery charges. Desai also had other corruption cases against him. Several doctors and public health specialists had pointed out the violation of ethics in his appointment.

“Dr Desai’s escalation to the post of the president of the World Medical Association is a result of Indian Medical Association’s lobbying,” said Jesani.

Support our journalism by subscribing to Scroll+ here. We welcome your comments at letters@scroll.in.
Sponsored Content BY 

Swara Bhasker: Sharp objects has to be on the radar of every woman who is tired of being “nice”

The actress weighs in on what she loves about the show.

This article has been written by award-winning actor Swara Bhasker.

All women growing up in India, South Asia, or anywhere in the world frankly; will remember in some form or the other that gentle girlhood admonishing, “Nice girls don’t do that.” I kept recalling that gently reasoned reproach as I watched Sharp Objects (you can catch it on Hotstar Premium). Adapted from the author of Gone Girl, Gillian Flynn’s debut novel Sharp Objects has been directed by Jean-Marc Vallée, who has my heart since he gave us Big Little Lies. It stars the multiple-Oscar nominee Amy Adams, who delivers a searing performance as Camille Preaker; and Patricia Clarkson, who is magnetic as the dominating and dark Adora Crellin. As an actress myself, it felt great to watch a show driven by its female performers.

The series is woven around a troubled, alcohol-dependent, self-harming, female journalist Camille (single and in her thirties incidentally) who returns to the small town of her birth and childhood, Wind Gap, Missouri, to report on two similarly gruesome murders of teenage girls. While the series is a murder mystery, it equally delves into the psychology, not just of the principal characters, but also of the town, and thus a culture as a whole.

There is a lot that impresses in Sharp Objects — the manner in which the storytelling gently unwraps a plot that is dark, disturbing and shocking, the stellar and crafty control that Jean-Marc Vallée exercises on his narrative, the cinematography that is fluid and still manages to suggest that something sinister lurks within Wind Gap, the editing which keeps this narrative languid yet sharp and consistently evokes a haunting sensation.

Sharp Objects is also liberating (apart from its positive performance on Bechdel parameters) as content — for female actors and for audiences in giving us female centric and female driven shows that do not bear the burden of providing either role-models or even uplifting messages. 

Instead, it presents a world where women are dangerous and dysfunctional but very real — a world where women are neither pure victims, nor pure aggressors. A world where they occupy the grey areas, complex and contradictory as agents in a power play, in which they control some reigns too.

But to me personally, and perhaps to many young women viewers across the world, what makes Sharp Objects particularly impactful, perhaps almost poignant, is the manner in which it unravels the whole idea, the culture, the entire psychology of that childhood admonishment “Nice girls don’t do that.” Sharp Objects explores the sinister and dark possibilities of what the corollary of that thinking could be.

“Nice girls don’t do that.”

“Who does?”

“Bad girls.”

“So I’m a bad girl.”

“You shouldn’t be a bad girl.”

“Why not?”

“Bad girls get in trouble.”

“What trouble? What happens to bad girls?”

“Bad things.”

“What bad things?”

“Very bad things.”

“How bad?”

“Terrible!!!”

“Like what?”

“Like….”

A point the show makes early on is that both the victims of the introductory brutal murders were not your typically nice girly-girls. Camille, the traumatised protagonist carrying a burden from her past was herself not a nice girl. Amma, her deceptive half-sister manipulates the nice girl act to defy her controlling mother. But perhaps the most incisive critique on the whole ‘Be a nice girl’ culture, in fact the whole ‘nice’ culture — nice folks, nice manners, nice homes, nice towns — comes in the form of Adora’s character and the manner in which beneath the whole veneer of nice, a whole town is complicit in damning secrets and not-so-nice acts. At one point early on in the show, Adora tells her firstborn Camille, with whom she has a strained relationship (to put it mildly), “I just want things to be nice with us but maybe I don’t know how..” Interestingly it is this very notion of ‘nice’ that becomes the most oppressive and deceptive experience of young Camille, and later Amma’s growing years.

This ‘Culture of Nice’ is in fact the pervasive ‘Culture of Silence’ that women all over the world, particularly in India, are all too familiar with. 

It takes different forms, but always towards the same goal — to silence the not-so-nice details of what the experiences; sometimes intimate experiences of women might be. This Culture of Silence is propagated from the child’s earliest experience of being parented by society in general. Amongst the values that girls receive in our early years — apart from those of being obedient, dutiful, respectful, homely — we also receive the twin headed Chimera in the form of shame and guilt.

“Have some shame!”

“Oh for shame!”

“Shameless!”

“Shameful!”

“Ashamed.”

“Do not bring shame upon…”

Different phrases in different languages, but always with the same implication. Shameful things happen to girls who are not nice and that brings ‘shame’ on the family or everyone associated with the girl. And nice folks do not talk about these things. Nice folks go on as if nothing has happened.

It is this culture of silence that women across the world today, are calling out in many different ways. Whether it is the #MeToo movement or a show like Sharp Objects; or on a lighter and happier note, even a film like Veere Di Wedding punctures this culture of silence, quite simply by refusing to be silenced and saying the not-nice things, or depicting the so called ‘unspeakable’ things that could happen to girls. By talking about the unspeakable, you rob it of the power to shame you; you disallow the ‘Culture of Nice’ to erase your experience. You stand up for yourself and you build your own identity.

And this to me is the most liberating aspect of being an actor, and even just a girl at a time when shows like Sharp Objects and Big Little Lies (another great show on Hotstar Premium), and films like Veere Di Wedding and Anaarkali Of Aarah are being made.

The next time I hear someone say, “Nice girls don’t do that!”, I know what I’m going to say — I don’t give a shit about nice. I’m just a girl! And that’s okay!

Swara is a an award winning actor of the Hindi film industry. Her last few films, including Veere Di Wedding, Anaarkali of Aaraah and Nil Battey Sannata have earned her both critical and commercial success. Swara is an occasional writer of articles and opinion pieces. The occasions are frequent :).

Watch the trailer of Sharp Objects here:

Play

This article was published by the Scroll marketing team with Swara Bhasker on behalf of Hotstar Premium and not by the Scroll editorial team.