Servants of the state: nurses caught between professional ethics and deathwork
Bibliographic record
Abstract
Nurses frequently top the polls as caring and trustworthy professionals. So consistently do nurses outperform other professions in these polls that nurses take for granted the public's esteem and affection. Indeed, so strong is the current of sentimentalism that surrounds nursing that whenever the media runs a story on nursing we are described in ‘angelic’ terms. While the profession basks in the public's trust, nursing's halo is brought into question by Holmes and Federman's invited commentary (this issue). One of the nursing profession's ‘dirty little secrets’ is exposed in this paper which brings to light nurses’ direct and indirect involvement in the execution of prisoners in the United States. Since 1977, death by lethal injection raises the possibility of some nurses being part of such American deathwork. They can be involved in assessing the prisoner's health, supervising or monitoring the procedure as well as procurement or preparation of the drugs or solution, insertion of intravenous equipment or injection of the solution (a nurse anaesthetist's or physician's role). There are two issues that we feel are important to emphasize here. The first is the zone of silence around these practices in the nursing literature. The second is the tragic irony of nursing, without any apparent sense of hypocrisy, continuing its caring discourse while transparently being engaged in sovereign practices (such as capital punishment) on behalf of the state. Are nurses aware that lethal injection or the procedures surrounding it are undertaken by physicians and nurses? What Holmes and Federman found is that this is a little known fact. Moreover, this is scarcely surprising as it is not possible to obtain any information about this area of practice. The states that use lethal injection have refused to release any information regarding the identity of nurses and physicians who participate in capital punishment. The number of registered nurses, advanced practice nurses and nurse anaesthetists who have participated in the execution of prisoners in the United States is unknown. Likewise information about the precise duties of nurses during the lethal injection process is suppressed. In addition, the nursing literature is so uncomfortable with any airing of this dirty linen that it was simply impossible for Holmes and Federman to be published in the North American nursing literature. To find their work you will need to look in the sociology and criminology literature (see their commentary for full references). Thus nurses searching on the usual databases and reading the current literature will find no reference to this troubling practice. The second issue to highlight is why is it so disturbing that nurses participate in capital punishment? It is our belief that the discomfort and the silence derive from the fact that nursing's humanist self-identity is seriously challenged by nursing work becoming merely the naked rule of the state. Is this caring, and if not, how can this be nursing? and if this is nursing, then the previously taken-for-granted reality of nursing as a humanist science must be questioned. This is evidently a re-evaluation that nursing is not ready to undertake and the actual (and easiest) solution is to keep these disturbing revelations confined to criminology, sociology and human rights organizations’ documentation. But this is an issue that will not go away. The criticisms of human rights groups of nursing's professional participation in lethal injection warrant frank and fearless discussion by ethicists, by specialist groups and by the profession more generally. If nurses are comfortable with lethal injection as an advanced practice role, let them defend this position. But first and foremost, let the veil of secrecy around these practices be challenged and allow nurses the long-overdue debate on the question.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.004 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.006 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".