Choosing how to live: death row inmates and terminally ill patients

by Shlomit Harrosh

Convicted murderer Ronnie Lee Gardner was killed by gunfire on July 18, 2010. Given the choice between lethal injection and being shot, Gardner opted for the firing squad. This was the first firing squad execution in the state of Utah since 1996.

In the 37 states where the death penalty is in practice, lethal injection is the primary method of execution. Alternative methods are provided in 20 states, contingent upon the prisoner’s choice, the date of execution or sentence and the constitutional standing of the method used. In Virginia, for example, a convicted murderer can elect to be executed either by lethal injection or electrocution, while in Washington prisoners are executed by lethal injection unless they choose death by hanging.
Assuming that it is a good thing for prisoners to have some choice as to their method of execution, what does this tell us about the morality of voluntary euthanasia in terminally ill patients?

One thing stands out and that is the value of autonomous choice in directing our lives. Voluntary euthanasia, or assisted suicide in terminally ill patients, is often depicted as a matter of choosing death, or at least, of choosing to hasten death. But it can also be seen as a choice of a certain way of life.

Death Row inmates have little control over their lives. Like the choice of a last meal, the choice of method of execution is a final exercise in personal autonomy. Within limits, it gives prisoners the opportunity to choose the final experiences of their lives and express their values and preferences.

Ronnie Lee Gardner has always preferred death by gunfire. “I like the firing squad,” he said in an  interview in 1996. “It’s so much easier … and there’s no mistakes.” And yet in the decade that followed his initial death sentence in 1985, he changed his mind, opting for death by lethal injection. The reason he gave was concern for his then young children. His change of heart reflected his values as a parent. As his children grew and his appeals were rejected, he reverted back to his original choice.

Choice of method of execution can also be used as a form of protest.  John Albert Taylor chose the firing squad to protest against the death penalty (Utah, 1996), while Earl Conrad Bramblett chose the electric chair to protest against the guilty verdict (Virginia, 2003). Since lethal injection is the default method of execution in all States, electing to die by less humane methods like firing squad, hanging and the electric chair is certain to draw media attention and provoke public debate.

For some people, choosing a method of execution that involves greater suffering can also be a form of atonement. 

Choosing a method of execution, then, is not simply about choosing how to die. It is also a choice of how to live before one’s death and in the final moments of one’s life.

Terminally ill patients who choose voluntary euthanasia are similarly choosing how to live. The choice to hasten death is simply a means to an end: ensuring that their remaining time is lived according to their standards of a worthwhile life, expressing their values and preferences. These usually include the desire to avoid intolerable pain, the value of maintaining a certain level of independency and the values realized by engaging with worthwhile ends and relationships which one enjoys.

In choosing how to die and when to die, prisoners and patients are also choosing how to live as an expression of who they are and what they value as autonomous agents.

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6 Responses to Choosing how to live: death row inmates and terminally ill patients

  • Honer says:

    It should be remembered that the shooting squad was chosen for “religious” reasons since the prisoner was a mormon and desired to offer a blood payment for his crimes. An execution by injection does not spill blood and was therefore not acceptable to him.atherefore his decision was conditioned by considerations which are perhaps difficult for others to understand.This situation has little relationship with terminal illness, it would seem?

  • Andy says:

    And yet, Gardner quote “It’s so much easier … and there’s no mistakes” makes it seem like he had other reasons besides religion alone.

  • Shlomit Harrosh says:

    Thanks for the helpful comments Honer and Andy.

    Comparing death row inmates and terminally ill patients regarding end of life choices is meant to emphasize that in both cases the choice is also about how to live as an expression of one’s values and preferences as an autonomous agent.

    Gardner’s preference for the firing squad was motivated in part by religious reasons and in this sense his choice was an expression of his values. For some terminally ill patients, loss of independence and control over their lives, rather than severe pain, is the determining factor in their choice to end their life early. This is a choice that reflects a certain idea of a good or decent life, expressing the values of ‘a fiercely independent person,’ for example.

    Respecting end of life choices, then, is about respecting a person’s autonomous choice to live according to his or her values and preferences, even in the shadow of death.

  • Anat Amitay says:

    giving a death row inmate the choice of how to die is more about giving him the delusion of controle, so that he will make less trouble on ” his way out”. like the way a parent gives a two year old the choice between two outfits so that the child feels in controle and gives the parents less trouble when its time to get dressed. people like choices, even when it means how to die, they feel better about themselves so they aer more manigable for others. the end result is the same. the state doesnt realy care how the inmate dies as long as ” the deed is done” with as little fuss as possible. like the parent who doesnt care if the dress is blue or red as long as the kid is happy and they can leave the house on time in the morning. the choice has nothing to do with respect just convienience. terminally ill patient are a diffrent issue. i don’t think the two are related subjects at all.

  • Shlomit Harrosh says:

    Thanks for this Anat. Here are some comments:

    First, control is real when one can direct the course of one’s life, even if it is limited in scope and duration.

    Second, giving death row inmates a choice as to their method of execution does not guarantee that they will go to their death “without a fuss”, particularly since inmates may panic at the last minute. There are also more efficient ways of ensuring their manageability during those last minutes: sedatives.

    Third, the death penalty has been practiced ‘successfully’ for centuries without condemned prisoners being given a choice as to how they would die. It is only in the 19th century, as more humane methods of execution were adopted, that inmates were given the choice between the old method and the new method, which promised a quicker, less painful death. In Utah, for example, this meant a choice between hanging and firing squad until 1980, and later between firing squad and lethal injection. In the absence of choice, the default method was the more humane one, firing squad in the first instance and lethal injection in the second. A similar pattern is found in Virginia, where the electric chair was the authorized method of execution for most of the 20th century. When lethal injection was introduced in 1994, inmates were given the choice between this method and the electric chair, with lethal injection being the default choice.

    Given the choice, most inmates elect to die by lethal injection. Yet a few, like Ronnie Lee Gardner, chose death by other means, some of which are arguably more painful than lethal injection. James Earl Reed (South Carolina, 2008) and Paul Warner Powell (Virginia, 2010) both chose the electric chair, while hanging and firing squad were the preferred methods of execution for Billy Bailey (Delaware, 1996) and John Albert Taylor (Utah, 1996), respectively.

    Giving inmates a choice between the old and the new methods of execution was motivated by legal considerations. At the same time, allowing inmates to choose less humane methods of execution is consistent with the primacy of respect for personal autonomy over the value of lessening pain and suffering. This accords with the values of voluntary euthanasia, where it is the patients’ desires to end their suffering, rather than the suffering itself, which determines the permissibility of the act.

  • MRC says:

    I do not think that we can give equal weighting to euthanasia and execution as the cost to society is measured differently. The final moments in the patient and the murderer are superficially the same because they have taken ownership of their lives. However we have to acknowledge motives and other psychological factors when contrasting these two events. As individuals we are likely to be subjective about issues that although have different driving forces are emotive and remind us of our mortality.
    As a society we have to protect an individual’s rights from being coerced into poor decisions. Can we ever be sure that a terminally ill patient is able to make a rational decision when they are in pain or under the influence of medication? Any outcome from voluntary euthanasia that includes a financial gain for family members or medical profession would need to be carefully monitored. The state would then have to take a moral stance but as individuals we may all wish to have the option to end our lives if we suffer pain or our quality of life is diminished.
    Once the state has established the guilt of a murderer and has the option of execution the prisoner has very little personal control over their lives. The psychological drives are not the same as in a terminally ill patient and the prisoners will probably look for little victories. These appear to take the form of the prisoner trying to control the state by making themselves central to proceedings rather than being processed according to schedule. They in effect take centre stage with their own versions of events.
    It is better to approach these two events by looking at the individuals and societies motives as they have different agendas. We are more likely to have sympathy for a terminally ill patient but forbid euthanasia and yet have less sympathy for a murderer but sanction an execution. It would seem that as a society we are more interested in revenge that alleviating a person’s suffering. If we accept that a murderer is in some way suffering are we in effect alleviating it by ending their lives.
    This could lead us to the conclusion that morality is purely subjective with us wanting to take a stance when the emotional repercussions are distant from the individual. With voluntary euthanasia the emotions are more attuned to illness and experiences are more likely to be on a personal level. An individual may be choosing how to live their lives but the state or society and its individuals have conflicting ideologies. It may be that our morality has been informed from a number of sources and that our behaviour is the result of rituals that have been refined through the generations. Because we are dealing with these issues in a more secular society we are less likely to opt for a traditional stance.

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