The healthcare community has an important role in opposing the death penalty, argues an expert in The BMJ today.
Bharat Malkani, reader in law at Cardiff University, says doctors must refuse to participate in the execution process and speak out against a practice that is antithetical to their commitment to promote health and wellbeing.
Amnesty International reports that although the number of countries carrying out executions is decreasing, the number of executions in countries where it is legal has increased in recent years, he explains.
At least 1518 executions took place globally in 2024, rising from 1153 recorded in 2023, making it the fourth consecutive year that the annual total has gone up. The 2024 total was the highest recorded by Amnesty International since 2015, when 1634 executions were recorded.
Most of the recorded executions in 2024 took place in just three countries: Iran (at least 972); Saudi Arabia (at least 345), and Iraq (at least 63), while Saudi Arabia has already executed at least 241 people in 2025 and could reach a record number for the year.
Amnesty International notes that there are also believed to be thousands of executions in China each year, but official numbers are a state secret.
Some people are being sentenced to the ultimate punishment for relatively minor crimes, and for criticising governments, notes Malkani.
For example, in Saudi Arabia, Turki al-Jasser, a journalist who exposed corruption within the Saudi royal family, was executed in June. "His execution, and that of other political prisoners globally, should be a cause of concern for anyone who cares about justice and freedom of speech," he says.
There are also reports of people with mental illness and intellectual disability being subject to capital punishment, despite international law prohibiting their execution.
Another concerning aspect of capital punishment that needs more attention from medical communities is the use of medical professionals in execution processes, adds Malkani.
In its code of medical ethics, the American Medical Association takes the position that doctors must not participate in a legally authorised execution, but such guidelines have not prevented some doctors from taking part in executions.
Elsewhere, physicians who refuse to take part in the execution process can be compelled by law to administer lethal injections. The World Medical Association has therefore issued a resolution calling for an end to physician involvement in executions.
Given the worldwide trend towards authoritarianism and "tougher" approaches to law and order, it is unlikely that executions will stop anytime soon, says Malkani. It is therefore incumbent on campaigning groups to keep highlighting the injustice and immorality of state sanctioned executions.
"Healthcare professionals have powerful voices and are well respected. They can thus have a vital role in abolitionist efforts by refraining from being complicit in executions and by emphasising that the punishment is both inhumane from the point of view of medical ethics and a violation of the right to life," he concludes.
