LOUISVILLE, Ky. -- When Governor Ernie Fletcher signed a death warrant for a convicted killer this month, he may have done more than start the clock ticking on an execution. Some say Fletcher, a doctor, may have put his medical license at risk.
American Medical Association guidelines bar doctors from taking part, directly or indirectly, in executions. And Kentucky requires doctors to follow AMA ethical guidelines.
''I think it's a clear violation," said Dr. Arthur Zitrin, an 86-year-old retired psychiatrist in New York and an outspoken death-penalty opponent. Zitrin is also challenging the license of a Georgia doctor accused of helping nurses find a vein in a condemned man for a lethal injection.
A group of doctors is seeking an opinion from the Kentucky Board of Medical Licensure on whether Fletcher can sign death warrants without running the risk of having his medical license revoked. The board is not scheduled to take up the matter until at least January, and would not comment in the meantime.
On Nov. 8, Fletcher signed a death warrant for Thomas Clyde Bowling, 51, convicted of shooting to death the husband-and-wife owners of a dry cleaning business in 1990. Bowling is set to die by lethal injection Nov. 30.
Fletcher's executive counsel, John Roach, said the Republican governor did not violate AMA guidelines or other ethical standards.
''By signing a death warrant, in no way is Governor Ernie Fletcher participating in the conduct of an execution," Roach said. ''Governor Fletcher's role under the law is consistent with the roles of judges fulfilling their legal duty and jurors fulfilling their legal obligations regardless of their professions."
The AMA guidelines forbid doctors to actively take part in an execution or to take any ''action which would directly cause the death of the condemned" or ''which would assist, supervise or contribute" to the death of the inmate.
In a statement, Dr. Michael Goldrich, chairman of the AMA Council on Ethical and Judicial Affairs, stopped short of saying whether the governor violated the guidelines.
Goldrich said the code prohibits any role by a doctor, passive or active, in an execution. But he also said the code ''does not speak to individuals with a medical degree who no longer maintain any involvement with medicine and are engaged in activities that are outside the sphere of the medical profession."
Fletcher, 52, earned his medical degree at the University of Kentucky and was a family practitioner until he was elected to Congress in 1998. He was elected governor last year and is still licensed as a physician in Kentucky.
The Federation of State Medical Boards said it has no information on any doctors who may have been disciplined for taking part in an execution. Not all states incorporate AMA guidelines into state law. For example, it would not be illegal in California for a physician to participate in an execution, according to Candis Cohen, spokeswoman for the Medical Board of California.
According to the National Governors Association, there have been three other doctors who have been US governors since the AMA guidelines took effect in 1980. But none was in the position of having to decide whether to sign a death warrant.
Dr. Otis Ray Bowen of Indiana left office in 1981 without signing a death warrant. Vermont, where Dr. Howard Dean spent 12 years as governor, has no death penalty. Dr. John Kitzhaber was governor during two executions in Oregon before leaving office in 2003. But the Oregon governor does not sign an execution warrant -- a judge does. Kitzhaber could have granted clemency to the condemned but chose not to.
Senate majority leader Bill Frist, Republican of Tennessee, was a heart surgeon before being elected to the Senate.
State Representative Jim Wayne, a Democrat, said of the governor: ''It's curious he will keep his no-new-taxes pledge but will violate his Hippocratic oath. I'm not sure how he sleeps at night with this kind of decision."