No one would call a plumber to say Vespers or expect a CPA to tailor trousers, but we inexplicably think that medical personnel should handle our executions.

In a 7-2 ruling yesterday, the Supreme Court upheld Kentucky’s use of lethal injection. Justice Thomas called it “an easy case.” As Scalia argued, it’s difficult to claim that “a criminal sanction expressly mentioned in the Constitution violates the Constitution,” and the majority was unpersuaded that Kentucky’s protocol was deliberately designed to inflict pain.

Unaddressed by the justices’ opinions—indeed, outside their purview—is a more difficult case: the social symbology of involving the healing professions in the killing process.

Jonathan Froner, trauma medical director at Children’s Hospital in Columbus, Ohio, described the typical death chamber:

The room would have looked familiar to a surgeon (or any doctor who performs procedures under sedation): it contained a trolley; cardiac monitor and defibrillator; medical equipment cabinets (including one for storing drugs); equipment stand; and the standard catheters, tubing, and sterile saline bags used to start intravenous lines.

Indeed, lethal injection mirrors a procedure repeated countless times a day in hospitals around the country. It was developed by a doctor–Stanley Deutsch, an anesthesiologist at the University of Oklahoma—and medical skills are necessary to administer the drug cocktail. Following the first test of lethal injection, in Texas in 1982, one witness related, “With the medical paraphernalia, intravenous tubes, a cot on wheels, and a curtain for privacy, the well lighted cubicle might have been a hospital room.”

The American Medical Association states that “requiring physicians to participate in executions violates their oath to protect lives and erodes public confidence in the medical profession.” But many states still hire doctors to advise on venal access and pronounce death. There are multiple instances of physicians giving the lethal dose.

Crisp sheets and privacy curtains provide familiar quarantine for something we’d rather not confront. But no one committed to saving life should be co-opted to end it. Appropriating the medical paradigm has more to do with soothing collective squeamishness than administering superior justice.

More primitive methods of execution are gruesome—as are the crimes for which felons forfeit their lives. But that harshness conveys a visceral condemnation, a sense of the criminal being cast from the community, his sin atoned. In some perverse way, the blade, the bullet, and the noose honor life by making breath something wrenched from a man rather than gently removed. Punitive death need not be savage, but it shouldn’t be sterile.