Marc Katz could perform an execution. The North Carolina physician assistant, who has practiced medicine since 1979, currently works with patients at an ear, nose and throat practice. He says many people in his profession, not just doctors, have the ability to administer lethal injection drugs to death row inmates. Whether they would choose to do so is a different question.

“It’s not anything real technical,” says Katz. “It’s just finding a vein and just putting medicine in it.”

North Carolina currently has 149 people on death row, but carried out its last execution in August 2006. Since then, North Carolina doctors have refused to work with the state’s corrections department to carry out executions even though the death penalty remains legal. Under a proposed law, conservative state lawmakers are hoping to break through that stalemate by letting physician assistants, nurses, emergency medical technicians, and other healthcare workers oversee executions. But those elected officials face another set of challenges including opposition from the professional organizations representing the workers impacted in the bill.

In an effort to revive the death penalty, Republican state representative N Leo Daughtry has pushed a measure that would no longer require doctors to be present during executions. Instead of a doctor, nurses, physician assistants, or emergency medical technicians could oversee the death penalty. The bill would also keep secret the identities of medical professionals assisting in executions.

The North Carolina House of Representatives on 29 April voted 84-33 in favor of the legislation. Daughtry, who did not respond to the Guardian’s request for comment, said the measure would allow North Carolina to move past the current impediments getting in the way of the death penalty.

“The fact that doctors are not willing to be there for the execution has caused a real stumbling block for us,” Daughtry told WRAL-TV.

Democratic state representative Graig Meyer, who voted against the bill, says the measure provides an unnecessary workaround to a “de facto moratorium” caused by the state’s flawed policy. He says doctors have refused to participate in executions due to their professional ethical codes that require them to preserve life when possible.

Meyer, who unsuccessfully added an amendment to the bill to repeal the death penalty, says executions violate the constitutional rights of the inmates currently spending their days on North Carolina’s death row. Given the current US supreme court case looking at lethal injections, he says state lawmakers should not be moving forward to bring back the death penalty.

“The timing is interesting,” Meyer says. “We debated this bill on the same day the US supreme court had their arguments. I question why the majority would want to take such a controversial issue when it’s being played out at a much higher level on a much bigger stage nationally.”

In other states were lethal injection remains legal, nurses and physician assistants face similar restrictions from their fields’ ethical codes and the professional organizations enforcing those guidelines. To avoid that scrutiny, states such as Arizona and Georgia have enacted laws to conceal the identities of people assisting executioners with the death penalty. Hiding the medical team’s experience levels has its costs: a paramedic who participated in the botched execution of Oklahoma inmate Clayton Lockett helped turned what’s supposed to be a painless procedure into a slow, harrowing death described by one witness as “torture”.

In 2006, the North Carolina medical board revised its policies to take disciplinary actions against licensed doctors conducting executions. One year later, a state judge overruled the board in determining it could not sanction doctors for helping to carry out the death penalty. Though free from sanctions, physicians have continued to not work with the state’s corrections department.

Katz, president of the North Carolina Academy of Physician Assistants, says turning to other medical professionals for executions might lead to similar results. Physician assistants also receive licenses from the North Carolina medical board. To obtain a license, he says physician assistants must outline their “scope of practice” defining their roles alongside their respective doctors, including the basics such as physical exams and more specialized procedures.

Participation in an execution would ultimately require the approval of a doctor agreeing to share responsibility. Katz says that’s a probable nonstarter given doctors’ opposition to executions over the past decade.

“If a physician isn’t going to want to do it himself, why would he have you do that since he’s overseeing you in your actions?” Katz says.

Although the NCMB couldn’t issue a sanction, he says physician assistants helping out with executions could still lose NCAPA certification, which would hurt their future job prospects in the state.

In a prepared statement, the North Carolina Nurses Association’s board of directors says the organization stands behind the American Nurses Association’s policies in opposition to the death penalty. According to ANA guidelines, nurse participation in any part of the execution process runs contrary to the “fundamental goals and ethical traditions” of the profession.

“NCNA continues to believe that participation in executions should not be a required component of any nurse’s job description and he/she should be able to object for ethical reasons without retribution or loss of employment,” the board of director says.

A spokeswoman for the North Carolina department of health and human services, the agency responsible for emergency medical technician certification, did not respond to a request for comment.

The legislation still requires approval from the North Carolina Senate followed by Governor Pat McCrory’s signature. Representatives for both NCAPA and NCNA said their groups intend to lobby state lawmakers about the proposal in hopes of stopping its passage.

Even if it becomes law, David Weiss, a staff attorney with the Center for Death Penalty Litigation, doesn’t think the policy will bring back executions across the state due to multiple lawsuits seeking to protect inmates’ constitutional rights. He also says recent exonerations – including Joseph Sledge in January – and additional evidence of racial injustices on death row have further strengthened calls to end the death penalty.

But the hardest part might not be passing the law. It could be convincing people like Katz to put down his otoscope to place a needle into an inmate’s arm prior to his death. Partaking in that process, Katz says, runs contrary to the work he’s performed for the past 36 years. He’s not alone in that regard.