Raleigh, N.C. — The death penalty in North Carolina is officially at an impasse -- an impasse that looks like it will be settled in a Wake County courtroom.

So far, five executions have been put on hold while the state tries to work out an apparent conflict between a law that says a doctor must be present and a North Carolina Medical Board policy that says it is unethical for physicians to participate in executions.

The nearly year-long journey to this juncture on the state's death penalty began when a handful of doctors wrote letters to the N.C. Medical Board last spring regarding their concerns about a physician's role in capital punishment.

Raleigh internist Dr. Robert Bilbro has practiced in Raleigh since 1972. He co-authored a letter with his friend, retired doctor Elizabeth Kanof, on April 11, 2006. They asked the Medical Board to address the apparent contradiction between a doctor's oath to save lives and his or her role at executions.

“The medical community needed to come to focus on this issue,” Bilbro said.

And that’s exactly what they did. Because of the letters, the Medical Board considered the issue this year and took the position that a doctor should not participate in executions.

It was an outcome the letter writers hoped for, but one they say they never expected.

“It's very gratifying in this complex world of ours (that) a few people still can make a difference,” Kanof said.

As a result, there is a de-facto moratorium on executions in North Carolina until the legal issues can be resolved.

“My hope is that will lead to a more permanent moratorium in which the whole issue will be very carefully studied,” Kanof said.

The North Carolina Department of Correction filed a lawsuit against the Medical Board Tuesday arguing that capital punishment is legal and is not a medical procedure. Therefore, doctors should not be disciplined for participating, the department argued.

The board responded Thursday by saying it is aware of the lawsuit and will file a response, but in the meantime is standing by its position.

Doctors question whether there is any way to resolve the issue.

“I do think it's foolhardy to think the administrators of the corrections system, the courts or the vote of the Legislature can reverse the ethical standards,” Bilbro said.