By The Redemption Project Newsroom
Government Desk
Tennessee’s failed attempt to execute Tony Carruthers has reopened a question larger than one condemned man, one execution chamber or one delayed sentence.
Can the state carry out its current lethal-injection protocol without asking medical professionals to do work their own profession says they should not perform?
That is now one of the conflicts facing Gov. Bill Lee after Tennessee halted Carruthers’ execution May 21 because the execution team could not establish the required intravenous access. According to state officials and witnesses, one IV line was placed, but Tennessee’s protocol required a backup line before lethal drugs could be administered. After more than an hour of additional attempts, the second line still could not be established.
Lee halted the execution and granted Carruthers a one-year reprieve. The failed attempt has since drawn calls for review from death-penalty opponents, medical professionals and even Republican lawmakers who continue to support capital punishment.
On July 28, more than 40 Tennessee physicians, nurses and other medical professionals publicly asked Lee to pause executions until the state shows it has corrected the failures exposed during the Carruthers execution attempt. The medical professionals said doctors and other health workers should not be placed in roles that conflict with their ethical obligations.
That moment exposed a practical problem inside Tennessee’s death-penalty system.
Lethal injection depends on medical skill.
Medical ethics may prohibit the people with those skills from participating.
The procedure behind the punishment
Many people understand lethal injection as a simple shot. It is not.
Execution by lethal injection requires reliable venous access, correct placement of IV lines, confirmation that drugs will enter the bloodstream and monitoring during the procedure. If the line fails, infiltrates tissue or cannot be maintained, the execution can become prolonged, painful or impossible to complete.
Establishing IV access is routine in medicine, but it is not always easy. Patients with chronic illness, dehydration, obesity, scar tissue, prior IV drug use or other medical complications can present difficult access problems. In ordinary clinical settings, that can require advanced vascular-access skill.
That is where the conflict begins. The state needs qualified people to perform procedures that look and function like medicine. But major medical organizations have long said physicians should not participate in executions, except for limited acts such as certifying death after the execution is complete.
The American Medical Association’s ethics guidance defines physician participation in executions broadly, including actions that directly cause death, assist another person in causing death or automatically cause an execution to be carried out. Its examples include starting IV lines, selecting injection sites, monitoring vital signs and supervising lethal injection.
The reasoning is simple.
Medicine exists to heal.
Execution exists to kill as punishment.
The protocol problem
Lee has indicated he does not believe Tennessee’s execution protocol needs to be changed. He has said the protocol was followed and suggested the Carruthers incident does not justify rewriting the state’s method.
