{"id":15780,"date":"2026-09-29T09:00:00","date_gmt":"2026-09-29T09:00:00","guid":{"rendered":"https:\/\/medical-article.com\/?p=15780"},"modified":"2026-09-29T09:00:00","modified_gmt":"2026-09-29T09:00:00","slug":"after-failed-execution-health-workers-say-states-rules-flout-medical-ethics","status":"publish","type":"post","link":"https:\/\/medical-article.com\/?p=15780","title":{"rendered":"After Failed Execution, Health Workers Say State\u2019s Rules Flout Medical Ethics"},"content":{"rendered":"
\n

This story describes a lethal injection procedure used in state executions.<\/em><\/p>\n

In May, a group of healthcare workers spent about an hour trying to establish complete IV access so they could inject Tony Carruthers, an inmate at the Riverbend Maximum Security Institution in Nashville, Tennessee, with a lethal dose of sedative.<\/p>\n

Maria DeLiberato, an attorney for Carruthers, was in the room. She said the workers stuck his arms and feet with needles, to no avail. A doctor then tried to insert a central line through his collarbone and shoulder. That didn\u2019t work, either.<\/p>\n

Carruthers groaned in pain and blood oozed from puncture wounds, DeLiberato said in a news briefing.<\/p>\n

After more than an hour, Gov. Bill Lee called the warden, ordering him to halt the execution attempt. He later granted Carruthers a one-year reprieve.<\/p>\n

Now, as another death row inmate\u2019s execution<\/a> approaches, doctors and nurses in the state say they want medical professionals removed from the execution process. They\u2019ve also joined defense attorneys and nine Republican state lawmakers in demanding a moratorium on the death penalty and an overhaul of the state\u2019s execution methods.<\/p>\n

The doctors\u2019 arguments echoed those the American Medical Association has made before the U.S. Supreme Court<\/a> and in its code of ethics.<\/p>\n

Tennessee is among <\/a>27<\/a> states<\/a> where the death penalty is legal, according to the Death Penalty Information Center, a nonprofit that offers data and analysis on issues surrounding capital punishment.<\/p>\n

Governors in four of those states have halted all executions, citing moral concerns<\/a> and logistical ones<\/a>, such as being unable to obtain lethal injection drugs amid pharmaceutical companies\u2019 refusal to sell them for use in executions. Lethal injection is still the primary execution method<\/a> nationwide, but some states may use gas<\/a>, a firing squad<\/a>, or electrocution<\/a>.<\/p>\n

Since the beginning of 2020, 170 people have been executed in 17 states, with most occurring in Florida, Texas, and Oklahoma. In that time, six states have had botched lethal injections<\/a>, according to the Death Penalty Information Center<\/a>, which defines those as executions that include a departure from the protocol because of unanticipated problems and that cause more pain for the prisoner than anticipated, whether they ultimately end with a death or not. Several of the stories read like Carruthers\u2019 \u2014 protracted but ultimately failed attempts to establish IV access.<\/p>\n

Tennessee Health Workers\u2019 Concerns<\/strong><\/p>\n

The IV team gave up on trying to place a typical line into Carruthers after several failed attempts, according to DeLiberato\u2019s account. Following protocol<\/a>, physician Mark Fowler, a contractor for the state\u2019s prison system, then tried to place a central line in a deeper vein. That\u2019s a quasi-surgical procedure in which a plastic tube is inserted in the chest, groin, or neck. Fowler used a series of syringes, trying to insert the tube under Carruthers\u2019 collarbone and then through his shoulder.<\/p>\n

In an October 2025 deposition<\/a>, Fowler said he hadn\u2019t done such a procedure in the 12 years since he had stopped working in an emergency room, and didn\u2019t know that placing a central line could be among his execution duties.<\/p>\n

Fowler told NPR by phone on Sept. 24 that \u201cthe doctor does not participate in the execution. The only thing the doctor does is declare the person dead.\u201d He did not have further comment.<\/p>\n

Two months after the halted lethal injection, more than 40 doctors and nurses sent a letter<\/a> to Lee, calling on the Republican governor to pause executions and redesign the protocol to omit health workers from the process.<\/p>\n

The letter said that Tennessee\u2019s rules requiring the participation of pharmacists, physicians, and other healthcare workers in executions are at odds with medical ethics, as well as guidelines explicitly laid out by groups such as the American Medical Association. The AMA code says<\/a> doctors are to preserve life when there is hope of doing so and bars participation in executions.<\/p>\n

\u201cThis means that the health care professionals who agree to take part in Tennessee\u2019s executions are those willing to set aside their professional ethics,\u201d the letter to Lee reads. \u201cThe problems that we have seen, such as in Mr. Carruthers\u2019s case, are the predictable result of working with such unscrupulous actors.\u201d<\/p>\n

John Greer, a retired Nashville hematologist, said in a news conference about the letter that he wasn\u2019t surprised the central line placement went awry.<\/p>\n

\u201cPlacing a central line is not just sticking a needle in a person\u2019s arm,\u201d he said.<\/p>\n

Greer said the doctor has to tap a large vessel above the heart. He said that it\u2019s a risky procedure in which an error could cause a collapsed lung or heavy bleeding \u2014 and that only those with specific training and routine practice should attempt.<\/p>\n

\u201cAnd I cannot imagine that there would be someone who\u2019s doing these routinely who would be involved in this procedure,\u201d Greer said.<\/p>\n

Some Republican state senators also called for a<\/a> hold on executions and an overhaul of the process, saying that \u201cincompetent administration\u201d of capital punishment gives its critics more ammunition.<\/p>\n

This summer, Lee said he didn\u2019t want a pause.<\/p>\n

\u201cThe Department of Correction did exactly what they should,\u201d he said. \u201cIt should not affect executions in the future.\u201d<\/p>\n

\u201cIt\u2019s one of the most difficult things that we do in this state,\u201d Lee said later. \u201cBut I am committed to making sure that it is done in the way that it should be.\u201d<\/p>\n

The state\u2019s lethal injection protocol orders the prison to keep a curtain over the media witnesses\u2019 viewing window until the IVs are established, so none of them could offer a visual account of the failed execution attempt.<\/p>\n

A lawsuit challenging that policy<\/a> has been filed has been filed by the Reporters Committee for Freedom of the Press and news outlets including NPR member station WPLN. The lawsuit argues the lack of transparency during the IV placement process obscures problems like the ones that happened in Carruthers\u2019 case.<\/p>\n

There\u2019s a broad understanding in the U.S. that the medical establishment doesn\u2019t participate in executions, said Matthew Wynia<\/a>, director of the Center for Bioethics and Humanities at the University of Colorado\u2019s medical school.<\/p>\n

\u201cWe came out of World War II with a whole bioethics and medical ethics enterprise that is really strongly opposed to medicine serving as an arm of the state and using specialized medical skills to hurt people or kill people,\u201d Wynia said.<\/p>\n

A history of medical abuses by government doctors \u2014 such as forced sterilizations<\/a> and unethical studies of untreated syphilis<\/a> in the U.S., and murder and torture<\/a> in Nazi Germany \u2014 forged that consensus, he said.<\/p>\n

Wynia mentioned other nations where medical professionals still participate in executions.<\/p>\n

\u201cBut they are, you know, Iran and Saudi Arabia and Russia, sort of authoritarian states, where medicine is an arm of the government,\u201d Wynia said. \u201cMedical involvement in executions ends up happening because medicine is unable to say, \u2018No, we don\u2019t do that.\u2019\u201d<\/p>\n

Upcoming Execution<\/strong><\/p>\n

On Sept. 30, Tennessee is scheduled to execute Christa Pike, who was 18 years old when she and her boyfriend killed Colleen Slemmer.<\/p>\n

Pike\u2019s attorneys this year raised several concerns that the state\u2019s lethal injection protocol would violate her rights. Among them is their contention that because she suffers from a platelet disorder, it\u2019s likely she will need a central line placed. They also argued that she was at risk of needless suffering, alleging Carruthers\u2019 execution showed that Fowler \u2014 who has confirmed publicly<\/a> that he will oversee Pike\u2019s execution \u2014 is incompetent at placing central lines.<\/p>\n

In June, they put all of those concerns in a request<\/a> to the Tennessee Supreme Court, asking for a special investigator to collect evidence and hold hearings to determine whether they warranted an order to delay her execution and design a method for only her.<\/p>\n

The court did appoint a special investigator, Senior Judge Mark Ward. He held a series of hearings in Knoxville last month. Ward said he didn\u2019t believe Pike\u2019s rights would be violated by the process and submitted his report<\/a> to the court.<\/p>\n

On Sept. 23, the Tennessee Supreme Court denied Pike\u2019s stay<\/a>, agreeing with Ward, saying none of the concerns amounted to a constitutional violation. On Sept. 28, Lee announced he would not grant her clemency.<\/p>\n

This article is from a partnership that includes <\/em>WPLN<\/em><\/a>, <\/em>NPR<\/em><\/a>, and KFF Health News.<\/em><\/p>\n<\/div>\n

KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/em><\/p>\n

This article<\/a> first appeared on KFF Health News<\/a> and is republished here under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License<\/a>.<\/p>","protected":false},"excerpt":{"rendered":"

This story describes a lethal injection procedure used in state executions. In May, a group of healthcare workers spent about an hour trying to establish complete IV access so they could inject Tony Carruthers, an inmate at the Riverbend Maximum Security Institution in Nashville, Tennessee, with a lethal dose of sedative. Maria DeLiberato, an attorney…<\/p>\n","protected":false},"author":0,"featured_media":15781,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-15780","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articles"],"_links":{"self":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/15780"}],"collection":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=15780"}],"version-history":[{"count":0,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/15780\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/media\/15781"}],"wp:attachment":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=15780"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=15780"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=15780"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}