Medical Ethics Clash With Death Penalty as States Face Execution Drug Crisis

Healthcare workers across the nation increasingly demand their removal from state execution processes, joining lawmakers in calling for systemic reforms after a series of botched lethal injections exposed deep conflicts between medical practice and capital punishment. The mounting crisis stems from pharmaceutical companies refusing to sell execution drugs, forcing states to explore alternative methods while healthcare professionals cite fundamental ethical violations.

In May, healthcare workers spent approximately one hour attempting to establish complete intravenous access on Tony Carruthers, an inmate at the Riverbend Maximum Security Institution in Nashville, Tennessee. The team stuck needles into his arms and feet without success, then a doctor attempted inserting a central line through his collarbone and shoulder, which also failed.

Maria DeLiberato, Carruthers’ attorney who witnessed the procedure, said Carruthers groaned in pain as blood oozed from multiple puncture wounds. After more than an hour, Gov. Bill Lee called the warden ordering him to halt the execution attempt and later granted Carruthers a one-year reprieve.

Medical Community Demands Systematic Changes

As another death row inmate’s execution approaches, doctors and nurses in Tennessee now want medical professionals completely removed from the execution process. They have joined defense attorneys and nine Republican state lawmakers in demanding a moratorium on the death penalty and an overhaul of execution methods. Their arguments echo positions the American Medical Association has previously made before the U.S. Supreme Court and codified in its ethics guidelines.

Tennessee ranks among 27 states where the death penalty remains legal, according to the Death Penalty Information Center, a nonprofit providing data and analysis on capital punishment issues. Governors in four of those states have halted all executions, citing moral concerns alongside logistical challenges such as being unable to obtain lethal injection drugs amid pharmaceutical companies’ refusal to sell them for use in executions.

Lethal injection remains the primary execution method nationwide, although some states may use gas, firing squads, or electrocution. Since early 2020, approximately 170 people have been executed across 17 states through recent years, with most occurring in Florida, Texas, and Oklahoma. During that period, six states experienced botched lethal injections, defined as executions including departures from protocol due to unanticipated problems that cause more pain than anticipated, whether ultimately ending in death or not.

Alternative Execution Methods Gain Traction

With lethal injection drugs proving both costly and difficult to obtain, a growing number of Republican lawmakers and state officials push for alternatives, particularly the firing squad. In Indiana, lethal injection currently serves as the only authorized execution method under state law.

After a yearslong pause, the state resumed executions in December, using a single-drug protocol of pentobarbital to execute Joseph Corcoran. A second execution followed in May when Benjamin Ritchie died by the same drug, marking Indiana’s first executions since 2009. A third execution for convicted murderer Roy Lee Ward was tentatively set for October in a subsequent year and would also be carried out by lethal injection.

Republican Representative Jim Lucas said he explores legislation to allow executions by either firing squad or gallows, noting both methods are “cheaper, easier” and already permitted in several other states. Lucas pointed to the staggering cost of lethal injections in Indiana, emphasizing the $300,000 price tag for a single dose of pentobarbital.

Financial Burden Drives Policy Reconsideration

“That price, that fact right there is why we should be looking at other methods and forms of capital punishment,” Lucas told the Indiana Capital Chronicle. “These other methods are certainly a hell of a lot less expensive than our current method with lethal injection drugs.”

Republican Governor Mike Braun stopped short of endorsing any specific execution methods but pointed to South Carolina, which recently reinstated the firing squad as an option after years of delays due to its inability to obtain lethal injection drugs. In June, Braun disclosed that Indiana officials spent $1.175 million on lethal injection doses over the past year, with $600,000 spent on drugs that expired before use.

The cost ranges between $275,000 and $300,000 per dose. The governor revealed Indiana no longer maintains any usable lethal injection drugs, and instead of purchasing more and risking expiration given the drug’s 90-day shelf life, his office plans to order new executions only when needed.

Healthcare Oversight Faces Separate Scrutiny

In a parallel healthcare ethics development, the inspector general at the Department of Health and Human Services launched an examination into federal oversight of skilled nursing facilities. The review follows signs some homes fail to meet Medicare’s minimum staffing requirements. The investigation stems from a Kaiser Health News and New York Times investigation that found nearly 1,400 nursing homes report having fewer registered nurses on duty than the Centers for Medicare & Medicaid Services requires or failed to provide reliable staffing information.

The Office of Inspector General will examine staffing data nursing homes submit through the new system using payroll records, which provides a more accurate view than the self-reported numbers facilities had provided for nearly a decade. Donald White, a spokesman for the inspector general, said the project formed “part of our ongoing review of programs at the department,” with the report likely issued in the federal fiscal year beginning in October of the following year.

Toby Edelman, a senior policy attorney at the Center for Medicare Advocacy, said she hoped the probe would spur action against facilities where payroll records show insufficient nursing coverage. In July, Medicare assigned its lowest staffing rating of one star to nursing homes not meeting the registered nurse standard as published on the Nursing Home Compare website, though only about half of those homes saw their overall star rating drop.