Tennessee Executes Inmate with Active Defibrillator, Sparking Ethical Debate

On August 5, 2025, the state of Tennessee executed inmate Byron Black, despite concerns that his active defibrillator could have caused him unnecessary pain during the lethal injection. Black, who was 69 years old, had been convicted in the 1988 shooting deaths of his girlfriend and her two young daughters.

In the weeks leading up to the execution, Black's attorneys had argued that officials needed to deactivate his implantable cardioverter-defibrillator (ICD) to prevent the device from shocking his heart when the lethal chemicals took effect. Black suffered from a host of medical issues, including dementia, brain damage, kidney failure, and congestive heart failure, and was confined to a wheelchair.

However, the state Supreme Court ultimately overturned a lower court's order to have the device deactivated, stating that the judge lacked the authority to make such a ruling. Tennessee officials maintained that the lethal injection would not cause Black's defibrillator to shock him, and that he would not feel the effects regardless.

Witnesses reported that shortly after the lethal injection began, Black told a spiritual advisor in the room that he was in severe pain. He was observed looking around the room and breathing heavily as the execution proceeded. Black was pronounced dead at 10:43 a.m.

The case has sparked an ethical debate over the participation of medical professionals in executions, as most consider it a violation of healthcare ethics. It also raises questions about the treatment of inmates with serious medical conditions on death row.