Tennessee Executes Inmate Byron Black Despite Medical and Ethical Concerns Over Heart Device
NASHVILLE, Tenn. — On Tuesday, Tennessee carried out the execution of Byron Black, a 69-year-old death row inmate, despite ongoing legal and ethical disputes surrounding his implanted cardioverter-defibrillator (ICD), a device designed to regulate heart rhythm. Black’s execution marked a controversial first, as officials proceeded without deactivating the device, raising concerns about the potential for unnecessary pain and complications during lethal injection.
Byron Black was pronounced dead at 10:43 a.m. Following the start of the lethal injection, witnesses reported that Black expressed intense physical pain to a spiritual advisor present in the room. Observers noted that he showed signs of distress such as heavy breathing and sighing during the execution process.
Legal battles over Black’s execution centered on whether the ICD should be turned off prior to administering lethal chemicals. Medical experts and Black’s defense team argued that the device posed a risk of delivering electrical shocks during the execution, potentially prolonging and intensifying suffering. This concern was compounded by Black’s multiple health issues, including dementia, brain damage, kidney failure, and congestive heart failure—all factors rendering him wheelchair-bound and vulnerable.
In mid-July, a trial court judge ruled in favor of Black’s attorneys, ordering that the ICD be deactivated to prevent the risk of pain. However, the Tennessee Supreme Court reversed the decision, citing lack of authority by the lower court to mandate deactivation and emphasizing that such an order amounted to an unauthorized stay of execution. The U.S. Supreme Court later denied Black’s appeal for a stay, and Governor Bill Lee refused to intervene or grant a reprieve.
Officials acknowledged difficulties in deactivating the ICD, as Nashville General Hospital declined to participate in disabling the device due to ethical concerns. The Tennessee Department of Correction stated no medical professional was available to perform the procedure, leading the state to argue that Black would be unconscious during any potential shocks and thus unable to perceive pain. Tennessee Attorney General Jonathan Skrmetti endorsed this position, asserting expert testimony that refuted claims that Black would suffer severe pain.
The nonprofit Death Penalty Information Center indicated that Black’s case is unprecedented, as they have not identified any other executions involving functioning implanted defibrillators or pacemakers. His attorneys also highlighted the unprecedented nature of the case, underscoring unresolved ethical and legal questions about the use of such devices during executions.
Black was convicted in 1989 for the 1988 murders of his then-girlfriend Angela Clay and her two young children, Lakeisha, age 6, and Latoya, age 9. Advocacy groups have raised concerns about Black’s intellectual disability and his fitness for execution, spotlighting his deteriorating health and cognitive condition, but courts ultimately upheld the execution orders.
This execution was Tennessee’s second since a five-year hiatus triggered by the COVID-19 pandemic and administrative errors. The case has reignited debates over the death penalty, inmate medical care, and humane execution protocols, especially when complicated by vulnerable health conditions and implanted medical devices.
In a statement, Governor Lee emphasized the legality of carrying out the court-ordered execution in light of Black’s convictions for heinous crimes but refrained from addressing medical ethics directly. The Tennessee Supreme Court remarked that future agreements between parties could still be reached regarding ICD deactivation if feasible in other cases.
Byron Black’s execution highlights the challenges at the intersection of criminal justice, medical ethics, and technology in capital punishment, raising urgent questions about how states handle inmates with serious health complications during lethal injections.