Will Inmate’s Heart Device Cause Pain During Execution?

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Nashville, TN — Byron Black is scheduled to be executed on Tuesday for the 1988 murders of Angela Clay and her two young daughters, Latoya and Lakeisha. Black’s execution is moving forward despite a legal challenge concerning his implanted cardioverter-defibrillator (ICD).

Black’s attorneys argued that the lethal injection could cause the ICD to repeatedly shock him, leading to a prolonged and painful death. They sought to have the device deactivated before the execution, citing the Eighth Amendment’s prohibition against cruel and unusual punishment. His attorney, Kelley Henry, described the case as “first of its kind” and emphasized her concern for her client’s potential suffering.

The case highlights the complex intersection of medicine and capital punishment. The American Medical Association’s Code of Medical Ethics prohibits physician participation in executions.

Tennessee officials admitted in court filings they lacked a medical professional to deactivate the ICD, as Nashville hospital staff refused to participate. They maintain Black would be unconscious and unable to feel pain if the ICD activated.

Black’s legal team appealed to the U.S. Supreme Court to halt the execution after the Tennessee Supreme Court ruled it could proceed with the ICD active.

The Supreme Court denied the stay of execution on Monday. Tennessee Governor Bill Lee also declined to intervene.

Henry clarified the legal challenge was not aimed at stopping the execution, but at ensuring a humane process.

Attorney General Jonathan Skrmetti stated that expert testimony refuted claims Black would suffer undue pain. He emphasized the brutality of the crimes and the long legal process, stating his office remains committed to seeking justice for the Clay family.

Black was convicted for the murders, which occurred while he was on furlough from a workhouse sentence for shooting Angela Clay’s husband. A firearms expert linked bullets from the murder scene to the earlier shooting.

Black received two life sentences for the murders of Angela and Latoya Clay, and a death sentence for the murder of Lakeisha Clay. Bennie Clay, the girls’ father and Angela’s husband, declined to comment.

Black’s attorneys describe him as a frail, wheelchair-bound man with dementia and congestive heart failure, arguing these factors, along with an intellectual disability claim, should preclude his execution. They sought clemency or a reprieve from Gov. Lee to address the ICD issue, but the Governor refused.

The ICD, implanted in 2024, acts as both a pacemaker and defibrillator. Medical experts explained the defibrillator shocks can be extremely painful.

Deactivation requires a trained medical professional and can be done with a medical instrument or magnet. Black’s attorneys argued deactivating the device too early could be life-threatening, while the state’s experts claimed the lethal injection drug would render him unconscious.

Conflicting expert testimony debated whether the drug would cause unconsciousness or merely unresponsiveness.

A judge initially ordered the state to arrange for the ICD’s deactivation at the execution, later amending the order to allow deactivation a day earlier at a hospital. However, communication errors led to the hospital refusing to participate, citing ethical concerns and contractual limitations. The Tennessee Supreme Court ultimately overturned the judge’s order, ruling it exceeded the court’s authority, but leaving open the possibility of an agreement to deactivate the device if feasible.


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