Tennessee Medical Workers Demand Removal From Lethal Injections

More than 40 healthcare professionals, defense attorneys, and nine Republican state lawmakers in Tennessee have formally demanded an immediate moratorium on capital punishment. The coalition is also calling for the complete removal of medical personnel from state executions following a severely botched lethal injection attempt at the Riverbend Maximum Security Institution in Nashville.

The controversy stems from the May execution attempt of death row inmate Tony Carruthers. According to legal representatives and witnesses present during the procedure, execution workers spent over an hour struggling to establish intravenous access without success. They repeatedly stuck the inmate’s arms and feet with needles as he groaned in pain.

The Mechanics of the Botched Execution and Central Line Failure

State execution protocol mandates that if peripheral IV attempts fail, a contracted physician must perform a central line insertion into a deeper vein. In Carruthers’ case, physician Mark Fowler-a contracted doctor for the state prison system-attempted to insert a plastic tube using a series of syringes under the collarbone and through the shoulder.

Maria DeLiberato, an attorney for Carruthers who witnessed the event, reported that the procedure caused visible agony, with blood oozing from multiple puncture wounds. After more than an hour of failed efforts, Governor Bill Lee intervened by calling the warden directly to halt the execution. Gov. Lee subsequently granted Carruthers a one-year reprieve.

In a later deposition from October 2025, Dr. Fowler admitted that he had not performed a central line insertion in the 12 years since he left emergency room practice. He also stated he was unaware that placing a central line was part of his execution responsibilities. When reached by phone, Fowler maintained that doctors do not participate in executions beyond declaring a prisoner dead.

Medical Ethics, AMA Guidelines, and Growing Political Pushback

Two months after the halted execution, a coalition of more than 40 doctors and nurses sent an open letter to Governor Lee. The letter asserted that Tennessee’s execution protocols directly conflict with foundational medical ethics and the guidelines established by the American Medical Association (AMA).

The AMA code of ethics explicitly bars physicians from participating in executions because their professional mandate is to preserve life. Dr. John Greer, a retired Nashville hematologist, emphasized during a press conference that central line placement is an invasive, high-risk procedure capable of causing collapsed lungs or severe hemorrhaging if performed by anyone other than a specialist practicing routinely.

Criticism has also emerged from within political ranks. Several Republican state senators joined the call for a halt to executions, arguing that the incompetent administration of capital punishment undermines the justice system and hands ammunition to its opponents. Despite this, Governor Lee declined to issue a statewide pause, stating that the Department of Correction followed proper protocol and that future executions would proceed.

Ongoing Legal Challenges and Scrutiny Over Future Executions

The fallout from Carruthers’ execution cast an immediate shadow over subsequent capital cases in the state, including the scheduled execution of Christa Pike. Pike’s legal team argued that her underlying platelet disorder would likely necessitate a central line, placing her at grave risk of needless suffering given Dr. Fowler’s acknowledged lack of recent experience.

Although a special investigator, Senior Judge Mark Ward, concluded that Pike’s constitutional rights would not be violated, and the Tennessee Supreme Court subsequently denied a stay, federal appeals courts intervened to halt the execution shortly before it was set to take place.

Legal observers note that transparency issues continue to complicate the state’s procedures. Tennessee protocol requires a curtain over media witness viewing windows until IV lines are successfully established. This lack of visibility prompted a separate lawsuit from the Reporters Committee for Freedom of the Press and regional news organizations, challenging the state’s efforts to obscure potential procedural failures.

Frequently Asked Questions

Why are Tennessee medical workers demanding changes to the execution process?

Healthcare professionals are demanding changes because state execution protocols require doctors and nurses to perform tasks like IV and central line insertions. These tasks directly violate medical ethics codes, such as those set by the American Medical Association, that prohibit participation in capital punishment.

What happened during Tony Carruthers’ execution attempt in May?

During the execution attempt at Riverbend Maximum Security Institution, workers spent over an hour failing to establish peripheral IV access on Tony Carruthers. A prison doctor then attempted a complex central line insertion near his collarbone, causing him to groan in pain before Governor Bill Lee ordered the execution halted.

Does the American Medical Association support medical involvement in executions?

No. The American Medical Association code of ethics explicitly bars physicians and healthcare workers from participating in executions, stating their ethical duty is to preserve life.

How has Governor Bill Lee responded to the calls for a moratorium?

Governor Bill Lee has rejected calls for a moratorium or changes to the execution protocol. He maintains that the Department of Correction acted appropriately during the botched procedure.

What is a central line insertion in the context of lethal injections?

A central line insertion is a quasi-surgical procedure where a plastic tube is inserted into a major vein in the chest, neck, or groin. It is used in executions as a fallback method when standard peripheral IV lines cannot be established.