On August 5, 2025, the state of Tennessee carried out the execution of Byron Black, a 69-year-old inmate convicted for the 1988 murders of his girlfriend Angela Clay and her two daughters, Latoya and Lakeisha, aged 9 and 6. The execution, performed by lethal injection at the Riverbend Maximum Security Institution in Nashville, has since ignited a fierce debate about the ethics and practices surrounding capital punishment in the United States, particularly when it comes to prisoners with severe health conditions.
Black’s case was already marked by tragedy and controversy long before his final day. According to the Associated Press, Black had spent over three decades on death row after a jury found him guilty of killing Clay and her daughters in what prosecutors described as a jealous rage. The murders themselves were shocking: Black, then on work-release for a previous shooting, believed Clay was reconciling with her estranged husband. The jury, unmoved by pleas for mercy, handed down the death sentence in 1988.
But it was the circumstances surrounding Black’s execution that drew national and even international attention. As reported by NBC News and The Washington Post, Black suffered from a host of debilitating health conditions, including heart failure, kidney failure, progressive dementia, brain damage, and an intellectual disability. He was wheelchair-bound and required an implantable cardioverter defibrillator (ICD), a device designed to shock his heart back into rhythm if it became irregular.
In the weeks leading up to the execution, Black’s attorneys fought to have his ICD deactivated, arguing that it could override the effects of the lethal injection drugs and deliver repeated, painful shocks as he died. They contended that allowing the device to remain active could lead to unnecessary suffering, potentially violating constitutional protections against cruel and unusual punishment. A lower court initially sided with the defense, ordering the device shut off. However, the Tennessee Supreme Court swiftly overturned this decision, stating the judge lacked the authority to intervene, as reported by The Washington Post and Slate.
Nashville General Hospital, where the ICD had been implanted, refused to participate in deactivating the device, citing ethical concerns. This left Black’s legal team with few options. Their final appeals for clemency, based on his deteriorating health and intellectual disability, were denied by both the U.S. Supreme Court and Tennessee Governor Bill Lee. Black’s attorneys warned that this could become the first documented U.S. execution to proceed with an active ICD in place—a claim echoed by the Death Penalty Information Center, which noted the uniqueness of Black’s situation.
The execution itself unfolded in a way that seemed to confirm the defense’s worst fears. All seven media witnesses present agreed that Black appeared to be in significant distress. According to the Associated Press and eyewitness accounts, Black groaned, gasped, repeatedly lifted his head off the gurney, and uttered the words, “It’s hurting so bad.” His spiritual adviser, present in the death chamber, tried to comfort him, saying, “I’m so sorry. Just listen to my voice.” Black’s final words, when asked if he had any, were simply, “No sir.” He was pronounced dead at 10:43 a.m., about ten minutes after the execution began.
What exactly caused Black’s pain remains a matter of dispute. In the aftermath, his attorney Kelley Henry told reporters, “I interpret that my client was tortured today.” She later clarified, after receiving an initial evaluation of the ICD’s data, that the device had not shocked Black during the execution. “The ICD information eliminates one possible cause for Black’s comment about pain during his execution,” Henry said, but she emphasized that many questions remain. “Make no mistake, we all saw with our own eyes that the pentobarbital did not work like the State’s expert testified that it would. Mr. Black suffered.”
Pentobarbital, the drug used in Tennessee’s lethal injections, is supposed to cause rapid unconsciousness. State officials, including Attorney General Jonathan Skrmetti, insisted before the execution that a “lethal dose of pentobarbital ensures that Black will not be conscious to experience any pain.” Skrmetti reiterated after the execution that “Byron Black’s execution was entirely legal,” adding, “Every American has the right to their own opinion about the death penalty, but courts rely on actual facts and actual law, not on theatrics and passion.”
Yet, the visible signs of suffering witnessed by the media and described in detail by Black’s legal team have raised serious questions about the efficacy and humanity of Tennessee’s execution protocols. Henry noted that officials appeared to struggle to insert an IV line into Black’s left side, only succeeding after using an additional medical device, though witnesses could not see this part of the process. The discomfort and distress Black displayed were unlike what media witnesses had seen in previous executions, as confirmed by Steve Cavendish, editor-in-chief of the Nashville Banner: “It was unanimous among all of us that we saw him in distress. We heard him in distress.”
Legal experts and advocacy groups told The Washington Post that botched executions are unfortunately not new in the United States, but Black’s was different. Most botched lethal injections have involved difficulties accessing veins, but in Black’s case, the failure seemed entirely predictable and avoidable. Slate’s analysis pointed out that the state’s refusal to deactivate the ICD—a simple medical procedure—demonstrated a “reckless or depraved indifference to human life.” The publication argued that current legal standards governing what constitutes cruel and unusual punishment are outdated and ill-equipped to handle modern execution protocols and medical complexities.
Following the execution, Black’s attorneys announced plans to request a full autopsy and access to the ICD’s internal data, as well as electrocardiograph readings from the execution, to better understand what happened during Black’s final moments. An autopsy report is expected within eight to twelve weeks, according to Kelley Henry.
Byron Black’s execution was only the second in Tennessee in 2025, following a pause in executions due to previous problems with the state’s lethal injection protocols. His case has become a flashpoint in the ongoing debate over capital punishment in America, raising difficult questions about the treatment of vulnerable prisoners, the reliability of execution methods, and the willingness of courts and officials to heed warnings about unnecessary suffering.
As the autopsy results and further records are awaited, Black’s death stands as a stark reminder of the unresolved ethical and legal dilemmas at the heart of the American death penalty system. Whether or not it prompts real change remains to be seen, but the distress witnessed in Nashville this August will not soon be forgotten by those who saw it firsthand.