"It's also the only medical procedure where incompetence saves lives,"
Hannah Parry
Fri, October 9, 2026
NEWSWEEK
A former surgeon who has examined botched executions says Christa Pike's survival of two doses of pentobarbital in Tennessee's failed execution highlights a fundamental flaw in lethal injection: The medical professionals best equipped to administer drugs and respond to complications are barred by professional ethics from participating.
"The problem with lethal injection is the people who are most qualified to do it are ethically forbidden from participating," Jonathan Groner, expert on the medical aspects of capital punishment, told Newsweek. He described the dilemma as a "Hippocratic paradox."
Groner, who previously served as trauma medical director at Nationwide Children's Hospital in Columbus, Ohio, argued that this ethical restriction creates a fundamental challenge for a procedure that depends on medical expertise. Experience is also crucial when complications arise, he said.
"It's also the only medical procedure where incompetence saves lives," he said.
The American Medical Association's Code of Medical Ethics prohibits physicians from participating in legally authorized executions. This is a professional ethical prohibition, rather than a blanket federal criminal law barring every doctor from taking part in every execution.
Pike survived Tennessee's September 30 execution attempt and was taken to a hospital for emergency treatment. Her survival has raised questions about whether the drugs entered her bloodstream as intended, whether the medication was of the expected quality and how the execution team responded when the procedure did not have its intended effect.
Newsweek has reached out to the Tennessee Department of Correction for comment.
This undated photo released by the Tennessee Department of Correction shows Christa Pike. (Tennessee Department of Correction via the Associated Press)
How Did Christa Pike Survive Her Lethal Injection?
Groner suggested that problems with intravenous access could help explain Pike's survival, raising the possibility that the drug did not enter her bloodstream as intended.
One possibility he raised was extravasation, a complication in which an injected drug escapes from a vein into surrounding tissue rather than entering the bloodstream properly.
"You know, the problem with Pike is you took someone who apparently had atypical IV access and you paired them with somebody who was completely incompetent," he said.
Groner said that if the drug was injected under the skin, rather than intravenously, "it would just be slowly absorbed from those tissues." He compared the possible effect to a sustained-release preparation, in which a drug enters the circulation over time rather than all at once.
"So she basically had a slow, continuous infusion," he said.
Groner also pointed to reports of serious injuries to Pike's arms as a reason to investigate whether the IV lines were correctly placed.
Pike suffered severe burns, blistering and extensive swelling in her arms after the failed execution. Her attorney described her hands as looking "like if you were to blow up a surgical glove."
Groner said the reported injuries were consistent with the possibility of extravasation. Pentobarbital solutions can cause substantial tissue damage if they escape into surrounding tissue, potentially resulting in chemical burns, inflammation and swelling. However, Groner said he had not examined photographs of Pike's arms, and the precise cause and extent of her injuries have not been confirmed.
The route of administration, the amount of pentobarbital that reached her bloodstream and the quality of the medication would need to be established through evidence.
Groner also questioned whether the execution procedure allowed personnel to recognize problems as they occurred.
In an operating room, an anesthetist typically remains close to the patient and can observe the injection site while a drug is administered intravenously. An experienced clinician may also detect changes in resistance that indicate a problem with delivery.
"If you're pushing that syringe down, you know what it feels like. It's not going in," Groner said, describing how an experienced practitioner can recognize resistance when administering an IV drug.
He contrasted this with lethal injection procedures in which the person administering the drug may be separated from the prisoner by a screen or another room, with tubing connecting the syringe to the injection site.
Groner argued that the distance and equipment can make it harder to detect problems through direct observation and the feel of the injection.
He also questioned whether execution personnel necessarily have the experience needed to manage difficult IV access.
"It's a practice-based skill," he said, explaining that clinicians who perform IV procedures frequently are more likely to have experience recognizing and managing difficulties. "The people who are very good at it have done it all the time," he added.
Groner also raised the possibility of a problem with the drug itself. He said he could not rule out the possibility that the medication was defective or otherwise unsuitable because its source and quality had not been established in the information available to him.
He said it would be important to know whether drug concentrations were measured when Pike arrived at the hospital and what the clinical records showed about her condition. He also expressed concern about the apparent lack of a systematic neurological assessment during the execution, although the interview did not establish exactly what assessments were performed.
Can Fasting Make Lethal Injection Fail? Expert Explains
Questions have also been raised over whether Pike's decision to skip her final meal had an impact on the execution attempt's outcome.
The controversy follows another failed Tennessee execution in May, when officials called off Tony Von Carruthers' lethal injection after struggling to establish the required intravenous access. According to the Tennessee Department of Correction, personnel established a primary IV line but could not establish a backup line, and an attempt to insert a central line was unsuccessful. Governor Bill Lee subsequently granted Carruthers a one-year reprieve. Some state Republicans later attributed the failure to dehydration, although the publicly available information does not conclusively establish that explanation. Unlike Pike, Carruthers did not receive a completed lethal injection.
Pike chose to forgo her final meal and donate it to charity instead. Her attorneys have since pushed back against speculation that she had deliberately avoided food and water in an attempt to survive the execution. They said she consumed food and fluids, including Gatorade, before the September 30 attempt.
Groner said dehydration can make IV access more difficult, but rejected the suggestion that fasting would ordinarily render anesthetic drugs ineffective.
Patients are commonly instructed to fast before anesthesia primarily to reduce the risk of aspiration, when stomach contents enter the lungs. Fasting is not intended to make anesthetic drugs less effective.
"If anesthetic drugs were somehow affected by people not eating or drinking for the operation, then tens of thousands of operations would have been screwed up," Groner said.
Medical teams regularly establish IV access in patients who are dehydrated because of illness, vomiting or an inability to drink. Dehydration can make veins less prominent and IV access more challenging, but experienced clinicians can often overcome those difficulties, he said.
"The people who are very good at it have done it all the time," Groner said.
He argued that fasting is not an established way to make pentobarbital ineffective once an adequate amount reaches the bloodstream. The possibility that dehydration complicated IV placement is medically distinct from the claim that avoiding food or water makes someone resistant to the drug.
Will Christa Pike Be Executed Again?
Pike was sentenced to death for the 1995 murder of her classmate Colleen Slemmer in Tennessee. Her September 30 execution failed after the state administered two doses of pentobarbital. Pike survived and was taken to the hospital, prompting questions about the procedure and circumstances surrounding the drug administration.
It remains uncertain whether Tennessee will attempt to execute Pike again.
Her attorneys have challenged aspects of the failed procedure, and the case raises difficult questions about whether another attempt would violate the constitutional prohibition on cruel and unusual punishment. Her legal team may also present arguments concerning double jeopardy and the particular circumstances of the first attempt.
The medical implications are also uncertain. Pike's arm injuries could complicate future IV access, depending on their severity, location and recovery. Her neurological condition and overall health would also be relevant to assessing the consequences of the failed execution. The extent of any lasting injury has not yet been established.
The Supreme Court has ruled that executing people with intellectual disability violates the Eighth Amendment. That ruling does not automatically prohibit the execution of someone who has a mental illness, although separate legal questions can arise concerning competency to be executed.
Groner said he had initially worried that Pike might suffer a serious neurological injury from oxygen deprivation.
He explained that swallowing difficulties can sometimes arise from neurological injury, while intubation and other aspects of emergency treatment can also contribute to problems swallowing.
However, he acknowledged that reports indicated Pike's condition was improving.
Pike's survival has raised broader questions about the reliability of lethal injection, the medical expertise available during executions and whether a procedure presented as controlled can adequately prevent or respond to serious complications.
As Groner argued, the fundamental dilemma is that the clinical expertise needed to recognize and manage such complications may be precisely the expertise that professional medical ethics prevent physicians from using to carry out an execution.
Newsweek's reporters and editors used Martyn, our AI assistant, to produce this story. Learn more about Martyn here.
Contact Newsweek editors on this story: Samantha Beech and Edward T. Cummins
NewsNation
Sat, October 10, 2026
Candidate for Tenn. governor would preserve pause on executions
(NewsNation) — Jerri Green, the Democratic candidate for Tennessee governor, tells "NewsNation Prime" she would continue Republican Gov. Bill Lee's moratorium on executions, if elected.
Lee called for the pause through 2026 following the botched lethal-injection execution of inmate Christa Pike, which has revived debate about capital punishment amid similar gaffes involving death-row drugs.
"The state shouldn't be trying to kill people who kill people to prove that killing people is wrong," Green, a lawyer and member of the Memphis City Council, said Saturday.
Hannah Parry
Fri, October 9, 2026
NEWSWEEK
A former surgeon who has examined botched executions says Christa Pike's survival of two doses of pentobarbital in Tennessee's failed execution highlights a fundamental flaw in lethal injection: The medical professionals best equipped to administer drugs and respond to complications are barred by professional ethics from participating.
"The problem with lethal injection is the people who are most qualified to do it are ethically forbidden from participating," Jonathan Groner, expert on the medical aspects of capital punishment, told Newsweek. He described the dilemma as a "Hippocratic paradox."
Groner, who previously served as trauma medical director at Nationwide Children's Hospital in Columbus, Ohio, argued that this ethical restriction creates a fundamental challenge for a procedure that depends on medical expertise. Experience is also crucial when complications arise, he said.
"It's also the only medical procedure where incompetence saves lives," he said.
The American Medical Association's Code of Medical Ethics prohibits physicians from participating in legally authorized executions. This is a professional ethical prohibition, rather than a blanket federal criminal law barring every doctor from taking part in every execution.
Pike survived Tennessee's September 30 execution attempt and was taken to a hospital for emergency treatment. Her survival has raised questions about whether the drugs entered her bloodstream as intended, whether the medication was of the expected quality and how the execution team responded when the procedure did not have its intended effect.
Newsweek has reached out to the Tennessee Department of Correction for comment.
This undated photo released by the Tennessee Department of Correction shows Christa Pike. (Tennessee Department of Correction via the Associated Press)
How Did Christa Pike Survive Her Lethal Injection?
Groner suggested that problems with intravenous access could help explain Pike's survival, raising the possibility that the drug did not enter her bloodstream as intended.
One possibility he raised was extravasation, a complication in which an injected drug escapes from a vein into surrounding tissue rather than entering the bloodstream properly.
"You know, the problem with Pike is you took someone who apparently had atypical IV access and you paired them with somebody who was completely incompetent," he said.
Groner said that if the drug was injected under the skin, rather than intravenously, "it would just be slowly absorbed from those tissues." He compared the possible effect to a sustained-release preparation, in which a drug enters the circulation over time rather than all at once.
"So she basically had a slow, continuous infusion," he said.
Groner also pointed to reports of serious injuries to Pike's arms as a reason to investigate whether the IV lines were correctly placed.
Pike suffered severe burns, blistering and extensive swelling in her arms after the failed execution. Her attorney described her hands as looking "like if you were to blow up a surgical glove."
Groner said the reported injuries were consistent with the possibility of extravasation. Pentobarbital solutions can cause substantial tissue damage if they escape into surrounding tissue, potentially resulting in chemical burns, inflammation and swelling. However, Groner said he had not examined photographs of Pike's arms, and the precise cause and extent of her injuries have not been confirmed.
The route of administration, the amount of pentobarbital that reached her bloodstream and the quality of the medication would need to be established through evidence.
Groner also questioned whether the execution procedure allowed personnel to recognize problems as they occurred.
In an operating room, an anesthetist typically remains close to the patient and can observe the injection site while a drug is administered intravenously. An experienced clinician may also detect changes in resistance that indicate a problem with delivery.
"If you're pushing that syringe down, you know what it feels like. It's not going in," Groner said, describing how an experienced practitioner can recognize resistance when administering an IV drug.
He contrasted this with lethal injection procedures in which the person administering the drug may be separated from the prisoner by a screen or another room, with tubing connecting the syringe to the injection site.
Groner argued that the distance and equipment can make it harder to detect problems through direct observation and the feel of the injection.
He also questioned whether execution personnel necessarily have the experience needed to manage difficult IV access.
"It's a practice-based skill," he said, explaining that clinicians who perform IV procedures frequently are more likely to have experience recognizing and managing difficulties. "The people who are very good at it have done it all the time," he added.
Groner also raised the possibility of a problem with the drug itself. He said he could not rule out the possibility that the medication was defective or otherwise unsuitable because its source and quality had not been established in the information available to him.
He said it would be important to know whether drug concentrations were measured when Pike arrived at the hospital and what the clinical records showed about her condition. He also expressed concern about the apparent lack of a systematic neurological assessment during the execution, although the interview did not establish exactly what assessments were performed.
Can Fasting Make Lethal Injection Fail? Expert Explains
Questions have also been raised over whether Pike's decision to skip her final meal had an impact on the execution attempt's outcome.
The controversy follows another failed Tennessee execution in May, when officials called off Tony Von Carruthers' lethal injection after struggling to establish the required intravenous access. According to the Tennessee Department of Correction, personnel established a primary IV line but could not establish a backup line, and an attempt to insert a central line was unsuccessful. Governor Bill Lee subsequently granted Carruthers a one-year reprieve. Some state Republicans later attributed the failure to dehydration, although the publicly available information does not conclusively establish that explanation. Unlike Pike, Carruthers did not receive a completed lethal injection.
Pike chose to forgo her final meal and donate it to charity instead. Her attorneys have since pushed back against speculation that she had deliberately avoided food and water in an attempt to survive the execution. They said she consumed food and fluids, including Gatorade, before the September 30 attempt.
Groner said dehydration can make IV access more difficult, but rejected the suggestion that fasting would ordinarily render anesthetic drugs ineffective.
Patients are commonly instructed to fast before anesthesia primarily to reduce the risk of aspiration, when stomach contents enter the lungs. Fasting is not intended to make anesthetic drugs less effective.
"If anesthetic drugs were somehow affected by people not eating or drinking for the operation, then tens of thousands of operations would have been screwed up," Groner said.
Medical teams regularly establish IV access in patients who are dehydrated because of illness, vomiting or an inability to drink. Dehydration can make veins less prominent and IV access more challenging, but experienced clinicians can often overcome those difficulties, he said.
"The people who are very good at it have done it all the time," Groner said.
He argued that fasting is not an established way to make pentobarbital ineffective once an adequate amount reaches the bloodstream. The possibility that dehydration complicated IV placement is medically distinct from the claim that avoiding food or water makes someone resistant to the drug.
Will Christa Pike Be Executed Again?
Pike was sentenced to death for the 1995 murder of her classmate Colleen Slemmer in Tennessee. Her September 30 execution failed after the state administered two doses of pentobarbital. Pike survived and was taken to the hospital, prompting questions about the procedure and circumstances surrounding the drug administration.
It remains uncertain whether Tennessee will attempt to execute Pike again.
Her attorneys have challenged aspects of the failed procedure, and the case raises difficult questions about whether another attempt would violate the constitutional prohibition on cruel and unusual punishment. Her legal team may also present arguments concerning double jeopardy and the particular circumstances of the first attempt.
The medical implications are also uncertain. Pike's arm injuries could complicate future IV access, depending on their severity, location and recovery. Her neurological condition and overall health would also be relevant to assessing the consequences of the failed execution. The extent of any lasting injury has not yet been established.
The Supreme Court has ruled that executing people with intellectual disability violates the Eighth Amendment. That ruling does not automatically prohibit the execution of someone who has a mental illness, although separate legal questions can arise concerning competency to be executed.
Groner said he had initially worried that Pike might suffer a serious neurological injury from oxygen deprivation.
He explained that swallowing difficulties can sometimes arise from neurological injury, while intubation and other aspects of emergency treatment can also contribute to problems swallowing.
However, he acknowledged that reports indicated Pike's condition was improving.
Pike's survival has raised broader questions about the reliability of lethal injection, the medical expertise available during executions and whether a procedure presented as controlled can adequately prevent or respond to serious complications.
As Groner argued, the fundamental dilemma is that the clinical expertise needed to recognize and manage such complications may be precisely the expertise that professional medical ethics prevent physicians from using to carry out an execution.
Newsweek's reporters and editors used Martyn, our AI assistant, to produce this story. Learn more about Martyn here.
Contact Newsweek editors on this story: Samantha Beech and Edward T. Cummins
Candidate for Tenn. governor would preserve pause on executions
NewsNation
Sat, October 10, 2026
Candidate for Tenn. governor would preserve pause on executions
(NewsNation) — Jerri Green, the Democratic candidate for Tennessee governor, tells "NewsNation Prime" she would continue Republican Gov. Bill Lee's moratorium on executions, if elected.
Lee called for the pause through 2026 following the botched lethal-injection execution of inmate Christa Pike, which has revived debate about capital punishment amid similar gaffes involving death-row drugs.
"The state shouldn't be trying to kill people who kill people to prove that killing people is wrong," Green, a lawyer and member of the Memphis City Council, said Saturday.
U.S. Sen. Marsha Blackburn, the state's Republican candidate for governor, has opposed the moratorium on executions and said the state should look at alternative means of execution.
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