这篇报道描述了死刑执行中使用的致死注射程序。5月，一组医疗工作人员花了大约一个小时，试图为托尼·卡鲁瑟斯建立完整的静脉通路，以便向他注射致死剂量的镇静药。卡鲁瑟斯是纳什维尔河湾最高戒备监狱的一名囚犯。
This story describes the lethal injection procedure used in a death penalty. In May, a group of healthcare workers spent about an hour trying to establish complete IV access so they could inject Tony Carruthers, an inmate at the Riverbend Maximum Security Institution in Nashville, with a lethal dose of sedative.
卡鲁瑟斯的律师玛丽亚·德利贝拉托当时就在房间里。她说，工作人员用针刺他的手臂和脚，却毫无成效。随后，一名医生试图通过他的锁骨和肩部插入中心静脉导管，但也没有成功。
Maria DeLiberato, an attorney for Carruthers, was in the room. She said the workers stuck his arms and feet with needles, to no avail. A doctor then tried to insert a central line through his collarbone and shoulder. That didn't work, either.
卡鲁瑟斯痛苦地呻吟着，鲜血从穿刺伤口中渗出，德利贝拉托说。一个多小时后，州长比尔·李致电监狱长，命令他停止行刑。他后来将卡鲁瑟斯的死刑暂缓执行一年。
Carruthers groaned in pain and blood oozed from puncture wounds, DeLiberato said in a After more than an hour, Gov. Bill Lee called the warden, ordering him to halt the execution attempt. He later granted Carruthers a one-year reprieve.
如今，在另一名死囚即将被处决之际，该州的医生和护士表示，他们希望将医疗专业人员排除在行刑程序之外。他们还与辩护律师以及9名共和党籍州议员一道，要求暂停执行死刑，并全面改革该州的行刑方式。
Now, as another death row inmate's execution approaches, doctors and nurses in the state say they want medical professionals removed from the execution process. They've also joined defense attorneys and nine Republican state lawmakers in demanding a moratorium on the death penalty and an overhaul of the state's execution methods.
这些医生的主张与美国医学会此前向美国最高法院以及在其伦理准则中提出的主张如出一辙。美国的死刑据提供死刑相关问题数据和 analyses 的非营利组织“死刑信息中心”称，田纳西自2020年初以来，已有170人在17个州被执行死刑，其中大多数发生在佛罗里达州、得克萨斯州和俄克拉荷马州。据死刑信息中心（Death Penalty Information Center）的数据，在此期间，有六个州发生了执行死刑注射失败的情况。
The doctors' arguments echoed those the American Medical Association (AMA) has made before the U.S. Supreme Court and in its code of ethics. The death penalty in the U.S. Tennessee is among 27 states where the death penalty is legal, according to the Death Penalty Information Center, a nonprofit that offers data and analysis on issues surrounding capital punishment. Governors in four of those states have halted all executions, citing moral concerns and logistical ones, such as being unable to obtain lethal injection drugs amid pharmaceutical companies' refusal to sell them for use in executions.
该中心将此类事件定义为：由于出现未预见的状况而偏离既定程序，导致囚犯承受了超出预期的痛苦，无论其最终是否死亡。其中几起事件的经过与卡瑟斯（Carruthers）的案例相似——都是试图建立静脉通路的过程漫长，但最终未能成功。
Lethal injection is still the primary execution method nationwide, but some states may use gas, a firing squad, or electrocution. Since the beginning of 2020, 170 people have been executed in 17 states, with most occurring in Florida, Texas, and Oklahoma. In that time, six states have had botched lethal injections, according to the Death Penalty Information Center, which defines those as executions that include a departure from the protocol because of unanticipated problems and that cause more pain for the prisoner than anticipated, whether they ultimately end with a death or not.
田纳西州医生的担忧 根据德利贝拉托（DeLiberato）的陈述，静脉注射团队在多次尝试失败后，放弃了为卡瑟斯建立外周静脉通路的努力。随后，按照程序，州监狱系统的承包商、医生马克·福勒（Mark Fowler）尝试在更深的静脉中插入中心静脉导管。这是一种准外科手术，需要将塑料导管插入胸部、腹股沟或颈部。福勒使用了一系列注射器，试图将导管插入卡瑟斯的锁骨下方，然后穿过其肩部。
Several of the stories read like Carruthers' — protracted but ultimately failed attempts to establish IV access. Tennessee doctors' concerns The IV team gave up on trying to place a peripheral IV line into Carruthers after several failed attempts, according to DeLiberato's account. Following protocol, physician Mark Fowler, a contractor for the state's prison system, then tried to insert a central line in a deeper vein. That's a quasi-surgical procedure in which a plastic tube is inserted in the chest, groin, or neck. Fowler used a series of syringes, trying to insert the tube under Carruthers' collarbone and then through his shoulder.
在2025年10月的一份证词中，福勒表示，自他12年前停止在急诊室工作以来，他就未再进行过此类手术，并且不知道插入中心静脉导管可能属于其执行死刑的职责范围。
In an October 2025 deposition, Fowler said he hadn't done such a procedure in the 12 years since he had stopped working in an emergency room, and didn't know that placing a central line could be among his execution duties.
9月24日，福勒通过电话告诉美国全国公共广播电台（NPR）：“医生并不参与执行过程。医生唯一做的事情是宣布该人死亡。”他未作进一步评论。
Fowler told NPR by phone on Sept. 24 that "the doctor does not participate in the execution. The only thing the doctor does is declare the person dead."
在注射执行被中止两个月后，40多名医生和护士致信李州长（Gov. Lee），呼吁他暂停执行死刑，并重新设计执行程序，将医疗人员排除在流程之外。
He did not have further comment. Two months after the halted lethal injection, more than 40 doctors and nurses sent a letter to Gov. Lee, calling on him to pause executions and redesign the protocol to omit health workers from the process.
这封信指出，田纳西州要求药剂师、医生及其他医疗工作者参与执行死刑的规定违背了医学伦理，也与美国医学会等机构明确制定的指导原则相抵触。美国医学会的准则明确规定：只要还有挽救生命的希望，医生就必须尽最大努力挽救生命，同时禁止医生参与执行死刑。
The letter said that Tennessee's rules requiring the participation of pharmacists, physicians, and other healthcare workers in executions are at odds with medical ethics, as well as guidelines explicitly laid out by groups such as the American Medical Association. The AMA code says doctors are to preserve life when there is hope of doing so and bars participation in executions.
“这意味着那些同意参与田纳西州死刑执行的医疗工作者，实际上是那些愿意放弃自己职业道德的人，”信中这样写道。“像卡鲁瑟斯先生的案例中所出现的问题，正是与这些毫无道德底线的个人合作所带来的必然结果。”纳什维尔市的一位退休血液学家约翰·格里尔博士在新闻发布会上表示，他对插管手术出现失误并不感到意外。
"This means that the health care professionals who agree to take part in Tennessee's executions are those willing to set aside their professional ethics," the letter to Lee reads. "The problems that we have seen, such as in Mr. Carruthers's case, are the predictable result of working with such unscrupulous actors." Dr. John Greer, a retired Nashville hematologist, said in a news conference about the letter that he wasn't surprised the central line placement went awry.
“插管手术绝不仅仅是简单地将针头插入患者的手臂，”格里尔解释道：“医生必须穿刺心脏上方的大血管。这是一个高风险的操作——任何失误都可能导致患者肺部塌陷或大出血；只有经过专门培训并具备丰富实践经验的人才能进行这种手术。”
"Placing a central line is not just sticking a needle in a person's arm," he said. Greer said the doctor has to tap a large vessel above the heart. He said that it's a risky procedure in which an error could cause a collapsed lung or heavy bleeding — and that only those with specific training and routine practice should attempt.
“我无法想象会有那些经常从事此类手术的人参与执行死刑的过程，”格里尔补充道。
"And I cannot imagine that there would be someone who's doing these routinely who would be involved in this procedure," Greer said.
一些共和党籍州参议员也呼吁暂停执行死刑并对相关程序进行全面改革，他们认为对死刑的“管理不善”只会给批评者提供更多攻击的把柄。今年夏天，李表示他不希望暂停执行死刑的进程。
Some Republican state senators also called for a hold on executions and an overhaul of the process, saying that "incompetent administration" of capital punishment gives its critics more ammunition. This summer, Lee said he didn't want a pause.
“惩教部门确实做了他们应该做的事情，”他说，“这不应该影响未来的执行过程。”
"The Department of Correction did exactly what they should," he said. "It should not affect executions in the future."
“这是我们在这个州所承担的最艰巨的任务之一，”李后来说道，“但我致力于确保这一切都能按照正确的方式来进行。”根据该州的死刑执行规程，监狱必须在静脉注射导管安装完毕之前用帘子遮挡媒体观察者的视线，因此没有人能够亲眼目睹这次执行尝试的失败过程。
"It's one of the most difficult things that we do in this state," Lee said later. "But I am committed to making sure that it is done in the way that it should be." The state's lethal injection protocol orders the prison to keep a curtain over the media witnesses' viewing window until the IVs are established, so none of them could offer a visual account of the failed execution attempt.
记者自由委员会（Reporters Committee for Freedom of the Press）以及包括美国国家公共电台（NPR）旗下的WPLN电视台在内的多家新闻机构已经提起了诉讼，质疑这一规定。他们认为，在静脉注射导管安装过程中缺乏透明度，导致诸如卡鲁瑟斯案（Carruthers case）中发生的这类问题无法被及时发现。
A lawsuit challenging that policy has been filed by the Reporters Committee for Freedom of the Press and news outlets, including NPR Member station WPLN. The lawsuit argues the lack of transparency during the IV placement process obscures problems like the ones that happened in Carruthers' case.
科罗拉多大学医学院生物伦理与人文研究中心主任马修·温尼亚（Matthew Wynia）博士指出：“在美国，人们普遍认为医疗机构不应参与死刑执行。”
There's a broad understanding in the U.S. that the medical establishment doesn't participate in executions, said Dr. Matthew Wynia, director of the Center for Bioethics and Humanities at the University of Colorado's medical school.
“二战结束后，我们建立了一套完善的生物伦理和医学伦理体系，坚决反对将医学手段用于伤害或杀害他人。”温尼亚解释道，“美国政府医生曾犯下诸如强制绝育、对未经治疗的梅毒患者进行不道德的医学实验，以及纳粹德国时期的谋杀和酷刑等暴行，这些历史事件促成了这一共识的形成。”温尼亚还提到，有些国家至今仍允许医疗专业人员参与死刑执行。
"We came out of World War II with a whole bioethics and medical ethics enterprise that is really strongly opposed to medicine serving as an arm of the state and using specialized medical skills to hurt people or kill people," Wynia said. A history of medical abuses by government doctors — such as forced sterilizations and unethical studies of untreated syphilis in the U.S., and murder and torture in Nazi Germany — forged that consensus, he said. Wynia mentioned other nations where medical professionals still participate in executions.
“但你知道，伊朗、沙特阿拉伯和俄罗斯这类威权国家，医学是政府的附庸，”怀尼亚说。“医学之所以会卷入处决，是因为它无法说‘不，我们不这么做。’”医疗问题笼罩着即将到来的处决。田纳西州原定于9月30日处决克里斯塔·派克，她与男友杀害科琳·斯莱默时年仅18岁。联邦上诉法院在行刑前约一小时叫停了处决。
"But they are, you know, Iran and Saudi Arabia and Russia, sort of authoritarian states, where medicine is an arm of the government," Wynia said. "Medical involvement in executions ends up happening because medicine is unable to say, 'No, we don't do that.'" Medical issues loom over upcoming execution Tennessee was scheduled to execute Christa Pike on Sept. 30, who was 18 years old when she and her boyfriend killed Colleen Slemmer. A federal appeals court halted it about an hour before.
派克的律师今年提出了多项担忧，认为该州的注射死刑方案会侵犯她的权利。其中之一是，由于她患有血小板疾病，很可能需要置入中心静脉导管。他们还主张，她面临不必要的痛苦风险，并称卡鲁瑟斯的处决表明，福勒——他已公开确认将监督派克的处决——在置入中心静脉导管方面并不称职。
Pike's attorneys this year raised several concerns that the state's lethal injection protocol would violate her rights. Among them is their contention that because she suffers from a platelet disorder, it's likely she will need a central line placed. They also argued that she was at risk of needless suffering, alleging Carruthers' execution showed that Fowler — who has confirmed publicly that he will oversee Pike's execution — is incompetent at placing central lines.
6月，他们将所有这些担忧写入一份请求，提交给田纳西州最高法院，要求指派一名特别调查员收集证据并举行听证会，以判定这些担忧是否足以支持下令推迟处决，并为她单独设计一种行刑方式。
In June, they put all of those concerns in a request to the Tennessee Supreme Court, asking for a special investigator to collect evidence and hold hearings to determine whether they warranted an order to delay her execution and design a method for only her.
法院确实指派了一名特别调查员，名叫马克·沃德的高级法官。他上个月在诺克斯维尔举行了一系列听证会。沃德表示，他不认为这一程序会侵犯派克的权利，并将报告提交给法院。
The court did appoint a special investigator, a senior judge named Mark Ward. He held a series of hearings in Knoxville last month. Ward said he didn't believe Pike's rights would be violated by the process and submitted his report to the court.
9月23日，田纳西州最高法院驳回了派克的暂缓执行请求，同意沃德的意见，称这些担忧均不构成违宪。9月28日，李宣布他不会给予她宽赦。但在9月30日原定处决的早晨，处决被联邦上诉法院叫停。
On Sept. 23, the Tennessee Supreme Court denied Pike's stay, agreeing with Ward, saying none of the concerns amounted to a constitutional violation. On Sept. 28, Lee announced he would not grant her clemency. But on the morning of the scheduled execution on Sept. 30, the execution was halted by a federal appeals court.
这篇报道来自NPR与WPLN及KFF健康新闻的健康报道合作项目。
This story comes from NPR's health reporting partnership with WPLN and KFF Health News.