For Australian lawyers, particularly those working in human rights, health law, or international practice, a recent capital execution in the US is a reminder that neat solutions vanish when these systems intersect, writes Rebecca Ward, MBA.
Byron Black died on 5 August 2025 in a Tennessee execution chamber, strapped to a gurney, a large dose of pentobarbital surging through his veins. He was 66, in poor health, and carried inside him a small metal device, an implantable cardioverter defibrillator (ICD) and pacemaker, designed to prevent sudden cardiac death. Witnesses reported he cried out, “I can’t do this … it hurts so bad,” before losing consciousness.
For anyone unfamiliar, an ICD is not a trivial piece of equipment. It sits in the chest, connected to the heart by leads, constantly monitoring for dangerous rhythms. If it detects one, it delivers a shock to restore normal function. In Byron Black’s case, this meant that even as the state sought to end his life, a device in his body could try to keep him alive.
The paradox
This is where the story veers into the territory that makes lawyers, doctors, and ethicists equally uncomfortable. In May 2024, more than a year before his execution, Black’s ICD was implanted to preserve his life. At that time, the state’s duty of care was to keep him alive and medically stable.
When his execution date approached, he asked for the device to be deactivated to prevent painful shocks as his heart slowed. This is medically possible; some devices can be temporarily disabled with a specialised magnet, but every physician approached refused. The American Medical Association’s code of ethics is clear: doctors must not participate in executions, including by making a prisoner more “fit” to be killed.
If he had tried to remove the ICD himself, prison authorities would almost certainly have rushed him to hospital, treated his injuries, and restored him to baseline health, even if that delayed the execution. In practice, that would mean repairing the very device he wanted disabled, then rescheduling the date for his death.
It’s a paradox so sharp it borders on absurdity: preserve his life enough to kill him later, but refuse to make his death less cruel because that would breach medical ethics.
Law of the land versus human rights
Article 5 of the Universal Declaration of Human Rights (UDHR) is unequivocal: No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment. In international law, this is an absolute; it applies to everyone, regardless of crime.
But the UDHR is not legally binding. In the US, constitutional law takes precedence over international declarations. The US has ratified some binding treaties that mirror Article 5, such as the International Covenant on Civil and Political Rights, but with reservations that make them unenforceable without domestic legislation.
The US Supreme Court has consistently held that capital punishment is constitutional. Under current doctrine, if a prisoner claims a particular method of execution is cruel, the burden is on them to propose an alternative method that is less cruel and readily available. In other words, the constitutional prohibition on cruelty is functionally limited by the continued legality of execution itself.
Byron Black could not clear that hurdle. His lawyers argued his medical condition, combined with the device in his chest, created a serious risk of unnecessary pain. The courts were unmoved.
Medical ethics holds the line
On the medical side, the refusal to deactivate the ICD was the correct decision. Ethical codes across jurisdictions, including in Australia, state that medicine must not be co-opted as a tool of punishment. An oncologist would continue chemotherapy for a death-row prisoner up until the day before execution, but they could not lawfully or ethically participate in the execution itself.
This principle is deceptively simple: the state has a duty to preserve life until it lawfully takes it. Medicine’s duty is to preserve life, full stop.
The difficulty comes when those duties collide. In Byron Black’s case, they collided head-on. The law pressed towards execution. Medical ethics refused to smooth the path. Human rights principles were invoked, but had no legal force.
Why we still execute
Australia abolished death penalty decades ago. For most Australians, it’s a historical relic; the last hanging here was in 1967. In the US, however, capital punishment persists. Public opinion in some states still supports it, and political leaders often treat it as a symbol of “justice served”.
The Byron Black case doesn’t ask Australian lawyers to reconsider our stance on death penalty. It asks us to consider something harder: what happens when three separate systems – domestic law, international human rights, and medical ethics – demand different things? Which one wins? And what does that say about the society applying them?
The takeaway for lawyers
For lawyers, particularly those working in human rights, health law, or international practice, Byron Black’s death is a reminder that neat solutions vanish when these systems intersect. You can believe, as many do, that Black’s crimes warranted the ultimate penalty. You can also recognise the dissonance in preserving a man’s life up until the moment the state takes it, while refusing to make his death less cruel.
In Australia, we may never face this precise scenario, but the underlying clash is not confined to capital punishment. Asylum seeker healthcare, involuntary psychiatric treatment, and end-of-life decision-making can all produce the same collision between legal authority, human dignity, and professional ethics.
The challenge is to identify when those systems are at odds and to decide, consciously, which principles we will let bend, and which must never break.
Because if the law of the land, the language of human rights, and the ethics of medicine can all point in different directions, and we simply follow the one that’s most convenient, then we haven’t solved the problem. We’ve just delayed it until the next Byron Black comes along.
Rebecca Ward is an MBA-qualified management consultant with a focus on mental health. She is the managing director of Barristers’ Health, which supports the legal profession through management consulting and psychotherapy. Barristers’ Health was founded in memory of her brother, Steven Ward, LLB.
