A court in the United States has ruled that the southern US state of Tennessee can move forward with the execution of a man with an implanted defibrillator, despite concerns that the device could result in a botched execution.

The case before the Tennessee Supreme Court on Thursday concerned Byron Black, currently on death row after his conviction in a 1988 triple murder.

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Black’s execution has been delayed multiple times, but a date was set on August 5 for him to receive a lethal injection.

However, in July, his defence team argued the execution could not proceed without first deactivating Black’s defibrillator, for fear it would continuously shock his heart as he passed away, resulting in an unnecessarily painful and prolonged death.

Davidson County Chancery Court Judge Russell Perkins previously ruled that Black’s defibrillator would have to be removed prior to execution.

But the Tennessee Supreme Court overturned that decision, arguing that removing the defibrillator in advance would amount to a “stay of execution”.

The state justices added that the lower court’s order was invalid because it had exceeded its authority.

Kelley Henry, one of Black’s attorneys, said that she is looking at the opinion before making a decision about next steps.

Lawyers for the state said on Wednesday that healthcare workers, many of whom view participation in the execution process as a violation of medical ethics, were not willing to facilitate the defibrillator’s removal.

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The court did not address concerns over whether possible complications to the execution caused by the device could violate Black’s constitutional right against cruel and unusual punishment. It also left open the possibility that Black could still win a reprieve against his execution.

Botched executions have been a subject of debate for years in the US, one of the few Western countries that still uses capital punishment.

Capital punishment carried out through methods such as lethal injection and electrocution can be frequently error-prone, sometimes resulting in painful, drawn-out deaths for prisoners.

A 2022 report by the Death Penalty Information Center (DPIC) found that seven out of 22 attempted executions in the US were “visibly problematic” and included “executioner incompetence, failures to follow protocols, or defects in the protocols themselves”.

According to Amnesty International, the US executed 24 people in 2023, the third-highest number of confirmed executions in the world after Iran and Saudi Arabia. The US also had the fifth-highest number of death sentences, after China, Iran, Saudi Arabia and Somalia.

A 2024 Gallup poll found that 53 percent of people in the US still support the death penalty, while 43 percent disapprove. Those figures, however, represent some of the lowest levels of support on record, with favour dropping sharply over the last several decades.