NASHVILLE, Tenn. — More than 40 doctors and nurses in Tennessee are urging Gov. Bill Lee to pause executions and remove medical professionals from the process, following a failed attempt to establish IV access for death-row prisoner Tony Carruthers at Riverbend Maximum Security Institution in May. Carruthers’ attorney, Maria DeLiberato, said healthcare workers spent more than an hour trying to place an IV before a doctor attempted to insert a central line near Carruthers’ collarbone and shoulder. The effort failed, and the execution attempt was stopped after Lee directed the prison warden to halt it. Lee later granted Carruthers a one-year reprieve. DeLiberato said Carruthers groaned in pain as workers made repeated attempts, leaving blood at puncture sites. Under Tennessee’s execution protocol, media witnesses could not see the IV-placement process because a curtain covered the viewing window until access was established. In a letter sent to Lee two months after the attempt, the healthcare workers said Tennessee’s rules requiring pharmacists, physicians and other medical staff to assist with executions conflict with professional ethics. The American Medical Association’s ethics code bars doctors from participating in executions, while saying physicians should preserve life when possible. Dr. John Greer, a retired Nashville hematologist, said central-line placement is a risky procedure that requires specific training and regular practice. Mistakes can cause serious bleeding or a collapsed lung, he said. The doctor involved in Carruthers’ case, Mark Fowler, is a contractor for the state prison system. In a deposition, Fowler said he had not performed a central-line procedure in the 12 years since leaving emergency-room work and had not known it could be part of his execution duties. He told reporters that his role was not to participate in an execution, but to declare a person dead. Lee rejected calls for a broader pause. He said the Department of Correction had acted as it should and that the failed attempt should not affect future executions. The dispute has also surfaced in the case of Christa Pike, whose execution was scheduled for Sept. 30. Pike’s attorneys argued that her platelet disorder could make a central line necessary and that the procedure could expose her to needless suffering. A Tennessee judge appointed to review her concerns concluded that the execution process would not violate her rights, and the state Supreme Court denied her request for a stay. A federal appeals court halted the execution about an hour before it was scheduled to begin. Nine Republican state lawmakers have also called for a halt and an overhaul of Tennessee’s execution process, citing concerns about its administration. Separately, news organizations and the Reporters Committee for Freedom of the Press have sued over the state’s policy of blocking witnesses from viewing IV placement, arguing that the restriction prevents public scrutiny of potential problems. Tennessee is among 27 states where the death penalty is legal. Since the start of 2020, six states have had botched lethal injections, according to the Death Penalty Information Center, which counts attempts involving unexpected protocol problems that cause more pain than anticipated, whether or not the person ultimately dies. The debate reaches beyond the mechanics of lethal injection. Medical ethicists say professional standards developed in response to past abuses by governments are intended to prevent medicine from being used as an instrument of state punishment. The Tennessee healthcare workers say the Carruthers case shows why those boundaries matter.