The state executed Black after Tennessee Gov. Bill Lee declined requests from attorneys, advocacy groups and even some Republicans to intervene.

Byron Black was executed after a back-and-forth in court over whether officials would need to turn off his implantable cardioverter-defibrillator, or ICD. Black, 69, was in a wheelchair, suffering from dementia, brain damage, kidney failure, congestive heart failure and other conditions, his attorneys have said.

Black’s US lawyers raised concerns that his heart implant could shock him back to life, leading to undue suffering.