Bucklew v. Precythe
The Supreme Court ruled that a death-row inmate challenging a specific execution method as applied to his own unusual medical condition must still identify a feasible alternative method the state could use instead — the same requirement that applies to broader challenges to a method of execution.
Because the inmate, who suffers from a rare disease causing tumors in his throat, failed to show that nitrogen gas was a ready and workable alternative that would meaningfully reduce his risk of pain, the Court upheld the lower courts' rulings allowing Missouri to proceed with his lethal injection.
How it got here: A federal trial court rejected Bucklew's challenge and granted Missouri summary judgment; the Eighth Circuit affirmed twice over several years of litigation, and the Supreme Court agreed to review the case.
The Case in Depth
What happened
Russell Bucklew was convicted of murder and other violent crimes and sentenced to death in Missouri. He has a rare disease, cavernous hemangioma, that causes blood-vessel tumors to grow in his head, neck, and throat. He argued that Missouri's lethal-injection method, though generally constitutional, would cause him unusually severe pain because of his condition, and he proposed execution by nitrogen gas as a less painful alternative.
The question before the Court
Could a death-row inmate with a rare medical condition skip the usual requirement of proposing an alternative execution method, just because his challenge targeted his own case rather than the method generally?
The Court's answer
No \u2014 an inmate cannot skip the alternative-method requirement just by framing his challenge around his own unique medical condition rather than attacking the execution method generally. The Court held that the same constitutional test applies to both types of challenges: an inmate must identify a feasible, readily usable alternative method of execution that would significantly reduce a substantial risk of severe pain, and show the state refused to adopt it without a legitimate reason.
Applying that test, the Court found Bucklew's proposed alternative, nitrogen gas, fell short. He offered no real details on how it would be carried out, and Missouri had a legitimate reason to avoid being the first state to try an untested method. The Court also found no evidence that nitrogen gas would meaningfully reduce his risk of pain compared to the state's existing lethal-injection drug.
Curious how the Court got there? See the step-by-step legal reasoning →
Why it matters
The decision confirms that virtually anyone challenging how a state plans to execute them \u2014 not just people attacking a method for all prisoners \u2014 must propose a workable alternative and show it would meaningfully reduce pain. That makes it harder for individual inmates to delay or block executions based on personal medical conditions unless they can point to a real, ready-to-use substitute method.
What changes now
This is a final merits decision; the Eighth Circuit's judgment against Bucklew stands, and Missouri may proceed with his execution as planned. The ruling settles, going forward, that as-applied and facial method-of-execution challenges are governed by the identical legal test, and that inmates challenging their execution method on any theory must offer a genuinely usable alternative and evidence it would meaningfully cut their risk of pain.
What this does not decide
The Court did not decide that Missouri's lethal injection protocol is painless or ideal, nor did it hold that no execution method could ever be found unconstitutional. It also did not resolve the Thomas/Scalia view that only deliberately pain-designed methods violate the Eighth Amendment, since the case was resolved under the less demanding Baze-Glossip standard.
Concurrences and dissents
Concurrence — Justice Thomas
Justice Thomas said he would decide the case on a narrower ground: a method of execution violates the Eighth Amendment only if the state deliberately designed it to inflict pain, and there was no evidence Missouri intended that here. He nonetheless joined the majority's opinion in full because it correctly resolved the case under existing precedent, and he separately defended his intent-based standard against Justice Breyer's criticisms.
Concurrence — Justice Kavanaugh
Justice Kavanaugh joined the majority in full but wrote separately to emphasize that all nine Justices agreed an inmate's proposed alternative execution method need not already be authorized under current state law, which he said meaningfully lowers the practical burden on inmates and suggested options like the firing squad might qualify as an available alternative.
Dissent — Justice Breyer
“In my view, that holding violates the clear command of the Eighth Amendment.”Breyer's core objection to the majority's ruling allowing the execution to proceed.
Justice Breyer argued Bucklew had presented enough evidence of a genuine factual dispute over whether lethal injection would cause him prolonged suffocation and pain to warrant a trial, that the Glossip alternative-method requirement should not extend to a narrow, personal medical challenge like this one, and that the majority's closing remarks about delay in capital cases were unnecessary and troubling. He would have reversed and allowed the case to proceed to trial.
Dissent in part — Justice Sotomayor
Justice Sotomayor joined Justice Breyer's dissent except for its final part, reiterating her view that inmates should never have to identify their own execution method. She wrote separately to object specifically to the majority's closing discussion of last-minute stay applications, calling it unnecessary dicta that could wrongly be read as making late-filed capital claims presumptively suspect.
How the Court got there
The legal reasoning, step by step
- The Court applied the two-part test from Baze v. Rees and Glossip v. Gross: to prove an execution method is unconstitutionally cruel, an inmate must identify a feasible, readily usable alternative method that would significantly cut a substantial risk of severe pain, and show the state refused it without a legitimate reason.
- The Court traced the Eighth Amendment's original meaning, explaining that it bars methods that 'superadd' terror, pain, or disgrace beyond what's needed to carry out a death sentence, but does not guarantee a painless death — a standard that requires comparing the challenged method to a real alternative rather than judging it in isolation.
- The Court rejected the argument that a challenge focused on one inmate's unique medical condition should be treated differently from a broad challenge to a method's use on everyone, reasoning that the same substantive constitutional standard applies regardless of how narrowly the lawsuit is framed, and that carving out an exception would invite manipulative pleading.
- Turning to the facts, the Court found Bucklew's proposed alternative — nitrogen gas — was not detailed enough to count as 'readily implemented,' since he offered no evidence on basic questions like delivery method, gas concentration, or safety for execution staff.
- The Court also found Missouri had a legitimate reason to stick with its existing protocol rather than be the first state ever to carry out an execution by an untested method.
- Even assuming nitrogen gas were workable, the Court concluded the evidence did not show it would meaningfully reduce Bucklew's risk of pain compared to the state's lethal-injection drug, in part because his own expert's testimony about a horse study on that point was later shown to be mistaken.
Doctrinal impact
Cases affected by this decision
Reaffirms Baze v. Rees (553 U. S. 35)
The Court reaffirmed Baze's plurality test as the binding standard for all execution-method challenges.
Reaffirms Glossip v. Gross (576 U. S. ___)
The Court reaffirmed and extended Glossip's rule requiring proof of a workable alternative to as-applied claims.