A majority of the Tennessee Supreme Court has held that death row inmates failed to establish that the current, three-drug lethal injection protocol violates prohibitions against cruel and unusual punishment under the United States Constitution and the Tennessee Constitution.

In January 2018, the Tennessee Department of Correction ("TDOC") adopted a three-drug lethal injection protocol as an alternative method of execution to the single-drug protocol using pentobarbital. In February 2018, thirty-three death-sentenced inmates filed a constitutional challenge to this three-drug protocol. While the inmates' case was pending, TDOC eliminated the single-drug lethal injection alternative, leaving the three-drug protocol as the only available lethal injection execution method in Tennessee.

On July 26, 2018, the chancery court in Davidson County dismissed the inmates' complaint, and twenty-nine of the plaintiffs filed a notice of appeal on July 30, 2018. On August 9, 2018, following the Court's denial of a stay of execution, Billy Ray Irick, one of the plaintiff inmates, was executed using the three-drug lethal injection protocol. On August 13, 2018, the Tennessee Supreme Court assumed jurisdiction over the inmates' appeal on its own initiative in order to expedite the appeal. On August 23, 2018, the remaining four plaintiffs filed a notice of appeal. The case was heard before the Supreme Court in Nashville on October 3, 2018.

In an opinion filed today, a majority of the Court held that current federal and Tennessee law required the inmates to plead and prove the availability of an alternative method of execution that entails a lesser risk of pain. The Court held that the inmates failed to prove the availability of pentobarbital - the only alternative method that the inmates sufficiently pleaded in their complaint. Thus, the Court concluded that the inmates failed to establish that the three-drug protocol violated either the United States Constitution or the Tennessee Constitution. As a result, the Court affirmed the trial court's dismissal of the inmates' action.

Justice Sharon G. Lee dissented, concluding that the inmates were denied due process because the proceedings were not fundamentally fair. Justice Lee noted several reasons for the unfairness, including that the inmates had to prove an alternative execution method, even though the three-drug method was shown to cause intolerable pain; the Court's rush to execute that resulted in the case being placed on an expedited docket; and TDOC's last minute changes to the lethal injection protocol.