Claiborne Matthews, Wake Forest University School of Law JD ’27
Guard
I give mom a quick hug and kiss on the cheek before hurrying out the door. I try to ignore the fact that I can feel her shoulder blades through the thick robe she is wearing.[1]
As I carefully juggle the mug nearly full with scolding hot coffee she just brewed, and the brown paper bag filled with lunch she just fixed, I dig into my pockets, hunting for my car keys.
With only a few drops of coffee landing on my black tactical boots, I finally find them in one of the many pockets of my cargo pants and climb into the car.
By November, the southern heat and coastal humidity have finally subsided. I decide to roll the windows down for my drive, enjoying the cool air and admiring the peaceful sunrise that has turned the dark sky a vibrant pinky-orange.
As I make my way out of residential Mobile and onto I-65 North, I have a little under fifty minutes of straight highway to cruise.[2]
Flicking on the radio to whatever station pops on first, I sip my coffee and enjoy the last minutes of sunlight in my day.
I turn onto AL-21, passing Coastal Alabama Community College, one of the last buildings I pass before getting to my destination.[3]
I drive another few miles, turning onto Ross Road,[4] finally passing by the sign of the prison, reading: W.C. Holman, Correctional Facility.[5]
The color of the sign matches the blue sky above it.[6] A strangely cheery color.
As the prison comes into view, the familiar feeling of dread starts to settle in.
My hands suddenly feel slick against my steering wheel, and the smell of my coffee is suddenly nauseating.
It’s a hard job, working as a guard here.[7]
I find my parking spot. It’s not technically mine, but I’ve been parking in this same spot for the past three years I’ve been working here, so it’s informally mine.
I picked it because it’s the farthest away from the prison. I get a few extra seconds of fresh air as I head inside.
I make it to the first gate, installed within an imposingly tall barb-wire fence that lines the perimeter of the prison compound.[8]
Once I’m within the bounds of the compound, I take my time heading for another gate, which leads to the prison building itself.[9]
I take my last breaths of fresh air for the day, reminding myself I get to leave once my shift is done.
My black tactical boots are loud on the epoxy floors.
Continuing on, I walk through yet another gate, into the living, working and feeding areas of the general prison.[10] I keep on trekking, finally making it to the gate that leads into where I work: the condemned prisoner subdivision within the isolation unit.[11]
After a few moments, I open the gate into the death row unit, and I hear inmate #148 tapping his feet again.
Inmate #148
I sit in the corner of my cell, tapping my feet.
I am anxiously awaiting what I have been looking forward to for the past twenty-some hours: stepping outside of my cell.[12]
I couldn’t sleep at all again last night, so I’ve been waiting for what feels like forever.[13] My feet are starting to get tired, having tapped away all night long.
I don’t usually sit on the floor all night though. I will usually pace around my cell after I’ve had enough tossing and turning in my bed.
But I’m getting old, so I’ve been pacing less often. The epoxy floors hurt my back, and I get dizzy, having to make a turn every few feet.
Apparently, there are 147 others in here with me.[14] I wouldn’t know though, because the only inmates I interact with are the two guys in the cells to either side of me.
We can speak to each other, but we often run out of things to say.
Over the years here, I’ve tried plenty hard to touch my cell neighbors through the bars.[15] Just to feel another person’s human skin. Human skin that isn’t charged with animosity.
I touch the guards’ skin plenty, as they are putting me in my cuffs, but that’s not the type of human connection I’m looking for.
Even though my thirty minutes of exercise will be in a cage, at least it’s a different cage than this one.[16] Anything is better than these same four walls.
I’m in a better mood than normal today. It’s a special day. I get to leave my cell twice.
I’ll get to leave to exercise, and to see my mom.
I already used my contact visit for the month, so today’s noncontact visitation will have to do.[17]
She’ll be separated from me by an obnoxious metal grid I will have to practically scream through.[18]
Still, the chance to faintly hear my mom’s voice is worth the toll the visits cause me.[19] I’ve lost hope of getting out. My mom though, she hasn’t. It can be painful to watch, and I often leave our visits frustrated.
Inmate #148’s Mom
I pretend like I can hear what he’s saying. I can’t.
But I don’t say anything, because I know it will only upset him if I do. He’s speaking as loud as he can, just short of outright yelling.
Still, his voice isn’t traveling well through the metal grid, and my old ears are not doing me any favors.
I am shocked every time I see him. He seems to have aged years within the few weeks since I saw him last.
If a stranger saw us two side-by-side, they would think we’re the same age.
I can’t see him perfectly through the metal grid, but I can see him well enough to notice he has a strange rash on his inner elbow, and seems to have lost even more weight, which I thought impossible.[20]
I put my concern aside. I have to put on a brave face.
I tell him about the beautiful sunrise I saw this morning, that lit up the sky with an orange sherbert color.
I immediately regret it, feeling like I had been insensitive. It’s a fine line to walk, between relaying information and flaunting it.
I wish my son could come home. I cling to the hope that he will one day.
Guard’s Mom
I can’t wait for my son to get home.
I’ve been trying to hide it from him, but my everyday routines and habits are getting to be impossible.
I haven’t gotten out of bed all day. Making his coffee and packing his lunch this morning was enough activity to keep me bedridden.[21]
Even though I worry about him working at that horrible prison, I’m happy that he’s out of the house most days, so he doesn’t see me like this.
I’m embarrassed to even admit to myself how long it has been since the last time I’ve left this house, since the last time I’ve felt the sun on my skin, or since the last time I’ve felt fresh air in my lungs.
It’s been too long.
I didn’t realize how quickly my normal functioning would go.
I was diagnosed with ALS just a few months ago. I went to the doctor when I started noticing cramping in my hands and feet.[22] I figured it was just a bit of early arthritis.
I was a collegiate gymnast. I assumed the intense practices and grueling physical demands of the sport had finally caught up to me.
I was shocked when the Doctor came in and gave me the diagnosis.
I had to look it up after, because I was in too much shock after hearing the Doctor say I’d have three to five years to live.[23] I didn’t hear anything else he had said after that.
I barely had time to process the news before the disease progressed.
Now, my right arm is completely immobile, and my other arm is getting ready to follow.[24]
I think I may be in a plateau now, though.[25] I’ve been here for the past few weeks, but I’m dreading the impending progression.
I can’t help but fear that I’ll progress to an unbearable point, then hit another plateau, and be stuck. I try not to think about it, but my mind often wanders.
Last winter, I was walking miles in Mardi Gras Parades[26] and running around my classroom, trying to corral my first-grade students.
A year later, my muscle weakness and fatigue is so intense I can’t make it from one end of our small ranch home to the next without taking a break.
It is inconvenient, to say the least, that my room is across the house from the kitchen and living room.
I can only imagine where I will be a year from now.
For the past few days, while John Paul has been at work and while I can still use my left arm, I’ve been doing some research of my own on the computer.
That’s what I’ve been doing in bed all day, interspersed between fitful naps.
I feel horrible for even entertaining the idea, but I’ve been watching videos of people who have chosen to get Medical Aid in Dying (MAiD).[27]
Before all of this happened, I would have been disgusted by someone who would ever even consider such a thing.
I guess it’s true that you don’t know what you’d do in a situation until you’re in the situation. Well, I’m here now, and it doesn’t seem as disgusting as it once did.[28]
This house, and my body, is starting to feel like a prison.
My research is no more than a curious endeavor though. Even if I seriously decided I wanted to pursue MAiD, I wouldn’t be able to.
Alabama doesn’t allow MAiD.[29] I don’t have that choice.
So, instead, I’ve just been researching it, acting like I do.
Guard
There’s an execution this evening. I try not to look at the inmate sitting in the silent cell, awaiting his imminent execution, as I head to the staff room to have my lunch.
It never gets easier. It takes a toll on you, having to see, aid, and complete these executions.[30]
But, I have to find comfort in the deterrent effect of the executions.[31] The death penalty serves a purpose. I have to remind myself of that often.
I don’t know what’s been more painful, though: putting other people to death, or watching my own mother die in front of my eyes.
She tries to hide it, but I can see she’s progressing quickly.
She told me about her diagnosis, but said she’d be Okay. I’ve done some research, and I know she won’t.
That’s why I cherish the hot coffee and lunch bag she hands me every morning as I run out the door.
A sweet ritual we have done ever since I embarked on my first day of school (minus the coffee, of course).
The coffee she makes is too strong, and the lunch she makes is a variation of the same lunch I’ve had every day for the past thirty-some years: a sandwich with tomato, mayo, and some sort of meat, a pack of chips, and blackberries when they’re in season.
It’s not the coffee or the lunch that I really enjoy. It’s the ritual and the effort. A simple act of love and care.
My favorite part is the napkin that’s always sitting inside my brown paper lunch bag. It always has some sort of note written on it.
In middle and high school, the notes used to embarrass me. I’d often immediately throw them out without reading them, scared one of my classmates would catch a glimpse of it.
As an adult though, her notes have become the favorite part of my lunch break.
Recently, I’ve noticed her handwriting has gotten quite poor.
That’s probably because she has started writing with her left hand, since she can no longer use her right (which she thinks I haven’t noticed).
But her left-hand handwriting, which was pretty horrible to begin with, has become illegible.
In the past few weeks, the only thing on my napkins has been a simple smiley face or a heart.
Today, there’s no note on the napkin.
I use it to blot the tears that have suddenly welled in my eyes.
Inmate #148
I used to think about getting out. Part of that thinking was driven by genuine hope, another part driven by a simple desire to be entertained.
But, after so many years here, the thought is painful, a sort of self-inflicted torture that has become unbearable.
I don’t even think about how I didn’t commit the crime I’m in here for.
A whole bunch of things went wrong in my trial. For starters, I was wrongfully identified.[32] The lady who identified me must have thought I looked like whoever did it.
And on top of that, the jury must not have completely bought the prosecution’s story, because two of them voted against the death penalty for me.
Yet, somehow, I’m in here. Somehow a non-unanimous jury got me in here.[33] And somehow all these years of fighting over my wrongful conviction and sentence have proved fruitless.
That’s why my mom still clings to her hope. That’s why she feels okay telling me about the sunrise she saw this morning, or about the delicious dinner she had at a new local restaurant last night.
She still thinks I’ll have a chance to see and experience things like that again. I know better.
Sure, people get off.[34] The system finally realizes their pleas of innocence are legitimate. But I have to tell myself that won’t be the case for me.
I’ll suffer two deaths. One of them I’m living out now, awaiting my execution, and the other will come when I actually die.[35]
Guard’s Mom
What a weird thing to know exactly how you’re going to die, and be able to do absolutely nothing about it.
And it’s exactly the way I feared: without dignity, without a choice.
Inmate #148
What a weird choice it was to decide how I want to die.
Except, recently, I’ve been second-guessing my choice quite a bit.
Rumors have traveled down the cell block about how a string of lethal injections were botched.[36]
I’d rather not know about that.
I’ve been sitting here for years waiting to die, I hope not to suffer through another few hours on the gurney.[37]
Guard
I walk down the cell block, doing yet another headcount. I can’t shake the feeling of guilt I can feel in my stomach.
Last night I needed to use the computer that my mom and I share, so that I could job search.
These past weeks, I’ve hit my breaking point. I have decided I can no longer work in the execution chamber.
I can feel my dissatisfaction with my job turning into something more. I think that “something more” is depression. I’m not exactly sure, but I would rather not find out.
So, I sat down last night for the first time to start seriously looking into other jobs.
But when I cracked open the laptop, I realized my mom’s tabs were still open on the browser.
She’s not very good with technology, so I don’t think she realized she hadn’t cleared out her tabs.
As I went to close out her dozens of open tabs, one caught my eye. My stomach dropped.
It was some map, with the title “Death with Dignity.”[38]
I went to the home page and figured out it was a site advocating for the freedom to choose end-of-life options.[39]
I was confused. I’d never heard of such a thing.
Well, except for in the context of death row, where prisoners can choose their method of execution.
I went to the tab next to it and found an article explaining what “Medical Aid in Dying” is.[40]
I couldn’t read the whole thing, before I started to feel too nauseous.
But the general gist of what I read was that it’s when eligible people can request medical assistance in dying, when they have some sort of serious illness.[41]
Thank God it’s not legal in Alabama.
But why had my mom been looking at these pages?
I felt betrayed and confused, and I immediately went to bed without saying goodnight.
I still feel guilty this afternoon. I feel guilty because I didn’t say goodnight to my mom last night.
I went to bed without making sure she had gotten herself to bed.
When I walked into the kitchen this morning, I saw out of the corner of my eye that she was in the same spot on the couch as when I saw her last night.
Wearing the same clothes as yesterday.
She’ll never admit it, but I know she didn’t just accidentally fall asleep on the couch.
She must be sicker than I had realized.
Inmate #148
After eating dinner, I decide I’m going to head to bed early tonight.
I crawl under my covers as my stomach growls loud enough for my cell-neighbors to notice. I hear them chuckling to themselves.
I do this most nights. Naively getting into bed, hoping for the slight mercy of a restful night. Hoping for an escape into my dreams.
But as I close my eyes, I can feel it’s going to be another sleepless night.
I hang my leg off the side of my mattress and start tapping my foot.
Guard’s Mom
As the sun starts to set, that’s my sign I need to get myself put together.
John Paul will be home from work soon, and I want him to come home to the mom he knows: the one that has the house in order, the one that has provided for him his entire life, the one that always has a smile on, and, at a bare minimum, the one who can change out of her pajamas for the day.
So, I begrudgingly take off my bathrobe, which I have been in all day, and embark on the aggravating journey of getting dressed.
I finally manage to get my head through my sweater, and wriggle my arms in. By the time my pants are around my waist, I’m dripping in sweat, and completely out of breath. I take a seat on the corner of my unmade bed.
After five minutes of fiddling with my pant zipper and button, I give up. My long sweater thankfully hides the fact it’s undone anyways.
With a shaky hand, I put on my signature coral lipstick in the mirror of my bathroom. I turn away from it quickly once I’m done, trying not to dwell on the fact that I’ve gone far outside my lip line.
Guard
As I make my commute home, headed down I-65 South, I sit in silence.
Normally, I always have the radio on for my drives. Sometimes, although I don’t like to admit it, I’ll also scroll on my phone during the drive.
Tonight, I resist the urge to flick on the radio and refrain from pulling my phone out. Tonight, I sit in silence.
As nice as it would be to distract myself from this enduring uncomfortable feeling that has been gnawing at me all day,[42] I force myself to sit in it.[43]
To actually think through it for once.
It’s uncomfortable.
But I resolve to work through this unabating feeling.
.
.
.
I come to the conclusion that this feeling isn’t just about not saying goodnight to my mom last night. It isn’t just about letting her sleep on the couch.
I feel uncomfortable, I realize, because somehow, the state of Alabama is permitted to execute these inmates on death row, yet Alabama prohibits my mom from choosing as to how and when her life will end.
It seems strange that the state is able to condemn people to death, yet force others to endure life.
And I’m part of that inconsistency.
These people on death row deserve it though. They deserve this punishment. I’m not the one who got them where they are, their own choices did.[44]
For some reason though, this justification doesn’t feel quite as convincing as it normally does.
Thankfully I won’t be doing this job for much longer.[45]
Guard’s Mom
I slowly make my way to the kitchen, walking in the direction of the freezer.
After I had received my diagnosis, I didn’t know what to do with all of my nervous energy, so I poured it into cooking. I cooked and cooked and cooked for about two weeks straight.
Thank goodness, because I accumulated a supply of frozen food that I’ve been relying on for the past few months for dinners.
Making John Paul his lunch is one thing, but cooking an entire dinner is another.
As I open the freezer though, I’m worried to see there is only what looks to be enough for about a week’s worth of dinners.
Pretty soon I’m going to need some help.
I startle as I hear the front door open.
Legal Issues Raised by “A Day of Juxtaposition: Punished to Death, yet Forced to Endure Life”
In writing this piece, I endeavored to demonstrate the seemingly inconsistent situation in states, such as Alabama, where the death penalty is permitted, yet medical aid in dying is prohibited.
Permittance of the Death Penalty
In 1976, in Gregg v. Georgia, the Supreme Court affirmed the constitutionality of the death penalty, determining that it was not per se cruel and unusual punishment and was in compliance with the Eighth and Fourteenth Amendments.[46] The Court noted that the social purposes of the death penalty include retribution, “deterrence of capital crimes by prospective offenders,” and incapacitation of dangerous criminals.[47]
So, as the Supreme Court refused to declare the death penalty as cruel and unusual punishment, states are left to “evaluate . . . the moral consensus concerning the death penalty and its social utility as a sanction.”[48]
Prohibition of Medical Aid in Dying
In Washington v. Glucksberg, the Supreme Court considered the constitutionality of Washington’s law that criminalized physician-assisted suicide.[49] The Court found that the Due Process Clause does not protect the right to physician assisted suicide. Thus, Washington’s criminal ban on the practice was Constitutional, as the ban was rationally related to Washington’s interest in preserving human life, protecting the integrity and ethics of the medical profession, and shielding the disabled and terminally ill from prejudice.[50]
The Supremacy Clause guarantees that the minimum protections of the Constitution are available nationwide.[51] While states may not dip below the Federal Constitutional Standard, they are free to recognize additional rights. So, just because there is not a Constitutional right to die, as determined by the Supreme Court, states can nonetheless codify such a right, affording their citizens additional protections.
For example, in Washington, after the Glucksberg decision, citizens exercised their voting powers, and the Washington Death with Dignity Act was passed in 2009. The Act permits terminally ill, mentally competent individuals to be prescribed medication that will end their lives.[52]
The States as Laboratories; Alabama as a Faulty Scientist
On issues that are not constitutionally protected, and on which there is no contrary federal law, states are permitted to make laws and craft policies however they see fit.
As Justice Brandeis has highlighted, states can be seen as laboratories, capable of experimenting with novel social and economic policy, without nationwide risk.[53]
So, on the issues of both the death penalty and MAiD, states are free to perform their functions as laboratories, and the legislators can be seen as the “scientists.”
When looking at either issue in their own silos, rationalization is relatively simple. Death penalty advocates point to various rationales for the practice, including deterrence,[54] and retribution.[55] MAiD critics point to various rationales for the prohibition of the practice, including the contrary oath doctors take,[56] and the opportunity for abuse.[57] However, when looking at the two practices together: allowing the death penalty, while prohibiting MAiD, the support for each practice erodes in this stark comparison.
How can the state government say that they (the state) can kill someone, yet someone cannot make such a choice for themselves? In “A Day of Juxtaposition: Punished to Death, yet Forced to Endure Life,” I endeavored to explore the discomfort one is confronted with when these two contrary values come crashing together (i.e, the feeling of cognitive dissonance).
While the two topics, MAiD and the death penalty, are easily separated by hundreds of pages of statutory language in Alabama’s code, in the real-world, these inconsistencies become strikingly apparent. The real-life implications do not exist in silos, and when they come into conflict, as I tried to demonstrate in “A Day of Juxtaposition: Punished to Death, yet Forced to Endure Life,” it’s uncomfortable, and requires some sort of human action to address this cognitive dissonance.
Both the permittance of the death penalty and the prohibition of MAiD are relatively simple to theorize on and to rationalize. But, practically, these two practices, held side by side, make very little sense together. What is one to do with such an inconsistency?
The first step is recognizing the inconsistency and paying attention to the discomfort it causes. Then comes addressing the issue, to reduce the cognitive dissonance it causes. In “A Day of Juxtaposition: Punished to Death, yet Forced to Endure Life,” the Guard deals with the inconsistency by forsaking one of the values (belief in the death penalty), so they are no longer in conflict. While this is a personal, individualized method to avoid the discomfort of contrary beliefs, it could be dealt with on a larger scale, by crafting legislation that is not only theoretically consistent, but also practically consistent.
[1] Mark R. Janse van Mantgem et al., Prognostic Value of Weight Loss in Patients with Amyotrophic Lateral Sclerosis: A Population-Based Study, 91 J. Neurology, Neurosurgery & Psych. 867, 869 (2020) (finding that 67.5% of 2,420 patients who were diagnosed with ALS between 2010 and 2018 reported weight loss at diagnosis).
[2] Driving Directions from Mobile, Ala. to Holman Prison, Google Maps, https://www.google.com/maps (search starting point field for “Mobile, AL” and search destination field for “Holman Prison”).
[3] Id.
[4] Id.
[5] William C. Holman Correctional Facility, Ala. Dep’t of Corr., https://doc.alabama.gov/facility.aspx?loc=33 (last visited Mar. 25, 2026) (noting that Holman Correctional Facility is Alabama Department of Correction’s primary correctional facility for housing death row inmates and is where all the executions in the state take place).
[6] Gabrielle Caplan, Photograph of a sign for the Holman Correctional Facility, in Chiara Eisner et al., Alabama Executes Man by Nitrogen Gas for the First Time in the U.S., NPR (Jan. 25, 2024, 9:44 PM EST), https://www.vpm.org/npr-news/npr-news/2024-01-25/alabama-executes-man-by-nitrogen-gas-for-the-first-time-in-the-u-s.
[7] See Chiara Eisner, Carrying out Executions Took a Secret Toll on Workers– Then Changed Their Politics, NPR (Nov. 16, 2022, 4:01 PM ET), https://www.npr.org/2022/11/16/1136796857/death-penalty-executions-prison (discussing NPR’s interview of 26 current and former workers, collectively involved with more than 200 executions across 17 states and the federal death chamber. These interviews revealed that most of the workers involved in executions reported suffering serious mental and physical repercussions.)
[8] Robert Johnson, Warehousing for Death: Observations of the Human Environment of Death Row, 26 Crime & Delinq. 545, 546 (Oct. 1980) (giving a first-person account of the physical setting of Holman’s death row).
[9] Id.
[10] Id. at 546-47.
[11] Id. at 547.
[12] Id. at 549 (noting that death row inmates at Holman spend twenty-three and one-half hours alone in their cells, constituting virtual solitary confinement); A Death Before Dying: Solitary Confinement on Death Row, ACLU, 5 (July 2013) https://assets.aclu.org/live/uploads/publications/deathbeforedying-report.pdf (finding, via a survey of death row conditions nationwide, that 93% of states keep their death row prisoners in their cells for 22 or more hours per day).
[13] ACLU, supra note 12, at 6-7 (citing Craig Haney, Mental Health Issues in Long-Term Solitary and ”Supermax” Confinement, 49 Crime & Delinq. 124, 130, 134 (2003)) (noting that trouble sleeping is a consequence of solitary confinement).
[14] Alabama Inmates Currently on Death Row, Ala. Dep’t of Corr., https://www.doc.alabama.gov/DeathRow.aspx (last visited Mar. 25, 2026).
[15] Johnson, supra note 8, at 549 (quoting a death row inmate at Holman: “You can pass objects to each other, and you can virtually touch hands then if you wanted to. . . but that’s as close as we come to each other. At any time– 24 hours a day, 365 days a year– that’s the situation.”).
[16] Id.
[17] Id. at 550 (noting death row inmates at Holman are restricted to one hour per month of contact visitation).
[18] Id. (quoting a death row inmate at Holman: “My wife, she comes and you have got to sit at that hard stool and holler at the top of your voice so that she can hear you because the little holes, they are clogged up with paint and you can’t hear and your voice echoes in the room– you can’t even hear yourself. It would be something different if you could talk without screaming at the top of your voice, you know, and then they only allow you to stay there an hour, too. So it’s the same thing all over again. You didn’t accomplish nothing.”).
[19] Id. (explaining that noncontact visits can leave Holman prisoners feeling emotionally trained and “bitter at how fruitless [their] attempts are to sustain ties with family and loved ones”).
[20] Justin D. Strong et al., The Body in Isolation: The Physical Health Impacts of Incarceration in Solitary Confinement, 15 PLOS One 1, 8 (2020) (finding that skin irritations and weight fluctuation were common types of physical symptoms participants (selected from a random sample of prisoners (n=106) in long-term solitary confinement in Washington State Department of Corrections in 2017) experienced in solitary confinement).
[21] Amyotrophic Lateral Sclerosis (ALS), Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/16729-amyotrophic-lateral-sclerosis-als (last visited Mar. 25, 2026) (noting that symptoms of ALS include fatigue).
[22] Amyotrophic Lateral Sclerosis (ALS), Nat’l Inst. Neurological Disorders & Stroke, https://www.ninds.nih.gov/health-information/disorders/amyotrophic-lateral-sclerosis-als (last visited Mar. 25, 2026) (noting that early symptoms of ALS include muscle cramps).
[23] Supra note 21 (noting that, on average, the life expectancy after an ALS diagnosis is three to five years).
[24] Id. (noting that as ALS progresses, increasing immobility occurs).
[25] R. Vasta et al., Plateaus in Amyotrophic Lateral Sclerosis Progression: Results from a Population–Based Cohort, 27 Eur. J. Neurology 1397, 1397 (Aug. 2020) (“Plateaus in ALS progression lasting at least 6 months appear in about one out of six patients and could last even 12, 18 months or more in a smaller subgroup of patients.”).
[26] Mardi Gras in Mobile, AL, Visit Mobile Alabama, https://www.mobile.org/events/mardi-gras/ (last visited Mar. 25, 2026).
[27] CBS Evening News, A Woman with ALS Shares Her Last Day after Choosing “Medical Aid in Dying”, YouTube (Jan. 31, 2025), https://www.youtube.com/watch?v=jeV3KUoW31U.
[28] Brandon Heidinger et al., International Comparison of Underlying Disease Among Recipients of Medical Assistance in Dying, 185 JAMA Internal Med. 235, 235-36 (Dec. 9, 2024)
(finding, based on data from 20 jurisdictions representing 84,695 MAiD deaths and 12,933,459 total deaths between 1999 and 2023, that, “[b]y condition, the share receiving MAID was highest for ALS (2,967 of 17,631 deaths [16.8%] in all jurisdictions), followed by cancer (122,759 of 3,277,368 deaths [3.7%])”).
[29] Current as of March 24, 2026 in Your State, Death with Dignity, https://deathwithdignity.org/states/ (last visited Mar. 25, 2026).
[30] Letter from Joe M. Allbaugh, Director, Oklahoma Department of Corrections, 2016-2019 et al. to Gentner Drummond, Oklahoma Attorney General (Jan. 13, 2023) (on file with Oklahoma City Free Press), https://freepressokc.com/wp-content/uploads/2023/02/letter-to-drummond.pdf. (A joint letter to the Oklahoma Attorney General was written by nine former senior corrections officials. In this letter, they asked for the pace of executions to slow down, noting that “[p]ost traumatic stress disorder, substance abuse, and even suicide increase among corrections staff following proximity to an execution, even among those who did not participate directly.”)
[31] Deterrence and the Death Penalty, The Death Penalty Project, 5, 6 (2022), https://deathpenaltyproject.org/wp-content/uploads/2022/08/The-Death-Penalty-Project_Policy-Deterrence.pdf#:~:text=Even%20the%20most%20sophisticated%20quantitative%20studies%20have,reviews%20of%20the%20wider%20deterrence%20research%20base. (Despite reports like the Committee of the US National Research Council’s 2012 report, concluding that research to date could not provide any credible evidence of a deterrent effect from capital punishment, notions of deterrence remain influential.)
[32] The Most Common Causes of Wrongful Death Penalty Convictions: Official Misconduct and Perjury or False Accusation, Death Penalty Info. Ctr., https://deathpenaltyinfo.org/stories/dpic-analysis-causes-of-wrongful-convictions (last visited Mar. 25, 2026) (noting that out of 836 homicide exonerations: misconduct was a contributing factor in 68.3% of them; perjury or false accusation was a contributing factor in 68.3% of them; mistaken witness identification was a contributing factor in 24.3% of them; false or misleading forensic evidence was a contributing factor in 23.3% of them; false or fabricated confessions was a contributing factor in 21.8% of them, and inadequate legal representation at trial was a contributing factor in 26.1% of them).
[33] Ala. Code §13A-5-46 (2024) (“The decision of the jury to recommend a sentence of death must be based on a vote of at least 10 jurors”); see also Megan Scarano, Breaking Down Alabama’s Death Penalty Laws as State Executes Inmate by Lethal Injection, ABC 33/40 News (Nov. 17, 2023, 7:54 AM),
https://abc3340.com/news/local/breaking-down-alabamas-death-penalty-laws-execution-inmate-lethal-injection-casey-mcwhorter-st-clair-county-capital-punishment-tapero-johnson-unanimous-jury (noting that Alabama is one of only two states that allows a death penalty sentence without a unanimous recommendation from the jury).
[34] Innocence, Death Penalty Info. Ctr., https://deathpenaltyinfo.org/policy-issues/policy/innocence
(last visited Mar. 25, 2026) (noting that since 1973, 201 death row inmates have been exonerated nationwide, and 7 death row inmates have been exonerated in Alabama specifically).
[35] Robert Johnson, Solitary Confinement Until Death by State-Sponsored Homicide: An Eighth Amendment Assessment of the Modern Execution Process, 73 Wash. & Lee L. Rev. 1213, 1214 (2016) (explaining that many condemned prisoners see themselves as “the living dead” and death row as “a living death”).
[36] Barber v. Ivey, 143 S. Ct. 2545, 2548 (2023) (Sotomayor, J., dissenting) (noting that three lethal injections in Alabama were botched in a row, as “medical personnel in three consecutive executions spent hours repeatedly puncturing prisoners in increasingly painful attempts to locate a vein for an IV line.”).
[37] Id. at 2546 (“[I]n July 2022, [at Holman Correctional Facility,] Joe Nathan James, Jr., was concealed behind a curtain for three hours as medical personnel struggled to establish IV access . . . .[A] state autopsy revealed James had been punctured multiple times, including at both of his inner forearms, wrists, and hands, as well as his right foot. After the curtain between the execution chamber and the observation room finally lifted, observers reported that James was nonresponsive. He never spoke the last words he had allegedly planned.”).
[38] Supra note 29.
[39] We Should All Have the Right to Die with Dignity, Death with Dignity, https://deathwithdignity.org/ (last visited Mar. 25, 2026).
[40] Efua Andoh, Medical Aid in Dying Brings a Compassionate Close to Life, 56 Monitor on Psych. 58 (2025).
[41] Id.
[42] Alexandre Bran & David C. Vaidis, On the Characteristics of the Cognitive Dissonance State: Exploration Within the Pleasure Arousal Dominance Model, 60 Psychologica Belgica 86, 86 (2020) (explaining the Cognitive Dissonance Theory, which proposes that humans experience psychological discomfort when “they are confronted with inconsistent cognitions”).
[43] April McGrath, Dealing with Dissonance: A Review of Cognitive Dissonance Reduction, 11 Soc. & Personality Psych. Compass e12362, 4 (2017) (explaining that distraction allows individuals to “divert their attention away from their dissonant cognitions and avoid the negative affective state caused by dissonance”).
[44] Id. at 5 (demonstrating that “the denial of responsibility may be a particularly appropriate way of reducing dissonance associated with feelings of shame and guilt”).
[45] Id. at 6 (noting that changing one’s behavior is “a major route of dissonance reduction . . . [yet it] requires effort and is often not the most convenient way to reduce dissonance”).
[46] Gregg v. Georgia, 428 U.S. 153, 168-187 (1976).
[47] Id. at 183 n.28.
[48] Id. at 187.
[49] Washington v. Glucksberg, 521 U.S. 702, 705 (1997).
[50] Id. at 728, 731-32, 735.
[51] U.S. Const. art. VI, cl. 2.
[52] Wash. Rev. Code § 70.245.010–.904 (2024).
[53] Gonzales v. Raich, 545 U.S. 1, 42 (2005) (O’Connor, J., dissenting) (citing in part New State Ice Co. v. Liebmann, 285 U.S. 262, 311 (1932) (Brandeis, J., dissenting) (“One of federalism’s chief virtues, of course, is that it promotes innovation by allowing for the possibility that ‘a single courageous State may, if its citizens choose, serve as a laboratory; and try novel social and economic experiments without risk to the rest of the country.’”)).
[54] Supra note 31, at 6.
[55] Thomas E. Robins, Retribution, the Evolving Standard of Decency, and Methods of Execution: The Inevitable Collision in Eighth Amendment Jurisprudence, 119 Dick. L. Rev. 885, 889 (2015) (explaining that retribution serves as a constitutional rationale for the death penalty).
[56] Dallas R. Lawry, Rethinking Medical Aid in Dying: What Does it Mean to ‘Do No Harm?’, 14 J. Advanced Prac. Oncology 307, 309 (2023) (explaining that the Hippocratic Oath doctors take, to do no harm to their patients, has ties to the debate regarding the ethics of MaiD, as some doctors see assisting a patient in ending their life as murder or suicide).
[57] D. Benatar, A Legal Right to Die: Responding to Slippery Slope and Abuse Arguments, 18 Current Oncology 206, 206 (2011) (noting that an argument “invoked by opponents of a legal right to die is the argument that such a right will be abused and that no legal safeguards can prevent that abuse”).
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