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Even then, Stephens may still have to determine whether putting an inmate to death without a doctor's assistance is constitutional. That issue is at the heart of this debate and has derailed the death penalty in nine other states, including Florida and Tennessee.

North Carolina's debate, with its shades of meaning, different venues and competing and seemingly contradictory execution procedures, can be confounding. Here's what preceded Tuesday's meeting:

* Last year, a federal judge allowed executions to proceed because a doctor was tracking inmates' consciousness on a brain-wave monitor.

* Then, the Medical Board forbade doctors from doing anything more than being present at an execution.

* Last month, lawyers for inmates with pending executions went into state court saying that, without a doctor, prison officials could not guarantee an inmate was fully sedated before lethal drugs were injected. Therefore, they argued, the execution would be unconstitutional.

* To comply with the new medical ethics policy, prison officials told the federal judge that a nurse would watch the brain-wave monitor and the doctor would monitor the patient in case of a medical emergency. If anything went wrong, they said, the doctor would tell the warden to stop the execution and the doctor would provide medical assistance.

* The inmates' attorneys say this latest manifestation of the protocol is illogical because the doctor would have to step in to save an inmate in the process of being killed.

Regardless of how Stephens rules, the losing side will appeal, and the resulting litigation may go to the North Carolina or U.S. supreme courts. And at any point, lawmakers could change the law.

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