Russell Bucklew, shown in an undated photo, was scheduled to be killed by injection on Tuesday but was spared for now. (Jeremy Weis Photography/AP)

For the second time in his life, the murderer Russell “Rusty” Bucklew has been spared from execution at the last possible moment because the U.S. Supreme Court could not abide the manner of the execution — at least not yet.

The lawyer for the 49-year-old Missouri inmate argues that injecting a lethal drug would risk rupturing rare tumors on Bucklew’s head, likely causing him to “choke and cough on his own blood.”

A bare majority of Supreme Court justices voted to stay Tuesday’s execution, the Associated Press reported.

Four years earlier, the court reached much the same conclusion.

In the spring of 2014, Bucklew was scheduled to be the first person executed in Missouri since a botched lethal injection in another state one month earlier. That inmate, in Oklahoma, had convulsed, bled and writhed in anguish for 43 minutes before finally dying of a heart attack.

Bucklew had been in prison for decades, winding his way to the end of a long appeals process, like many death row inmates.

Those who would kill him tended to cite the brutality of his crime. As a young man in 1996, the Associated Press wrote, Bucklew had stalked a woman to her boyfriend’s trailer, shot the man dead, tried to shoot a fleeing child, then handcuffed the woman, dragged her into a car and raped her. He wounded an officer in a subsequent gunfight.

Bucklew later escaped from jail and attacked his rape victim’s mother with a hammer before he was recaptured.

A lawyer called him “the most purely evil man I ever prosecuted” as the courts wrangled over Bucklew’s execution in 2014, according to the St. Louis Post-Dispatch.

Weighing against lethal injection, however, was a rare medical condition that Bucklew was born with, The Washington Post wrote at the time. Vascular tumors partially covered his head, neck and throat. They were untreatable, his lawyers argued, and likely to react to drugs in a way that would make the Oklahoma inmate’s botched death seem almost serene.

“I’m sick about it not working on me; I’m afraid that it’s going to turn me into a vegetable, that I’d be brain dead,” Bucklew told the Guardian shortly before his death date in May 2014.

With public confidence in the death penalty falling, the case seemed to have no easy answer.

As Robert Barnes and Mark Berman wrote for The Post, an appeals court panel stayed Bucklew’s execution, only for a higher court to order it proceed, only for the Supreme Court to order the case kicked back down for another review by lower courts.

Bucklew’s lawyer was thrilled at the time. She could now argue that her client’s medical condition made lethal injection a cruel and unusual punishment.

Four years and another round of hearings later, everyone was pretty much back where they started.

Bucklew would have been the first prisoner in Missouri executed since January 2017, had it gone through as planned, the AP wrote. But one of his tumors had grown larger since 2014, defense lawyers said, to the size of a grape.

On Tuesday night, protesters stood outside the Boone County Courthouse, the Missourian reported. A few days before, the Kansas City Star editorial board had urged clemency, pointing to apparent flaws in Bucklew’s original defense, along with his illness.

“The crimes of Russell Bucklew are heinous,” the board wrote. “He deserves to die in prison, but not by the hand of Missouri.”

And so again, at the last minute, a reprieve came. The governor has not commented on Bucklew’s request for clemency.

“We are thrilled and relieved and look forward to continuing to work with Rusty,” defense attorney Cheryl Pilate told the Star after the stay was announced.

If rulings keep going Bucklew’s way, the AP writes, Missouri may need to use gas to kill him.  It’s a legal method in the state, but would likely require building a gas chamber and resurrecting an execution method not used since before the inmate was born.

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