Emails and memos show corrections officials struggling to reconcile their duty to provide medical care with the political ramifications of spending thousands of dollars for surgery on a man they plan to execute. A key problem was security issues that led several hospitals to balk at treating inmate Robert Foley.

Foley, 55, was convicted of killing six people in Kentucky in 1989 and 1991, making him the most prolific killer on that’s state’s death row.

His attorney, James Drake, said the state must care for condemned inmates. Foley, who has been on death row since 1993, can’t get around without help because he’s at risk of falling and hurting himself. “If you’re on death row, it’s just like anybody else,” Mr Drake said. “If you need a new hip, you need a new hip. It hurts.”