The Near Death Experiences of America's Executioners

Death row staff are often untrained and unprepared for the monumental task of taking a life

When Frank Thompson became superintendent of the Oregon State Penitentiary in 1994, he was prepared to do whatever was necessary to meet the expectations of his job—including conducting executions. Thompson had accepted the death penalty, however flawed, in his opinion, as part of the criminal justice system.

“You hope you never have to perform in that role,” says Thompson, who served as a military police officer during the Vietnam War and later as a patrol officer. “But I was ready. I was a professional, and I was trained and capable of doing my job. I realized that this [conducting an execution] could happen.”

And, it did. Eighteen months later, Thompson was tasked with conducting Oregon’s first execution in 34 years. When he was notified, he discovered that the protocols were for execution by gas, not lethal injection. No one at the correctional facility had ever participated in an execution, so Thompson had to rewrite the procedures and train an execution team.

“I actually had to train the executioner,” Thompson explains. “I had him sitting over a bucket of water repeatedly depressing the syringe to learn how to administer the lethal injection.”

Few corrections officers enter the field expecting to participate in state-sanctioned executions. Thompson, with his military and law enforcement background, had been trained to use lethal force under very narrow circumstances. Now, he was calling upon volunteers—individuals who didn’t have his experience or training—to enter a room and take a man’s life.

The weight Thompson’s team felt, as they prepared for the state’s first death by lethal injection, was insurmountable. Although four years had passed, the gruesome botched execution of Ricky Ray Rector in nearby Arkansas cast a dark shadow across the industry. There were eight additional botched executions between the time Rector was put to death and when the day arrived for Thompson’s team to carry out the sentencing of murderer Douglas Franklin Wright in September of 1996.

A Mother Jones headline from 2014 claimed, ‘State Executioners: Untrained, Incompetent, and “Complete Idiots.”’ Thompson, intimately familiar with those who step inside the death chamber, says the people on an execution team are usually “decent men and women” and “people we stand in line with at the grocery store or sit next to at church.” But he’s quick to point out that these are not people trained to kill. When it comes to lethal injection, these are also not people specifically trained to perform intricate procedures such as venous access.
The simple fact that we do have unqualified, non-medical personnel attempting procedures like venous access is almost a disregard for human life—both the prisoner’s and those on the execution team.
Typically, lethal injection is administered using peripheral IVs in the arms, which, in theory, is much like a blood draw—except the catheters are broader and the person does not wake up. When peripheral access cannot be established,' a central line can be inserted in veins through the neck, chest or groin. A report published in The Postgraduate Medical Journal  cautioned that, “Peripheral venous line placement can be difficult [even in a hospital setting]” and “Central venous line placement is not to be undertaken lightly as a substitute for difficult peripheral venous access. The procedures involved usually require a high level of operator skill.”

Wright’s execution went as cleanly and humanely as possible under the laws and ethics set by the state of Oregon. But the margin for error is high, and human error can play a significant role when an execution goes wrong.

Between 1890 and 2010, roughly 3 percent of U.S. executions were botched. Lethal injection had the highest rate of botched executions (7.12 percent). “Lethal injections require medical skills,” says Michael L. Radelet, a professor of sociology at the University of Colorado-Boulder who has published research and testified as an expert on death penalty issues.

Although a physician must be present at an execution to pronounce death, that’s where the line is usually drawn. Radelet says most doctors will not participate in the process of administering a lethal injection—something the American Medical Association and other professional groups consider highly unethical—even when things go wrong. So, we task corrections personnel, employees who are already feeling the weight of one of the most stressful jobs in the United States, with the responsibility of performing this tricky procedure. “In most cases, the problems with lethal injections arise from the inability of an executioner with little training to find a good vein for the insertion of the catheter,” Radelet explains.

Austin Sarat, a professor of jurisprudence and political science at Amherst College and author of Gruesome Spectacles: Botched Executions and America's Death Penalty, says, “It is very difficult to put someone to death in the way in which we now ask these prison guards.” Aside from the inability to gain venous access, because of the absence of appropriate medical training, other problems persist with lethal injection. There have been instances where the strap-down teams have fastened the leather restraints so tight that the flow of chemicals have been restricted. Other times executioners administered the wrong dosages of specific drugs, inserted IV lines into soft tissue rather than veins, or did not sufficiently anesthetize a prisoner before the painful drugs were administered.

“You’ve got to get the drugs right. You’ve got to get the dosages of the drugs right. You have to find usable veins. You have to deliver the lethal chemicals. It’s turned out that this procedure [lethal injection] is difficult to get right,” Sarat warns.

February’s botched execution of Doyle Hamm of Alabama is the most recent, and perhaps the most profound, example of what can go wrong during a lethal injection.

Hamm, who was sentenced to death for the 1987 murder of a hotel clerk, presented an atypical case—one that even an anesthesiologist, with decades of daily experience placing catheters into veins, deemed would be complicated, if not impossible. Hamm’s attorney, Bernard Harcourt, had warned officials that his client had deeply compromised veins and lymph-node abnormalities from illness and years of drug use and any attempt to place an IV line for a lethal injection would likely fail. He argued that this could violate a constitutional protection against cruel and unusual punishment.

After a final appeal was denied, the state of Alabama went forward with Hamm’s execution on the night of February 22, 2018. For more than two hours, the execution team struggled to find a viable vein in Hamm’s legs, ankles, and feet, puncturing him at least a dozen times. When they couldn’t gain peripheral access, they attempted to insert a central line through his groin, most likely puncturing Hamm’s femoral artery as well as his bladder. The execution was finally called off around midnight.
With corrections officers, they almost always breach their personal belief systems, possibly infringing their First Amendment rights, when taking part in an execution.
“No lethal injection protocol, or no vision of what I would call standard operating procedure for lethal injection, would entail being jabbed all over your body for hours to try to find a usable vein,” says Sarat.

Hamm survived the ordeal and immediately filed a civil rights action. In a written statement, Harcourt said the procedure amounted to torture and provided clear evidence that lethal injection causes Hamm the kind of “needless and severe suffering” prohibited by the Eighth Amendment. He also stated that a second execution would be a violation of the Fifth Amendment, which forbids the government from putting any person “in jeopardy of life or limb” twice for the same offense. Hamm has since settled with the state in a confidential agreement and will not face another execution attempt.

One of the mysteries surrounding Hamm’s botched execution is who attempted venous access. As with most lethal injections, the identities and qualifications of the execution team members are shrouded in secrecy and shielded by law. It’s possible that some physicians break their Hippocratic Oath and take part in the process, which could explain why the curtain is often not drawn for witnesses until the catheter is in place and the lethal chemicals are ready to go. There are also documented cases where EMTs and nurses have assisted with lethal injections. Even so, according to a Human Rights Watch report, “Most lethal injection protocols say little or nothing at all about the training, credentials, or experience required of persons who will be on the execution team, either the person who inserts the catheter or the persons responsible for injecting and monitoring the drugs.”

Corrections is plagued with shortages and a field with one of the highest employee turnover rates. Executions are also not a daily or weekly occurrence in most states. Those on an execution team are probably not seasoned veterans. At the very least, they’re not honing their skills everyday like other professionals. So, it seems unconscionable, morally corrupt, that we would ask them to perform lethal injections, knowing how complicated they are to administer and how tricky they become when prisoners have exacerbating medical conditions or compromised veins. The simple fact that we do have unqualified, non-medical personnel attempting procedures like venous access is almost a disregard for human life—both the prisoner’s and those on the execution team. Both suffer to some extent. And both, it would appear, have certain civil liberties violated.

With prisoners, recent cases suggest that when mistakes happen, botched executions would almost certainly become akin to torture and would seemingly violate the Eighth Amendment. Yet, court rulings suggest otherwise.

“While many would argue that the problems with lethal injection indeed qualify as cruel and unusual punishment, the Constitution is not violated unless the Supreme Court says it is violated,” says Radelet. “To date, there have been few signs that most members of the Supreme Court have concerns with these blundered cases.”

With corrections officers, they almost always breach their personal belief systems, possibly infringing their First Amendment rights, when taking part in an execution, according to Thompson. Thompson has also written about how they are placed in a situation where they cumulatively face PTSD, alcoholism, domestic violence and broken homes. After the execution of Wright, Thompson says his staff immediately began to show signs of psychological distress.

“Somehow or another, we get so angry at the person on the gurney, that we want to go in there and personally slit their throat. We’re so angry, that we think little or nothing about the men and women in uniform that we’ve commissioned to do that and what that might cause them,” says Thompson. “Believe me, killing somebody is no small task.”

Photo credit: Aceross Lord

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