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Death Sentences

Why This Physician Testifies in Favor of the Firing Squad

James Williams is an ER doctor, a hunter, a gunshot victim — and the go-to expert for death row prisoners seeking an alternative to lethal injection.

An older White man with white hair and a beard, wearing a white medical coat and blue shirt, stands in front of a window.
Dr. James Williams, an emergency room doctor in Abilene, Texas, has become a leading courtroom expert on the firing squad.
Dr. James Williams, an emergency room doctor in Abilene, Texas, has become a leading courtroom expert on the firing squad.

The Trump administration recently pledged to help executioners across the country secure lethal injection drugs. But many drug companies still refuse to sell them, so some state officials are looking at other options. This week, Alabama plans to carry out its fourth nitrogen gas execution in roughly a year. And the firing squad is also emerging as a likely contender. South Carolina presented it as an option to the last three men executed in the state; none chose it. Idaho lawmakers are talking about making it their default method. And Trump himself reportedly mentioned the method on the campaign trail last year.

Executioners have only turned to guns a handful of times in the last century. The last time was in Utah in 2010. But recently, in at least 10 states, death row prisoners said they would prefer the firing squad over other options. They’re doing this because 10 years ago the Supreme Court ruled they needed to suggest such alternatives in order to fight lethal injection.

At the center of these legal debates sits Dr. James Williams. Born in Canada and based in Texas, he is now arguably America’s leading expert on the firing squad. He has appeared in courtrooms across the country to testify about the method’s effectiveness — always on the side of prisoners, never the state. His expertise is based on a career spent treating gunshot victims, teaching police how to shoot more effectively, and competing in shooting competitions. Before all that, he survived a gunshot himself.

Our conversation last year — edited here for length and clarity — came at a fraught moment for him. He had come to believe that his testimony in several states about specifics like bullet choices may have influenced South Carolina’s new firing squad protocol. A spokesperson for the South Carolina Department of Corrections declined to confirm this, but it opens Williams to criticism from death penalty opponents that he’s helping executioners.

It remains unclear why the three men in South Carolina declined the method, but Williams told me he hoped his work helped them make those “very difficult decisions,” and his goal is not to advocate executions; it’s to minimize suffering.

You were once introduced in court as an expert in the firing squad, and the judge responded, “I’m not sure what that means.” How did you get here?

A friend in the firearms community introduced me to death row public defenders, and I had the right resume: I had trained police and military on how to shoot more effectively, keeping up with the research on wound ballistics. I also dealt with countless gunshot wounds as an emergency room doctor.

In 2016, some men on death row were thinking about asking for the firing squad, but wanted to know what would happen when the bullets hit their body. I met with two of them. I felt a sense of privilege, to meet them face-to-face as human beings and say they do not need to fear a prolonged and painful death as they might with a lethal injection. I said, in effect, “You’ll be OK. I mean, you’ll be dead, but you’ll be OK.”

Why is the firing squad more effective?

Going back to the Napoleonic wars, the focus was always shooting at the heart. There is a lot of evidence that the near-instant loss of blood pressure means no blood gets to the brainstem, and there is a rapid loss of consciousness. You see it as well with the applied lateral carotid neck restraint, the so-called chokehold, where loss of consciousness can come in three to five seconds.

I interviewed several U.S. military field medics who witnessed men shot in the heart at very close quarters, and they said, in every case, the victim stopped moving purposefully within a few seconds and did not vocalize or express that they were experiencing pain. In 1938, during a firing squad in Utah, a doctor monitored the man’s heart activity, and it stopped entirely 15 seconds after the shots were fired.

And you were shot yourself, right? Is that relevant to your knowledge?

I was 18, growing up in Calgary, Alberta, and my friend was drunk and pointed a .22-caliber pistol at my face. I told him it was loaded, and he thought I was joking and fired. I twisted away, and it hit me in the clavicle and penetrated my trapezius. I had nightmares and stopped using guns myself for a few years.

But in terms of the gunshot itself, I did not experience pain for two to three hours. At first, it felt like a hard blow to my chest and shoulder area, followed by an unpleasant tingling sensation. I can’t say it’s completely painless in every case, but I’ve asked patients since then and some compare it to a hard tackle in football.

This adds to my perception that it will be less painful than other methods of execution. An even more effective way to guarantee there is no pain would be to aim for the brain or brainstem. That might be more effective biologically, but it’s more grisly and unpleasant from society’s perspective.

You mean a bullet to the head?

Or the guillotine. There isn’t a lot of research, but if you’re measuring the encephalogram of mice that are decapitated, their brain function drops very quickly — a disruption within a couple of seconds and no brain function soon after. There were accounts written during the French Revolution. One physician said a person continued to blink — meaning to show brain activity — for 15 or 16 seconds, which I find not believable given what we know now. It was probably three to four seconds.

And lethal injection takes at least two minutes, if it isn’t botched entirely.

I thought the original arguments for lethal injection were sound, drawing on how we euthanize dogs and cats to try to be more humane. But then anti-death penalty activists lobbied companies to stop providing drugs. I think the motivations were honorable, but it meant states came up with cocktails that weren’t as effective. I also think prison agencies are trying to do the right thing, given the handicaps they now have, but people end up lingering in distress due to ineffective drugs.

To me, the key question of the firing squad is why we’ve avoided it.

This is really a cultural question. The method was long associated with dignity and honor in the military, often used for deserters. At the same time, there is a long historical thread of people wanting vengeance: In the Middle Ages, we were disemboweling people, and more recently in the U.S., executions were public entertainment.

When I see how popular true crime content is today, it makes me think that we still remain fascinated by death. But today there is a sense that we don’t want to confront executions directly or look death in the eye. That’s an abrogation of our responsibility as citizens, to know what happens in our name and to consider it rationally. Is giving a guy drugs that don’t work so he is in agony for 40 minutes or longer better than the firing squad?

On the other hand, I met the son of a firing squad member, who said the experience scarred his father forever. He was critical of me, the idea that I was facilitating firing squads in a sense.

Are you?

I told him that the state is going to execute these men, and I feel my role can be to ensure that these men suffer as little as possible, which is in keeping with my professional values.

I’ve wanted to be a physician since I was little, growing up in rural Canada, where my pediatrician was inspiring, the way he loved kids. I realized that you have to see patients as human beings, but I disagreed with peers in medical school who said their only role was to save lives. My role is actually to relieve suffering, not always stop death.

When I was 5, on our family farm, I saw my uncle stick a knife in a pig’s throat, and it kicked and screamed in a pool of blood. It bothered me. But the next year, my father said, “No, we’re using a gun,” and boom. The pig fell over, and I felt relief. I saw you could make death an easier passage.

I haven’t testified for the state, and I wouldn’t design a protocol. When it comes down to it, I am mostly opposed to capital punishment. Perhaps there are some who need to be killed, though I haven’t met one yet. But we as a society have more options than we used to, like life without parole, which I also think might be more horrific for some than death.

But now South Carolina may go through with it, possibly drawing on your opinions. How do you feel?

The feeling isn’t good or bad — it’s a watercolor, still wet. I can feel good that perhaps I helped prevent a botched firing squad. I feel bad because there will be a dead man, and that will happen either way, but I want him to die with as little pain and suffering as possible.

South Carolina says the prisoner will be hooded and strapped to a chair. Three volunteer corrections employees will fire through an opening in a wall. Witnesses will be behind bulletproof glass. Can something go wrong?

The possibility always exists. Utah had executed 41 people by firing squad since the 1850s, and only two were botched. In one case, they failed to tie the man down, and he tried to flee as they shot him. In another, the firing squad members did not shoot at the heart, as they’re required to do, because they wanted the man to suffer. But put another way, when the written protocol was fully followed, none were botched, which speaks strongly to the reliability of this method. Utah had four loaded rifles and South Carolina will use just three, along with a blank, which should be adequate. But there’s the possibility a shooter is not adequately trained, or faulty ammunition.

We know that carrying out an execution can be traumatic. Do the dynamics differ with a firing squad?

We don’t know. But people will have a hard time witnessing this. We know the gas chamber and electric chair are quite gruesome and cause very adverse effects, and I think the firing squad may be more like those methods than lethal injection.

Frankly, most Americans have never seen an animal be killed, much less a person. With all of my experience killing animals on the farm as a child, and in a lifetime of hunting, along with my ER experience, death still has an effect emotionally.

I train law enforcement to shoot more effectively, and we talk a lot about the doctrine of competing harms, that sometimes you have a finite amount of time to respond with deadly force to prevent harm to others or yourself. Some officers appear to have less trauma when they believe their own lives are on the line. But this is the opposite. There will be a sense of agency and complicity [among the executioners], and not just for them but for the witnesses too.

Maurice Chammah Twitter Email is a staff writer and host of the podcast “Just Say You're Sorry,” as well as the author of “Let the Lord Sort Them: The Rise and Fall of the Death Penalty.” He writes narrative features on a range of criminal justice subjects, including the death penalty, forensics and art and music by incarcerated people.