Idaho’s Department of Correction announced a significant shift in execution procedures on Tuesday, revealing that death row prisoners may now face lethal injections via central veins located in the groin, neck, chest, or arm if conventional intravenous (IV) access fails. This brutal adjustment comes in the wake of a failed execution earlier this year, where eight attempts to find suitable veins in a prisoner’s limbs were unsuccessful.

Central line injections: A last-resort measure now formalized

While the state had always considered central venous lines a backup option, they had never been used due to concerns about protecting the condemned individual’s dignity. However, after February’s botched execution of Thomas Eugene Creech, Idaho prison officials have been forced to revisit the practice. Creech, a death row inmate, survived an execution attempt after eight failed attempts to insert an IV into veins in his arms and legs.

Failed execution prompts changes

The failed attempt to execute Creech, who has been on death row for over 30 years, sparked legal challenges from his defense team, who argued that a second attempt would violate protections against cruel and unusual punishment. These claims were dismissed by a judge in September. In response to the controversy, Idaho has begun renovating its execution chamber to accommodate central venous line insertions in a manner that can be publicly witnessed, as required by law.

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A new procedure for lethal injections

Under Idaho’s revised execution protocol, if prison officials cannot establish a standard peripheral IV line, a doctor will perform the procedure to insert a central venous catheter. These are larger veins that can be accessed through short surgical procedures, usually in the groin, neck, or chest.

This new procedure addresses both practical and legal concerns. Idaho is one of the few states that mandates public witnessing of the entire execution process, including the insertion of IV lines. The 9th U.S. Circuit Court of Appeals made this ruling in response to lawsuits filed by the Associated Press and other media organizations, arguing for increased transparency.

Witness access and safety concerns

To maintain witness access while protecting the inmate’s dignity, Idaho will now allow media and other witnesses to observe the insertion of the central line via a closed-circuit camera system, while the actual procedure will be performed in a separate room. Once the catheter is inserted, the inmate will be moved to the main execution chamber for the final stages of the lethal injection.

In contrast, many other states, such as Texas and Oklahoma, conduct the IV insertion process in areas hidden from public view. The Idaho Department of Correction’s new approach is intended to maintain transparency while adhering to legal requirements.

Challenges and risks with central venous lines

While peripheral IV lines are relatively straightforward to establish, requiring only a simple needle stick, central venous catheters involve significantly more risk. The veins targeted for these lines are located close to critical arteries and organs such as the lungs, meaning the procedure must be conducted by a doctor with specialized training. Improper needle placement could result in life-threatening complications, including arterial bleeding or collapsed lungs.

Idaho’s move to formalize this procedure has already sparked debate over the ethical and practical implications of such a method, with many pointing to the increasing difficulty states are facing in carrying out lethal injections.