Joseph Ernest Atkins was born in June 1947 in South Carolina. As an infant, he was adopted by Benjamin Frank Atkins and Gladys Atkins and raised in North Charleston. His upbringing was marred by abuse; his adoptive father frequently beat and berated him, and his older half-brother, Charles Edward Atkins, physically assaulted him. On one occasion, Charles stabbed Joseph in the stomach, necessitating surgery. Joseph also witnessed his adoptive father's abuse of his mother, which he believed contributed to her death from a brain tumor when he was 15.​

In the late 1960s, Atkins served in the Vietnam War, fighting near the borders of Cambodia and Laos. He experienced intense combat, witnessing killings and mutilations, and hearing the torture of captured soldiers. He returned to the U.S. in October 1969 and was awarded the Vietnam Campaign Medal, the Vietnam Service Medal, and the National Defense Service Medal.​

On December 31, 1969, Joseph and his half-brother Charles, 23, were visiting a friend's house when they got into a fight. Joseph left, retrieved a shotgun from his adoptive father's house, returned, and fatally shot Charles. He was indicted for murder in March 1970. A plea deal for manslaughter fell through when Joseph claimed self-defense, leading to a trial where he was found guilty of murder and sentenced to life in prison. In 1980, after his adoptive father advocated for his release, Joseph was paroled and returned to North Charleston.

On October 27, 1985, while intoxicated, Atkins broke into his neighbors' house armed with a machete, a shotgun, and a revolver. He fatally shot 13-year-old Karen Patterson as she slept and chased her mother back to his own house, where he then killed his adoptive father, Benjamin Atkins. He was arrested the same day. In June 1986, he was convicted of the two murders and sentenced to death. After a failed appeal for clemency, Atkins was executed by lethal injection at Broad River Correctional Institution on January 23, 1999. He declined to make a final statement.​