Thursday, March 12, 2009

Final Exit arrests bring more attention to assisted suicide debate

This NY Times article includes comments from the disability rights group and assisted suicide opponents, Not Dead Yet:

ATLANTA — An undercover state investigator told a right-to-die network that he wanted to kill himself. In response, he later testified, officials of the network planned to have him asphyxiate himself with a helium-filled face mask while holding down his arms.

After an investigation, four officials of the group, known as the Final Exit Network, were arrested last month on charges of racketeering and assisted suicide.

The arrests raised questions about whether the group, which has helped some 200 people commit suicide since 2004, merely watched people take the leap into death, or pushed them over the edge.

Officials with the Georgia Bureau of Investigation say the network, which says it has 3,000 dues-paying members in the United States, actively takes part in suicides, an act that is illegal in every state except Oregon and Washington. “The law is clear, and they violated it,” said John Bankhead, a spokesman for the Georgia bureau.

The arrests followed an inquiry in which an investigator posed as a cancer patient and persuaded network members to help him prepare to commit suicide.

According to the agent’s affidavit, network members instructed him to buy a helium tank and a plastic “exit mask.”

Thomas E. Goodwin, who was the network president at the time, and Claire Blehr, a member, planned to hold down the agent’s hands while helium flowed into the mask, the affidavit says. The agent would lose consciousness within seconds and die within minutes, and the guides would remove evidence from the scene.

“They went through a dry run just to let the agent know what would happen,” Mr. Bankhead said. “Mr. Goodwin got on top of the agent and held down both of his hands,” which investigators say would have prevented him from removing the mask if he had changed his mind during a real suicide.

Georgia authorities arrested Mr. Goodwin and Ms. Blehr, and Maryland officials arrested the group’s medical director, Dr. Lawrence D. Egbert, and a regional coordinator, Nicholas Alec Sheridan, for authorizing member suicides.

The network, based in Marietta, Ga., says it provides only lawful instruction and emotional support, and only to patients with incurable diseases or tremendous suffering.

“Assisted suicide is Jack Kevorkian putting a needle in someone with a deadly substance,” said Jerry Dincin, (pictured) who became the network president after the arrests. “We provide information that we think is protected under the First Amendment.”

A 1994 Georgia law defines assisted suicide as “direct and physical involvement, intervention or participation” in a deliberate suicide and carries a five-year prison sentence.

The arrests have thrust the little-known organization into the national spotlight. Since its founding in 2004, the network has neither shunned public attention nor received much of it. A registered nonprofit organization, the group runs a Web site, promotes a suicide manual by Derek Humphry, the chairman of the network’s advisory board, and belongs to the World Federation of Right to Die Societies.

Network literature says members receive services including “counseling, support and even guidance” on suicide, in exchange for an annual $50 fee.

The group also sends trained “exit guides” to provide comfort and instruction during a suicide but is adamant that members buy their own materials and conduct the suicide themselves. While political and educational groups like the Death With Dignity National Center and Compassion and Choices work with lawmakers to advance physician-assisted suicide, the Final Exit Network ministers directly to the suicidal.

Other groups are concerned that the network will portray the movement negatively.

“People don’t want to do this underground or covertly, with hushed tones, with great risks to themselves and their loved ones,” said Barbara Coombs Lee, the president of Compassion and Choices, which supports end-of-life decisions. “They want to have their physician involved. They want hospice care involved. They want their family there without shame or risk.”

If brought to trial, legal experts say, the case against the network could clarify the distinctions between the lawful act of witnessing a suicide and the illegal act of assisting one.

The Supreme Court ruled in 2006 that states can set their own laws on suicide
assistance. But experts say the term “assistance” can be difficult to define.

“You have some in our society saying this action is a crime,” said William H. Colby, a lawyer and fellow of the Center for Practical Bioethics. “You have others saying this is such an important right that it rises to the level of our Constitution.”

Mr. Humphry said the network’s protocols were deliberately written to avoid illegality. “The person does everything themselves,” he said. “They don the hood. They tie it around their neck. They reach forward. They turn on the gas.”

Guides often hold a dying person’s hands, he said, but for support, not restraint.

Supporters are concerned that the network arrests will set back the right-to-die movement. Mr. Kevorkian, the Michigan pathologist who served eight years in prison for second-degree murder for assisting a suicide, issued a statement on Tuesday through his lawyer supporting the right to physician-assisted suicide but condemning its practice by “ordinary citizens” in the network.

Opponents of assisted suicide were harsher.

“These are people who instead of pulling you back from the ledge, they shove you off,” said Stephen Drake, a research analyst for Not Dead Yet, an advocacy group for the disabled that opposes assisted suicide. “Legally, we may not know what this means. But in a personal sense, it can mean the difference between life and death.”

The investigation began after relatives of a Georgia man, John Celmer, who committed suicide in June, told the police they believed that the network had taken part in Mr. Celmer’s death.

Mr. Celmer’s mother said her son had long suffered from mouth and throat cancer, but Georgia investigators said he had overcome the disease by the time he killed himself and was instead embarrassed about a facial disfigurement.

His wife, Susan, issued a statement of gratitude to the law enforcement officials who “pursued this matter vigorously.”

Mr. Dincin, the network president, said Mr. Celmer deserved the right to end his suffering.

“There are millions of people who think what we do is just awful,” Mr. Dincin said. “They think we shouldn’t touch a person’s natural course from living to dying, but I think people have a right to decide for themselves.”