Dig Deeper: Assisted Suicide in America

In this May, 12, 2011 file photo, Oregon State Sen. Floyd Prozanski shows a "suicide kit" consisting of the book "Final Exit," plastic tubing and a plastic bag with a collar that fits over a person's head at his Capitol office in Salem, Ore. The Oregon House has voted to make it illegal to assist another person in committing suicide, a move that targets so-called suicide kits that can be bought on the Internet. The House's 52-6 vote Monday, June 13, 2011, sends the bill back to the Senate, which unanimously approved it last month but must sign off on changes made in the House.

Photo: Oregon State Sen. Floyd Prozanski shows a "suicide kit" consisting of the book "Final Exit," plastic tubing and a plastic bag with a collar that fits over a person's head at his Capitol office in Salem, Ore. (AP/Don Ryan)

February 7, 2012

Yesterday, the Georgia Supreme Court ruled that a 1994 state law criminalizing the promotion of assisted suicide is unconstitutional under the First Amendment. The case involved a lawsuit brought by four current and former members of the right-to-die group Final Exit, who were charged under the law after correspondence and other written material was found in the home of John Celmer, who committed suicide in 2008.

John Celmer had cancer. After two surgeries, the cancer was gone, but he was left with a painful hole in his jaw. He couldn’t eat; his food had to be blended into milkshakes. Here’s the story of Celmer and his wife Sue, and how their lives intersected with members of Final Exit:

Final Exit

By Charles Bethea, Atlanta Magazine (March 2010)

“He still had Sue and the kids, and for as long as he could work, he had his laundry job and the customers and neighbors he made smile. He had faith, too, which is no small thing. But he didn’t have the same body he had before he went into the operating room. Instead, he had a body he barely recognized, with a whole new set of seemingly intractable problems. He took the morphine and codeine he was prescribed. He self-medicated with nicotine and beer. In October of 2007, John found the website of the Final Exit Network, an end-of-life advocacy group that believes it is fighting the last great civil rights battle: the human right to a death with dignity. He clicked the site’s icon that read “Exit Guide Services” and, from that moment on, began actively pursuing his own death. This, FEN officials say, is what he wanted. He never mentioned it to his wife.”

One of the Final Exit members charged in Georgia was Dr. Lawrence Egbert, who once served as the organization’s medical director. He no longer faces charges in Georgia, and was acquitted in an Arizona assisted suicide case last spring:

After the Death of Jack Kevorkian, Lawrence Egbert is the New Public Face of American Assisted Suicide

By Manuel Roig-Franzia, The Washington Post (January 2012)

“Egbert estimates he has been present for 100 suicides in the past 15 years, a figure that puts him in the same league with the famed assisted-suicide maverick Jack Kevorkian, who claimed to have helped more than 130 people die. Egbert calls Kevorkian a “radical” because the latter took an active role in some suicides, building a machine to administer lethal doses and sometimes injecting patients himself. Egbert sees his work as a calling, a vocation aimed at ending suffering. But he says he provides only guidance and support.”

Kevorkian’s vocal presence, in fact, was the reason Georgia’s 1994 law was passed in the first place. Here’s a glimpse into his legal battles, almost 20 years ago:

Death Becomes Him

By Jack Lessenberry, Vanity Fair (July 1994)

“For years, [Kevorkian attorney Geoffrey] Fieger had insisted that “no jury will ever convict Jack Kevorkian.” Indeed, polls consistently showed Kevorkian with strong support in Michigan, generally around 60 percent. And his fame is nationwide: 94 percent of Americans know who he is; only the president and First Lady have higher name recognition.

But assisted suicide is much more complicated than the polarized debate over Kevorkian, who passed away last June at the age of 83. Take this argument from bioethicist Ezekiel Emanuel, who served as special health care adviser to President Obama. Emanuel rejects some of the “myths” around physician-assisted suicide, including that advances in medical technology that keep sick people alive unnecessarily and that pain relief is the primary reason people seek assisted suicide:

Whose Right to Die?

By Ezekiel J. Emanuel, The Atlantic (March 1997)

“The proper policy, in my view, should be to affirm the status of physician-assisted suicide and euthanasia as illegal. In so doing we would affirm that as a society we condemn ending a patient’s life and do not consider that to have one’s life ended by a doctor is a right. This does not mean we deny that in exceptional cases interventions are appropriate, as acts of desperation when all other elements of treatment — all medications, surgical procedures, psychotherapy, spiritual care, and so on — have been tried. Physician-assisted suicide and euthanasia should not be performed simply because a patient is depressed, tired of life, worried about being a burden, or worried about being dependent. All these may be signs that not every effort has yet been made.”

In 1997, a few months after this article was published, the U.S. Supreme Court ruled that the Constitution doesn’t guarantee the right for physician-assisted suicide; that decision should be left up to individual states. Currently, two — Oregon and Washington — have Death With Dignity laws on the books. Montana ambiguously opened the door for such a law in 2009, and both Vermont and Massachusetts have potential bills in the works.

Some Americans have sought physician-assisted suicide abroad. One of the most prominent international organizations is Dignitas, run by Ludwig Minelli in Switzerland. Switzerland is generally seen as having the most liberal assisted suicide laws in the world, allowing it since the 1940s. Minelli has helped more than 1,000 people end their lives since 1998, but not without controversy:

Death Becomes Him

By Bruce Falconer, The Atlantic (March 2010)

Minelli’s vision was never confined by lines on a map. “I have always been convinced that the right to die is, in fact, the very last human right,” he says. “Why should I be able to tell a Swiss lady suffering from breast cancer with metastases that Dignitas will help her, but tell a French lady with the same condition just on the other side of the border that we will not?” So it was that, among the five suicides he assisted in the following year, one was an elderly German woman named Maria Ohmsberger, the first foreigner to die at Dignitas. Minelli had crossed the Rubicon.

Craig Ewert, an American citizen we profiled in our 2010 film The Suicide Tourist, ended his life with the guidance of Dignitas. Ewert, who was diagnosed with ALS, crossed the Atlantic with his wife, Mary, and allowed his experience to be filmed. In light of the decision in Georgia, it’s a timely and deeply personal window into one man’s decision to die. You can watch the film here.

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