I have to preface this article with an admission. I had a lot to do with how this article turned out. Columnist Tim Steller called Diane Coleman Friday (Nov 1) afternoon wanting to interview her about an upcoming visit to the area by Derek Humphry, who would apparently be talking about assisted suicide for people with “mental illness.” Humphry is, of course, one of the founders of the Hemlock Society. He also runs his organization ERGO – which sells materials related to assisted suicide and euthanasia. Most importantly, as far as this story is concerned, Humphry is the Chair of the Final Exit Network Advisory Board. The Final Exit Network is a group of underground assisted suicide vigilantes who “help” people commit suicide with plastic bags and helium and then clean up the scene to make it look like the deceased individual died a natural death.
All of the above is relevant and important to any story about Derek Humphry discussing assisted suicide for people with mental health issues in Arizona. See, what was probably the most notorious case involving the Final Exit Network was in Arizona – and it involved a woman named Jana Van Voorhis. Van Voorhis had no serious physical health issues, but had a long history of emotional troubles.
When I talked with Steller, he was vaguely aware of the Van Voorhis case, but remembered none of the particulars. He wasn’t familiar with the Final Exit Network and was unaware of Humphry’s role in the group.
It went like this: We discussed an email that Humphry sent to the area promoting two talks he’d be giving in which he spends a lot of space talking about assisted suicide for people with mental health issues. I said that Arizona was a curious choice to push that particular envelope. Steller didn’t have any idea it would be significant. That’s when I explained the history of the Jana Van Voorhis case, the Final Exit Network, and even some less-than-compassionate comments by Humphry on the subject that appeared in a documentary. Accordingly, I sent him links to articles and videos about the Final Exit Network, Humphry, Vanvoorhis, and some other material – much of which is used in the article. I also had my own reactions, which don’t appear in the article, but which I’ll add after discussing the article linked and excerpted below, along with some other thoughts. Steller’s column was published in the November 3rd edition of the Arizona Daily Star.
From the column “Right-to-die advocate pushes new frontier”:
Announcing his visit to Tucson for two Nov. 23 presentations, Derek Humphry, a pioneer in the movement for legal assisted suicide, broached this shocking notion: assisted suicide for those suffering from mental illness and unable to get better.
The idea, he said, came from his long experience in the movement. As right-to-die advocates have become more visible in their fight to establish physician-assisted-suicide laws, people with mental illness have been increasingly approaching Humphry and others seeking what he called “positive help” — in other words, assistance in killing themselves.
“From their point of view, the suffering is as great as a person dying of a physical illness,” he wrote in the announcement of his Tucson presentations. “And it probably is! They argue a terminal patient knows soon death will bring about the end of pain, whilst they are condemned to a lifetime of suffering. They report they have endured long hours of therapy and used mountains of prescribed medications. Still they would prefer death, they say.”
Tucson is an important place for Humphry, who rose to prominence with his 1975 book, “Jean’s Way,” about his first wife’s death by suicide in the face of terminal breast cancer. He founded the Hemlock Society in 1980, and Tucson was the first place in America with a local chapter.
When I spoke to Humphry Friday, he wasn’t willing to advocate directly for the idea and said it won’t be the thrust of his presentations here, but instead explored how and if it would work.
“If ever people wanted to pass laws for the mentally ill,” he said, “it would be done most carefully. There would have to be long record of treatment of illness for the individual” before suicide assistance would be permitted.
Humphry’s disclaimer seems disingenuous at best. The email that went out promoting his talks consisted mostly of a copy of a 2009 blog entry by Humphry (I tracked the source using google) titled “Realistically, assisted suicide for the troubled is not available“. There’s just a relatively few sentences at the end talking about Humphry’s former ties to the area and where he’ll be appearing. Since the column’s publication, Humphry has gone farther in denying he’s pushing the envelope in regard to “mentally troubled people” in messages to his “right to die email list“. For example, in a message containing Steller’s column, a note is included from Humphry: “D H writes: I have never pushed, or even suggested, for assisted suicide for mentally troubled people, as this headline and article imply. Terminal or hopeless illness is my field. It is sufferers and journalists who constantly put the ‘mental’ question to me.” Personally, I think he’s protesting way too much – anyone receiving the promotional email I was shown would expect Humphry to be talking and promoting the topic of expanding assisted suicide “eligibility.”
In his column, Steller reported reactions from 3 people regarding expanding the idea of assisted suicide as an “option” for people with mental health issues: a man identified as having bipolar disorder and who runs supports groups; a psychiatrist; and the sister of Jana Van Voorhis, the woman who died with the “help” of the Final Exit Network. All of them think it’s a very bad idea. He also writes:
The issue is not just hypothetical. An American advocate of assisted suicide, George Exoo, claimed in a British documentary to have assisted more than 100 people in killing themselves, including a severely depressed Irish woman and others with mental illness. Irish authorities issued an arrest warrant, and he was arrested by FBI agents, but his extradition was denied.
The link is to the first of nine parts of a 2008 documentary by Jon Ronson that aired on the BBC. It has never been aired in the United States.
At about 4:30 into this video segment Derek Humphry – one of many people interviewed by Ronson – talks about getting calls from people without serious physical issues. The transcript of his remarks are below. They don’t exactly reek of compassion, but seem to express annoyance with having to deal with these callers – and a lack of concern regarding whether or not they live or die:
Once or twice a week I get very strange people on the telephone and they’re anxious to commit suicide because of their depression or their sad life or something. When you get one of these people gets on to your number they want to talk talk and call again call you adjectives and pursue you … and they call all the other right to die groups.and they would say ‘oh we can’t help you it’s not really in our parameters, but George Exoo will probably help you’. You see, and that gets them off the phone and on to George.
If you’re able to watch and hear the video, Humphry’s dismissive and callous demeanor comes across even more clearly through tone and body language. I recommend seeing the entire documentary, in fact. Exoo – the main subject of the documentary – is still out and about. And the parts featuring other “right to die” leaders aren’t exactly flattering to them.
Back to Steller, now on the Final Exit Network and Jana Van Voorhis:
In April 2007, members of the Final Exit Network — inspired by Humphry’s 1991 suicide self-help book, “Final Exit” — assisted Phoenix resident Jana Van Voorhis in killing herself. Van Voorhis, 59, had long suffered from mental illness, her sister, Viki Thomas, told me Friday. They helped her kill herself anyway.
In 2009, then-Maricopa County Attorney Andrew Thomas brought charges of conspiracy to commit murder against the group. One man, Final Exit’s then-medical director, was acquitted at trial, but the other three pleaded guilty to lesser charges.
Humphry, who chairs the Final Exit Network’s advisory board, told me Friday the group acknowledged “that was a blunder on their part.”
“She said she was terminally ill and described her terminal illnesses,” Humphry said. “The Final Exit Network accepted that. If they had investigated, they would have found she was mentally ill, not terminally ill.”
As I reported at the beginning of this post, Steller had no idea that the VanVoorhis suicide had anything to do with what he was writing before he talked to me. He might not have caught up enough on all the details to properly fact-check Humphry. The statements from Humphry regarding the Final Exit Network and Van Voorhis go beyond misleading – they’re pretty close to outright lies. There was no “blunder.” And, in fact, the “exit guides” had been told that her claims had been investigated by their so-called “medical director,” Lawrence Egbert. Here is some info on that from the transcript of “The Suicide Plan,” a documentary aired on PBS on the series Frontline:
WYE HALE-ROWE: She certainly had disordered communication and it took some work to help her complete the sentences, but she certainly had thinking behind it. Sometimes an illness itself has some cognitive components, and people have difficulty communicating.
And so my concern about her cognition was, does she understand the consequences of what she is requesting? Does she understand finality? Does she know what’s going to happen? And she explicitly knew.
But it was deeply disappointing to find out, for me, that none of those physical diagnosis, medical diagnoses, were real, and that this had not been validated by the medical committee of Final Exit Network.
TOM THOMAS, Jana Van Voorhis’ Brother-in-Law: The man that was supposed to be the medical director of this Final Exit Network organization received actually nothing from any medical personnel, nothing from a hospital, nothing from a doctor. He received a little handwritten thing about her exposure to rat poisoning, bugs eating her, and some of the illnesses she did have over the previous 20, 25, 30 years.
How this so-called medical director didn’t say, “Something is really wrong here. Let’s— let’s step back, let’s take a look at this lady and see what’s really wrong with her”— How that happened is— I don’t know. I don’t know.
LAWRENCE EGBERT, Medical Director, Final Exit Network 2004-2009: We accept, at least theoretically, any individual patient with a disease that’s causing unacceptable suffering, by their definition, not by our definition, and that, of course, would include mental diseases.
Jana Van Voorhis, it was so clear what her problems were. It was also very clear, even on paper, that she’d done a lot of suffering for a lot of years. I was told she wanted to die, and then evaluated the case, thought it was acceptable, and wrote “accepted,” told the coordinator that she was accepted medically, and that’s all I did.
Wye Hale-Rowe, one of the defendants who agreed to a plea bargain, obviously felt misled by Egbert, who in turn seemed to be doing very little “medical evaluation” at all.
As to reactions from the sister of Jana Van Voorhis, they’re mentioned, in part, here:
While Thomas objected to Final Exit’s helping her sister kill herself, she said something surprising Friday that made me stop and wonder: “She’s in a better place, I know that.”
That comment, similar to many people trying to come to terms with a tragedy, leads to an “epiphany” of sorts for Steller, that runs counter to all of the lousy history, negative reactions and hasty retractions associated with this type of expansion of the – to put it euphemistically – the “right to die.”:
That, in a nutshell, is what makes Humphry’s flawed suggestion worth talking about at all — the suffering of people with serious mental illness is real and torturous enough that sometimes death seems better than life, even to loved ones. It might be a discussion worth having if we were doing the more basic work of ensuring that seriously mental ill people get the treatment they need.
Not only does this conclusion go contrary to most of the rest of the article, but the two sentences contradict each other.
Which brings me back to other parts of my discussion with Mr. Steller. I described assisted suicide rhetoric as being an unholy mix of both libertarian and paternalistic arguments – on the one hand, “people should end their lives how and when they want” but OTOH “they need help to make sure they don’t have to deal with an undesired outcome.” These two stances are normally diametrically opposed.
For NDY’s part, we’re against any public policy that sanctions the encouragement and facilitation of some suicides, while treating the suicides of other individuals as “preventable tragedies.” I added that disability activists were far more concerned with the excesses exercised in terms of suicide prevention – with people’s lives and bodies being violated by forced treatment and institutionalization. And that there are many people in the movement who have experienced such harm at the hands of the mental health system that they’d rather die than be within its control again.
And how about those suicide prevention groups? I’ve already written about the political, ethical and moral cowardice they’ve exhibited through their collective silence in terms of the promotion of suicide for old, ill and disabled people. Will they maintain their silence on this topic? It seems less likely, if only for the most cynical reasons – Too many careers and financial interests involved in diagnosing, labeling and treating (even if its unwanted) people with “mental health” issues.
Obviously, whether or not Derek Humphry wants it to be a major topic when he hits Tucson later this month (now that there’s been fallout), it’s almost assured it will be at the top of the list of things people want to talk about. Stay tuned.
Click here for exhaustive NDY coverage of the Final Exit Network.
Click here for NDY coverage of George Exoo.
It never ceases to amaze me how the media has since a hard time understanding why people with disabilities are opposed to assisted suicide. I really wish they would stop pandering to the idea that the lives of disabled people are so miserable that we all want to die.
As someone who considers himself to be a political progressive/liberal, it absolutely appalls me that for some weird reason, assisted suicide seems to have been adopted as some type of liberal or progressive position.
How in the hell did that happen, and how can we combat it?
The fact is – neither the conservatives nor the progressives (and most of my personal politics fall in the latter camp) see disabled people as much more than their own personal nightmares who dare to present ourselves in broad daylight. Both communities have their ways of devaluing us.
As for how the left got there… Well, many lefty disability activists were slow to get on board for fear of being associated with right-wingers. There’s an interview with Lennard Davis – disability scholar and critic of Not Dead Yet – in which this comes across pretty well. Alas, while Davis alleges that NDY and other disability activists conflate “disability” and “terminal,” he’s voiced no such criticism of pro-assisted suicide advocates really conflating the two.
As for “what else can we do?” – Stay tuned – we may have opportunities coming up in the months ahead that go beyond letter writing, blogging, etc.