What Humphry considered an act of love could legally be considered an act of manslaughter. In 1961, when Britain’s Suicide Act decriminalized suicide and attempted suicide, it added a law that made aiding and abetting a suicide a felony, punishable by up to fourteen years in prison (thus making it a crime to help someone commit an act that was itself not a crime). When a journalist asked the police what they intended to do about Humphry, who in the book and in television and newspaper interviews freely admitted he had helped his wife kill herself, an investigation was launched. Eventually, the public prosecutor dropped the case for “lack of evidence.” Privately, he admitted that he had been moved by the book and thought Jean had been extremely brave.
In 1979, when Jean’s Way was published in the United States, where Humphry and Wickett had moved, there was an even greater furor. Humphry told his story on Donahue, 60 Minutes, and Good Morning America. He received hundreds of letters, many from people who wanted to know what drugs Jean had taken and how to procure them. Humphry was struck by how many people faced situations similar to the one he and Jean had faced and who had nowhere else to turn. He combed through newspaper clippings at the library of the Los Angeles Times, where he now worked. “I saw case after case just as compassionate and loving as mine, where people had been prosecuted for aiding and abetting a suicide,” he recalls. Humphry felt there should be some sort of organization to help these people. He resigned from his job and organized a meeting of twenty experts in the field of death and dying: professors, lawyers, doctors, social workers, and nurses. He described his goal of a society dedicated to legalizing active voluntary euthanasia for the terminally ill and asked who would be willing to join. “They were all in favor in principle, but they said they couldn’t get involved,” says Humphry. “They were afraid of how it would reflect on their professional practices.” Some feared for their safety. “My God, they firebomb the houses of pro-abortion people,” said one attorney. “What do you think they’ll do to us?” Nevertheless, on August 21, 1980, Humphry held a press conference to announce the formation of the Hemlock Society, named for the poison that Socrates used to commit suicide. There were four members: Humphry, Wickett, lawyer Richard Scott, and Gerald Larue, a professor of religion at USC. The fledgling organization would operate out of Humphry’s Santa Monica garage.
Ten years later, operating out of an office in Eugene, Oregon, and boasting a staff of eight, the Hemlock Society had forty-six thousand members and eighty-one chapters across the United States. Dedicated, as its letterhead said, to “supporting the option of active voluntary euthanasia for the terminally ill,” the society had two goals: to educate the public about right-to-die issues and to change U.S. laws to make it legal to assist the terminally ill to take their own lives. To that end, the society published books (including Common-Sense Suicide, an apology for elderly suicide by Hemlock member Doris Portwood, and Double Exit, Ann Wickett’s study of double suicides); edited the Euthanasia Review, a scholarly journal; issued the Hemlock Quarterly, a newsletter keeping members abreast of the movement; produced a thirty-minute educational video on euthanasia, available for sale or rent to colleges as well as to Hemlock members “for home use”; distributed more than 1 million copies of the Living Will and Durable Power of Attorney for Health Care; issued a wallet-size card on which members could specify their medical wishes in case of an accident; and advertised its work in such diverse publications as the New York Times Book Review, Science Digest, Lancet, and Hustler. (Only two publications, the Gray Panther newsletter and Modern Maturity, refused to run Hemlock ads.)
As its executive director and the public face of the organization, Humphry spent much of his time spreading the word. Lugging a briefcase crammed with Hemlock books, brochures, and membership applications, he spoke wherever he was invited: high school and college classes, retirement communities, hospices, nurses’ training courses, and professional conferences. (For a time Hemlock employed a Hollywood publicity agent to book Humphry on radio and television shows.) As a former journalist, Humphry knew the power of the press and how to court it. He published a collection of news clippings on right-to-die cases and sent journalists yellow Rolodex cards, their tabs labeled DEATH/DYING, with a list of topics, from “Pulling the Plug” to “Double Suicide,” on which he was prepared to give “background and quotes.” Humphry admitted that his efforts may have appeared overly gung ho. “I’m a street fighter, not a philosopher,” he told me. “I’m trying to change public opinion.” As he addressed Hemlock members in a fund-raising letter, “Your good end in life is our concern! Please help us to help you achieve it.” He promised that as soon as the laws changed to permit doctors to help terminally ill people take their lives, Hemlock would, as he put it, “commit corporate suicide.”
At its height, Hemlock received some 230 letters and phone calls each day, most of them requests for membership applications, living wills, and books. Not surprisingly, Hemlock also received desperate appeals from people in harrowing circumstances: a man whose wife was dying of cancer and wanted the name of a pharmacist who would supply her with a lethal dose; a woman who had just been told she was terminally ill with pancreatic cancer and said she must know where to get drugs immediately; a woman who had hoarded a supply of barbiturates and wondered whether such and such an amount was enough to kill her. Callers frequently offered Humphry money to help them end their suffering. “I’ve been offered as much as ten thousand dollars to go into their home and sit with them while they die,” Humphry told me. “One woman offered me her Cadillac if I would help her. It’s a measure of their desperation. They say, ‘Jean had you, I’ve got nobody, you must help me.’”
When such help was requested, Humphry never actively intervened or provided specific information about dosages. Not only was he mindful of the legal danger—in giving such information he could have been charged with aiding and abetting a suicide—but it went against his moral grain. “I never tell anybody what to do or what not to do, but I will discuss with them the pros and cons of their situation,” he told me. “How serious is their illness? Does their spouse know? Have they told their doctor of their plans? How long do they think they can hang on? Are they willing to go into the hospital again? Most people appreciate being able to talk this over with somebody. But it is for the individuals and their associates to make the decisions and carry out whatever actions they choose.” Humphry often referred callers to local hospices for palliative care, or to lawyers for legal advice. Occasionally, people who appeared emotionally disturbed called or wrote. “We tell them we can’t help them, and they would be wrong to join this society,” said Humphry. “We suggest that they seek help from a therapist or a crisis intervention center because mental illness can be curable. In addition, a mentally ill person can go and kill himself whereas a terminally ill person is often physically incapable of taking his own life.” In 1988, the year before inventing his Mercitron, Jack Kevorkian approached Humphry and offered to open a clinic in Los Angeles to which terminally ill Hemlock members might be referred for assistance in dying. Humphry told Kevorkian he preferred trying to change the law to breaking it.
Many people assumed that Hemlock members must be radical leftists, lonely depressives, or morbid weirdos. But according to membership surveys, Hemlock members represented an average cross section of Americans except that they were apt to be older, wealthier, better educated, and whiter. They ranged in age from nineteen to ninety-eight, with an average age of sixty. Two out of three members were women—not surprising, given that in the United States there are four times as many widows as widowers. The membership included more than two hundred doctors. Only one in twenty Hemlock members was terminally ill. Some joined because of a philosophical belief in the right to die. Others joined to obtain practical information about euthanasia in the event that they became incapacitated. “Hemlock is my insurance policy against pain, senile old age, and loneliness,” wrote one member. The majority joined because they had seen someone close to them die in ext
reme pain and suffering and were determined not to let it happen to them.
Hemlock members also joined because the society acted as a support group. Members could attend not only their local chapter meetings but Hemlock’s biennial national conferences, which had the pep and can-do atmosphere of any professional convention, as I found when I attended Hemlock’s Second National Voluntary Euthanasia Conference in 1985. In the Starlight Room of the Miramar Sheraton Hotel in Los Angeles, a ballroom-size space accustomed to hosting bridal shows and car dealers’ conventions, 240 Hemlock members who had come from as far away as New York, Chicago, and Fort Lauderdale sat at tables draped with gold tablecloths, listening attentively (some taking notes in Hemlock-provided notebooks) to two days of speeches and workshops on such topics as “Memorial Societies and Funeral Prearrangement,” “How Euthanasia Was Legalized in Holland,” “The Law and Euthanasia,” and “The Sexual Needs of the Terminally Ill Person.” Anyone expecting Hemlock to behave like a typical special-interest group with an ax to grind would have been surprised by the roster of speakers, which included several opposed to suicide. Edwin Shneidman pushed suicide prevention in the keynote address. Stephen Levine, a Buddhist therapist, meditated before the audience in the lotus position before urging them to “meet pain with love instead of fear” and to resist the temptation to leave their bodies “in an angry, self-hating manner.” At the pro-suicide end of the spectrum, German surgeon Julius Hackethal screened a videotape that showed him giving cyanide to a sixty-nine-year-old woman suffering from terminal cancer. In his presentation, “Medical Questions in Euthanasia,” Colin Brewer, an English psychiatrist, said, “I want to urge upon you the values of the humble plastic bag. People seem to feel it has certain aesthetic objections. But in combination with even a smallish dose of sedative drugs, it does in fact form a very effective method of ending life because it’s essentially a belt-and-braces policy.”
As Brewer’s advice suggests, the emphasis at Hemlock conferences was not on the philosophical but on the pragmatic. During coffee breaks members were apt to be discussing the shelf life of certain drugs, the optimal wording of living wills, the names of medical textbooks containing tables of lethal dosages, and the ingredients of what some called the “recipe”—what drugs to take for a swift, painless death. Although there was also talk of active, happy lives—it was not uncommon to see people proudly showing photos of their grandchildren or discussing upcoming vacations—each person had come to the conference with a story and a need to tell it. “I have lymphoma of the bones,” said a man in a wheelchair. “I’m forty-four. The average age of the patients in my nursing home is seventy. There are people dealing with me that have no training. People are allowed to be in pain. They are put in positions that are painful, and their pleas for medication are often ignored. I came here because I was thinking of ending my life, and I don’t know how to do it.”
The man with lymphoma could have found out how to end his life by buying one of Hemlock’s “how-to” manuals. Although Humphry would have preferred that doctors be allowed to supply the information and assist in the death, since that was—and is—illegal in all but a few corners of the world, he believed that people who took the matter into their own hands were in need of some practical guidance. In 1981, Hemlock published Let Me Die Before I Wake, a hundred-page “book of self-deliverance” for the dying, in which Humphry told the stories, down to the specific drug dosages used, of seven terminally ill people who had taken their own lives. Burying the dosages within the stories, Humphry said, forced a person to read the book and partake of Hemlock’s message of nonviolence, advance planning, and sharing. It also lessened the likelihood of legal problems. (Let Me Die was addressed to terminally ill people. Those contemplating suicide for other reasons were urged to speak to their family, friends, physician, counselor, minister, or suicide prevention center.) When Let Me Die was first published, its sale was limited to Hemlock members of three months’ standing. In 1982, spurred by appeals from people who said they needed the book immediately, and knowing there had been no evidence of misuse, Hemlock decided to make the book available to the public. Eventually, Let Me Die Before I Wake, described by 60 Minutes as “the bible of the euthanasia movement,” would sell some 150,000 copies. Doctors and hospice administrators called Hemlock to request copies for patients who asked about euthanasia, and the book was a popular item at libraries. The Los Angeles Public Library told the author it was their most frequently stolen book; eventually, Humphry noted proudly, they were forced to keep it “under lock and key.” Among those who took their lives with the help of Let Me Die Before I Wake—Humphry estimates the number to be in the thousands—was an elderly Florida gentleman with a brain tumor who ended his life after several months of keeping the book under his pillow.
Many readers, however, grumbled that they had to do too much reading. “The biggest complaint about the book comes from little old ladies who don’t want to dig through all the words to find the information,” Humphry told me. “They skim the book and say, ‘It’s too difficult—all I want is the little pill.’ I tell them there is no such thing as The Pill. I tell them to read the book again, take notes, underline the important bits. Or I’ll say, ‘Page sixty is what you want.’ I don’t say what’s on the page, I just say read page sixty.” Prodded by such complaints, Hemlock finally printed a brief, easily understandable toxicity chart in the Hemlock Quarterly with lethal dosages listed for seventeen drugs. “Only for the information of terminally ill, mature adults,” it warned. “Keep this document in a secure, private place.”
Eventually, Humphry decided to take things, as he put it, “one step further,” by writing Final Exit: The Practicalities of Self-Deliverance and Assisted Suicide for the Dying. Following a poetic epigraph from Keats—“Now more than ever seems it rich to die, / To cease upon the midnight with no pain”—Final Exit cut to the chase, albeit in fourteen-point type for the convenience of readers with failing eyesight. In a no-nonsense fashion that called to mind Dorothy Parker’s poem “Resume” (“Razors pain you / Rivers are damp . . .”), Humphry evaluated more than a dozen possible methods, including shooting (“messy”); hanging (“ugly and extremely traumatic for your loved ones”); car exhaust (“high chance of discovery”); poisonous plants (“risky and painful”); household chemicals (“painful in the extreme”); charcoal cooking fires (“too uncertain”); freezing (“a method for which I have respect”); nonprescription drugs (“a prescription for disaster”); self-starvation (“not as easy as it sounds”); cyanide (“difficult to secure”); injecting air into the veins (“most unsatisfactory”); and electrocution (“Unless you are an ingenious and accomplished engineer . . . definitely not advised”). The book’s recommended technique? An overdose of barbiturates (“the drug of choice in self-deliverance”) accompanied, just to make sure, by a plastic bag. “If you are repulsed by the addition of the plastic bag, then you must accept a ten percent chance that by some quirk you will wake up, and will have to try again,” Humphry wrote. “With the bag, it’s 100 percent certain.” In a chapter forthrightly titled “Self-Deliverance Via the Plastic Bag,” Humphry offered not only practical advice (“It is very important that it be firmly tied around the neck with either a large rubber band or a ribbon. No more air must come in”), but personal philosophy as well (“Should you use a clear plastic bag or an opaque one? That’s a matter of taste. Loving the world as I do, I’ll opt for a clear one if I have to”).
To obtain the drugs, Humphry suggested asking one’s physician directly, or requesting two separate barbiturate prescriptions on different dates. He also offered advice on how to shop for a sympathetic doctor; gave tips on how to store lethal drugs; warned readers to check their insurance policies; outlined a suggested suicide note; and weighed in on miscellaneous matters of protocol. “If you are unfortunately obliged to end your life in a hospital or motel, it is gracious to leave a note apologizing for the shock and inconvenience to the staff. I have also heard of an individual leavin
g a generous tip to a motel staff.” The book concluded with a checklist for potential self-deliverers, from (1) “Be sure that you are in a hopeless condition. Talk it over with your doctors one more time” to (16) “Make the preparations for your end extremely carefully and with consideration for others. Leave nothing to chance.”
Published in March 1991, nine months after Kevorkian had hooked up Janet Adkins to his suicide machine, Final Exit created a sensation, spending eighteen weeks on the New York Times best-seller list, selling over a million copies (Katharine Hepburn had two, one for each nightstand), being translated into ten languages, and inspiring numerous letters of thanks from survivors of those who had taken their lives with the book’s help.
But Final Exit also reached a subset of readers whose friends and families were not so grateful. In 1993, in a report published in the New England Journal of Medicine, researchers compared the number of asphyxiation deaths by plastic bag in New York City for one-year periods immediately before and after the publication of Final Exit. The number jumped from eight to thirty-three, an increase of 313 percent. A copy of Final Exit was found at the scene of nine of the suicides; in six other cases, there was clear evidence that the deceased had taken their own lives with the information from the book. In most of the fifteen cases linked to Final Exit, there was no evidence of terminal illness; in six cases, an autopsy could find no illness of any kind. Nationwide, the number of cases of asphyxiation by plastic bag rose from 334 to 437, an increase of 31 percent. Although the total number of suicides did not increase over that time, suicide prevention experts worried that, despite the book’s warning, on page 123, that “this information is meant for consideration only by a mature adult who is dying,” it would, inevitably, be misused by depressed, impulsive, suicidal people who were not terminally ill—such as the young California woman whose thirteen-year-old daughter found her dead, a plastic bag over her head and a copy of Final Exit, pertinent passages highlighted, nearby. Humphry seemed to consider such deaths a kind of collateral damage. “This misuse I regret but can do nothing about,” he wrote in Final Exit’s third edition, published in 2002. “Suicide has always been endemic in mankind; some of us do not have the emotional and intellectual equipment to cope with a lifetime of troubles—real and imagined—and elect to die. Self-destruction of a physically fit person is always a tragic waste of life and hurtful to survivors, but life is a personal responsibility. We must each decide for ourselves.”
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