Pros: Well laid-out, clear, practical; subject matter treated with compassion and sensitivity. Clarifies legal aspects.
Cons: Readers will find it necessarily depressing.
The Bottom Line: A useful guide for those considering ending their life as because of terminal illness, a debilitating handicap and/or intense suffering. Does not offer solutions for chronic depression.
heidifromoz's Full Review: Derek Humphry - Final Exit: The Practicalities of ...
Intro
Euthanasia is an emotive and deeply divisive issue, with no middle ground likely to satisfy the polarised groups. Derek Humphry’s Final Exit, which first appeared in 1991, received a mixed reaction from the public because of its controversial subject-matter; since then, it has twice been revised and updated with the third edition sporting “The #1 New York Times Bestseller” tag.
The fact that it is so widely read, not only in the States but in other English-speaking countries, suggests that it fills a much-needed gap in people’s knowledge on the subject.
Content
As its title suggests, the book discusses the practical aspects of “self-deliverance and assisted suicide for the dying”: reasons for wanting to die, dealing with the legal ramifications, searching for a doctor who will help, methods of dying, and so on. In his introduction, Derek Humphry states that since 1976 he has fought for those adults who desire relief from suffering in the last stages of terminal illness, or those with an irreversible illness causing protracted and unrelieved suffering. (His first wife, stricken with a cancer that caused her bones to break when she moved, asked him for assistance in terminating her life. He did so and later published a book about what she had gone through.)
From the outset, Humphry makes it quite clear that his book is not intended for use by those suffering depression or stressing out because of life’s pressures. He also reminds people not to use it in respect of any legal matters that are discussed, suggesting instead that they see an attorney.
How It’s Done
A note at the front of the book advises that large font has been used to make it easier for readers with bad eyesight.
The Contents pages list 27 chapters, each dealing with a specific topic, e.g., Beware of the Law, The Hospice Option, Bizarre ways to Die, The Final Act, Risky Drugs, etc.
At the end are several Appendices: Glossary of Terms, Oregon’s Death with Dignity Act, Current Laws on Voluntary Euthanasia and Assisted Suicide, A Living Will and Durable Power of Attorney for Health Care. Then follows a list of related books, an Index, a small section outlining the role of ERGO! (Euthanasia Research and Guidance Organization) and a brief write-up on the author.
In Chapter 1, which examines the decision to end one’s life and the various euthanasia options that are available, Humphry is at pains to advise believers that this path is not for them, suggesting instead that they look at pain management and/or hospice care. Subsequent chapters explore issues of finding a doctor who will help, euthanasia laws and how America compares with other countries, whether hospice care is appropriate, followed by a discussion on cyanide: is it as quick and as painless as it seems in James Bond movies? Or is what happened in the Jonestown massacre a more realistic scenario, where the victims took several minutes to die – in agony?
Humphry points out that more often than not, “Death Hollywood Style” is a glamorised myth, ditto crime mystery stories, and that people should not use these as guidelines when considering self-deliverance. He goes on to talk about the bizarre attempts people have tried, as well as methods which can go wrong: electrocution, hanging, drowning, shooting, ovens, charcoal cooking fires, household cleaning / drain clearance chemicals, poisonous plants, freezing, and non-prescription drugs. He describes the damage to the body and/or brain, permanent or not, that can result if a victim survives.
One chapter is dedicated to those who are severely handicapped – paraplegics or quadriplegics – who lack quality of life as well as dignity, who are more susceptible to terminal illness because of their inactivity and who feel they have no control over their existence. The moral dilemma is outlined, as well as the legal ramifications of helping such a person terminate their existence. In discussing the pros and cons of these cases, Humphry shows unwavering sympathy and compassion and also concern for the friends and family of handicapped people who might be put in the unenviable (and dangerous) position of being asked to help their loved one die.
The chapter entitled The Final Act is, Humphry says, the most important one because it talks about botched attempts and how to avoid them. He offers “three commonsense ways for self-deliverance from hopeless physical suffering”: powerful barbiturates (e.g. Seconal), barbiturates plus plastic bag, non-prescription sleep aids or inert gas and plastic bag. He outlines a “self-deliverance timetable”, explaining what to do when, quantity of drugs and fluid to be taken, and suggests leaving a note for the authorities explaining what has happened; in this way others are protected and also an autopsy might be avoided.
In The Risky Drugs Humphry says that because of the difficulty in obtaining barbiturates, people often resort to drugs such as painkillers, morphine (in the case of cancer patients), Orphenadrine, Chloroquinine (anti malaria), or Insulin. He discounts these because even if they can potentially cause death when ingested in vast quantities, they might produce only a prolonged sleep or extremely unpleasant side-effects. This chapter is followed by a table with drug names, lethal dosage, whether it comes in tablet or other form, and comments as to side effects and toxicity.
The final chapter documents the problems for physicians outside of Oregon who help their patients die (Dr Jack Kevorkian being one example), explaining how the law differentiates between “euthanasia” and “assisted suicide”. It discusses the services and support offered by right-to-die groups in the States one of which is the Hemlock Society (which Humphry founded), Australia, Canada and Europe.
Conclusion
I am aware that many readers will be opposed to this book for ethical, moral or religious reasons but they should remember that Derek Humphry does not advocate suicide to resolve depression or life’s problems. His premise, quite simply, is that people should have a right to choose when and how to die if they feel they have no quality of life. He does ask that they consider other possibilities (pain management, hospice care, maybe even trying so-called ‘miracle cures’) and to be certain none of them will work, before contemplating self-deliverance.
While its content is undeniably depressing, this is an important and thought-provoking book and Derek Humphry’s approach to an intensely human dilemma is practical, realistic and compassionate.
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