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Brief, pragmatic and informal introduction to self-deliverance
on June 5, 2013
(Note: Page numbers cited without a source refer to the third edition of Final Exit)
Final Exit's primary audience is older individuals who are considering "self-deliverance" (i.e. suicide), and also their caretakers. I am not in either of these positions and am quite young, so my perceptions may not always be relevant to the primary audience, but I hope I have something to offer anyway.
In order of occurrence, the book deals with legal matters (living wills, durable power of attorney); locating and choosing a congenial doctor; international and U.S. laws regarding euthanasia; hospices as an alternative to self-deliverance; methods of suicide: cyanide, "Hollywood" style and bizarre or extreme and methods of suicide; problems faced by handicapped persons desiring self-deliverance; starvation, the "will to die" and the improbability of "miracle cures"; who should be informed of your decision, life insurance issues, and the possibilities of autopsies after death; secrecy and tips such as avoiding 911 calls; psychological support and therapy; suicide notes and "double exits" (spouses killing themselves at the same time, even if one is not terminally ill); final matters such as deciding exactly when to die; how to acquire and store drugs; using car exhaust to commit suicide; using a plastic bag in conjunction with sedatives; the inert gas or "helium method" (one of the most detailedly described in the book); checklists and final tips; a discussion of "risky drugs" and a table of drugs and dosages; self-deliverance involving and not involving a physician (this section describes the concoctions used by physicians in both the Netherlands and Oregon); the appendices which consist of a glossary, the content of Oregon's Death with Dignity Act, current laws, examples of a living will and durable power of attorney; a list of further literature on the topic.
Final Exit is not a work on the philosophy of self-deliverance (Humphrey refers readers of the Author's Note to The Right to Die for the philosophical aspects). It is rather brief, and covers a lot of ground in very little space. Someone who wants very detailed information on any topic covered in the book will not find it here; they will find a quickly paced introduction to key names (Kevorkian, &c.), key terms and fundamental methods (physician assisted suicide, the "helium method," &c.), and key legal issues (the Oregon Death with Dignity Act, &c.). Though there is an online update for the the book (which I have not yet downloaded), keep in mind that the latest hardcopy edition was published in 2002. Since the publication of the third edition, Washington and Vermont have passed assisted suicide laws, and the so-called helium technique for self-deliverance has been chewed over considerably in other publications on euthanasia and on the Internet. The book as it now stands is just a bit dated.
The book's strength is its swift introduction to the terminology and techniques of euthanasia and surrounding topics, but it sports a number of weaknesses and oddities. Some of this may be due to the its publication history: it was first a self-published work (p. xvii), which has been updated and expanded twice for commercial distribution (it is now in its third edition). None of its weaknesses are overbearing, but there are so many of them that they deserve some airing. This is especially the case when we consider seriously Humphrey's repeated recommendation that a copy of Final Exit be placed near someone who has committed suicide (see for example p. 20), or that it be mentioned in your suicide note (p. 94). Do you want your body to be found with a book that does not cozily conform to your outlook?
Someone with little patience for alternative medicine will be irritated by Humphrey's claim that double exits (spouses exiting together) "is an enigma that has no scientific answer" (p. 98), and by the suggestion that Indian Yogis can essentially think themselves to death (p. 64). Humphrey rather vaguely says that being in the right state of mind helps death "only a bit" (p. 65) but provides no elaboration. What pray tell is this "only a bit," how does it help, what does it help, why does it help?
Final Exit irregularly cites sources. Though there is frequent citation (for example) on pages 32-33, and a list of "Books to Read" is provided, there are many lapses of rigor. On p. 35 we are told that "evidence in textbooks" (which ones?) shows that sheep who eat plants containing cyanide will not die unless they are near (and presumably drink) water. On p. 46 we are informed that the pain of death by ingesting lye induces some people to throw themselves through plate glass windows; Mr. Humphrey has "heard of" this happening, but provides no other information. On p. 140 we are told that the future of assisted suicide may lie in creating pills from puffer fish poison; I find this an incredible idea, but alas no sources are provided. Since Final Exit is so brief, finding additional information on the topics it covers is a necessity for any thorough researchers. Further information can still be found, of course (web searches make this comparatively easy), but having an exact and cited reference makes the research almost effortless and also allows someone to directly compare an author's generalizations and interpretations with source materials.
People who are particularly sensitive to literary style may be irked by Humphrey's sometimes "journalist" method of exposition ("The old 'denial of death' syndrome was in play" p. xvi, "it was the most talked about book in America" p. xvi, "a book for now and the future" p. xxvii, "If you or someone you love" p. 90), or by his tastes in poetry (the book opens with an excellent piece by Keats; not everyone will agree about its excellence). Perhaps you don't think Arthur Koestler is an intellectual giant (p. xxvi). The book is very self-promotional, with the author recommending that a copy be placed near a suicide's deathbed and that it perhaps even be mentioned in a suicide note (see above). Part of the verification process supposedly followed by assisted suicide groups when supervising euthanasia is "The patient must always have read this book" (p. 169)!
I have little intellectual sympathy for religion, but I also try to refrain from caricaturing its supporters. Yes, much opposition to euthanasia comes from politically visible Christian groups, but there are also many people who endorse a more freewheeling approach to their religion. Humphrey does mentions at least one theologian who committed suicide (Henry Pitney Van Dusen, p. 98), but also makes some blanket statements like "If the reader of this book is deeply religious, and takes all guidance from divinity, then there is no point in reading further" (p. xiv). These kinds of blanket dismissals may alienate religious readers who would otherwise warmly endorse the material Humphrey offers.
Final Exit needs to be defended against one particularly nagging and potentially grave criticism, ample illustrations of which can be found in the one-star reviews of the book on Amazon. People with no signs of physical or irreversible mental deterioration may use the information provided to commit suicide. How can someone then defend it? Just "being a statistic" is widely disdained, but when someone has to do the job of social planning for over three hundred million people, there seems to be no other option than a statistical approach. Not everyone will be saved, not every life will be ideal. This is not to say we should not try to always improve uncongenial conditions when we find them, but merely that the world is not perfect. If the information provided by Humphrey was not available, many people who now can die quickly, painlessly, and happily would die slowly, painfully, and miserably. Taking away this "suicide manual" and preventing some misguided suicides means condemning other people to terrible deaths, not to mention robbing them of a freedom of choice (and a freedom of information). Alcohol causes many nasty things, but Prohibition was such a headache that it was repealed. Allowing information on suicide to be disseminated may cause some nastiness, but it prevents quite a bit more.
There is comparatively little widely available (and inexpensive) literature on the topic of self-deliverance and Humphrey's broad survey is about the only well-known introduction to the topic. Some of the book's eccentricities, and especially its lack of rigorous citation, are definitely obstacles. It is perhaps a quirky place to start, but self-deliverance is an often quirky topic (read up on Jack Kevorkian for a taste of this).