Customer Reviews: Final Exit: The Practicalities of Self-Deliverance and Assisted Suicide for the Dying, 3rd Edition
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on September 26, 2005
I found this book to be incredibly informative. Watching my parents in the throes of death has made me vow to not do this to my children. Any ideas I had prior to reading this book were dispelled and I'm grateful to know what doesn't work! The book is not for the weak at heart - especially the illustrations but I've already connected with a partner and hope, that when the time comes, I'll have the fortitude to carry through.
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on April 24, 2004

After I read this book (first edition published in 1991) by Derek Humphry, I read some reviews of it on this site as well as on other sites. In many cases, I wondered whether a particular reviewer read the same book as I did! There seems to be some confusion as to the purpose of this book.

I think the confusion stems from a lack of understanding of two terms. "Suicide" is deliberately ending one's life. It is usually an irrational act. (For the record, I don't believe in irrational suicide.) "Self-Deliverance" is the action of an irreversible ill person (such as a person who is hopelessly ill or is terminally ill) who makes a rational, voluntary decision to end his/her own life.

The second of these two definitions is what this book is about. In the author's own words: "Please respect the true intensions of [this book]: the right of a terminally ill person with unbearable suffering to know how to choose to die."

Thus, this book is not for the depressed, mentally ill, or suicidal. The author elaborates: "I ask people with suicidal thoughts to share them with family or friends and if this does not help, to call one of the hot lines or help lines listed in their local telephone books."

There is an argument that the above three types of people might use the information in this book for their own early demise (despite the book's warnings) and therefore it should not have been published. But this is like saying tall buildings (or cars or bridges or etc.) should not be built because those with the intension of suicide might use them for an early demise. The fact is a suicidal person will always find a way.

Also, this book is not for the religious. The author, again, elaborates: "If the reader of this book is deeply religious, and takes all guidance from a divinity, then there is no point in reading [this book]. [As well], all I [the author] ask of persons to whom any form of euthanasia [or assisted dying] is morally repugnant is tolerance and understanding of the feelings of others who want the right to choose what happens to their [dying] bodies in a free society." Thus, "this book assumes the reader's ethical acceptance of the right to choose to die when terminally ill and [so] the arguments for and against are not addressed."

This 27-chapter book covers all the practicalities involved in self-deliverance. From the importance of certain documents, to the law, to consideration of others, to the pros and cons of various methods (including certain drugs), you'll find this book a compassionate and sensitive guide. It contains clear instructions for supportive doctors and families so they can keep a person's dying intimate, private, and dignified.

This book has four appendices. I think most people will find Appendix A: "Glossary of Terms Connected with Dying" most informative.

Finally, this is an excellent book for those (like me) who are interested in knowing more about this neglected subject. The obvious fact is that we all die sooner or later. Knowing some of the information in this book will help the reader understand and not deny that death exists. As well, I learned about rights. Some people want to endure every last minute of life no matter how painfully gloomy and that is certainly their right. (In fact, there is a chapter in this book entitled "The Hospice Option.") However, others do not want to endure pain and suffering and I think that should be their right.

In conclusion, this book should not to be read by the depressed, suicidal, mentally ill, or the strictly religious. For all other readers, it can be used as a practical guide or as an educational text to understand death and basic human rights.

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on March 17, 2003
Final Exit does not discuss the spiritual and ethical issues surrounding suicide and euthanasia. Some have criticized Derek Humphry for not including such discussions, but I contend that author has acted appropriately: the scope of this book is inform others on how to effectively plan and execute the last moments of life. It would be presumptuous of the author to lecture his readers on their own faith. If you are looking for answers concerning the spiritual ramifications of ending your life, then you should refer directly to sources on which you base your faith.
Concerning Final Exit's effectiveness as a manual, the language is clear and concise, the description of materials and their use is accurate, and the book provides you with adequate information to help you troubleshoot any problems unique to your situation.
I left off one star only because some of the drugs mentioned in the book are next to impossible to obtain due to the termination of production by pharmaceutical companies. There are alternatives, but these will require a bit more effort on the part of the reader.
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on June 18, 2004
What I like most about this man is that he genuinely appreciates life and encourages people to live....surprised? This book is not aimed at everyone, only the terminally ill. He strongly discourages people from taking their own life unless they're sick. I respect his view that humans have the right to end their existence, even if the problem is mental distress, not physical. I did see a few methods that anyone who can walk themselves to the store with some cash on hand can do. Those methods require no doctor or hard-to-get materials. For sure, anyone with access to a doctor can use this book as a guide to obtain the essential materials needed.
I did wish the book had more methods of self deliverence (that are available without prescription), and more detailed instructions on using prescribed drugs.
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on March 6, 2003
I once happened upon a mouse caught in a trap. It was badly wounded, but not dead. Needless to say, I put it out of its misery.
Unfortunately, our culture is dominated by a monstrous world-view that has less regard for human life than I had for that mouse: Christianity.
Politicians who thumb their noses at the Constitution forcibly impose their theological dogma on all of us--a dogma that I can only call "the Divine Right of Suffering"--the view that your life belongs, not to you, but to a sadistic supernatural ghost, and that no matter how much pain you're in, you have no right to end your own life. To call their vicious dogma "respect for life" is the most monstrous "big lie" that can be imagined.
Until Christians are civilized and made to respect the right of every individual to his own life, "Final Exit" is an essential book to have. Since a fair amount of preparation is necessary--preparation that in a decent society you could seek from a skilled professional--you should have this book on hand well ahead of time--just in case you ever need it.
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on September 1, 2005
While most readers who seek out this book will probably be disappointed that the author can't definitively provide a simple, dignified, and foolproof way of ending one's life, we still need to be grateful that this book offers us the best possibilites that society currently allows. Religious zealots and others who think they have the right to make decisions for everyone else still limit our choices and condemn free people to pointless suffering. For anyone who feels that this decision belongs to oneself alone, the author does his best to provide the available answers.
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on September 20, 2005
For the purposes for which people read this book, it is excellent. Thorough, readable , and humane. One of the few books I want to own AFTER having read it.
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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).
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on May 7, 2007
I just read Derek Humphry's controversial FINAL EXIT, a book whose



wouldn't say I enjoyed it (in large part because of the subject

matter), I did find it very thought-provoking.

Humphry, a journalist and author, is perhaps best known

as the person who launched the Hemlock Society in

1980 in California . . . though that organization is no longer

in existence, the idea behind it still lives on; i.e., that people

should have the right to choose rational suicide as an option

in certain instances.

Now please don't get on my case if you disagree with that

opinion . . . I'm not advocating for it one way or the other--or

at least not in this review . . . in fact, in this book, Humphry

actually presents more reasons why somebody should not

commit suicide . . . as he notes:

If you are considering taking your life because you are unhappy,

cannot cope, or are confused, please do not use this table but

contact a Crisis Intervention Center or Suicide Prevention Center.

(Look in the telephone book. It may be under "Hotlines.') An un-

finished life is a terrible thing to waste. This information is meant

for consideration only by a mature adult who is dying and wishes

to know about self-deliverance.

Yet for those with an incurable disease and who want an easy

passing for themselves and/or their loved ones, then the author's

story about his wife will offer much insight:

I was Jean's safety device against a too early self-deliverance.

While I did not want her to die, I was willing to take my share of

the responsibility of decision-making if it brought her peace.

Assisting in difficult decisions is an essential responsibility of

a loving relationship.

USA TODAY in 2007 listed FINAL EXIT as amongst the

25 most influential books of the previous quarter century . . . it

is definitely NOT for everyone, yet that said, I also liked the fact

that it has such useful advice for anybody facing death as the

following tidbit:

Tell those around you the complimentary things which have been left

unsaid due to the strain of illness. The appropriate "I am grateful for

what you've done" or similar remark will help comfort those left

behind after you have gone.

Wouldn't it be grand if we could do the above more often, especially

when we're healthy?
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on June 24, 2015
Dispassionate and intelligent discussion of end-life choices. Here's a hard fact: pain meds often don't work. Doctors often will do horrific procedures to keep patients alive. I read this because I live with chronic pain and narcotics and barbiturates are of little help. I worry what might happen if the pain becomes unbearable. This book eased my mind. Please note: The author recommends readers exhaust every remedy before making any choices, as well as talking with family members. A brave and cautious author.
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