ATLANTA – The case against members of an assisted suicide ring charged with helping a Georgia man kill himself has exposed a rift in the "right-to-die" movement as key players, including Dr. Jack Kevorkian, rush to distance themselves from the group's practices.
Kevorkian and others active in the movement have long argued that terminally ill people should be able to seek assistance ending their lives, but only from doctors. The Georgia-based Final Exit Network uses volunteers who are not physicians as "exit guides," contending such efforts are necessary to help those who want to die but live in states where doctor-assisted suicide is illegal.
"It just feels like something that's so totally different from what we do — working with legislators, physicians and pharmacists over the ethical way to do this," said Peg Sandeen, executive director of the Oregon-based Death With Dignity National Center. "I'm concerned there's not a set of standards that are followed that protect people."
Kevorkian, who claims he participated in about 130 deaths before going to prison in Michigan for second-degree murder, is also critical of the network's methods.
"They're doing what they can do within the bounds of circumstance. I understand that, but it is still the wrong way," he told Detroit's WXYZ-TV last week shortly after Georgia authorities arrested four network members for helping 58-year-old John Celmer kill himself.
The Georgia Bureau of Investigation says the group may have helped 200 people around the nation commit suicide by sending exit guides to their homes to show them how to suffocate themselves using helium tanks and a plastic hood.
The network says it caters to people with incurable conditions suffering from intolerable pain. Under the group's rules, a medical committee must vet each applicant's file, but a physician need not be present during a suicide.
The arrests came after an eight-month investigation in which an undercover agent infiltrated the group, which bases its work on "The Final Exit," a best-selling suicide manual by British author Derek Humphry. Search warrants were executed at 14 sites in Arizona, Georgia, Florida, Maryland, Michigan, Ohio, Missouri, Colorado, and Montana.
Network members say they don't actively aid suicides but rather support and guide those who decide to end their lives on their own.
"This method is so quick and so sure and so painless," said Jerry Dincin, a Chicago clinical psychologist who recently took over as president.
The network's supporters are rallying to the cause, and Humphry has launched a campaign to help pay the group's legal costs, calling it a "test case."
"The day all Americans have access to assisted suicide, I'll trash my book, and I'd recommend the network should close down," Humphry said. "But until we get there, there has to be freelance efforts."
Those efforts don't sit well with people like Kevorkian, who was released on parole last year.
"He does not agree with their approach because there's not a physician involved. He believes it should be a medical service," Kevorkian said through his attorney, Mayer Morganroth. "And, at the point where it's illegal, they should be working toward having it legalized."
Assisted suicide is illegal in most states, with penalties varying widely. In Georgia, the Final Exit Network members face up to five years in prison if convicted of assisting suicide.
Oregon allows doctors, but not regular citizens, to help terminally ill people kill themselves. The state specifically outlaws assisted suicide and allows doctors to prescribe lethal medication only to those with less than six months to live. A similar law takes effect Thursday in Washington, and a judge in Montana has ruled doctor-assisted suicide is legal there, though that could be overturned by the state Supreme Court.
Dr. Robert Thompson, an internist and cardiologist in Seattle who supported Washington's law, said ending a life because of a medical condition is a grave decision that should involve a doctor. In Celmer's case, his doctor told investigators he had made a "remarkable recovery" and was cancer-free at the time of his suicide.
"If you've got in your mind that you had brain cancer but instead you had migraine headaches, it would be a shame if you do yourself in," Thompson said.
But Dincin said the laws in Oregon and Washington don't go far enough to help to those suffering from agonizing conditions that are degenerative but not necessarily terminal.
"It doesn't serve those who have irreversible illnesses that last longer than six months," Dincin said. "And our group — theoretically — is filling that void."
Dr. Timothy Quill, a professor of medicine at the University of Rochester in upstate New York, said the case demonstrates a need for "a more humane approach."
"They are symptomatic of the desperation and fear when people feel that their doctors and health care teams won't be responsive," said Quill, a supporter of the laws in Oregon and Washington.
"These are folks who don't have any expertise in end-of-life care," he said of the network members. "They are well-meaning, but they're trying to be responsive to situations that are very complicated."