Monday, March 27, 2017

An Exit Guide on a mission

The other day, I had a conversation with a woman who was about to embark on a visit in rural Washington to be an Exit Guide. This term was unfamiliar to me, even having read Derek Humphrey's book, The Final Exit, a number of years ago. Humphrey was a founder of The Hemlock Society. The Society's name disappeared when it merged and became the more mainstream non-profit, Compassion and Choices.

Apparently some were unhappy with this and decided to continue the efforts of Humphrey. I must admit I felt a bit queasy when reading chapters in The Final Exit which explain how to tie a bag around your neck after ingesting medications, and how "to go together" with your loved one.

The Exit Guide I met is a retired physician though she said this wasn't necessary. She had joined and been trained by the Final Exit Network to be present with the person wishing to end their life. From her, I learned that pure nitrogen (N2) works well and the individual passes out without struggling in about 30 seconds and is soon dead from lack of oxygen. There are head-bag kits and videos on line for instruction and purchase. The individual she was visiting had some degree of dementia and lived in Washington State (where a death with dignity law exists) and this individual apparently did not qualify for physician assisted death.

I have so many questions. How much "assistance/instruction" can the Exit Guide give without being held legally liable? Do they remove the plastic bag and equipment before reporting the death, thus making it very hard to determine it was a suicide? How careful is the vetting? What degree of dementia is acceptable with their criteria? Washington State law says you have to be considered terminal within 6 months. What guidelines do the Exit Guides follow?

In addition to individual cases, some states are now looking to use nitrogen as the favored means for executions. There is a great deal of discussion about what's going on in Oklahoma.

For myself, I don't think I could become an Exit Guide. Could you? It's a question of a bright line between supporting an individual's autonomy and protecting their rights when mentally incompetent or not terminal. Making "how to" kits for head-bags and nitrogen, still makes me queasy.

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