Flashback 1987: Ending the agony of terminal illness by suicide — Hemlock Society fights for the right to die.

 

"The Death of Socrates," by Jacques Louis David (Metropolitan Museum of Art)

     My colleague Tina Sfondeles wrote an important story on a pending law that would let terminally ill Illinoisans end their lives. When I read it, I immediately thought of this story, written a few weeks before I was hired by the Sun-Times. It made an impression on me. I can still remember Don Shaw pulling that big amber bottle out of the drawer. I also distinctly recall thinking, "These people are hot to kill themselves." I was 26. Now that I've had 37 years more of experience, I know that one reason the American medical system is the cruel, expensive farce it often seems to be is because control is wrenched away from the people who should exert it. 

     Don Shaw died at 81 in May, 2001, at a senior care facility in Evansville, Indiana. The Hemlock Society was renamed End-of-Life Choices in 2003, and the next year became Compassion and Choices. 

     Asked what he would do if he ever was struck by a catastrophic illness, Donald Shaw pulls open a desk drawer and reaches for an amber plastic bottle filled with 50 red capsules. Each capsule contains 100 milligrams of the tranquilizer Seconal.
     "What I would do is take it out of the little shells — a hell of a job — and mix it with honey or ice cream," he says. "The stuff is bitter."
     Shaw goes on to describe how he would drink whiskey, to multiply the fatal effect of the overdose, eat a light snack and take an antiregurgitative to help keep the poisonous mixture down.
     An amiable, robust man of 67, Shaw talks casually about the prospects of suicide, as do many members of the Hemlock Society, an international group advocating that terminally ill people should have the right to kill themselves.
     The Hemlock Society reports having 13,000 members, most of them in the United States. About 300 of those members are in Illinois, mostly around Chicago.
     Shaw, a former Episcopalian priest, is chairman of the Illinois chapter. His interest in the subject of escaping terminal illness through suicide began after his mother's protracted death.
     "My mother died of cancer when I was 25," he says. "My aunt and I took turns caring for her 24 hours a day. Until one day she said: `Don, I'm going to stop eating. I just want to die.' And for me it was absolutely sensible."
     Members of the Hemlock Society plan for their own deaths, convincing relatives not to take "heroic" measures to keep them alive, stockpiling fatal doses of drugs and lobbying for a variety of "right-to-die" issues.
     They support legislation, such as the Illinois Living Will Act of 1983, which created a document where signers request "that my moment of death shall not be artificially postponed . . . if at any time I should have an incurable injury, disease or illness judged to be a terminal condition by my attending physician. . . . "
     The society was formed in 1980 by Derek Humphry, a British journalist who assisted his terminally ill wife in killing herself. His book chronicling that experience, Jean's Way, and other writings, including Let Me Die Before I Wake, a guide to suicide methods, are distributed by the society.
     The name of the society, "Hemlock," refers to a poisonous herb of the carrot family. The poison is famous as being the one Socrates, the Greek philosopher, was forced to drink in 399 B.C., a suicide that ironically goes against Hemlock Society principles, which state that suicide should be voluntary and not due to any emotional, traumatic or financial reason unassociated with terminal illness.
     "I'm sorry we have the name, but I'm perfectly willing to make the best of it," says Shaw.
     The Illinois chapter holds monthly meetings, where members watch films related to the right-to-die movement, discuss issues and socialize.
     "It's an interesting group of people," said Louise Haack, a retired teacher. "I've been to two meetings; it's nice to be with people of like mind. So often the perception is that this must be a bunch of Gloomy Guses. But this is not the case. The people I have met through Hemlock are very lively indeed, and most are bent on living a long and productive life."
     Haack, 62, has her own stockpile of drugs, but worries about the drugs losing their potency over time.
     "I probably do not have a lethal dose of anything at this point," she says, "because medicines do become outdated. You need a spectrum of medical doctors who will prescribe 30 of this or 30 of that so you can acquire a lethal dosage, and that is a handicap nowadays."
     Like Shaw, Haack's interest in the Hemlock Society came from the death of a parent. Five years ago her father died of colon cancer at age 88.
     "That made me realize it would have been nice if he and I could have had a conversation about how we'd like to leave this earth," she says. "Fortunately, we had pretty good nursing-home care, and the principal physician in charge was in tune to not having this old gentleman returned to the hospital for any reason. The doctor knew how I felt, and had some discussions with the nursing-home staff. Nothing in writing, but a tacit understanding.
     "My father was struck with influenza, which could have been `cured.' They could have called for an ambulance, taken him to a hospital, all that garbage. But they did allow my father to die, without making an issue of it, and I'm very grateful for that. He did have a peaceful departure, certainly compared to what it could have been. A certain amount of homework can prevent the horror stories we have heard of.
     "A friend had mentioned the Hemlock Society. I wrote away for literature and joined. I've been very, very impressed with the thoughtfulness and leadership and care with which these subjects are being discussed. I don't thing everybody needs to make this commitment, but everyone needs to look at this issue and think about it."
     According to Shaw, while death was once an accepted part of the cycle of life, today it is a distant and taboo subject.
     "Death is a part of living, a part of life, Shaw says. "In most cases it's welcome. But still death is something that is not talked about, not prepared for. One reason is that people don't die at home anymore. They used to die at home. Everybody knew what death was about. Children saw it. In the old days, there was no place else to die. I think the problem began when death was removed from home and placed in the hands of specialists, hospitals and funeral directors."
     Shaw has certainly planned out his own death in some detail. Not only has he arranged a convenient means of suicide, should the opportunity to kill himself arise, but he has planned the ceremonies surrounding his passing. His tombstone is already in place, in a cemetery in Enid, Okla., and preparations have been made for his wake.
     "A cocktail party: hors d'oeuvres, some of my special music," he says, smiling at the thought. "It's going to be a joyous occasion, if I die soon enough. If I get to be 85, they're won't be as many people there.
     "I have here my suicide letter to my family," he continues, producing a 1,200-word document beginning "Dear Family and Selected Friends" and dealing mostly with Shaw's belief that suicide is a valid avenue should "the dissatisfactions of life significantly outweigh the satisfactions."
     When asked what he meant when he referred to a suicide-inducing "catastrophic" illness, Shaw said it was "some physical condition the treatment of which I was not able to pay for."
     It is an attitude that is questioned by some people.
     "When do you decide a disease is life- threatening?" asked Ken Howard, head of the clinical psychology department at Northwestern University and an expert in the area of suicide. "I see a potential harm in having a support group that says whenever life is too hard for you - you have skin cancer that may or may not metastasize - you monitor it yourself, and whenever you get too scared go ahead and take these pills. I don't think that's good advice.
     "I'd like to see the extent that their plans are really followed through," Howard said. "My experience with people who have taken that position is once they get the first signs of a life-threatening disease they do what everybody else does: fight dearly."
     Howard said that, rather than being ultimately concerned with death, Hemlock Society members instead are trying to gain a feeling of control over their own lives.
     "One way to make peace with the fact that you're going to die is to say you have the power to make that happen," he says. "It's a case of ultimate control; one way of saying: This is my life, and I have some say in it."
     And in fact, Shaw reports that, in the five years of his being chairman of the Hemlock Society in Illinois, he has never had a member commit suicide.
     Shaw's son, David Shaw, 37, a lawyer in Evansville, Ind., finds himself in general agreement with his father's principles, but also suspects that there are other issues at work, beyond avoidance of terminal illness.
     "I'd say that's probably a fair observation," says David Shaw. "If he's going to go, he'd rather do it himself. I'd say it's a matter of control. I'd think he'd like to go out with style."
            —Originally published in the Sun-Times, March 3, 1987