Supporting the human right to a Death With Dignity
Supporting the human right to a Death With Dignity
866-654-9156
Final Exit Network is a national non-profit (501c3) organization 
serving members throughout the country - in all 50 states. 

Final Exit Network is the only national organization that publicly offers education, support, and a compassionate presence to our members. We provide exit guides throughout the U.S. to those who meet our Medical Committee requirements.

Through the defense of our Exit Guides, we have made significant changes to laws in states where our right to provide services has been challenged. As the U.S. host of the 20th international biennial conference, our support of the World Federation of Right to Die Society's Conference in September 2014 in Chicago highlighted the importance of this significant WORLD movement. 

Many of our members join to promote the right to death with dignity. Others join to support our exit guide volunteers, or to help pay for legal protection for our exit guides.

It is our hope that one day, the right to death-with-dignity will be far more than a phrase, but a right that each one of us may choose to exercise at the end of our lives and, if necessary, at a time of our own choosing.


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Supporting the human right to a Death With Dignity
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Q&A
FEN General Counsel Robert Rivas reports on the trial in Hastings, MN.
Read the AP news story for preliminary information. Read General Counsel Robert Rivas's report below.
      For Faye Girsh's trial commentary, request ERGO's free, 
      nonprofit world news list in digest form [right-to-die@lists.opn.org]. 
      Photos this page courtesy of Faye Girsh / ERGO.
Thursday, May 14: Final Exit Network found guilty on two charges.
Minnesota Case: Final Exit Network Found Guilty
Of a Crime For Showing Compassion
By Rob Rivas, General Counsel Final Exit Network

HASTINGS, Minnesota, May 14 — A 12-member jury found Final Exit Network, Inc. guilty of “assisting” in a “suicide” and interfering with the scene of a death so as to “mislead” the coroner. 

A five-woman, seven-man jury deliberated for only about half an hour at the end of the day on Wednesday, May 13, then another hour in the morning the next day before rendering its unanimous verdict, finding the not-for-profit corporation guilty on both of the counts against it. 

Judge Christian Wilton set the sentencing hearing to take place at 9 a.m. on August 24. The “assisting” in a “suicide” count, a felony, carries with it a potential fine of $30,000, while the charge of interfering “with the body or scene of death with intent to mislead the coroner or conceal evidence,” a “gross” misdemeanor, is punishable by a fine of up to $3,000.

Thus, since a corporation cannot be incarcerated, and no Final Exit Network board members or volunteers face any potential sanctions, the maximum possible punishment is a fine of $33,000.

The State’s case consisted of proof that the Network’s volunteers provided information, education, and emotional support to Doreen Dunn, 57, of Apple Valley, in her self-deliverance on May 30, 2007.

“The State’s entire case proceeded on the theory that Final Exit Network could be convicted solely for exercising its First Amendment-protected right to freedom of speech,” said the Network’s attorney, Robert Rivas. “And the judge instructed the jurors that they could convict the Network with no evidence of actual assisting, but only of speech.” 

The Network immediately initiated plans to appeal to the Court of Appeals of Minnesota, the first step in the ladder of appeals from a conviction in the District Court of Dakota County.

To those who have followed the Network’s battle with the State of Minnesota since it began in 2012, the infringement of free speech rights that unfolded at the trial this week would seem completely implausible and inexplicable. Here’s how it happened.

The Minnesota statute prohibiting assistance in a “suicide” prohibits not only “assisting,” but also “advising” or “encouraging” a suicide. The State originally indicted the Network with plans, as openly stated, to try to convict the Network of “advising” or “encouraging” a suicide, since the State had no evidence of “assisting.” 

The Network moved to dismiss the indictment to the extent it relied on “advising” or “encouraging” a suicide, saying these two provisions violated the First Amendment-protected right of free speech. All the while the Network acknowledged that the State could theoretically convict a defendant of “assisting” in a “suicide” if it could prove actual physical assistance. 

The trial court judge, Karen Asphaug, agreed with the Network and ordered that the State’s case could proceed only on the “assisting” language of that statute, holding the “advise” and “encourage” clauses unconstitutional. The State appealed to the intermediate Court of Appeals of Minnesota. 

In 2013, the Court of Appeals, in resounding terms, agreed with the Network and Judge Asphaug and held the Minnesota statute unconstitutional under the First Amendment to the extent it prohibited “advising” and “encouraging” a “suicide.” Final Exit Network’s leadership thought they had struck a decisive blow for the First Amendment and thought the Hastings prosecution could not go forward based on pure speech, and might not be able to go forward at all. 

In the meantime, the Supreme Court of Minnesota was considering the appeal of William Francis Melchert-Dinklel, a middle-aged registered nurse who, as a hobby, trolled the Internet, sought out suicidal young people, pretended to be a suicidal teenager himself, and tried to talk his victims into hanging themselves in a double suicide pact. His only apparent motivation was to watch people die via a Skype hookup. He was charged under the same statute as Final Exit Network — the law against “advising, encouraging, or assisting” in a “suicide.”

In its Melchert-Dinkel decision, the Supreme Court — consistent with the Court of Appeals’ decision in the Final Exit Network case — held that the “advising” and “encouraging” provisions of the Minnesota statute had to be severed from the statute as violative of the First Amendment. 

Yet the Melchert-Dinkel precedent contained one paragraph that came back to haunt the Network this week. It said “assisting” in a “suicide” could be accomplished by “speech” if the speech “enabled” a suicide. Thus, having said a state law could not constitutionally prohibit “advising” or “encouraging” a “suicide,” the Supreme Court of Minnesota decreed that the courts themselves could prohibit “advising” or “encouraging” a “suicide” by their interpretation of the meaning of the word “assisting.”

In Hastings, Judge Wilton’s instructions to the jury said the jury could convict the Network of “assisting” in a suicide by “speech” if the speech “enabled” a suicide. In other words, speech on how to commit “suicide” would now be punishable as the felony of “assisting” in a “suicide.”

The final trap was sprung on the Network the day before the trial began, when the State filed a motion to amend the indictment. Where the indictment alleged that the crime took place on May 30, 2007, the day of Ms. Dunn’s self-deliverance, the proposed amendment expanded the date range for the commission of the crime to span from February 1, 2007 to May 30, 2007. By this sleight-of-hand the State swept all the communications between the Network and Ms. Dunn, from the day she applied for Exit Guide services through the date of her death, into the period of time during which the crime was allegedly committed.

Astoundingly, the judge granted the State’s motion to amend the indictment the day before the trial began. 

Between the expanded definition of “assisting” in a suicide, and the expanded date range for the crime, the State was allowed to contend that all of the activities that Final Exit Network performs in connection with Exit Guide services — all of the information, education, and support services routinely provided by Final Exit Network — together constituted a crime. The State was allowed to argue, and put on all its evidence in support of the argument, that the Network provided Ms. Dunn a “blueprint to kill herself,” and thereby “enabled” her to commit suicide, which constitutes “assisting” in a “suicide.”

The State’s successful prosecution in Minnesota sets a precedent that threatens the core of Final Exit Network’s Exit Guide program. Under the Minnesota precedent, any state with a law prohibiting “assisting” in a “suicide” could apply the Minnesota definition to the word “assisting.”

Minnesota did not protect free speech rights by its appellate rulings in 2013. Minnesota has merely recast the terminology in which free speech rights are violated. Now, any state may infringe on freedom of speech without openly saying so. Even a state that never before had a law prohibiting the “advising” or “encouraging” a “suicide” may now ban “advising” or “encouraging” a suicide by interpreting and redefining the word “assisting” to include the concepts of “advising” or “encouraging.”

THANK YOU FOR YOUR SUPPORT! We were gratified to have people in the Minneapolis
area who joined us for the entire trial. Thank you to our members and supporters
who shared this important experience in Final Exit Network history. 
The Guardian reported 22 July 2015:
Love and choosing death: 
A couple's plea for assisted dying rights -

 In January, Steve Goldenberg and his doctor joined a lawsuit against
 several district attorneys across New York that aims to legalize aid in
 dying -- also called physician-assisted suicide. In April, state district
 attorney Eric Schneiderman made a motion to dismiss the suit.

 Whether the judge decides to hear arguments, it's unlikely Goldenberg
 will survive to see the final outcome.

 "If I get to see spring, I'll be lucky," Goldenberg said. If throat
 cancer doesn't end his life, complications from diabetes or many
 illnesses related to AIDS will, he said. He wants his doctor to
 prescribe life-ending medication in case the pain becomes unbearable.

 His doctor would like to help but could face manslaughter charges if he
 does.

 Since December 2014, lawmakers in the District of Columbia and at least
 25 states across the nation, including New York, have introduced
 so-called death with dignity bills.

View the video that accompanies this article:
http://www.theguardian.com/society/video/2015/jul/22/physician-assisted-dying-rights-new-york-steve-goldenberg-video

 First City in Arizona to Pass Resolution 
 in Support of Aid in Dying

 Bisbee, Arizona .. On September 1, 2015, the Bisbee City Council passed
 a resolution by a 4-3 vote supporting Aid in Dying (aka Death with
 Dignity), an option already available in several states enabling a
 competent, terminally ill adult to obtain a life-ending medication
 should their suffering become unbearable.

 Spear-headed by Bisbee Councilperson, Joan Hansen, the resolution is the
 first of its kind in Arizona. Although the resolution cannot change the
 current laws, it recognizes the growing public support and call for a
 humane and dignified end-of-life option. Aid in Dying provides the
 medical freedom of a competent, terminally ill adult -- one who has been
 diagnosed with an incurable illness likely to cause death within six
 months -- the right to request a prescription for life-ending medication,
 the option to fill that prescription, and the option to self-administer
 the medication at the time and place of that person's choosing.

 The resolution affirms that the City of Bisbee:
 - Respects the diversity of perspectives of its citizens,
 - Supports equal protection within the diversity of perspectives on
 end-of-life decisions,
 - Recognizes the practice of Aid in Dying as a legitimate individual
 liberty,
 - And -- while not a legally enforceable document -- urges prosecutorial
 discretion by the Cochise County Attorney in de-prioritizing cases
 involving prosecution of a person who has supported, been present, or
 facilitated a loved one to advance the time of his or her imminent death
 when facing intolerable suffering.

 Although Bisbee is the first Arizona municipality to go on record with
 its support of Aid in Dying, it joins Los Angeles, San Francisco, West
 Hollywood, and the counties of Santa Barbara, Ventura, Santa Cruz,
 Alameda in California, which have passed a similar resolution in support
 of California's End of Life Option Act.

 "I believe that working 'from the ground up,' at the city level, is
 among the best ways to move legislation forward to the state and federal
 level," said Lizann Michaud of Bisbee. "It's a way that movements can
 make headway without having money and political influence behind them."
 (Bisbee Observer, 8/27/15) This is not the first time Bisbee has been
 forward-thinking and acting. In 2013, it was the first city in Arizona
 to legalize same-sex civil unions. And in 2014, Bisbee was the first
 city in Arizona to ban plastic bags.

-- ERGO Listserv
MEMBERSHIP
FEN president Janis Landis

"Be with us now, so we can be 
with you later."
President's Response
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By Lamar Hankins | Dementia
Analyzing two advance directives for dementia and VSED from EOLW






Dec. 1, 2017
U.S. News and Health Report
Health Buzz: A Man Came In With a 'DNR' Tattoo. Here's What His Doctors Did
An unconscious patient and his unusual tattoo made for quite the ethical dilemma.
By David Oliver, Associate Editor, Social Media
     Doctors from the University of Miami encountered seemingly the ethical dilemma of all ethical dilemmas: A patient with "Do Not Resuscitate" tattooed on his chest, along with what seemed like his signature, arrived at the hospital unconscious and with a high blood alcohol level. Hours later, he developed low blood pressure.
    "We initially decided not to honor the tattoo, invoking the principle of not choosing an irreversible path when faced with uncertainty," the doctors wrote to the editor of the New England Journal of Medicine. 
READ MORE

Suicide is not the same as PAD
Press Release
American Assn of Suicidology
Position paper 
   The American Association of Suicidology (AAS) recognizes that the practice of physician aid in dying (PAD) is distinct from the behavior that has been traditionally and ordinarily described as “suicide.” Although there may be overlap between the two categories, legal physician assisted deaths should not be considered to be cases of suicide.
READ MORE

By JoNel Aleccia
Kaiser Health News
November 3, 2017
New ‘Instructions’ Could Let Dementia Patients Refuse Spoon-Feeding
Patients with advancing dementia now have a document they can add to their advanced directives.
READ MORE

End of Life Washington State
INSTRUCTIONS FOR REFUSING ORAL FEEDING AND DRINKING - Directives for patients with advancing dementia to add to your Living Will.
READ MORE

April 19, 2017
HARVARD LAW
Changing the Paradigm of Advance Directives to Avoid Prolonged Dementia
By Norman L. Cantor
With the increasing prevalence of Alzheimer’s disease and similar degenerative dementias, the focus of advance directives has changed for some people. The primary specter is neither an unavoidable looming demise nor the insensate limbo of permanent unconsciousness.
READ MORE


N E W S
N E W S
Members: Watch for your 
Fall 2017 newsletter in the mail!
April 29, 2017
THE ECONOMIST
A Better Way to Care 
for the Dying
How the medical profession is starting to move beyond fighting death to easing it.
READ MORE

THE NEW YORK TIMES
We're Bad at Death, 
Can We Talk?
A new wave of research sheds light on what patients want at the end of life, and who is or isn’t getting it.
READ MORE

THE ECONOMIST
HOW TO HAVE A BETTER DEATH
A treatment that is unbearable in the imagination can seem like the lesser of two evils when the alternative is death. Some patients will want to fight until all hope is lost.
CLICK HERE


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THE NEW YORK TIMES
OP-ED
FEBRUARY 18, 2017
First, Sex Ed. Then Death Ed
By Dr. Nutik Zitter, Oakland, CA
     Five years ago, I taught sex education to my daughter Tessa’s class. Last week, I taught death education to my daughter Sasha’s class. In both cases, I didn’t really want to delegate the task. I wanted my daughters and the other children in the class to know about all of the tricky situations that might await them. I didn’t want anyone mincing words or using euphemisms. Also, there was no one else to do it. And in the case of death ed, no curriculum to do it with.
READ MORE.

THE OREGONIAN
FEBRUARY 1, 2017
     Trump supreme court nominee Neil Gorsuch cited Oregon law in his book on assisted suicide
By Eder Campuzano
    Donald Trump on Tuesday announced his pick to replace Supreme Court Justice Antonin Scalia, who died suddenly last February. The president's nominee, Neil Gorsuch, has been likened to the late justice by several media outlets.
     If confirmed, one thing Gorsuch would have with Scalia is their view on assisted suicide. In fact, Gorsuch published a book on the subject in 2006. "The Future of Assisted Suicide and Euthanasia" cites Oregon law extensively, from the first chapter to the epilogue.
The book was published the same year the U.S. Supreme Court rendered a verdict in the case of Gonzalez v Oregon, where it ruled George W. Bush's attorney general couldn't use the Controlled Substance Act against state doctors who assisted their patients in dying.
     Scalia was one of the dissenting votes in the 6-3 case. Throughout his book, Gorsuch argues against assisted suicide.
     The seventh chapter, in particular, cites Oregon law extensively. If readers had any doubt about the Supreme Court nominee's thoughts on the matter, the title would be illuminating: "Legalization and the Law of Unintended Consequences: Utilitarian Arguments for Legalization."
     The second paragraph of the chapter even refers to the practice as "consensual homicide." Much of the chapter is free to preview on Google Books. The epilogue, which deals exclusively with the Gonzalez v Oregon decision, is not.
Gorsuch's views on assisted suicide have been taken by many to assume he'd side with anti-abortion arguments in cases concerning the practice. He's never ruled on an abortion case in his time on the Tenth Court of Appeals, although he has issued rulings against the Affordable Care Act's requirements on contraceptives.
     For much of the campaign, Trump vowed he'd choose a "pro-life" justice to fill Scalia's seat on the court. The president even claimed he was open to appointing someone who would overturn Roe v. Wade, leaving states to make their own rules on abortion.
     Although Gorsuch characterized the 1973 decision as "a new right in the face of substantially contrary history," the 1992 Planned Parenthood v. Casey decision seemed to placate his concerns with the older ruling.


DC Mayor Signs Assisted Suicide Bill
​The Washington Times
December 20, 2016
By Robert King
     Washington, DC Mayor Muriel Bowser signed into law Tuesday a bill that would make assisted suicide legal in the district, if it gets through Congress.
     If approved by Congress, the district would join six states that allow assisted suicide for the terminally ill.
   The bill, which the D.C. Council approved last month, would enable someone 18 years or older who is mentally capable and terminally ill to end their life. It sets up reporting requirements for physicians and the district's Department of Health.
   It is not clear if Congress will approve the legislation. It has blocked D.C. legislation before, most recently the city's recreational marijuana law. Under the Constitution, Congress has to sign off on all D.C. laws.
   California, Colorado, Oregon, Montana, Washington and Vermont are the other states that have assisted suicide bills on the books. [It is an error to state that Montana has an assisted suicide law. Montana's is a Supreme Court ruling that only says that doctors will not be prosecuted.]
​ 
Waiting for The Die Medicine
By Myriam Coppens, Special to the Sentinel
The Santa Cruz Sentinel, California, November 22, 2016:
Read more.

The Washington Post
November 1, 2016:
By Fenit Nirappil
     The D.C. Council on Tuesday gave initial approval to legislation that would allow physicians to prescribe fatal drugs to terminally ill residents in the city, making the District the sixth jurisdiction nationwide to allow the practice.
     It is the first predominantly black community to legalize so-called "death with dignity," overcoming objections from some African American residents.
     A spokesman for Mayor Muriel E. Bowser (D) declined to say whether the mayor would approve or veto the legislation, although he said Bowser expects the bill to become law.
     The council still must hold a final vote on the bill, possibly as early as Nov. 15.
Read more.