![]()
Every story has a beginning. This one starts in late 2001, when my father-in-law fractured three of his ribs. Harry was a retired physician, and after a thorough workup that he insisted on, it turned out that his bone density was severely compromised for no immediately apparent reason. Further tests eventually revealed the cause: He had multiple myeloma, a cancer of the bone marrow. Harry's cancer was caught early, and it progressed slowly. By 2007, however, it had taken over his body. When my wife saw him in early 2008, she remarked that he looked like someone in a lot of pain but trying not to show it—despite the fact that he was taking oxycodone, a powerful opiate. During a career that lasted more than three decades, he had watched all too many of his patients struggle with their final months, and this experience had persuaded him that he would take his own life if he found himself dying of an agonizing and clearly terminal illness. Now he was. Finally, on the evening of January 29, he stumbled and fell during the night, and decided his time had come: He was afraid if he delayed any longer he'd become physically unable to remain in control of his own destiny. This was important. Since Harry lived in California, where assisted suicide was illegal, he had to be able to take his life without help. Because of this, he initially intended not to tell either of his daughters about his decision. He wanted to run absolutely no risk that merely by being with him in his final moments, or even knowing of his plans, they'd be held responsible for his death. Luckily, neither my wife nor her sister had to learn of their father's death via a call from the morgue. A friend persuaded him to call both of them, and on January 30 we all drove out to Palm Springs to say our last goodbyes. After that, Harry wrote a note explaining that he was about to take his own life and that no one else had provided any assistance. It was time. He categorically forbade any of us from so much as taking his arm. He walked into his bedroom, put a plastic bag over his head, and opened up a tank of helium. A few minutes later he was dead. Harry was a methodical man, and when he decided he would eventually take his own life, he naturally looked for advice. The place he turned to was the Hemlock Society, founded in 1980 with a mission of fighting to legalize physician-assisted suicide for terminally ill adults. When we went through Harry's files after his death, we found a slim manila folder with several pages copied from various Hemlock publications, nestled between a bunch of fat folders containing financial information, his will, and his medical records. One of the pages recommended that you write a note making it clear that you had taken your own life, unassisted by anyone else. This was meant for the sheriff or the coroner, and was designed to protect anyone who might be suspected of illegally aiding you. There were also several pages with instructions on how to take your life using an "inert gas hood kit." This is a fairly simple and painless way to die, since your body reflexively wants to breathe, but doesn't really care what it breathes. If you breathe pure helium, or any other inert gas, you won't feel any sensation of suffocation at all. You simply fall unconscious after a minute or so, and within a few more minutes, you die. At the time of Harry's death, the Hemlock Society—known today as Compassion & Choices—was one of the oldest and best-known organizations working to legalize physician-assisted suicide. But it was hardly the first. During the 19th century, as opioid painkillers became widespread, euthanasia became a lively topic of discussion. By the turn of the century it had been banned in nearly every state. Public opinion finally started to shift in the 1930s, and by 1949 it had progressed enough that the Euthanasia Society of America was able to recruit several hundred Protestant and Jewish clergymen in an effort to challenge New York's law prohibiting physician-assisted suicide. Thanks partly to fresh memories of the infamous Nazi "forced euthanasia" programs that killed thousands of the disabled and mentally ill, and partly to the Catholic Church's opposition to any form of suicide, their effort failed. Still, support for physician-assisted suicide continued to tick slowly upward, from 37 percent in 1947 to 53 percent by the early '70s, when the birth of the patients' rights movement helped shine a new spotlight on issues of death and dying. Karen Ann Quinlan provided the spark when she fell into a coma and was declared by doctors to be in a "persistent vegetative state." Her parents went to court to have her respirator removed, and in 1976 the New Jersey Supreme Court ruled in their favor. That year California became the first state to recognize living wills as legally binding documents that authorize the removal of life-sustaining treatment in the face of imminent death. Other states followed, and end-of-life directives became an increasingly common part of the medical landscape. Today, there's hardly a medical show on television that hasn't dealt with the now-famous DNR—Do Not Resuscitate—order. Active euthanasia remained illegal everywhere, but the door had been opened a crack—and supporters of assisted suicide started pushing to open it further. Founded in the aftermath of the Quinlan fight, the Santa Monica-based Hemlock Society soon became one of the most aggressive backers of abolishing legal bans on physician-assisted suicide. By the end of the 1980s, national support had gained another 12 polling points, and success seemed within grasp. In 1988, supporters of assisted suicide tried but failed to get a measure on the California ballot. In 1991, a similar measure made it on the ballot in Washington state but failed to gain passage. In 1992, Californians got a measure on the ballot, and polls showed the public widely in favor. But a well-funded opposition campaign, led by the Catholic Church, took its toll, and in the end the initiative failed, 54 to 46 percent. Finally, in 1994, backers succeeded in Oregon. Three years later, following a court fight and a second ballot measure, Oregon became the first state to legalize physician-aided suicide. Ever since Oregon's
