Most how-to books instruct readers in ways to refinish furniture, profit from a recession, communicate with one's in-laws or cook some exotic ethnic casserole. But one of the hottest tomes of the moment -- it has sold out its first printing of 41,000 copies and will top next week's best-seller list of how-to and advice volumes in the New York Times -- explains, step by step, how to end a human life.
The book, Final Exit, is a manual for committing suicide or helping someone else to do so. It includes charts of lethal dosages for 18 prescription drugs, primarily pain killers and sleeping tablets; it debates and debunks the merits of cyanide; it offers abundant practical advice about asphyxiation by plastic bag or auto exhaust. Seemingly every detail is addressed: mixing pills with yogurt or pudding so that the patient does not vomit or pass out before ingesting a lethal amount; not turning off the telephone or message machine, because "any changes will only alert callers to something unusual happening"; having family members avoid any direct physical assistance, so they cannot be prosecuted; and, if concealment of the cause of death is sought, telling heirs to object to an autopsy.
Even more jarring to critics, the book exhorts doctors and nurses actively to abet the "self-deliverance" of the terminally ill. Author Derek Humphry contends that such assistance is common but tacit. "Part of good medicine is to help you out of this life as well as help you in," he argues. "When cure is no longer possible and the patient seeks relief through euthanasia, the help of physicians is most appropriate."
Humphry proudly asserts that he has assisted three family members in ending their lives when they faced intolerable pain or debilitation: a brother whose life-support machinery was disconnected and a wife and father-in-law who took sleeping pills. A former journalist with the London Sunday Times and Los Angeles Times, he now makes his living promoting the right to die. He is the author of three previous books on the subject and founder and executive director of the Hemlock Society, a group based in Oregon that claims 38,000 dues-paying members. Its motto: "Death with Dignity."
One committed member, publisher Steven Schragis of Carol Publishing Group, a small New Jersey house that is distributing the book, urged Humphry to move beyond philosophical arguments to practical guidance. Schragis says, "At some point you have to make a decision: Should people be able to have this information? This is our way of making a statement that they should." Alan Meisel, professor of law and director of the Center for Medical Ethics at the University of Pittsburgh, sees the publication as a significant change. "People are very worried that their dying is going to be prolonged and painful," he says. "With this book, it's clear we have entered a new phase of the right to die."