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The book was published in April but at first languished unnoticed. Then, after a Wall Street Journal feature and stories on ABC's Good Morning America and CNN, sales skyrocketed. Says Humphry: "People want to take control of their dying. My book is a sort of insurance, a comforter there on the bookshelf that they could make their escape from this world if they were suffering unbearably." According to bookstores, many customers who seek the book are elderly; some others appear to be health-care professionals or AIDS patients. To date, apparently no one has been publicly identified as having relied on the manual to complete a suicide.
Given how controversial the topic is, Final Exit has generated surprisingly little heat. No prosecutor has attempted to suppress it. The National Right to Life Committee criticizes it in interviews but is not actively campaigning against it. A few booksellers decline to carry it, generally on moral and religious grounds. Says Ruth Holkeboer, owner of the Bookworm in Grand Rapids: "My father was a doctor, and my brother is a doctor. I was raised in the atmosphere of caring for life and saving life. My sales staff felt the same way. They said they could not put such a book in a customer's hands when they didn't know how it would be used." Some physicians are offended. Lonnie Bristow, a trustee of the American Medical Association who practices internal medicine in San Pablo, Calif., says, "For doctors to on one hand be of help and on the other be harboring ideas of dispatching their patients would destroy the therapeutic relationship of trust."
Some critics have contended that the book might encourage suicide among the unstable. But the text is full of cautionary statements about the value of counseling. Humphry distinguishes between "rational" suicide, undertaken by the irreversibly handicapped or the terminally ill, and "emotional" suicide by those who are depressed, of which he disapproves. He says, "My book pleads with the depressed to go to a psychiatrist. But it's addressed to the 6,000 people who die every day, not the handful who commit suicide." Others have been concerned that the book's data on lethal doses might make suicide -- or murder -- easier. Yet the U.S. is a society in which guns can be obtained with less paperwork than automobiles, and almost every kitchen contains some lethal cleanser.
Humphry argues that he will not make suicide easier -- just more reliable, less painful, less messy and above all less solitary. He urges those who choose suicide to gather family and friends around them for solace as they slip away. That gesture might require the biggest social and cultural change of all. Many people who could accept the idea of ending a loved one's pain would find it impossible to watch, and be complicit in, the actual suicide. For the one who dies, there may be a final exit. But those who live on might have to dwell with ceaseless doubt, guilt or scorn. Even if a suicide is rational, mankind remains emotional.