When Boca Raton Police Officer Lora McHugh entered Sandra Snow's bedroom around 4:30 p.m. July 22, 2008, she found the plump 62-year-old lying face up on the bed, a green blanket pulled up to her neck. Snow was dead.

"Every person deliberately assisting another in the commission of self-murder shall be guilty of manslaughter, a felony of the second degree."

The officer checked for signs of foul play but found none. Snow's nephew, a 49-year-old realtor named Jeffery, said he'd discovered his aunt's body just 15 minutes earlier, when he'd arrived to take her car in for service.

Jeffery dialed a number and handed the phone to McHugh. Snow's doctor advised that Sandra hadn't been in good health. He offered to sign the death certificate. The cop hung up and concluded in her report, "Apparent cause of death was natural causes."

The "exit hood" recommended by the group Final Exit.
Photo by Russel Odgen, published with a study in the Journal of Medical Ethics
The "exit hood" recommended by the group Final Exit.

But the truth was far more complicated. It involved lies, secrecy, a tank of helium, and something called an "exit hood" that would lead to suicide.

A year later, authorities connected Snow's death to a little-known assisted-suicide group called Final Exit that has 30-year-old roots tracing to California journalist Derek Humphry. In 1991, Humphry published a bestselling manual that not only considered the ethics of suicide but also included instructions on how best to do it.

Humphry founded the nation's best-known assisted-suicide group — the Hemlock Society — which would eventually fracture, with some members going on to found Final Exit. It made headlines throughout the 1990s, at the same time as "Dr. Death," Jack Kevorkian, who spent eight years in jail and assisted in 130 suicides. The issue came back into focus last month when the Belgian Senate ignited controversy by approving euthanasia for kids under age 18.

Most states have provisions against "aiding" or "assisting" in a suicide, though several allow physician-assisted suicides for terminally ill patients. Florida law holds that "every person deliberately assisting another in the commission of self-murder shall be guilty of manslaughter, a felony of the second degree."

"Final Exit Network never encourages anyone to self-deliver," says Robert Rivas, a Tallahassee-based attorney for Final Exit. People who apply for assistance, he says, are "screened very carefully" by the group's medical committee. They need not be diagnosed with a terminal illness but must be deemed to have "no hope." Those individuals are accepted and assigned two exit guides, who "give information... and moral support," Rivas says.

Criminal statutes, he asserts, are applicable only if a volunteer were to physically help a person die — like "crush a pill or hand them a drink." Yet "some prosecutors in some states still think [what we do] is illegal assistance," Rivas says.

Prosecutors in Minnesota in 2012 charged four Final Exit volunteers with assisting in a suicide. That case is being reviewed by the Minnesota Supreme Court. Rivas believes appeals could take the case to the U.S. Supreme Court — and eventually invalidate at least six other similarly worded state laws.

Until that happens, and as Sandra Snow's case illustrates, Final Exit volunteers carry out their mission with significant legal risks. This small but committed group is today the most fascinating voice in the national right-to-die debate.

Almost a year after Snow's death, Georgia authorities investigating a death there seized records from Final Exit and discovered the organization's involvement in cases in other states — including Snow's. Georgia police forwarded those records. On May 19, 2009, Boca police summoned Jeffery Snow to the station. In a videotaped interview, the realtor said that Sandra had never been diagnosed with a terminal illness but that in her final days, she had been so frail she couldn't pick up a cup of coffee. She was bedridden and used a wheelchair.

Asked if he knew anything about Final Exit, he said Sandra had received mail from the organization. But "Jeffery's body language indicated he wasn't being completely truthful," Det. Mynor Cruz wrote in a report. He suggested that Jeffery think things through and get back in touch if he remembered anything.

The next day, Jeffery faxed a letter through an attorney. In it — and in follow-up meetings with police — he confessed that in April 2008, he'd sat in on a meeting between his aunt and a Final Exit volunteer he remembered only as "Mike." Sandra Snow had initially considered suicide by overdosing on drugs, Jeffery said, but was afraid she would end up in a vegetative state.

Mike explained she could end her life by inhaling helium, warning her that this method "was secret and should not be shared with children," Jeffery recalled. He advised that Sandra would need to get tanks of helium from Costco and then buy an "exit hood" — a plastic bag that would cover her face and include a tube to connect to the helium tank.

"Snow would have to be able to put the mask on by herself and also turn the helium tanks on by herself," a police report explained. "Starved of oxygen, she would get light-headed and pass out, then die painlessly in a matter of seconds. Mike would then remove the mask within minutes and leave with the mask and tank."

The Georgia records led to a Palm Beach Gardens man, Michael McGoldrick, and a Sarasota man, James Chastain, who were the "exit guides" assigned to Snow's case. An "exit log" included handwritten notes that said, "Snow was a hospice nurse. She planned all details perfectly... She laughed a lot, then said she was ready, had her dog on the bed with her. She had arranged for a nephew to find her at 3:30. All went smoothly according to plan — no complications."

Jim Chastain is now 87 years old and still travels around the country to offer his services. Reached by New Times at his Sarasota home, he declined to talk about Sandra Snow or any specific case but explained he became interested in the right-to-die movement because "so many people die in an unhappy way." A former college professor, he and his wife joined the Hemlock Society in the late 1980s. But when that group chose to concentrate on legislation — "the unimportant part" — he splintered off with Final Exit.

"I get a couple of calls a week," he says.

Chastain says he'll self-deliver when he becomes a burden on his children. "Is there such a thing as a completed life?" he muses. "Would it be appropriate for a person to say, 'I've lived as long as I want to live'?"

Fran Schindler, 75, handles Final Exit "applications" from her home in North Carolina and helps assign the 25 or so exit guides around the country. It should be "a basic human right" to decide "how, where, and most importantly, with whom they choose to die," Schindler insists. She has sat in on 27 deaths since 2007 and says Final Exit helps people with anticipatory grieving. "Families are able to say all the things to each other that they want to say," she explains. "One lady had a great birthday party and a dinner" just before her self-delivery, she says. Another woman's grandson sat next to her with his arm around her.

Schindler, a retired nurse, found Final Exit after having scares with breast cancer and Lou Gehrig's disease. If she ever gets a terminal illness or is diagnosed with dementia, she knows how she will go. "I was so obsessed" with the fear of dying badly, she says. "When I learned I would not have to die alone — that there would be people who would come sit with me — I was not scared anymore. Bring it on."

Rivas, the Final Exit attorney, remembers how Sandra Snow's case ended: "Jim Chastain had a police officer knock on his door at 7, and Chastain told him to go straight to hell." Police also tracked down McGoldrick, who refused to talk. Eventually, prosecutors decided that because Sandra Snow's body — the evidence — had been donated to science and then cremated, it would be impossible to win in court. The medical examiner reclassified her death as a suicide by helium asphyxia, and Boca police closed their case in 2011.

Today, Jeffery Snow remains a realtor in Boca Raton. "It's no fun to be interviewed by the police," he says, but his experience made him a strong supporter of Final Exit. He became a member himself and has referred the organization to several friends who became agonizingly sick and struggled with every breath.

To witness Final Exit reassure his aunt "that we can be there — we can't help you physically, but we can be there for you... To witness a body who hears that, what comfort that brings, that was incredible," he says. "It's very unfortunate that dying with dignity isn't considered an option for some people."

Jeffery says that for him, the secrecy wasn't much of a burden, because "you get such joy out of helping people." Sandra Snow had been a nurse and then a pharmaceutical rep. She was also a big animal lover and, in her retirement, launched an animal transport business. She didn't want suicide to be her legacy, he said.

Still, he understands the legal risks. Not only is there a risk of criminal charges, but some families could also face legal battles with life insurance companies that might refuse payments for suicides. Jeffery says Sandra Snow had no life insurance, and although he was the sole beneficiary of his aunt's trust, there was not much to inherit.

Jeffery says he's "so dedicated to Final Exit" that he'd "love to see a video" so there'd be proof that exit guides help people experience an easy, painless death instead of a protracted, agonizing one. "If I ever get a terminal illness," he declares, "I'll volunteer to do the video."

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Another thing. The Boca police say they abandoned the case because the body was cremated and as a result there was no evidence. This is self-serving propaganda. I don't fault New Times for falling for it, though I could have clarified if I had been asked. A body does not yield any evidence when a person dies from the displacement of oxygen by helium. The body would not have provided the prosecution with any evidence whatsoever. The Boca police abandoned the case because they had no case, and it had nothing to do with the lack of a body. The Boca police have no evidence that anybody from Final Exit Network "assisted" in any death. Period.


Your story builds to the big dramatic breathless punchline:  "But the truth was far more complicated. It involved lies, secrecy, a tank of helium, and something called an 'exit hood' that would lead to suicide." (Scary music here.) But where in the story is anything about anybody lying to anybody? Nowhere. What about secrecy?  Final Exit Network is a nationwide not-for-profit organization that does everything in the open --- except for one thing. Final Exit Network keeps its members' medical information confidential. Is that "secrecy"? Is it wrong? Only to someone who is trying to sound melodramatic and breathless in a BS story. By the way, the story keeps referring to "Final Exit." Final Exit is the name of a book. The organization is Final Exit Network. A real news medium knows what words mean and how to use them.


At the end, the author babbles that "some families could face legal battles with life insurance companies who might refuse payments for suicides," and refers to "legal concerns about a policy being nullified" by "suicide." There is no attribution to this discussion because there is no truth to it.  The fact that one dies by "suicide" is not a basis for a life insurance carrier to deny a death claim unless the person dies during the "contestability" period, which is one or two years from the date the policy was taken out. It is implausible that someone would be terminally ill and imminently dying within two years of having, by chance, taken out a life insurance policy.  After 15 years in the movement for the right to death with dignity, I have never heard of life insurane being an issue for anyone. The contestabiilty period is only designed to stop people from taking out a life insurance policy with the intention of killing themselves to collect the proceeds. Life insurance never becomes an issue with someone who is legitiately planning to hasten an otherwise intolerable death from disease. In Oregon, Washington, and Vermont, the states with physician assisted death laws, insurance carriers are prohibited from denying the death claim on the mere basis that the physician-aided death is labled "suicide" by opponents of the practice. 


This story is truly inept journalism. The headline says, "Should Assisted Suicide Be Legal?" Yet nowhere in the story is there any mention of anyone contending that assisted suicide should be legal, or of any debate about it. As the general counsel for Final Exit Network, I can assure you that the organizaation has never asserted that "assisted suicide" should be "legal," except in connection with a Death With Dignity Law such as those in Oregon, Washington, and Vermone, where the practice is limited to physicians. Final Exit Network does not assist in suicides (and neither did the old Hemlock Society), yet the story calls Final Exit Network and the Hemlock Society "assisted suicide" groups. The author seems unaware that to call Final Exit Network and the Hemlock Society "assisted suicide" groups is to pronounce them guilty of crimes. It's like writing a story about an upcoming murder trial and saying, "The murderer goes on trial next week." Nobody associated with Final Exit Network has ever been convicted by a jury of any crime.

funchey1 moderator editor

@robertrivas1  You say "The fact that one dies by "suicide" is not a basis for a life insurance carrier to deny a death claim unless the person dies during the "contestability" period, which is one or two years from the date the policy was taken out. It is implausible that someone would be terminally ill and imminently dying within two years of having, by chance, taken out a life insurance policy."

... But one need not be terminally ill to get help from Final Exit -- so anyone who takes out a policy but "self-delivers" within two years "COULD also face legal battles.