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Final Exit: Group That Helps Suffering People Commit Suicide Is Active in Florida

Final Exit: Group That Helps Suffering People Commit Suicide Is Active in Florida
Photo by Russel Odgen, published with a study in the Journal of Medical Ethics

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

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 before, 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."

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 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 terminally ill 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, the 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," Detective Mynor Cruz wrote in a report. He suggested 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 that 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 morphed into an organization called Compassion & Choices and chose to focus on legislation -- "the unimportant part" -- he splintered off with Final Exit to help individuals.

"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?" Chastain 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 7:00, and Chastain told him to go straight to hell." Police also tracked down McGoldrick, who refused to talk. Eventually prosecutors decided that since 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 Sandra Snow's 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 got 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, 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 face legal battles with life insurance companies who 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, he says.

Jeffery says that "I'm so dedicated to Final Exit" that "I'd love to see a video" so that 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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