Amicus Curiae Brief — Vacco v. Quill

——_-

BEST AVAILABLE COPY

Nos. 96-110 and 95-1858

In The

Supreme Court of the United States

October Term, 1996

STATE OF WASHINGTON, et al.,

Petitioners,

v.

HAROLD GLUCKSBERG, M.D., et al.,

Respondents.

ON WRIT OF CERTIORARI TO THE UNITED STATES

COURT OF APPEALS FOR THE NINTH CIRCUIT

DENNIS C. VACCO, et al.,

Petitioners,

v.

TIMOTHY E. QUILL, M.D., et al.,

Respondents.

ON WRIT OF CERTIORARI TO THE UNITED STATES

COURT OF APPEALS FOR THE SECOND CIRCUIT

=

BRIEF AMICUS CURIAE OF SURVIVING

FAMILY MEMBERS IN SUPPORT OF

PHYSICIAN-ASSISTED DYING

- IN SUPPORT OF RESPONDENTS -

———$——<$—$$—<—s-_-<e —e e

TABLE OF CONTENTS

STATEMENT OF AMICUS CURIAE ..... ae

SUMMARY OF ARGUMENT ................ 4

THE CONSTITUTION PROTECTS INTIMATE,

PERSONAL, AND IMPORTANT DECISIONS

INCLUDING THE CHOICE OF PHYSICIAN

ASSISTANCE TO HASTEN DEATH FOR A

TERMINALLY ILL, COMPETENT ADULT ..... 6

DENIAL OF THE CHOICE OF PHYSICIAN

ASSISTANCE TO HASTEN DEATH FOR

COMPETENT, TERMINALLY ILL ADULT

PATIENTS IMPERMISSIBLY INFRINGES UPON

THE LIBERTY INTEREST OF THE PATIENTS 9

A. Terminally I! Patients Denied the Choice of

Physician-Assisted Dying May Be Forced to

Endure Horrific Pain and Suffering and Loss

UGS D DBebaind > ods 0 0009000. y)

B. Terminally Ili Patients Denied the Option of

Physician-Assisted Dying Are Sometimes

Forced to Experience a Violent, Lonely, at

Times Gruesome Death .............. 12

c. Terminally Ili Patients Denied the Option of

Physician-Assisted Dying May Be Forced to

Rely on Family Members to Assist in

ES BOG bo S60 60000 cee. 16

Vi.

ii

TABLE OF CONTENTS - Continued

Page

D. Terminally Ili Patients Denied the Option of

Physician-Assisted Dying Sometimes Fail in

Their Attempts to Hasten Death, with Tragic

DENIAL OF THE OPTION OF PHYSICIAN

ASSISTANCE TO HASTEN DEATH FOR

COMPETENT, TERMINALLY ILL PATIENTS

HAS DEVASTATING CONSEQUENCES FOR

SURVIVING FAMILY MEMBERS ........... 24

THERE IS NO MEANINGFUL DISTINCTION

FOR THE PATIENTS AND SURVIVING

FAMILY MEMBERS BETWEEN A

PHYSICIAN’S ASSISTANCE IN HASTENING

DEATH AND A PHYSICIAN’S WITHDRAWAL

GP EG GSC OEe | See ide ceo cccccces 27

A. The Deceased Loved Ones of the Amicus

Were Dying of Terminal Illnesses and

Suffering in the Same Way «at

Terminally Ill People with Life

Support Measures Suffer.............. 27

B. The Legislatures’ Distinctions Between the

Refusal or Withdrawal of Life Support to

Hasten Death and the Acceptance of Other

Forms of Physicians’ Assistance to Hasten

Death is Not Rational ................ 28

VER, GEMS oc ccc cece esac ccncedeereesecs 29

iil

TABLE OF CONTENTS - Continued

APPENDICES:

Declaration of Roberta Lau

Declaration of Patsy 'icLaughlin McGeorge

Declaration of Leanne Gallison

Declaration of Kay Beck

Declaration of E!vin O. Sinnard

Declaration of Patty Rosen

Declaration of Jeff (Joseph) Halsey

Declaration of Tania Bloom

Declaration of Gail Bereny

Declaration of Dorothy B. Hoogstraat

Declaration of Gésta Pearson

Declaration of Keith William Green

Declaration of William F. Meyer III

Declaration of Steve Knipp

Declaration of Jinny Tesik

ARoBDUISeeryYAvewn-

iv

TABLE OF AUTHORITIES

Page

CASES

79 F.3d 790 (9th Cir. 1996) ...... Cenc wte e passim

: D seiesoeri Dest. of Heakt

GT OS. 260 CODED 6c ccc cnceccccceccessss. 6

Quill v. Vacco, 80 F.3d 716 (2d Cir. 1996) ........... 4,28

Planned Parenthood y. Casey, 505 U.S. 833 (1992) ...... 6,9

492 US.

490, 106 L. Ed. 2d 410, 109 S. Ct. 3040 (1989) .... 4

OTHER AUTHORITIES

Battin, M., The Least Worst Death (1994) ............ 3,7,9

Burnell, G., Final Choices: To Live or to Die

in an Age of Medical Technology (1993)......... 3

Farnsworth, C., Vancouver AIDS Suicides Botched,

> CL Se Be SE 6 cece ececeesenecas 3,23

Jamison, S., Final Acts of Love (1995) .............. 3,16

Kolata, G., AIDS Patients Seek Solace in Suicide

But Many Risk Added Pain in Failure, N.Y.

De Pr te <. peeckt see een eae + ae t 4,30

The New York State Task Fores on Life and the

Vv

TABLE OF AUTHORITIES - Continued

Page

Nuland, S., How We Die: Reflections on Life’s

TIT REE 4,10

Posner, R., Age and Old Age (1995) ................, 7

Quill, T., Death and Dignity: Making Choices

and Taking Charge (1993) ................... 4

Quill, T., A Midwife Through the Dying Process (1996) .. 4,7,

10,29,30

Rachels, J., The End of Life (1986) .................., 4

a 4

Shavelson, L.,

Singer, P., Rethinking Life and Death (1994) .......... 4.7

Solomon, A., A Death of One’s Own,

The New Yorker, May 22,1995 ............. 4,23

l

I. STATEMENT OF AMICUS CURIAE.

The amicus curiae is composed of fifteen distinct

individuals--not an organization, a religious group, or a group of

politicians. The amicus consists of one family member of an

individual who experienced the positive aspects of physician-

assisted dying and fourteen family members of individuals who

experienced unnecessarily painful, traumatic deaths in the

absence of physician-assisted dying. They submit this Brief in

support of Respondents.' The family members’ are the voices of

their deceased loved ones, describing for the Court the differing

realities of what happens to families when a competent,

terminally ill person is granted or forbidden the choice of a

hastened death. The individual experiences present the Court

with the emotional resonance of dying with and without

physician assistance to hasten the process. In each case, the

dying person desperately wanted to hasten death--some were

successful with plastic bags, some chose guns, some died slowly

but naturally, in agony and without dignity, and one died when

and how he wanted, under medical care, peacefully, with loved

ones present. The perspective of persons who have had recent

experience with this issue is relevant and necessary to the

Court’s proper and full consideration.

Declarations of the fifteen family members are attached

hereto as Appendices 1-15.’ The group includes a woman

whose husband, dying of lung cancer, obtained medication from

his physician and was able to have a peaceful and gentle

death--with his wife, daughter, nurse and trained Compassion In

'The parties have consented to the filing of this Brief and the

letters of consent are on file with the Clerk of this Court.

The term “family member" includes spouses, children,

parents, and partners involved in a close personal relationship.

*Originals of the declarations are either on file in the Ninth

Circuit case below or in the office of the counsel of record herein.

2

Dying volunteers at his bedside (App. 1). In juxtaposition, the

remainder of the group includes:

a widow whose husband of 25 years was

compelled to shoot himself in their front yard in

order to end his debilitating pain (App. 2);

a daughter whose mother was wasted by cancer

to a mere 60 pounds before she swallowed

morphine (App. 3);

a widow who helped her husband prepare the

sleeping pills he would take to avoid the

devastating terminal stages of esophageal cancer

(App. 4);

a husband whose wife of 49 years had to die

alone with a plastic bag over her head rather

than face the unbearable pain caused by a heart

condition (App. 5);

a mother who struggled to medically assist her

26 year old daughter to die, because a doctor’s

help was not available (App. 6);

the partner of a man who, dying of AIDS,

withheld his own insulin to hasten his death,

dying with convulsions, dementia, violent

outbreaks, and a total loss of dignity (App. 7);

a daughter whose family had to clean her

father’s splattered brains off the basement walls

after he shot himself with his 12-gauge shotgun

to avoid the excruciating pain caused by lung

cancer (App. 8);

a daughter whose father lay dying, diapered,

moaning in pain and begging to die while the

3

doctor refused morphine because it could kill

him (App. 9);

° a widow devastated by watching her husband of

47 years live two months longer than he wished,

slowly dying of cancer (App. 10);

° a man whose surrogate son failed in his suicide

attempt and ended up in a coma (App. |! 1);

° a partner who was charged with murder and

assisted suicide because he was present when his

partner, dying of AIDS, ‘ok pills and sat in his

car to ingest carbon monoxide (App. 12);

° a son who was criminally prosecuted for helping

his 88 year old father, dying of cancer, hold a

plastic bag over his head (App. 13);

° a man whose partner, dying of AIDS, destroyed

his last few weeks of life agonizing about how

to commit suicide (App. 14); and

° a daughter who had to leave her father to die

alone so she would not be implicated in his

death (App. 15).

. The fifteen are among a significant number of

Americans who have witnessed loved ones die in pain and

agony, against their wishes and in an affront to their beliefs and

personhood--denied the legal right to meuical assistance to end

unbearable suffering and hasten inevitable death.‘ They give

“Various sources recount experiences of hundreds of

Americans similar to the experiences of the fifteen representative

family members. M. Battin, The Least Worst Death (1994); G.

Burnell, Final Choices: To Live or to Die in an Age of Medical

Technology (1993); C. Farnsworth, Vancouver AIDS Suicides Botched

N.Y. Times, June 14, 1994 at C12; S. Jamison, Final Acts of Love

4

their names and sacrifice their privacy and that of their family to

preserve their liberty and the liberty of others who are terminally

ill and wish to die with dignity. With the combined personal

experiences of this group, the amicus has a profound interest in

this litigation.’

Il. SUMMARY OF ARGUMENT.

The amicus urges this Court to affirm the en banc

decision of the Ninth Circuit Court of Appeals, Compassion in

Dying v. State of Washington, 79 F.3d 790 (9th Cir. 1996), and

the decision of the Second Circuit Court of Appeals, Quill v.

Vacco, 80 F.3d 716 (2d Cir. 1996) finding unconstitutional

Washington and New York statutes which make it a crime for a

physician to knowingly aid another person in committing suicide

as applied to the care of a competent, terminally il! patient.

(1995); G. Kolata, AIDS Patients Seek Solace in Suicide But Many

Risk Added Pain in Failure, N.Y. Times, June 14, 1994 at C1; S.

Nuland, How We Die: Reflections on Life’s Final Chapter (1994),

T. Quill, Death and Dignity: Making Choices and Taking Charge

(1993); T. Quill, A Midwife Through the Dying Process (1996); J.

Rachels, The End of Life (1986); B. Rollin, Last Wish (1985); L.

Shavelson, ici

(1995); P. Singer, Rethinking Life and Death (1994); A. Solomon, A

Death of One’s Own, The New Yorker, May 22, 1995 at 54.

‘Statements to the Court similar to those filed herein are not

without precedent. In Webster v. Reproductive Health Services, 492

U.S. 490, 106 L. Ed. 2d 410, 109 S. Ct. 3040 (1989), an amicus brief

filed with and considered by this Court, entitled "Women Who Have

Had Abortions, et al.," included declarations by numerous women who

had experienced legal and illegal abortions. As in Webster, the

declarations filed here contain relevant first-hand information by

persons intimately familiar with the issues on appeal. It should be

noted that Petitioner State of Washington's Brief cites newspaper

accounts of stories of people dealing with this issue. Washington

Petitioner’s Br. at 16-17.

5

The experience of one of the fifteen survivors--

recounting the positive aspects of having a physiciar and other

medical personnel assist in a hastened death--demonstrates why

the choice to seek physician assistance is a liberty interest

protected by the Due Process Clause of the Fourteenth

Amendment. This one experience evidences the profoundly

personal, intimate, and important nature of this decision, central

to personal dignity and autonomy.

‘The experiences of the remaining fourteen survivors

exemplify how the state laws prohibiting physicians from

prescribing medication to hasten death burden the liberty interest

of competent, dying patients. The Ninth Circuit decision below

correctly recognized that the extent of the burden on liberty was

one of several relevant factors in determining whether the

challenged law violates an individual’s substantive due process

rights. Compassion in Dying, 79 F.3d at 816. The individual

experience of each of the fourteen surviving family members

presents one or more of the following ways in which the current

laws constitute an undue burden:

¢ The current laws result in untold pain, agony, and

suffering for some dying patients who would prefer

death; a slow, debilitating death is often

accompanied by a profound loss of dignity and self-

respect.

° The current laws cause some patients to choose a

violent, often gruesome manner of hastening death:

these suicides are generally committed alone,

without family present.

¢ The current laws result in the failure of some

attempts to hasten death, due to the absence of

trained medical care--sometimes leaving the patient

in worse condition than before the attempt.

° The current laws result in some family members

feeling compelled to assist their loved ones to hasten

6

death, with concomitant fear and hiding, guilt, and

occasional criminal investigation and prosecution.

e The current laws result in suffering, guilt, anger, and

remorse for some surviving family members.

Additionally, to deny medical assistance at a time of

such need is to deny some terminally ill people equal protection

of the law under the Fourteenth Amendment. To permit

physicians to remove life support systems or to refrain from

taking life sustaining measures, thereby hastening death,

provides those terminally ill patients with a choice to die with

dignity, a choice denied other terminally ill patients who cannot

obtain medical assistance to hasten death.

Ill. THE CONSTITUTION PROTECTS INTIMATE,

PERSONAL, AND IMPORTANT DECISIONS

INCLUDING THE CHOICE OF PHYSICIAN

ASSISTANCE TO HASTEN DEATH FOR A

TERMINALLY ILL, COMPETENT ADULT.

A competent, terminally ill patient has a liberty interest

in determining the time and manner of his or her death.

Planned Parenthood v. Casey, 505 U.S. 833, 851 (1992); Cruzan

y. Director, Missouri " pt. of Health, 497 U.S. 261, 281 (1990).

In Casey, this Court recognized that certain matters "involving

tl.e most intimate and personal choices a person may make in a

lifetime, choices central to personal dignity and autonomy, are

central to the liberty protected by the Fourteenth Amendment."

Casey, 505 U.S. at 851. As the Ninth Circuit court below

added:

A competent terminally ill adult, having lived nearly the

full measure of his life, has a strong liberty interest in

choosing a dignified and humane death rather than being

reduced at the end of his existence to a childlike state of

helplessness, diapered, sedated, incontinent. How a

person dies not only determines the nature of the final

7

period of his existence, but in many cases, the enduring

memories held by those who love him.

Compassion in Dying, 79 F.3d at 814.

For Richard Lau, the decision he made to choose

physician assistance in dying during the last weeks of his life

exemplifies the intimate, personal, and important nature of this

decision.° For Roberta Lau, his widow, his decision positively

affected the "enduring memory" she had of her husband’s

demise. Her statement reflects the dignity and peace that can

accompany a physician-assisted death:’

*Providing the means and ability to hasten death for the

terminally ill can also provide a feeling of control over one’s life and

peace of mind, even if the physician prescribed medication is never

used. Richard Posner, Age and Old Age 243-53 (1995). Moreover,

having a physician involved in this important decision-making process

can sometimes reverse a patient’s decision to end his or her life.

Under current state laws patients "... cannot make use of the

professional help their doctors, psychologists, psychiatrists, or other

counselors have to offer in exploring choices of suicide and which

might provide them with very real help. As a result, some older,

disabled, or dying persons commit suicide when they do not really

wish to do so..." Margaret Pabst Battin, The Least Worst Death 272

(1994). “Our public policy should encourage doctors to be creative

and openly responsive, rather than fearful and secretive, when patients

are faced with a bad death." Timothy E. Quill, M.D., A Midwife

Through the Dying Process 26 (1996).

"See Peter Singer, Rethinking Life and Death 148 (1994) for

how a planned, hastened death in the Netherlands, where physician-

assisted dying for the competent terminally ill is legal, can be even

more dignified, since it is legal. The author describes the planned

death of Carla: “She had the best possible medical attention, right up

to the moment of death. Her family could be with her, and even her

priest. Nothing had to be furtive. There was no need to fear failure.

No-one had to lie awake afterwards wondering if the police would

knock."

My husband of 42 years, Richard A. Lau, died on

October 12, 1995. My husband’s desire and intent

always was to find the means to hasten his own death

when his physical condition was no longer bearable. He

died after taking a sufficient supply of drugs prescribed

by a physician that took a long search and numerous

inquiries to locate.

Richard had been battling lung cancer for two years

before he died. ...

Approximately three weeks prior to Richard’s death, he

was examined by an independent physician, not his

treating physician. This physician verified that Richard

was mentally competent, not depressed, and fully aware

of the consequence of his decisions. The physician

determined that Richard’s condition was terminal and

that he had no more than one to two months to live. ...

Richard decided that he wished to die on Thursday,

October 12, 1995. A nurse, my adult daughter, and two

trained volunteers from Compassion in Dying were

present with him. Everyone checked with Richard to

see if he had changed his decision. He was clear and

adamant in his determination to proceed.

Richard was helped with personal care matters, smoked

a cigarette and visited with those present. He then

personally took the medications. He was very relaxed

and at peace and thankfully welcomed his liberation. He

always worried so much about finding this assistance

and it was a blessing when we did. We did not believe

in prolong.ng suffering neediessly.

At the end, his death at home was very calm and

peaceful. I supported him all the way.

I believe all terminal and suffering persons should be

able to legally seek supervised and regulated assistance

9

in dying, if that is their wish. Prolonging suffering

needlessly is inhumane.

Appendix |.

IV. DENIAL OF THE CHOICE OF PHYSICIAN

ASSISTANCE TO HASTEN DEATH FOR

COMPETENT, TERMINALLY ILL ADULT

PATIENTS IMPERMISSIBLY INFRINGES UPON

THE LIBERTY INTEREST OF THE PATIENTS.

State regulations may not impose an undue burden on

recognized liberty interests. Casey, 505 U.S. at 873. The

majority of the declarations show that the Washington and New

York statutes, in prohibiting physicians from prescribing

medication to end life, do impose an undue burden and thereby

impermissibly infringe upon the liberty interests of competent,

terminally ill patients.

A. Terminally Ili Patients Denied the Choice of

Physician- Assisted Dying May Be Forced to

Endure Horrific Pain and Suffering and Loss of

Dignity.

All of the family members witnessed the intense

suffering of their loved ones in the weeks or months before their

inevitable deaths. The statements dispel the myth that pills can

always control all pain.* Moreover, doctors sometimes refused

to prescribe sufficient pain-killing medication because of their

*Despite new advances in pain treatment, an “irreducible core

of patients are trapped in physical agony (if they are awake).”

Kreimer, 44 Am. U.L. Rev. at 831, n.93. Pain cannot be controlled in

st 10% of cases. The New York State Task Force on Life and the

Medical Context 40, n.18 (1994). Often, controlling pain sacrifices the

patient's consciousness, which “is tantamount to causing death, the

patient has no further conscious experience and thus can achieve no

goods, experience no significant communication, satisfy no goals "

M.P. Battin, supra, at 105.

10

fear that it would be used to hasten death.’ Thus, laws barring

physician-assisted dying contribute to suffering by causing some

doctors to withhold m.dication. Additionally, as family

members attest, a slow, deteriorating death often leads to loss of

dignity and self-respect for the dying person. '°

Dorothy Hoogstraat witnessed her husband's horrible

suffering, which medication could not ease

My husband, Emerson E. Hoogstraat, a retired

Professor of Finance, from Portland State University,

died on March 25, 1995 of prostate cancer that had

spread to the bones. . . .

He was relatively comfortable until June of 1994

when a series of new problems developed. Following

further diagnostic procedures it was ascertained that the

cancer had spread to his ribs, spine and right femur. He

was in considerable pain when walking, sitting or lying

in bed. ... His ribs gradually broke, and as he said to me

many times, he could feel the broken edges of the bones

rub together as he would sit or attempt to arise from the

bed. He was in unbearable pain. He was an extremely

intelligent, courageous and dignified man and he did not

wish to suffer unbearable pain when there was no hope

of recovery from this condition. He would very much

like to have gone io sleep in his own bed and not had to

suffer further. He feii that it was his right to say when

he had suffered enough. He “lived” at least two months

after he would have preferred not to. The physicians

and Hospice people were constantly changing

medications and attempting to make him as comfortable

as possible-- which in his condition was an

°T. Quill, supra, at 197 ("Often, doctors undermedicate dying

patients’ pain or shortness of breath because of the legal risks [both

exaggerated and real] associated with overmedicating.").

"See Sherwin B. Nuland, How We Die, Reflect Life’

Final Chapter 142 (1995).

impossibility. It was a twenty-four hour a day

caregiving situation and he still suffered unbearably. He

remained at home until his death. ...

We had been married for forty-seven years and

shared a lifetime together, and truly, watching him suffer

and being unable to do anything for him that would

relieve his pain was for me devastating.

I do not believe that God intended for people to

suffer in this manner. We are more compassionate with

our pets than we are with our dearly loved family

members.

Appendix |0.

Gail Bereny speaks of the unwillingness of her father’s

physician to prescribe adequate pain medication:

Several years ago, my 80 year old father was

diagnosed as having terminal abdominal cancer. He

went to his doctor with two requests, (1) not to prolong

things, and, (2) to keep him as pain free as possible.

His doctor agreed. However when time came, the doctor

cid neither. And so my father, to whom dignity was

very important, lay dying, diapered, moaning in pain,

begging to die. | called the doctor’s office, crying,

begging him to relieve Dad's pain. He refused, saying

morphine could kill him. . . .

I felt very guilty then, and feel guilty now, about

Dad's terrible death. | feel guilty that he died in so

much pain and with no dignity left. The doctor had the

means to give him a gentle, painless death. | have been

left with frustration, anger, regret, and sadness. He had

been a very good father.

Appendix 9.

In a rumber of cases, the terminally iil chose violent

deaths rather than continued suffering.'' They died completely

alone, without the comfort of their families. Their violent

deaths often resulted in gruesome and tragic consequences for

family left to deal with the remains.

Tania Bloom describes the brutal experience of her

elderly father’s suicide:

In 1989, my father was dying of lung cancer and

was in excruciating pain. His doctor would not provide

pain medication other than Tylenol saying that to do so

“would not be medically advisable.” Father remained at

home and in spite of being hooked up to oxygen, he

struggled to breathe. We had access to morphine and

hinted to him that we could get it for him if he wanted

it. However, he refused because he knew it was illegal

to assist in a suicide.

When he realized that my family was going to be

away for a day, he wrote us a beautiful letter, went

down to his basement, and shot himself with his | 2-

gauge shotgun. He was 84....

This was a brutal and awful experience for my

children and for me. | felt a great deal of loss, anger,

and remorse about a system that would not allow my

father to die gracefully and with dignity.

''The Ninth Circuit court below cites the example of how one

of the patients of physician plaintiff Dr. Harold Glucksberg ended his

life by jumping from a bridge in Seattle after Dr. Glucksberg could not

legally prescribe medication to hasten his patient's AIDS-related dying,

Compassion in Dying, 79 F.3d at 834.

13

My son-in-law then had the unfortunate and

unpleasant task of cleaning my father’s splattered brains

off the basement walls.

Physician assisted suicide should be a rational choice

and a reassurance for people. Physician assisted suicide

can have safeguards and planning so that it wouldn't be

an impulsive, irrational act and one of unnecessary

violence such as that of my Dad’s.

Appendix 6.

Patsy McGeorge’s husband also felt compelled to end

his life with a gun:

My husband of twenty-five years, Emanuel J.

("Mac") McGeorge, had terminal cancer involving the

spine, lungs and lymphatic system. But terminal cancer

is cited only as “other significant condition" to his cause

of death on the death certificate. The certificate reads:

“Death due to or as a consequence of: Massive trauma to

head -- self-inflected [sic] gun shot wound-shotgun.” ...

During late spring of 1995, he broached the subject

of suicide. It was not the first time suicide had been

mentioned, but this time he was quite serious. He told

me of his great concern for becoming incapacitated, or

so ill that he would either be hospitalized or would not,

for some other reason, be able to govern his own

destiny. He was relieved to have my assurance that he

would never be hospitalized against his wishes, and that

I would respect and support any decision he made about

ending his own life. Mac also brought up the possibility

of assisted suicide with his doctor, but while his doctor

was understanding, he was not supportive.

By October, Mac had already surpassed his predicted

nine-month life expectancy, but the cancer was taking its

toll. He had gone from a man of 190 pounds of muscle,

exceptional strength, and superior stamina to a "145

pound weakling.” ... By January of 1996, he was able to

eat very little; his weight loss was becoming extreme.

The principal spinal tumor had grown so large that he

14

referred to his appearance as that of the “Hunchback of

Notre Dame." He could only sleep on his side, and

despite 800 mg. of morphine a day and Roxicet every

two hours, his pain was so extreme that sleep came only

in short intervals. He could lie down for only an hour

or two at a time. He struggled through January, but by

the first of February, he couldn’t take much more. We

were referred to Hospice, an outstanding group that does

a great deal to ease the pain and suffering of the

terminally ill, but regrettably cannot assist in ending that

suffering. With a subcutaneous pump to assure a

continuous morphine flow and additional medication,

Hospice nurses were able to provide Mac his first full

night’s sleep in months. But Mac did not want to be a

drugged vegetable. Following an almost 24 hour

drugged stupor, he decided that was not the answer.

On the morning of February 9, 1996, he had made

up his mind. ... After a brief and very personal

conversation, he gave me the note he had carried for

months, attesting to the fact that his decision was his

own; kissed me goodbye; went into the front yard, put a

shotgun in his mouth and pulled the trigger. Since a

peaceful death was not available, this was his way to

insure death with the dignity he valued so highly. Two

months ago | was emotionally wrenched by finding a

portion of his upper dental plate 50 feet from the site of

his death -- a testament to the violent alternative he was

forced to choose.

Mac was not depressed -- the overwhelming pain or

alternative of a drug stupor were simply unacceptable to

him. Mac honestly believed he, with my support, had

the right and the responsibility to control his own

destiny.

To say that | miss him would be the understatement

of the century. But I esteem his courage, his conviction,

and his integrity. | am thankful that he loved me

enough to share his most personal emotions. | wish |

could have been with him at the end, but he said no, "it

will be messy.” Appendix 2.

15

Jinny Tesik attests to the loneliness involved when

family members choose suicide, not wanting to legally implicate

those left behind:

Unable to live alone due to his own battle with

emphysema, Dad lived with me for the last two years of

his life. He was adamant that he would not let his

disease control him the way his wife’s lung cancer

controlled her. He intended to take his life while he still

had his dignity, self-respect, and, above all, was still in

control of his life. He made me promise that | would

honor his choice. He threatened that if the means for

him to take control of his death were not available, he

would kill himseli with a kitchen knife.

The emphysema progressed. Dad was tethered to 30

feet of oxygen tubing; he seldom left his bedroom.

Breathing became more difficult and eating became a

problem. His physician was totally opposed to

providing the help Dad requested. One morning, he

reminded me of my promise to help him. He discussed

his plan rationally, non-emotionally. He was ready to

die and needed my support. We raided the medicine

cabinet and | was sent out to buy some vodka. We

spent the day together. Toward evening, he asked me to

leave the house and not return until very late. He did

not want me to be implicated in any way in his suicide.

Saying goodbye to my dad was one of the saddest times

of my life. And I had to go through that long night

alone for |, in turn, could not implicate anyone else in

the knowledge of my dad’s death. He died in 1990 at

the age of 76.

Appendix 15.

16

C. Terminally Ill Patients Denied the Option of

Physician-Assisted Dying May Be Forced to Rely

on Family Members to Assist in Hasteniny Death.

Some of the fifteen deceased could or would not

violently end their life with a bullet to the head. Nevertheless,

they were determined to control the timing of their death and

felt compelled to rely on the assistance of family.'? This

alternative brings other problems. The dying person has to

worry about legal implications for survivors. Family members

must engage in a conspiracy of silence to hide their

involvement--at a time when they are grieving.'? For some,

criminal investigation and even prosecution for assisted suicide

does result. Clearly, having untrained, emotionally involved

family members assist in hastening death without medical

supervision is not the most desirable alternative. '*

Kay Beck, a retired school counselor, describes her

involvement in her husband’s death:

"The Ninth Circuit court below recognized that an additional

burden was that "[T]hose who decline to assist may always wonder

whether they should have tried to save their parent or mate from

enduring, unnecessary and protracted agony." ion in Dying,

79 F.3d at 836.

"Stephen Jamison, Ph.D., Final Acts of Love: Families,

Friends, and Assisted Dying 169 (1995) ("Until the laws change,

secrecy will remain one of the most dominant features of assisted

death.").

‘Ibid. 5 ("This illegal assistance ... goes on without

guidelines, safeguards, psychological counseling or evaluations,

required consultation with specialists, referrals to hospice, or even

mandatory discussion of alternatives."). Moreover, sometimes family

members are not those assisting. "In the absence of legally available

aid from physicians, abuses are occurring at the hands of unregulated

freelance euthanasists, illegal suppliers meeting an otherwise unmet

demand." Lonny Shavelson, A Chosen Death: The Dying Confront

Assisted Suicide 67 (1995).

17

On Nov. 11, 1991, I helped my husband, Jack, end

his life. In the terminal stages of esophogical [sic]

cancer, he faced paralysis within days. Paralysis for

Jack was a fate worse than death. Always an extremely

active, rational, self reliant, responsible person, he

fought for his life as long as he could. When it became

apparent the end was near our plan was that he would

end his life with sleeping pills, as difficult and isolating

as that proved to be. On the 10th of November he

wrote his suicide note and we prepared the drugs. Jack

died the next morning of a drug overdose in the room he

loved with me but not our children by his side.

The effect of the law against assisted suicide is to

create a conspiracy of silence around the terminally il! at

their time of ultimate loss and greatest need. It causes

isolation, anguish, desperate acts, and prolonged

suffering. I do not wish to go to jail but who is to

speak for those who have died alone or those who fear

prosecution if I do not.

To classify me as a criminal because | refused to

leave my husband’s side at his time of greatest loss |

find unconscionable. The law against assisted suicide is

a travesty, a violation of my rights as an adult. The

judicial system must find this law unconstitutional or be

prepared to put people like me in jail.

Appendix 4.

Patty Rosen had the unthinkable task of helping her

daughter hasten her death:

The person dying was my 25 year old daughter and she

asked me to help her die, and I did. | didn’t have to

assist Jody’s death. Jody was still capable of giving

herself a fatal dose of medication. But Jody didn’t vant

to die alone. She wanted me there with her, to comfort

her, and to make sure she died.

Bone cancer. Invasive bone cancer. Literally, from

her head to her toes she was filled with bone cancer. ...

Bedridden, Jody was trapped in a body that barely

worked. She slept, medicated, 23 out of 24 hours.

Even then her face reflected the pain she was constantly

enduring. She was also losing her sight, tolerated

painful procedures for total bowel obstruction, and

. Shuddered with pain if anyone so much as touched her

skin because of the tumors that were barely under the

surface. And, her bones. Bones that were slowly

"burning" ("it feels like hot molten lava inside of me")

away with cancer. Daily she let me feel her despair.

Daily, her eyes dulled by medication, the question would

come: "Mom, how long can you watch me suffer?"

"Mom, please help me.” ...

... She was dying, she knew it, and she was ready to

die now. Rational, calm, ready. However, it was illegal

for me to assist and she knew it. "I should be able to

talk with my doctor and plan this, not ask my Mom"

"Mom, what if you go to prison?" “What will happen to

you?" Worry made her small face with the sunken eyes

of the near death take on an incredibly distressed look.

Wasn’t it enough that she was dying without having to

worry about me? ...

Finally, four months after her request, choking on

my tears, I said, "Jody, I’m ready." A look of relief

came over her face. She was, in fact, almost giddy with

relief. Quietly, softly she said, "Oh Mom, thank you.

This is one of the happiest days for me. | don’t have to

wake up in this body again." ...

And then it was time. Jody calmly swallowed

everything I could give her, took a few sips of water,

kissed me, "See you later Mom," closed her eyes and

went to sleep. | went into a pure panic. What if |

failed? What if she regained consciousness? She would

be even worse off. But more than that, | would have

failed her. I began giving her all the I.V. medications |

could pump into her stilled body. | moaned, sobbed,

prayed, and kept pushing the drugs. | was as desperate

as | have ever been. ...

Ten hours after we had started the process came the

silence. She had finally stopped breathing. The year

19

and a half of pain, suffering, rage, and hopelessness had

ended. I climbed into her bed, gathered her still body

into my arms, finally able to hold her without hurting

her. Stroking her hair, rocking her gently, | surrendered

to my grief. A brave and wise young woman, Jody

Lynn Grape, age 26, died October 30th, 1986, at 1:30

p.m.

I have never felt guilt or remorse for assisting Jody’s

passing. It was the ultimate act of love a mother could

do for her suffering, dying child. | am grateful she

trusted me enough to ask, made me fee! her anguish,

and included me in her dying. ...

Appendix 6.

Elvin Sinnard describes his wife’s death and her worry

about Elvin’s involvement, even as she was on the brink of

death:

Sara and I were married for 49 years. She suffered

from a very painful heart condition the last eleven years

of her life. Two open heart surgeries, several trips

across the United States to specialty clinics, and very

competent care from her cardiologist failed to relieve the

debilitating pain. Finally life became unbearable. She

could not even talk to me, her children, or her friends

for five minutes without triggering the terrible pain. She

wanted to die but we did not know how to do it. We

could not ask her doctors since one practiced in a

Catholic hospital and the other had a national reputation

that would have been destroyed had he broken the law

to help her.

She feared over-the-counter pills, hearing of all the

cases where the person woke up a vegetable. Carbon

monoxide was out since she wanted the dignity of dying

in her own bed, surrounded by the things she loved. We

finally learned of the plastic bag method. On the day of

her decision, | was with her up to the point of placing

the bag over her head and she said, "Elvin, you must

20

now go to the office because you cannot be implicated

in this."

She had to die alone. I was denied my right to be

with her when she died. This is not right.

I was taken to the police headquarters and

interrogated for two hours attempting to establish a

direct action on my part to the suicide. The detectives

were polite and seemed sympathetic but they said, "Even

though we might agree with your action, we would have

to recommend indictment if we could establish a direct

action on your part to the suicide. It’s the law."

And, this is not right. My act was a loving act, not

a criminal act.

A person has the right to control the conditions of

their death as much as they have the right to control the

conditions of their living.

Appendix 2.

William Meyer details his prosecution for helping his 88

year old father end his life:

In 1991, my father, William F. Meyer Jr., who was

88 years old and had experienced five cancer operations,

was in rapidly failing health. The cancer that had begun

in his colon had spread to his lungs. He was losing

weight and was being eaten away. His doctor said he

only had a few months to live. ...

After my father and | met with my father’s doctor of

25 years, my father decided he would use the procedure

featured in the book Final Exit, taking 12 sleeping pills

and placing a plastic bag over his head.

My father’s first attempt at this action failed when

his reflex action, which comes from the feeling of

suffocating, caused him to pull off the plastic bag.

When I returned to my father’s home the next morning,

he was awake and distressed that he was still alive.

My father consulted with his doctor and was advised

that I could hold my father’s hands so the reflex action

murder

21

would not remove the plastic bag. My father and |

followed this procedure and he was able to end his life.

Since one of my father’s last requests was that | tell

his story, | joined the Hemlock Society and became a

vocal spokesman for death with dignity. In the summer

of 1994, I was interviewed for a story by Connecticut

Magazine. After the story, | was arrested and charged

by the police with second degree manslaughter. If

convicted, I faced ten years in prison.

At a hearing in December, 1994, before a Superior

Court judge in Hartford, Connecticut, two ministers and

several friends spoke on my behalf. Numerous people,

including eleven ministers and eighteen doctors, wrote to

the judge to support me. Even though the District

Attorney pleaded that my case go to trial, the judge

stated that although I had broken the law, | was

following my father’s wishes, and the judge considered

me an outstanding citizen. | was given two years

“accelerated rehabilitation" (after two years, all charges

are dropped, with no record)...

Appendix 13.

Keith Green describes the horror of being charged with

and assisted suicide after his long term partner died:

I was arrested on December 4, 1995 in West Los

Angeles after my lover of eight years committed suicide.

Within hours of the arrest, | was charged with murder

under California Penal Code section 187 and felony

assisted suicide under California Penal Code section 401.

In 1991, my lover tested positive for the human

immunodeficiency virus ("HIV") and was diagnosed

with full blown AIDS in early 1994. He was in the

advanced final stages of the disease at the time of his

demise. With his immune system entirely compromised

he suffered from a panoply of debilitating diseases

which were incurable....

22

On Monday, December 4, 1995, he told me that this

would be our last morning together. He went into the

bathroom where he remained for a considerable period

of time. I learned afterwards that he had been taking a

large and lethal quantity of chlorohydrate [sic] and

seconal. Because his prior attempt at suicide by pills

had failed, he had planned to use carbon monoxide as a

back up.

After a tearful goodbye, he went to the garage where

he had set up his car with tubing so as to facilitate the

ingestion of carbon monoxide. Once seated in the

driver’s side of his car, he told me that it was time for

me to leave...

I returned to our home within five to ten minutes of

leaving. I went to the garage which was then filled with

smoke and stayed with him in the car ...

After having been prosecuted for a felony for six

months, the charges were finally dismissed on June 4,

1996. Though released on my own recognizance within

a few days of having been arrested, the terms and

conditions of my release precluded me from being at his

funeral in his home town of Longview, Texas as | was

not allowed to leave California...

In the end, the charges that were filed against me

were the last thing that he would have ever wanted to

happen.

Appendix 12.

D. Terminally Ill Patients Denied the Option of

Physician-Assisted Dying Sometimes Fail in Thei

Attempts to Hasten Death, with Tragic Results.

Perhaps the worst result for a terminally ill competent

adult who attempts suicide--worse than a violent suicide, or a

lonely suicide, or a suicide implicating family members--is a

suicide that fails, leaving the patient worse off than before. The

denial of medical assistance inevitably increases the chance of a

botched hastened death. Patients cannot know the type or

dosage of medication to take or how to control nausea and

23

regurgitation accompanying the ingestion of lethal medication.”

As the Ninth Circuit decision stated, "Miscalculation can be

tragic.""* The consequence can be brain damage or a coma."”

For Gésta Pearson, his surrogate son, dying of AIDS,

failed in his attempt to hasten death which brought tragic

consequences.

On June 20, 1991, Hugo told me that he had decided

to take his own life with some pills he had stockpiled.

He told me | did not have to stay with him, but | wanted

to be by his side. He prepared two glasses of

‘SL. Shavelson, supra, at 126 ("From safer sleeping pills to air

bags in cars, science has made killing yourself without professional!

help a tremendously difficult task--and a mission fraught with the

potential for ghastly errors.”)

“Compassion in Dying, 79 F.3d at 832. Additionally, the

Second Circuit quoted from one of the declarants in that case, Quill v.

Vacco, 80 F.3d at 721:

It is not uncommon, in light of present legal constraints on

physician assistance, that patients seeking to hasten their

deaths try to do so without medical advice.... Very often,

patients who survive a failed suicide attempt find themselves

in worse condition than before the attempt. Brain damage, for

example, is one result of failed suicide attempts.

"See C. Farnsworth, Vancouver AIDS Suicides Botched, N.Y.

Times, June 14, 1994, at C12 (of 34 assisted suicides studied in

Vancouver, B.C. [which, similar to the U.S., bans physician assisted

suicide}, half were “botched, increasing suffering when the aim was to

alleviate it."); Andrew Solomon, A Death of One's Own, The New

Yorker, May 22, 1995, at 57 ("I heard of suicides as gruelling as the

diseases they were meant to terminate. In some cases, irreplaceable

pills were regurgitated. “My husband had to just eat his vomit,” one

woman said. “He was that determined. But then he threw up again.

We waited about an hour, then he downed it all again and | put a

plastic bag over his head so he would suffocate before he got sick, and

he finally died. He'd been through so much, and that whole

disgusting, humiliating business was the living end.").

24

medication and told me he was going to drink one glass

and then follow with the other. He then drank all of one

of the glasses. He then told me that “that didn’t taste

very good--will you get me a spoon of pudding from the

kitchen". I did and he said “that’s better." Then he

reached for the second glass and passed out before

taking the second glass of medication.

Hugo was in a coma for the next several days. |

immediately called his physician, who came and

examined him. Hugo remained in his home, receiving

no food or hydration. Medical personnel told me that

Hugo could hear us, even though he was not responding

to us.

This was the worst seven days of my life. It was

miserable for me, for Hugo, and for others to see his

desired death stretched out for so long. | slept in his

apartment during that week in order to be close to him.

If Hugo had been able to have a physician assist him

in his dying, he could have died when and how he

wanted, with dignity and without further complications

and problems.

A program should be able to be developed so that

people don’t make the same bungling mistakes Hugo

did. It is important for people in Hugo’s situation to

have the freedom of choice to end their life, without fear

and without complications which make their dying

process a nightmare.

Appendix 11.

V. DENIAL OF THE OPTION OF PHYSICIAN

ASSISTANCE TO HASTEN DEATH FOR

COMPETENT, TERMINALLY ILL PATIENTS

HAS DEVASTATING CONSEQUENCES FOR

SURVIVING FAMILY MEMBERS.

The states and other amici assert an interest in protecting

from suicide the family members and loved ones of the

25

terminally ill."* However, as the Ninth Circuit court below

observed, ". . . witnessing a loved one suffer a slow and

agonizing death as a result of state compulsion is more likely to

harm than further the interests of the innocent third parties.”

Compassion in Dying, 79 F.3d at 827.

The family members express extreme sadness, anger,

and guilt over their loved ones’ loss of dignity and loss of

control over their own lives, resulting from laws prohibiting

physician assistance in dying. Others decry a cruel legal system

which legislates against the abstract notion of "suicide" rather

than addressing the reality of the pain, suffering, and loss of

personal autonomy and dignity of terminally ill, competent

patients. This law leaves family members angry and frustrated

that they are unable to obtain comfort for the loved one at his or

her time of greatest need.

I felt very guilty then, and feel guilty now, about dad’s

terrible death. | feel guilty that he died in so much pain

and with no dignity left. The doctor had the means to

give him a gentle, painless death. | have been left with

frustration, anger, regret, and sadness...

Declaration of Gail Bereny (App. 9).

It was a very lonely death. That’s the one thing | will

never get over. My mother came from out-of-state to be

with me for a period of time as she was concerned for

my emotional health. | was in therapy for six months.

Declaration of Steve Knipp (App. 14).

"See Compassion in Dying, 79 F.3d at 816, for discussion of

State of Washington's arguments in this regard; also, see Amicus

Curiae Brief of Nat’! Right to Life Committee, Inc., p. 26, which

argues that children “may be more profoundly affected by suicide than

by other cases leading to the death of a parent." This is undoubtedly

true for ordinary suicides, but the statement hardly applies to suffering

parents at the end of their lives.

26

My mother’s terminal illness was awful for me because |

was very close to her. | had nightmares for weeks prior

to her death. She was desperate, and in spite of my

being a nurse, | felt helpless....

Declaration of Leanne Gallison (App. 3).

The Ninth Circuit decision voiced "serious doubts that

the terms ‘suicide’ and ‘assisted suicide’ are appropriate legal

descriptions of the specific conduct at issue here." Compassion

in Dying, 79 F.3d at 802. For this reason, we frequently use in

this brief the term “physician-assisted dying" or "hastened death"

rather than “suicide.” Jinny Tesik, who supported the controlled

dying of her 76-year-old father, suffering from terminal

emphysema, compares her father’s act with other suicides:

My 39 year old husband committed suicide violently

ten years ago by shooting himself in the head. That is

the kind of suicide that leaves the legacy of guilt, anger,

and unanswered questions. That kind of suicide

devastates and destroys those left behind.

After 12 years of working in hospice and as a grief

counselor, | have heard far too many cases of others like

my father who chose to be in control of their deaths.

For those who choose their own death in their own time,

let it be peaceful, loving and legal, not shattered by

violence and shame.

Appendix 15.

27

VI. THERE IS NO MEANINGFUL DISTINCTION FOR

THE PATIENTS AND SURVIVING FAMILY

MEMBERS BETWEEN A PHYSICIAN’S

ASSISTANCE IN HASTENING DEATH AND A

PHYSICIAN’S WITHDRAWAL OF LIFE

SUPPORT.

A. The Deceased Loved Ones of the Amicus Were

Dying of Terminal Illnesses and Suffering in the

Same Way that Terminally Ili People with Life

Support Measures Suffer.

The experiences of the amicus demonstrate that the

distinction in the laws between withdrawing or refusing life

support measures, a form of medical intervention, and choosing

other forms of physician assistance to hasten the death of a

terminally ill patient is meaningless for both the patient and the

family. The patients who seek physician assistance to prescribe

medication and those who seek physician assistance for

withdrawal of life-sustaining treatment to hasten death are

similarly situated. In both cases, the patients are facing an

inevitable death caused by a fatal disease and are suffering,

often unbearably.

The patients described by the fifteen declarants all

suffered from diseases for which "life support,” such as a

ventilator or respirator, was not at issue. But they suffered as

much as patients on life support, they knew they were dying,

and they had exhausted all efforts to save themselves. Like

those patients who make the choice to accept and hasten their

inevitable deaths by refusing or withdrawing life support, they

too wanted to end their suffering. Because of state statutes, they

were denied the option to end their suffering with dignity and

the comfort of their families.

The distinction in the law between withdrawal of life

support and physician-assisted suicide makes no sense to those

who are suffering while dying or to the families and loved ones

who watch them suffer. It is not legally sufficient to say that

because the state legislatures treat these actions as different, that

they are in fact different. The Second Circuit accurately

concluded that the withdrawal or refusal of life support is a form

of assisted hastening of death and the two classes of patients

should be treated equally. The Court explained:

Withdrawal of life support requires physicians or those

acting at their direction physically to remove equipment

and, often, to administer palliative drugs which may

themselves contribute to death. The ending of life by

these means is nothing more nor less than assisted

suicide. It simply cannot be said that those mentally

competent, terminally-ill persons who seek to hasten

death but whose treatment does not include life support

are treated equally.

Quill y. Vacco, 80 F.3d at 729.

The irrational nature of the distinction between the two

classes of people is demonstrated by the drastic actions patients

sometimes take to "legally" end their suffering. Jeff Halsey

explains his partner Danial Danzer’s struggle with AIDS:

My partner Danial Danzer’s biggest fear was that of

losing his mind. He wanted to die before he lost his

mind.

Danial had reached the final stages of AIDS. He

sought help with his problems from the medical

community but didn’t receive any. So when he felt his

mind was leaving him, he opted for a unique solution to

29

his problem, that being withholding his insulin and

letting himself die of insulin stock. It was a very long

five days of convulsions, dementia, violent outbreaks,

and a total loss of self-dignity.

I feel that had there been a way for him to end his

life peacefully, that he would have opted to do so.

Danial was lucky in that he had a way to deliver

himself--by withholding his insulin. Most people are not

that lucky. Most people must suffer even more than

Danial suffered.

Appendix 7.

It is ironic that Danzer could legally withhold

medication, such as insulin, but could not legally have a more

painless way to hasten his death and maintain his dignity.

Under Petitioners’ rationale, Danzer’s death was not legally

“suicide” because the death was "unintentional," “inactive,” and

“natural,” since Danzer died from diabetes and insulin shock.

Washington Petitioners’ Br. at 31 and New York Petitioners’ Br.

at 15-19. Clearly, Danzer’s death was intended and he very

actively sought death. How "natural" is it to die of convulsions

and dementia? Similarly, how "natural" is death by starvation

and dehydration, or an induced coma, both legal in Washington

and New York states? The Second Circuit concluded these

deaths are no more "natural" than a doctor prescribing

medication to hasten death. Quill, 80 F.3d at 729.

VII. CONCLUSION

As the experiences of the fifteen show, many people are

determined to control the dying process when faced with a

debilitating terminal illness. This Court cannot stop the

terminally ill from hastening their deaths--it does happen and

will continue to happen as long as human beings have free

30

will.'? The decision for this Court is how hastened dying for th’

adult terminally ill should occur: Will it be acts of violence

taken alone? Will it be untrained family members compelled to

assist in secrecy and fear? Or will it be medically-trained

personnel evaluating and assisting, in the open, according to

legal guidelines? Amicus urges the Court to recognize, as the

Second and en banc Ninth Circuit Courts did, that legal

guidelines can be established so that the state can protect its

legitimate interests without substantially infringing upon the

constitutional rights of those competent, terminally ill adults who

choose to end their suffering and hasten death.

Respectfully submitted,

KATRIN E. FRANK

*ROBERT A. FREE

KATHLEEN WAREHAM

MacDONALD, HOAGUE & BAYLESS

705 2nd Avenue, Suite 1500

Seattle, WA 98104

Telephone: (206) 622-1604

Attorneys for Amicus Curiae Surviving

Family Members in Support of Physician-

Assisted Dying

*Counsel of Record

December 5, 1996.

'°T. Quill, supra, at 199 ("Doctors, patients, and their families

are engaged in negotiated deaths every day in every community in the

United States."). With AIDS, the number of end-of-life suicides has

increased dramatically. G. Kolata, AIDS Patients Seek Solace in

Suicide But Many Risk Added Pain in Failure, N.Y. Times, June 14,

1994, at Cl.

PERSONAL NECLARATION OF ROBERTA LAU

My name is Robeita Lau. My address is 9586 Silver Creek

Lane NW, Bremerton, Washington 98311. My date of

birth is October 31, 1928.

I prepare this declaration to support the position of

Compassion in Dying in the case of Compassion in Dying

ys. State of Washington.

My husband of 42 years, Richard A. Lau, died on October

12, 1995. My husband's desire and intent always was to

find the means to hasten his own death when his physical

condition was no longer bearable. He died after taking a

sufficient supply of drugs prescribed by a physician that

took a long search and numerous inquiries to locate.

Richard had been battling lung cancer for two years before

he died. The cancer had metastasized from his lungs to his

thigh bone, hip, arm, neck and head. His body had become

a skeleton and his pain and suffering were worse. He

decided it was time to fulfill his wish of assistance in

dying. | was always aware of this intention and in total

agreement and understanding.

Approximately three weeks prior to Richard's death, he

was examined by an independent physician, not his

treating physician. This physician verified that Richard

was mentally competent, not depressed, and fully aware of

the consequence of his decisions. The physician

determined that Richard's condition was terminal and that

he had no more than one to two months to live. He

verified that Richard had lost 62 pounds in the last 15

months and had documented metastases.

Richard decided that he wished to die on Thursday,

October 12, 1995. A nurse, my adult daughter, and two

trained volunteers from Compassion in Dying were present

with him. Everyone checked with Richard to see if he had

Appendix 1-1

changed his decision. He was clear and adamant in his

determination to proceed.

Richard was helped with personal care matters, smoked a

cigarette and visited with those present. He then

personally took the medications. He was very relaxed and

at peace and thankfully welcomed his liberation. He

always worried so much about finding this assistance and it

was a blessing when we did. We did not believe in

prolonging suffering needlessly.

At the end, his death at home was very calm and peaceful.

I supported him all the way.

I believe all terminal and suffering persons should be able

to legally seek supervised and regulated assistance in

dying, if that is their wish. Prolonging suffering needlessly

is inhumane.

I hereby declare under penalty of perjury under the laws of

the State of Washington and of the United States that the above

statement is true and correct.

Dated: November 13, 1996

Place of execution: Bremerton, Washington.

/s/

Roberta Lau

Appendix 1-2

PERSONAL DECLARATION OF

PATSY McLAUGHLIN McGEORGE

My name is Patsy M. McGeorge (a.k.a. Patsy A.

McLaughlin, Ph.D.). My address is 1760 Parson Creek Road,

Sedro Woolley, WA 98284-9620. My date of birth is May 27,

1932.

I prepare this Declaration to support the position of the

Appellees in the case of Compassion in Dying v. State of

Washington.

My husband of twenty-five years, Emanuel J. ("Mac")

McGeorge, had terminal cancer involving the spine, lungs and

lymphatic system. But terminal cancer is cited only as "other

significant condition" to his cause of death on the death certificate.

The certificate reads: "Death due to or as a consequence of:

Massive trauma to head -- self-inflected (sic) gun shot wound-

shotgun.”

Mac was diagnosed with cancer in November of 1994.

Because he was 72 years of age, he rejected massive chemotherapy

and radiation and asked just for drugs to ease his then acute pain.

For a man who rarely took even aspirin, the nausea, dizziness, and

other side effects of simply increasingly higher levels of pain

medication served to reaffirm for him the soundness of his

decision.

During late spring of 1995, he broached the subject of

suicide. It was noi the first time suicide had been mentioned, but

this time he was quite serious. H~ told me of his great concern for

becoming incapacitated, or so ill that he would either be

hospitalized or would not, for some other reason, be able to govern

his own destiny. He was relieved to have my assurance that he

would never be hospitalized against his wishes, and that I would

respect and support any decision he made about ending his own

life. Mac also brought up the possibility of assisted suicide with

his doctor, but while his doctor was understanding, he was not

supportive.

Appendix 2-1

By October, Mac had already surpassed his predicted nine-

month life expectancy, but the cancer was taking its toll. He had

gone from a man of 190 pounds of muscle, exceptional strength,

and superior stamina to a "145 pound weakling." What stamina

remained came from sheer will power and intestinal fortitude, yet

he managed to put his shop in order, teach me his special

techniques in the darkroom and continue his daily routines. By

January of 1996, he was able to eat very little; his weight loss was

becoming extreme. The principal spinal tumor had grown so large

that he referred to his appearance as that of the "Hunchback of

Notre Dame." He could only sleep on his side, and despite 800

mg. of morphine a day and Roxicet every two hours, his pain was

so extreme that sleep came only in short intervals. He could lie

down for only an hour or two at a time. He struggled through

January, but by the first of February, he couldn't take much more.

We were referred to Hospice, an outstanding group that does a

great deal to ease the pain and suffering of the terminally ill, but

regrettably cannot assist in ending that suffering. With a

subcutaneous pump to assure a continuous morphine flow and

additional medication, Hospice nurses were able to provide Mac

his first full night’s sleep in months. But Mac did not want to be a

drugged vegetable. Following an almost 24 hour drugged stupor,

he decided that was not the answer.

On the morning of February 9, 1996, he had made up his

mind. He said he felt as if he had just been through Ray Milan’s

"Lost Weekend," and told me that with such a high level of pain

medication he would soon be a vegetable, unable to think, do for

himself, or control his own destiny — an intolerable situation. After

a brief and very personal conversation, he gave me the note he had

carried for months, attesting to the fact that his decision was his

own; kissed me goodbye; went into the front yard; put a shotgun in

his mouth and pulled the trigger. Since a peaceful death was not

available, this was his way to insure death with the dignity he

valued so highly. Two months ago I was emotionally wrenched by

finding a portion of his upper dental plate 50 feet from the site of

his death — a testament to the violent alternative he was forced to

choose.

Appendix 2-2

Mac was not depressed -- the overwhelming pain or

alternative of a drug stupor were simply unacceptable to him. Mac

honestly believed he, with my support, had the right and the

responsibility to control his own destiny.

To say that I miss him would be the understatement of the

century. But I esteem his courage, his conviction, and his integrity.

I am thankful that he loved me enough to share his most personal

emotions. I wish I could have been with him at the end, but he said

no, "it will be messy.”

I hereby declare under penalty of perjury of the laws of the

State of Washington and the United States that the above

mentioned is true and correct.

Signed: _/s/_

Dated: _ September 27, 1996 _

Place of execution: _Sedro Woolley, WA_

Appendix 2-3

PERSONAL DECLARATION OF

LEANNE GALLISON

My name is Leanne Gallison. My address is 7538 - 1 4th

Ave. N.E., Seattle, Washington 98115. My date of birth is

February 2, 1952.

I prepare this Declaration to support the position of the

Appellees in the case of Compassion in Dying v. State of

Washington.

My mother, B.!. Olsen, was diagnosed with cancer in

August, 1993 at the age of 69. She was given six months to two

years to live. In September she started chemotherapy which helped

a little. Later, additional chemotherapy didn't help. Sharp pains

developed in her chest and her spine. Shortness of breath

increased. Chemotherapy made her horribly ill, nauseated around

the clock. The doctor ordered radiation therapy to ease the pain.

At this time, she began to have seizures. Tumors were discovered

in her brain. Radiation was added to treat her brain but this

resulted in my mother becoming completely flattened with no

stamina, no energy. The doctor predicted that within a month or

so, she would begin to feel better, she would regain her strength,

and perhaps she and her family could go on a vacation. She never

got better. She couldn't even get out of the house.

My mother had been a single woman for 30 years. She

was left fatherless when she was 2 and abandoned by her husband

when her children were still in school. She built her own

successful business, traveled in Africa and the Middle East, and put

us all through graduate school. She even volunteered many hours

each week at a clinic for disabled children. She was petite,

beautiful, and determined. She was not about to give up control

over her destiny.

As the pain and sleeplessness increased, and in her

housebound state, she began to think about how she could end her

life with grace and dignity. The last thing she wanted was to be

completely dependent on her family. She asked her doctor for

Appendix 3-1

some barbiturates to “help her sleep.” When he realized why she

wanted them, he flatly refused. She was terribly discouraged. She

had to change doctors to seek help. On her bad days she would ask

me, “How am I going to get out of here?" And, "I want to go, and I

want to go NOW!" She weighed about 60 pounds. One evening,

with her children by her side, she consumed some antinausea

medication in mashed fruit, and later swallowed all of the

morphine she had left. She fell peacefully asleep. She stopped

breathing in two hours.

My mother’s terminal illness was awful for me because |

was very close to her. I had nightmares for weeks prior to her

death. She was desperate, and in spite of my being a nurse, | felt

helpless. I just don't see how an assisted suicide is dangerous if it

is regulated. It is like a Living Will; I just don't see anything wrong

in it.

I hereby declare under penalty of perjury of the laws of the

State of Washington and the United States that the above statement

is true and correct.

Date: July 29, 1994

Place of execution: Seattle, Washington

Signature: Js/

Leanne Gallison

Appendix 3-2

PERSONAL DECLARATION OF KAY BECK

My name is Kay Beck. My address is 5024 Nicklas Place

N.E., Seattle, Wa. 98105. My date of birth is Jan. 18, 1936.

I prepared this Declaration to support the position of the

Appellees in the case of Compassion in Dying v. State of

Washington.

On Nov. 11, 1991, I helped my husband, Jack, end his life.

In the terminal stages of esophogical cancer, he faced paralysis

within days. Paralysis for Jack was a fate worse than death.

Always an extremely active, rational, self reliant, responsible

person, he fought for his life as long as he could. When it became

apparent the end was near our plan was that he would end his life

with sleeping pills, as difficult and isolating as that proved to be.

On the 10th of November he wrote his suicide note and we

prepared the drugs. Jack died the next morning of a drug overdose

in the room he loved with me but not our children by his side.

The effect of the law against assisted suicide is to create a

conspiracy of silence around the terminally ill at their time of

ultimate loss and greatest need. It causes isolation, anguish,

desperate acts, and prolonged suffering. | do not wish to go to jail

but who is to speak for those who have died alone or those who

fear prosecution if I do not.

To classify me as a criminal because | refused to leave my

husband's ::ide at his time of greatest loss I find unconscionable.

The law ayainst assisted suicide is a travesty, a violation of my

rights as ¢n adult. The judicial system must find this law

unconstitutional or be prepared to put people like me in jail.

I hereby declare under penalty of perjury of the laws of the

State of Washington and the United States that the above statement

is true and correct.

Dated: August 2, 1994

Place of execution: Seattle, Washington

—lsL

Appendix 4-1

PERSONAL DECLARATION OF

ELVIN O. SINNARD

My name is Elvin O. Sinnard. My address is 23 Beckett,

Lake Oswego, Oregon 97035. My date of birth is May 30, 1917.

I prepare this Declaration to support the position of the

Appellees in the case of Compassion in Dying v. State of

Washington.

Sara and I were married for 49 years. She suffered from a

very painful heart condition the last eleven years of her life. Two

open heart surgeries, several trips across the United States to

specialty clinics, and very competent care from her cardiologist

failed to relieve the debilitating pain. Finally life became

unbearable. She could not even talk to me, her children, or her

friends for five minutes without triggering the terrible pain. She

wanted to die but we did not know how to do it. We could not ask

her doctors since one practiced in a Catholic hospital and the other

had a nationa! reputation that would have been destroyed had he

broken the law to help her.

She feared over-the counter pills, hearing of all the cases

where the person woke up a vegetable. Carbon monoxide was out

since she wanted the dignity of dying in her own bed, surrounded

by the things she loved. We finally learned of the plastic bag

method. On the day of her decision, | was with her up to the point

of placing the bag over her head and she said, "Elvin, you must

now go to the office because you cannot be implicated in this."

She had to die alone. I was denied my right to be with her

when she died. This is not right.

I was .aken to the police headquarters and interrogated for

two hours attempting to establish a direct action on my part to the

suicide. The detectives were polite and seemed sympathetic but

they said, "Ever, though we might agree with your action, we

would have to recommend indictment if we could establish a direct

a2ciion on your part to the suicide. It's the law.”

Appendix 5-1

And, this is not right. My act was a loving act, not a

criminal act.

A person has the right to control the conditions of their

death as much as they have the right to control the conditions of

their living.

I hereby declare under penalty of perjury of the laws of the

State of Washington and the United States that the above statement

is true and correct.

Dated: August 2, 1994

Place of execution: Portland, Oregon 97035

= =

Elvin O. Sinnard

Appendix 5-2

PERSONAL DECLARATION OF PATTY ROSEN

My name is Patty Rosen. My address is 60734 Bristol

Way, Bend, OR 97702.

I prepare this Declaration to support the position of

Compassion in Dying in the case of Compassion in Dying v. State

of Washington.

For as long as ‘ «an remember I have believed that any

person suffering from a terminal or debilitating illness has the right

to end their life when they choose. My religious and moral beliefs

have never interfered with my ability to listen and empathize as

patients have pleaded their case to die. | have even made pacts

with friends who feel as I do, agreeing that if the need should ever

arise, we will help each other die. I have also talked with my four

children about the right to choose, encouraging them to think about

it, discuss it, and come to their own conclusions. Then, in one

short year the subject of assisting the death of a terminally ill

person was no longer clinical and abstract. The person dying was

my 25 year old daughter and she asked me to help her die, and I

did. I didn't have to assist Jody's death. Jody was still capable of

giving herself a fatal dose of medication. But Jody didn't want to

die alone. She wanted me there with her, to comfort her, and to

make sure she died.

Bone cancer. Invasive bone cancer. Literally, from her

head to her toes she was filled with bone cancer. The failure to do

follow-up on an obvious, thyroid goiter, first diagnosed when she

was 18, had led her, over a five year span, to death's door. Jody

was devastated. Angry that she was dying, and furious that it could

have been prevented, she asked me to keep her at home and care

for her. She was also afraid that if hospitalized she would lose her

autonomy. She had been trained as a nurse's aid and had

witnessed, first hand, how the rights of patients were violated and

didn't want that to happen to her. I was greatly relieved she trusted

me so completely because I was frantic to take her in my arms and

somehow "make it better." But that never happened. Bedridden,

Jody was trapped in a body that barely worked. She slept,

medicated, 23 out of 24 hours. Even then her face reflected the

Appendix 6-1

pain she was constantly enduring. She was also losing her sight,

tolerated painful procedures for total bowel obstruction, and

shuddered with pain if anyone so much as touched her skin because

of the tumors that were barely under the surface. And, her bones.

Bones that were slowly “burning” ("it feels like hot molten lava

inside of me") away with cancer. Daily she let me feel her despair.

Daily, her eyes dulled by medication, the question would come:

"Mom, how long can you watch me suffer?" "Mom, please help

me.”

What could I say? Was I going to tell her she would get

better? That this was temporary? What reason could I give her not

to die when she was already dying? She was dying, she knew it,

and she was ready to die now. Rational, calm, ready. However, it

was illegal for me to assist and she knew it. "I should be able to

talk with my doctor and plan this, not ask my Mom" "Mom, what if

you go to prison?” "What will happen to you?" Worry made her

small face with the sunken eyes of the near death take on an

incredibly distressed look. Wasn't it enough that she was dying

without having to worry about me? In my most convincing style I

reassured her. Her trust and faith in me were humbling and | was

determined not to let her continue to suffer because of what might

happen to me. I found the idea absurd.

Finally, four months after her request, choking on my tears,

I said, “Jody, I'm ready." A look of relief came over her face. She

was, in fact, almost giddy with relief. Quietly, softly she said, "Oh

Mom, thank you. This is one of the happiest days for me. I don't

have to wake up in this body again." Those words, to this day,

make me sob with my own pain of loss. I miss her so much.

And then it was time. Jody calmly swallowed everything |

could give her, took a few sips of water, kissed me, "See you later

Mom,” closed her eyes and went to sleep. I went into a pure panic.

What if I failed? What if she regained consciousness? She would

be even worse off. But more than that, | would have failed her. |

began giving her all the I.V. medications I could pump into her

stilled body. I moaned, sobbed, prayed, and kept pushing the

drugs. I was as desperate as I have ever been. My mind started

playing tricks on me. Looking at her | would suddenly think I had

Appendix 6-2

—_

—- ~

made a mistake, that she was not terminally ill, but was getting

better. I fought the impulse to reach for her, to shake her awake, or

to pick up the phone and caul for help. I forced myself to stay in

the naked reality of the situation, to look at my daughter's withered

frame, her cadaver-like skull, and to continue my vigil.

. Ten hours after we had started the process came the

silence. She had finally stopped breathing. The year and a half of

pain, suffering, rage, and hopelessness had ended. I climbed into

her bed, gathered her still body into my arms, finally able to hold

her without hurting her. Stroking her hair, rocking her gently, I

surrender to my grief. A brave and wise young woman, Jody Lynn

Grape, age 26, died October 30th, 1986, at 1:30 p.m.

I have never felt guilt or remorse for assisting Jody's

passing. It was the ultimate act of love a mother could do for her

suffering, dying, child. I am grateful that she trusted me enough to

ask, made me feel her anguish, and included me in her dying. Her

request was a rational request. She made her decision

independently, following her heart and spiritual belief.

The day following Jody's death I rushed to the therapist

office seeking any wisdom and comfort she could offer. “Patty, |

have Jody's permission to tell you what she said at our last meeting

and I want to share it with you now." Leaning forward, taking my

hand, she told me Jody's last request: "please don't let anything

happen to my Mom."

I hereby declare under penalty of perjury under the laws of

the State of Oregon and the United States that the above statement

is true and correct.

Dated: November 2, 1996

Place of execution: _Bend, Oregon —

Ls/

Patty Rosen

Appendix 6-3

PERSONAL DECLARATION OF

JEFF (JOSEPH) HALSEY

My name is Jeff Halsey. My address is 1000 - 8th Avenue,

#A 806, Seattle, Washington 98104. My date of birth is April 5,

1958.

I prepared this Declaration to support the position of the

Appellees in the case of Compassion in Dying v. State of

Washington.

My partner Danial Danzer's biggest fear was that of losing

his mind. He wanted to die before he lost his mind.

Danial had reached the final stages of AIDS. He sought

help with his problems from the medical community but didn't

receive any. So when he felt his mind was leaving him, he opted

for a unique solution to his problem, that being withholding his

insulin and letting himself die of insulin shock. It was a very long

five days of convulsions, dementia, violent outbreaks, and a total

loss of self-dignity.

I feel that had there been a way for him to end his life

peacefully, that he would have opted to do so. Danial was lucky in

that he had a way to deliver himself--by withholding his insulin.

Most people are not that lucky. Most people must suffer even more

than Danial suffered.

I couldn't wait for him to die so that he would quit

suffering and I would quit suffering. | feel that Danial and I were

both robbed of important, quality time by his slow and painful

death. He might have been spared some of his greatest pain and

retained his dignity if he and his physician had received help from

a compassionate code of laws.

He was only 34 years old when he died on June 10, 1994.

Appendix 7-1

I hereby declare under penalty of perjury of the laws of the

State of Washington and the United States that the above statement

is true and correct.

Dated: August 1, 1994

Place of execution: Seattle, Washington

[si

Jeff Halsey

Appendix 7-2

PERSONAL DECLARATION OF

TANIA BLOOM

My name is Tania Bloom. My address is 3110 C Portage

Bay Place E., Seattle, Washington 98102. My date of birth is

September 28, 1936.

I prepare this Declaration to support the position of the

Appellees in the case of Compassion in Dying v. State of

Washington.

In 1989, my father was dying of lung cancer and was in

excruciating pain. His doctor would not provide pain medication

other than Tylenol saying that to do so “would not be medically

advisable.” Father remained at home and in spite of being hooked

up to oxygen, he struggled to breathe. We had access to morphine

and hinted to hm that we could get it for him if he wanted it.

However, he refused because he knew it was illegal to assist in a

suicide.

When he realized that my family was going to be away for

a day, he wrote us a beautiful letter, went down to his basement,

and shot himself with his 12-gauge shotgun. He was 84.

My youngest daughter did not have the benefit of having

her own father during her growing up years so my father became

her surrogate father. They became extremely close. The loss of

her grandfather was devastating for her. The nature of Dad's

suicide added to this tragedy. This was a brutal and awful

experience for my children and for me. I felt a great deal of loss,

anger, and remorse about a system that would not allow my father

to die gracefully and with dignity.

My son-in-law then had the unfortunate and unpleasant

task of cleaning my father's splattered brains off the basement

walls.

Physician assisted suicide should be a rational choice and a

reassurance for people. Physician assisted suicide can have

safeguards and planning so that it wouldn't be an impulsive,

Appendix 8-1

irrational act and one of unnecessary violence such as that of my

Dad's.

I hereby declare under penalty of periury of the laws of the

State of Washington and the United States that the above statement

is true and correct.

Dated: July 28, 1994

Place of execution: Seattle, Washington

Ls

Tania L. Bloom

Appendix 8-2

PERSONAL DECLARATION OF

GAIL BERENY

My name is Gail Bereny. My address is 2360 - 43rd Ave.

E., #307, Seattle, Washington 98112. My date of birth is

I prepare this Declaration to support the position of the

Appellees in the case of Compassion in Dying v. State of

Washington.

Several years ago, my 80 year old father was diagnosed as

having terminal abdominal cancer. He went to his doctor with two

requests, (1) not to prolong things, and, (2) to keep him as pain free

as possible. His doctor agreed. However when time came, the

doctor did neither. And so my father, to whom dignity was very

important, lay dying, diapered, moaning in pain, begging to die. |

called the doctor's office, crying, begging him to relieve Dad's pain.

He refused, saying morphine could kill him.

My father's brother, my uncle, has a weak heart. He was so

distraught that we were frightened for him. Dad's friends did what

they could to give hir: their that love and support. His best friend,

a retired cu diologist, was dismayed and angered at the physician's

lack of help and compassion. Dad would have been spared at least

a week or two, the worst part of his illness.

I felt very guilty then, and feel guilty now, about Dad's

terrible death. | feel guilty that he died in so much pain and with

no dignity left. The doctor had the means to give him a gentle,

painless death. I have been left with frustration, anger, regret, and

sadness. He had been a very good father.

I hereby declare under penalty of perjury of the laws of the

State of Washington and the United States that the above statement

is true and correct.

Dated: July 28, 1994

Place of execution: Seattle, Washington

/s/

Gail Bereny

Appendix 9-1

PERSONAL DECLARATION OF

DOROTHY B. HOOGSTRAAT

My name is Dorothy B. Hoogstraat. My address is

Beaverton Oregon. My date of birth is February 9, 1921.

1 prepare this Declaration to support the position of the

Appellees in the case of Compassion in Dying v. State of

Washington.

My husband, Emerson E. Hoogstraat, a retired Professor of

Finance, from Portland State University, died on March 25, 1995

of prostate cancer that had spread to the bones. He had been

diagnosed in Marc: of 1993 as having prostate cancer. We

obtained a second opinion and he decided to have surgical removal.

The physician did not complete the surgery as the cancer had

spread to the lymph nodes. He then had forty radiation therapy

treatments and after a few months of relatively pain free existence

he again began having problems. In late 1993 he had edema in the

right leg from hip to foot, caused by tumors pressing on the blood

vessels in the groin and at the suggestion of his urologist had an

orchiectomy, which we hoped would relieve the swelling in his leg

and slow the spreading of the cancer. He was relatively

comfortable until June of 1994 when a series of new problems

developed. Following further diagnostic procedures it was

ascertained that the cancer had spread to his ribs, spine and right

femur. He was in considerable pain when walking, sitting or lying

in bed. He had been given medication for the pain prior to this

time but it now became a necessity if he was to have an: measure

of relief. His ribs gradually broke, and as he said to me many

times, he could feel the broken edges of the bones rub together as

he would sit or attempt to arise from the bed. He was in

unbearable pain. He was an extremely intelligent, courageous and

dignified man and he did not wish to suffer unbearable pain when

there was no hope of recovery from this condition. He would very

much like to have gone to sleep in his own bed and not had to

suffer further. He felt that it was his right to say when he had

suffered enough. He "lived" at least two months after he would

have preferred not to. The physicians and Hospice people were

constantly changing medications and attempting to make him as

Appendix 10-1

comfortable as possible - which in his condition was an

impossibility. It was a twenty-four hour a day caregiving situation

and he still suffered unbearably. He remained at home until his

death.

He had been very active in promoting Measure 16 - we

both had - and he was sad that he was unable to receive help when

he so desperately wished and needed it!

We had been married for forty-seven years and shared a

lifetime together, and truly, watching him suffer and being unable

to do anything for him that would relieve his pain, was for me

devastating.

I do not believe it is suicide when a person is terminally-iil

and there is no relief for the pain and suffering. Quality of life is

very important.

I do not believe that God intended for people to suffer in

this manner. We are more compassionate with our pets than we are

with our dearly loved family members.

I hereby declare under penalty of perjury of the laws of the

State of Washington and the United States that the above are true

and accurate.

Dated: October 30, 1996

Place of execution: Beaverton, Oregon 97005

/s/

Dorothy B. Hoogstraat

Appendix 10-2

PERSONAL DECLARATION OF GOSTA PEARSON

My name is Gésta Pearson. My address is 7432 Latona

Avenue NE, Seattle, Washington 98115. My date of birth is June

29, 1925.

I prepare this declaration to support the position of

Compassion in Dying in the case of Compassion in Dying v. State

of Washington.

In 1991, | was with my very good friend, Hugo Vila, when

he died. Hugo moved to the United States from Cuba and became

an American citizen. He had no family members in the United

States and I became a surrogate father to him.

I spent the last few weeks of Hugo's life with him, as he

slowly but steadily was dying from AIDS. Hugo remained living

in his apartment and I spent several hours each day helping take

care of him. At the end, he could not walk and could only use one

of his arms. I think he had suffered a stroke which paralyzed one

side of his body. He had a catheter attached to him and he was

unable to control his bowel movements. Hugo was very upset

about messing himself in bed, since he had always been a

meticulous person. I had to pick Hugo up, put him in a wheelchair,

take him to the bathroom and lift him up and put him in the

bathtub, in order to clean him. Hugo had lost a lot of weight and

was virtually skin and bones the last few weeks of his life. Hugo

needed help in eating and in doing virtually everything in order to

Hugo told me that he was very concerned about his loss of

dignity snd ability to care for himself. He was mentally alert and

not @_,,e3sed during this period. Medication controlled his pain,

but the loss of dignity was horrible to him. He told me that he had

had a full life and he wanted to end his life with dignity, realizing

that things were only going to get worse as his AIDS progressed.

On June 20, 1991, Hugo told me that he had decided to

take his own life with some pills he had stockpiled. He told me |

did not have to stay with him, but I wanted to be by his side. He

Appendix 11-1

prepared two glasses of medication and told me he was going to

drink one glass and then follow with the other. He then drank all

of one of the glasses. He then told me that "that didn't taste very

good--will you get me a spoon of pudding from the kitchen". I did

and he said "that's better." Then he reached for the second glass

and passed out before taking the second glass of medication.

Hugo was in a coma for the next several days. |

immediately called his physician, who came and examined him.

Hugo remained in his home, receiving no food or hydration.

Medical personnel told me that Hugo could hear us, even though

he was not responding to us.

This was the worst seven days of my life. It was miserable

for me, for Hugo, and for others to see his desired death stretched

out for so long. I slept in his apartment during that week in order

to be close to him.

If Hugo had been able to have a physician assist him in his

dying, he could have died when and how he wanted, with dignity

and without further complications and problems.

A program should be able to be developed so that people

don't make the same bungling mistakes Hugo did. It is important

for people in Hugo's situation to have the freedom of choice to end

their life, without fear and without complications which make their

dying process a nightmare.

I hereby declare under penalty of perjury of the laws of the

State of Washington and the United States that the above

mentioned is true and correct.

Signed:__/s/

Dated: _November 21, 1996 __

Place of execution:_Seattle, Washington _

Appendix 11-2

DECLARATION OF KEITH WILLIAM GREEN

x My name is Keith William Green and | live in Los

Angeles, California.

2. I prepare this declaration to support the position of

Compassion in Dying in the case of Compassion in Dying vs. State

of Washington.

3. I was arrested on December 4, 1995 in West Los Angeles

after my lover of eight years committed suicide. Within hours of

the arrest, | was charged with murder under California Penal Code

section 187 and felony assisted suicide under California Penal

Code section 401. I was a defendant in the matter entitled People

y. Keith William Green, Los Angeles Municipal Court, West Los

Angeles District, Case Number SA023990.

4 In 1991, my lover tested positive for the human

immunodeficiency virus ("HIV") and was diagnosed with full

blown AIDS in early 1994. He was in the advanced final stages of

the disease at the time of his demise. With his immune system

entirely compromised he suffered from a panoply of debilitating

diseases which were incurable. During that time, | was his primary

caregiver, constant companion and, more often than not, his sole

source of emotional support.

5. Throughout the last year of his life, he suffered from a

variety of ailments including Cytomegalovirus ("CMV") retinitis,

an especially frightening condition in which the virus attacks the

optic nerve. It had rendered him virtually blind in one eye and was

threatening to cause total blindness in both. He suffered from

bacterial infections that caused chronic night sweats, fever, chills,

malaise, nausea, diarrhea and pain. He had been treated for CMV

Colitis by daily intravenous infusions of Foseavir, and suffered

from neuropathy, the primary symptom of which is pain throughout

the extremities. He could not drive, he could not work, he could

not live without pain and anxiety, and he had lost control of most

bodily functions.

Appendix 12-1

6. Having witnessed the deaths of many of our friends from

AIDS, he was aware of his fate. He unsuccessfully attempted

suicide in July 1995 by the ingestion of drugs that he had quiet!y

stockpiled. After several hours of distress and seizure it became

apparent that his attempt was flawed so I called 911. Because of

his attempt at suicide, he was confined by restraints to a bed at the

UCLA Medical Center. It was a horrible experience for the both of

us. In the end, the failed attempt only served to increase his sense

of helplessness, humiliation and resolve to die on his own terms.

7. He left numerous notarized suicide notes indicating that it

was his desire to end his life, that he had made the decision on his

own, that the reason was the lack of quality in his life, and he even

promised to sue anyone who attempted to revive him.

8. In late November, 1995, he was hospitalized again, with

his doctors encouraging surgery on the one eye from which he stil!

had some sight. Fearful that the surgery would render him totally

blind, he refused the procedure and left the hospital against medical

advice on or about December 1, 1995.

9. On Monday, December 4, 1995, he told me that this would

be our last morning together. He went into the bathroom where he

remained for a considerable period of time I learned afterwards

that he had been taking a large and lethal quantity of chlorohydrate

and seconal. Because his prior attempt at suicide by pills had

failed, he had planned to use carbon monoxide as a back up.

10. After a tearful goodbye, he went to the garage where he

had set up his car in a manner as to facilitate the ingestion of

carbon monoxide. Once seated in the driver's side of his car, he

then told me that it was time for me to leave.

ll. I left our home and began to drive aimlessly, but was

haunted by something he had asked me to promise again and again

during our last year together. He had repeatedly asked me to

promise him that I would not leave him as his condition worsened.

I, in turn, made a commitment that I would indeed never leave him.

Unable to silence the memories of these words, I returned to our

Appendix 12-2

home within five to ten minutes of leaving. I went to the garage

which was then filled with smoke and stayed with him in the car.

12. Given the circumstances, his decision to commit suicide

could hardly be described as anything but a rational choice.

Indeed, it was his fundamental natural right. In the same way, it

was my right to be by his side, not only to honor the promise made,

but also to honor our love and admiration for each other.

13. After having been prosecuted for a felony for six months,

the charges were finally dismissed on June 4, 1996. Though

released on my own recognizance within a few days of having been

arrested, the terms and conditions of my release precluded me from

being at his funeral in his home town in Texas as I was not allowed

to leave California.

14. I am the one person who stayed by him while everyone

else abandoned him as his condition worsened. | am the one

person whose love was sufficient to withstand the horrible strain

caused by his progressive illness. Despite all that, I am also the

one person who was charged with a felony and faced a prison term

of up to three years. In the end, the charges that were filed against

me were the last thing that he would have ever wanted to happen.

I hereby declare under penalty of perjury under the laws of

the United States of America that the foregoing is true and correct.

Executed this 28th day of November, 1996, at West

Hollywood, California.

/s/

KEITH WILLIAM GREEN

Appendix 12-3

DECLARATION OF WILLIAM F. MEYER III

My name is William F. Meyer III. My address is

2 Teragram Place, Westport, Connecticut 06880. My date of birth

is April 27, 1929.

I prepare this Declaration to support the position of

Compassion in Dying in the case of Compassion in Dying v. State

In 1991, my father, William F. Meyer Jr., who was 88

years old and had experienced five cancer operations, was in

rapidly failing health. The cancer that had begun in his colon had

spread to his lungs. He was losing weight and was being eaten

away. His doctor said he had only a few months to live.

My father approached me with the idea of taking his life, a

suggestion that I immediately rejected since he was my best friend

and advisor. For the next several weeks during weekly visits and

telephone conversations, I tried to change his mind. After

discussing my father’s decision with several close friends, plus my

minister, who is my spiritual leader (and who talked to my father), I

reluctantly agreed to my father’s wish. He took many of his close

friends, plus selected relatives, into his confidence concerning his

intention, and he even prepared a letter which I was to mail to 80

friends and relatives after he had taken his life. The letter said "I

happily decided that it was more kind and thoughtful of me to

terminate my life before I reached a decadent condition of

nelplessness."

After my father and I met with my father’s doctor of 25

years, my father decided he would use the procedure featured in the

book Final Exit, taking 12 sleeping pills and placing a plastic bag

over his head.

My father’s first attempt at this action failed when his

reflex action, which comes from the feeling of suffocating, caused

him to pull off the plastic bag. When I returned to my father’s

home the next morning, he was awake and distressed that he was

still alive.

Appendix 13-1

My father consulted with his doctor and was advised that |

could hold my father’s hands so the reflex action would not remove

the plastic bag. My father and | followed this procedure and he

was able to end his life.

Since one of my father’s last requests was that I tell his

story, | joined the Hemlock Society and became a vocal spokesman

for death with dignity. In the summer of 1994, I was interviewed

for a story by Connecticut Magazine. After the story, I was

arrested and charged by the police with second degree

manslaughter. If convicted, I faced ten years in prison.

At a hearing in December, !994, before a Superior Court

judge in Hartford, Connecticut, two ministers and several friends

spoke on my behalf. Numerous people, including eleven ministers

and eighteen doctors, wrote to the judge to support me. Even

though the District Attorney pleaded that my case go to trial, the

judge stated that although I had broken the law, I was following my

father's wishes, and the judge considered me an outstanding citizen.

I was given two years "accelerated rehabilitation" (after two years,

all charges are dropped, with no record).

I was and am still amazed at how many people relate

stories of prolonged, painful suffering of relatives or friends. They

called my story an act of courage and common sense. There is a

legion of people who live with a "secret agony” over watching a

loved one waste away.

From a religious standpoint my act of love for my father is

consistent with my church's beliefs. As a most loyal and active

member of the United Church of Christ, I concur with our

statement, "We affirm individual freedom and responsibility to

make choices in these matters.”

I hereby declare under penalty of perjury of the laws of the

State of Connecticut and the United States that the above statement

is true and correct. Executed at Westport, Connecticut, on _

December 2, 1996 _.

Ls/

William F. Meyer III

Appendix 13-2

PERSONAL DECLARATION OF

STEVE KNIPP

My name is Steve Knipp. My address is 150 Melrose Ave.

E., #102, Seattle, Washington 98102. My date of birth is May 28,

1962.

I prepare this Declaration to support the position of the

Appellees in the case of Compassion in Dying v. State of

Washington.

My partner, Tom Andolina, was diagnosed with AIDS in

February, 1990. His condition worsened to the point that he was

homebound and in a great deal of pain. Pain medications were not

working. Doctors would not prescribe medications to help him end

his life so he was forced to stockpile medications until he had

enough. He died on December !, 1991, alone, because of fear of

anyone stopping him if they were present.

We had planned on the time and the day. He was so

wrapped up for so many weeks planning his exit that he was unable

to enjoy what life he had left. He was very frustrated at how to

commit suicide; he didn't know how. There was no way that we

could find out how much medication he would need. We both

struggled with it for months. He didn't want to do anything violent

or painful. We didn't want him to commit suicide, but he was in

too much pain and had become housebound. The quality of his life

was severely diminished. He also had a fear that if he failed in his

attempt, he would be resuscitated.

Because he was afraid of my reaction, he decided to do it

alone. It was a terrible shock to wake up one morning and find him

dead in the livingroom. He had been dead for eight hours. I was

obviously devastated. We had been partners for ten years. Our

friends were very upset that they couldn't be with him to say

goodbye.

It was a very lonely death. That's the one thing I will never

get over. My mother came from out-of-state to be with me for a

Appendix 14-1

period of time as she was concerned for my emotional health. I

was in therapy for six months.

I hereby declare under penalty of perjury of the laws of the

State of Washington and the United States that the above statement

is true and correct.

Dated: July 31, 1994

Place of execution: Seattle, Washington

Ls/

Steve Knipp

Appendix 14-2

PERSONAL DECLARATION OF

My name is Jinny Tesik. My address is 3307 N.E. 125th,

Seattle, Washington 98125. My date of birth is April 20, 1942.

I prepare this Declaration to support the position of the

Appellees in the case of Compassion in Dying v. State of

Washington.

In 1986, I took a leave of absence from my position on a

Seattle Hospice Team to help my father care for his terminally il!

wife (my stepmother) of 36 years. She died slowly and stoically

from lung cancer. We were with her at home when she died. For

over two years, Dad watched his handsome wife succumb to the

ravages of the disease. He honored the choices she made in her

care and treatment even though they wouldn't have been what he

would have chosen for himself.

Unable to live alone due to his own battle with

emphysema, Dad lived with me for the last two years of his life.

He was adamant that he would not let his disease control him the

way his wife's lung cancer controlled her. He intended to take his

life while he still had his dignity, self-respect, and , above all, was

still in control of his life. He made me promise that | would honor

his choice. He threatened that if the means for him to take contro!

of his death were not available, he would kill himself with a

kitchen knife.

The emphysema progressed. Dad was tethered to 30 feet

of oxygen tubing; he seldom left his bedroom. Breathing became

more difficult and eating became a problem. His physician was

totally opposed to providing the help Dad requested. One morning.

he reminded me of my promise to help him. He discussed his plan

rationally, non-emotionally. He was ready to die and needed my

support. We raided the medicine cabinet and I was sent out to buy

some vodka. We spent the day together. Toward evening, he

asked me to leave the house and not return until very late. He did

not want me to be implicated in any way in his suicide. Saying

Appendix 15-1

goodbye to my dad was one of the saddest times of my life. And I

had to go through that long night alone for I, in turn, could not

implicate anyone else in the knowledge of my dad's dew i. He died

in 1990 at the age of 76.

My 39 year old husband committed suicide violently ten

vears ago by shooting himself in the head. That is the kind of

suicide that leaves the legacy of guilt, anger, and unanswered

questions. That kind of suicide devastates and destroys those left

behind.

After 12 years of working in hospice and as a grief

counselor, I have heard far too many cases of others like my father

who chose to be in control of their deaths. For those who choose

their own death in their own time, let it be peaceful, loving and

legal, not shattered by violence and shame.

I hereby declare under penalty of perjury of the laws of the

State of Washington and the United States that the above statement

is true and correct.

Dated: August |, 1994

Place of execution: Seattle, Washington

Ls

Jinny Tesik

Appendix 15-2