# Amicus Curiae Brief — Vacco v. Quill

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URL: https://www.frixlaw.com/law-library/documents/brief%3Amicro_IA40385013_0768%3A58

## Record

- **Collection:** Supreme Court brief
- **Document type:** Amicus Curiae Brief
- **Published:** January 1, 1997
- **Citation:** 521 U.S. 793

## Text

——_-

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 -

———$—— 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

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Source: Frix Law Library, https://www.frixlaw.com/law-library/documents/brief%3Amicro_IA40385013_0768%3A58. Public record. Not legal advice.