Death Wish

The Final Exit volunteers call it assisted suicide. Prosecutors may call it manslaughter

Last February, Phoenix oncologist Michael Roberts wrote in his notes that Jana Van Voorhis "wished to be moved to hospice. She believes she has holes in her belly, feet, and liver. She believes she is having pesticide toxemia . . . Clearly, at this point, I don't think that any further testing would benefit her unless there are more symptoms or more objective evidence."

Jana never did have cancer, her sister Viki says, noting that she collected medical records from Jana's doctors after the suicide.

Jana Van Voorhis (center) with family members in a photo from a few years ago.
courtesy of Jared and Viki Thomas
Jana Van Voorhis (center) with family members in a photo from a few years ago.
Dr. Jack Kevorkian assisted in more than 100 suicides before he was convicted of second-degree murder in 1999.
AP/Wide World
Dr. Jack Kevorkian assisted in more than 100 suicides before he was convicted of second-degree murder in 1999.

Dr. Roberts also wrote that Jana had called his office about 10 times weekly for the previous 11 1/2 years.

In March, he "fired" his longtime patient in a letter that concluded, "I will no longer be your doctor."

By then, Jana already had contacted Final Exit Network for help in committing suicide.

The network's Web site spells out what is supposed to happen after a potential "member" contacts it.

"A First Responder in your area will call you, talk you through our procedures, and make arrangements for an Exit Guide to contact you and arrange a personal interview in your home if that is appropriate.

"You will need to supply a personal statement and a medical diagnosis for our Evaluation Committee, and you must attest that all relevant family members or caregivers will not interfere with your wishes.

"Your individual needs and timetable will be evaluated and coordinated with your Exit Guide, who will provide you with information on all alternatives for care at the end of life, including all legal methods of self-deliverance that will produce a peaceful, quick, certain, and painless death."

During searches of the homes of the two exit guides present during Jana's suicide, detectives found copies of the "intake interview" with Jana, dated February 17, and a Final Exit form letter, which Jana initialed on March 24 and then again on the day she died.

That letter includes this statement: "Physicians have determined that I have a terminal or hopeless illness, with no expectation of improvement . . . My present condition is intolerable. I therefore seek information to help me explore my options for a hastened death."

Serious mental illness may last a lifetime, and, in that way, could be termed a "hopeless" condition.

But being profoundly depressed seems different from hopelessness endured by someone that, say, can't move a muscle because of a neurodegenerative disease.

Jana also inscribed her initials next to the following sentence in Final Exit's form letter: "I have considered the feelings of my family, friends and other loved ones, and have decided to choose the time and manner of my death. No one has tried to make this choice. It is entirely my own."

In the weeks before her suicide, Jana apparently spoke by phone to Final Exit's medical evaluation committee.

The word "apparently" is necessary, because Final Exit Network president Ted Goodwin says his attorneys advised him not to discuss the Van Voorhis case for this story.

"But I will say one thing of my own volition," the amiable Goodwin tells New Times. "I've spoken with both parties [Hale-Rowe and Langsner] at great length, and the allegations made under the provisions of the search warrant(s) are in no way substantiated by the facts in the case. I am confident of that."

Generalities aside, however, Final Exit's process of verifying the accuracy of Jana's true medical condition seems to have been as lacking as its decision not to contact her family.

Exit guide Frank Langsner continued to communicate with Jana in March and into early April.

Later, when Langsner finally admitted his key role in Jana's suicide to Phoenix police, he said he'd reminded Jana about another network "rule."

That, according to Final Exit's Web site, is "You must be able to procure the items required for your use [in a suicide]."

Jana had enough pills at her townhouse to bring down a small team of horses, so she really didn't have to procure anything.

But Final Exit Network prefers self-asphyxiation by inhaling helium through a hose, with an oxygen-eliminating hood snugly over one's head.

(An inert gas, helium doesn't show up in a body's bloodstream, which is one reason why right-to-die organizations often trumpet its use in assisted suicides. In the 1980s, a Hemlock Society publication noted, "The gas disperses easily and is difficult to trace in a corpse.")

Langsner advised Jana to contact a local party-supply store and order helium tanks, which normally are used for filling balloons. He also recommended that Jana order by mail the special hood said to be ideal for the bleak task of committing suicide by helium.

Final Exit literature says its exit guides are prosecution-proof if they follow this one-step-removed approach to assisting in suicides of its members.

Maricopa County prosecutors may have something to say about that.

Viki Thomas says she spoke for the last time to her little sister sometime during the daylight hours of April 12.

"It was a normal conversation, nothing alarming, about nothing in particular," she says.

The following afternoon, a Friday, Viki left the first of several messages, according to a police report that summarized the voice mails on Jana's home phone.

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Judith Haney
Judith Haney

I was friends with Jana from the late 1980's to the early 90's. I am shocked, as I have just read the story of her death. On the afternoon of April 12, 2007, I parked in front of her house and debated surprising her, as we haven't had contact for 15+ years.I had heard through a mutual friend that Jana asked about me everytime she heard from her.I decided not to ring her bell because I was not in a very good mood due to my marital problems. I did plan to visit the next time I was in town though, which was about six weeks later. My friend that knew Jana told me she saw her obituary but didn't know what had happened to her. I am sooo sorry I procrastinated visiting her. After reading this article, I can't help but wonder if it would have made a difference if I rang her bell. I send my deepest regards to Jana's family. I think the "exit people" robbed them of a chance to say goodbye, or any other final wishes/thoughts. Jana could be a handful at times, but I don't believe she ever had any ill intent. The years I hung around with Jana, she wasn't happy, but I never heard her mention suicide. I remember her wanting to get married and she wanted a baby. She even talked about adopting a Romanian orphan baby.She had a rather turbulent and abusive relationship with a haridresser for a couple of years. Marriage and family just weren't in her stars. I wish her well in her new life and hope all the suffering and torment have ended. Goodbye Jana�

colleen valdivia
colleen valdivia

wow. excellent job, new times. thank you for taking pains to do so much research. one point that may give your readers more insight on this topic:the hemlock society is not defunct. here is a quote from the organization's website: in 2005 Compassion in Dying and End-of-Life Choices unify to become Compassion & Choices. The new organization maintains headquarters in both Denver and Portland, and is the largest organization in the United States advocating for patients� rights at the end of life.

Joe Bethancourt
Joe Bethancourt

I knew Jana when we were much younger. The story was quite a shock to read ...

Derek Humphry
Derek Humphry

1. Paul Rubin might have checked up how I spell my name. It isHumphry, without an E.

2. It was poor journalistic ethics to invent a quote where he wrote:One of it's pitches: "Follow my instructions for a perfect death, with no mess, no autopsy, no postmortem." If Mr Rubin wants to describe my book, he should read it and do so in his own words, not create a harsh quote which is not in any of my books.

3. 'Final Exit' is a gentle, careful, considerate book which some people find useful when they are considering whether to die. Why else would it sell for 16 years over one million copies in English and eleven translations into other languages?

Jamie Gerston
Jamie Gerston

Hi--I was looking up something on assisted suicide when I found this incredible story. I read every word of both stories, and it read like a movie. Thanks to you and your paper for allowing such an in-depth story to be printed.

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