Death Wish

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

Still, she says, "This cause has been just a part of my life, certainly not my whole life. I've been ushered through a killer disease [she's a cancer survivor], and I've been kept alive and in reasonably good health to such an old age. I have a lot of things going on, and things I have been looking forward to.

"But not everyone has been so lucky as me. Maybe we have a more enlightened vision these days, because we don't blame people for wanting to die anymore. Some of them can be made much more comfortable and can enjoy living and stay around for a long time. But others really can't, and Jana was one of them. She wasn't getting better, and she could have been sent to some kind of facility and lived another 20 years — miserably."

Hale-Rowe confirms she's been present at almost 20 assisted suicides, most of them with members of the family present.

Colby Katz
Landon Armstrong

"People do have other options besides offing themselves," she says. "One of the first things that we see is if someone is hospice-eligible. We do want them in hospice care if possible, to give comfort to people who are dying. But many cases that Final Exit Network takes on aren't eligible for hospice because they have to be terminal, as defined by a prognosis of six months or less to live."

Hale-Rowe reiterates that Jana Van Voorhis hadn't wanted her family to know anything about her fatal intentions. She says that is appropriate under Final Exit's guidelines. But she seems at odds with herself when discussing the propriety of not contacting family members in assisted-suicide situations, especially when dealing with non-terminal, mentally troubled members..

"In the 1990s, I coordinated a national program with another [right-to-die] group that said families had to be contacted, which I thought was a good thing," she says. "Final Exit does not have that policy."

Hale-Rowe pauses, seemingly lost in thought.

"Why didn't I see this coming?" she finally says. "I worked as a family therapist, and I just didn't see this coming."

She says she's referring to her current status as a murder suspect.

"On the day that someone chooses to die, it's also up to the people that are with them whether it's going to happen with them present. You, as an exit guide, rely on the [network] doctor, the Final Exit data, the clinical psychologist and other people who evaluated the person up-front. Then you simply make an on-the-spot evaluation, 'Does she understand the consequences of what she's asking?' and make sure that you've spoken to her awhile about her life."

In Jana's case, Hale-Rowe says, "She responded to very, very short imperative statements that I had for her. I had to satisfy myself, and I know it's difficult to defend now. But I do know that Jana felt supported and she felt understood, and it was very clear to me that she knew she could change her mind before it was supposed to happen and that would be okay."

Hale-Rowe speaks movingly of the death of one of her own daughters from a terminal illness about four years ago.

"She didn't want to have anything to do with assisted suicide, even to her last breath," Hale-Rowe says, "and, of course, I respected her wishes. It's not about you. It's about them."

Hale-Rowe says she hasn't assisted in a "death event" since coming to Phoenix in April.

"They may make this a test case, which doesn't thrill me," she says. "I don't want to spend the rest of my time fighting this. My plan is to be 95 and to die in my sleep. But if I don't have the health, no, I won't want to stay around."

As recently as the mid-1960s, it was a crime in six states (not Arizona) to kill oneself, an absurdity that gave birth to the joke, "What's the punishment for suicide?"

Answer: "Life imprisonment."

But 44 states, including Arizona, currently do have laws that criminalize assisted suicide.

Only four states — North Carolina, Utah, Wyoming, and Virginia — don't have laws that make assisting suicide a crime. In Ohio, the state Supreme Court in 1996 ruled that assisted suicide isn't a crime, though the practice officially remains against public policy there.

Oregon is the sole state that permits physician-assisted suicide (see "The Last Word"), and then only under supposedly strict guidelines.

The laws in Arizona and most other states that forbid assisted suicide refer simply to the general illegality of helping a person kill him or herself.

Some states, such as California, are slightly more specific, making it a crime to "encourage" someone to commit suicide.

However, Jack Kevorkian's second-degree murder conviction in 1999 aside, prosecutions of those who assist in suicides are rare nationwide — and are unprecedented in Arizona.

One issue bound to arise inside the County Attorney's Office as prosecutors decide whether to charge Langsner and Hale-Rowe is this: Anytime you are in the presence of someone breaking the law and you aid them in committing a crime, you may be held criminally liable as an accomplice.

It's called "accomplice liability."

Classic examples are being a lookout for a robber, providing guns or other instruments of crime, driving a getaway vehicle, and so on.

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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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