Last spring, family and friends gathered at a service for Jana Van Voorhis, a 58-year-old Phoenix woman who recently had died at her home.
The memorial took place outside at the Greenwood Memory Lawn and Mortuary on West Van Buren, where Jana's mother, Mary Jane, had been laid to rest eight months earlier.
At the conclusion, Jana's family released helium-filled blue balloons into the air, something she had requested years earlier during what often had been a tortured existence marred by chronic mental illness.
Final Exit Network
Never married, Jana was well-loved by her family, including her two siblings, Viki Thomas of Phoenix and Wes Van Voorhis, a Seattle-area physician and University of Washington professor.
On the afternoon of April 15, Viki and her husband, Jared, found Jana's body in bed at a townhouse on East Hazelwood Street, south of Camelback Road.
They immediately suspected her death had been caused by a drug overdose, intentional or not. Those close to Jana knew she had a veritable apothecary of prescribed painkillers, sleep inducers, and mood stabilizers on hand.
But the couple noted that there wasn't a pill bottle in sight, which seemed odd to them. Also, Jana's body had been neatly tucked under the covers, her hands by her side atop the sheets, dark hair carefully fanned out on a pillow.
"It looked staged," Viki Thomas says.
A few months later, after the circumstances of what actually had been Jana Van Voorhis' assisted suicide emerged, the image of the balloons at the service struck Jared Thomas (whom everyone calls Tom).
"When those balloons were floating off, we didn't have a clue that helium had killed Jana," he says. "To think of her breathing in helium from a tank while two strangers just stood by and watched; it's just too much."
Maricopa County prosecutors are contemplating whether to file manslaughter charges against two senior citizens who have admitted to guiding Jana Van Voorhis through her suicide on April 12.
Arizona law makes it a crime to intentionally aid another person in committing suicide. But the prosecution would be a first in the state of Arizona, in part because the word "aid" is fraught with legal uncertainties in such circumstances.
Convictions would be anything but a slam dunk, but the facts in this case are extremely disturbing.
Jana's death became a murder investigation only because of blunders made by the two murder suspects that led Phoenix police to them.
Primary sources for this story include extensive police reports about the case, and New Times' interviews with Jana's family and with one of the two so-called exit guides from a national assisted-suicide group who were present when Jana died.
That "senior" guide was Wye Hale-Rowe, 79, a retired family therapist and great-grandmother from Aurora, Colorado. The title refers to her experience in the field, not her age. The second guide was Frank Langsner, a retired college professor who lives in Scottsdale.
They are volunteers for the nonprofit Final Exit Network, an offshoot of the now-defunct Hemlock Society, which was founded in 1980 by author Derek Humphrey. The Hemlock Society moved into the American consciousness in the late 1980s, some years before Dr. Jack Kevorkian's high-profile run of assisting in more than 100 suicides became headline news.
Humphrey's bestselling book, Final Exit: The Practicalities of Self-Deliverance and Assisted Suicide for the Dying, was published in 1991 and still sells well. One of its pitches: "Follow my instructions for a perfect death, with no mess, no autopsy, no postmortem."
Based in Marietta, Georgia, Final Exit Network is considered among the most radical of the assisted-suicide associations, in that it also embraces "members" who suffer from serious mental illnesses, not just physical.
According to a recent Final Exit newsletter, 1,041 new members joined in 2006. It costs $50 to become a member, and $500 for a lifetime membership. (The use of the word "lifetime" in this context carries a certain irony.)
In its literature, Final Exit calls itself "the only organization in the United States willing to help individuals who are not 'terminally ill' six months or less to live hasten their deaths. No other organization in the U.S. has the courage to make this commitment."
That bold statement is what may have attracted Jana Van Voorhis.
Records suggest she first contacted Final Exit last year, paid the $50 to join, and sought its help in dying sooner than later.
Helping meant teaching Jana the creepy how-to of inhaling helium after placing a hood tightly over her face.
Though she did have physical issues, Jana (according to family members and medical records) wasn't suffering from any illness about to kill her anytime soon.
What Jana was suffering from, and had been for decades, was serious mental illness.
Since her teenage years, Jana's problems had required intensive psychiatric care. Her troubles increased over time, especially after her mother became incapacitated with Alzheimer's disease and died in July 2006.
By mid-2006, according to notes made by Jana's final psychiatrist, Dr. Michael Fermo, she "had been increasingly becoming psychotic, claiming the roof rats have been overtaking her home, sneaking into her house, and attacking her."
According to Final Exit Network's written criteria, each applicant "must be mentally competent" before exit guides get the go-ahead to assist with a suicide (they call it aid-in-dying, hastening death, or another term that doesn't invoke the inflammatory "S" word).
Some experts contend that anyone desiring to commit suicide, especially a person not suffering from a fatal illness, may be considered mentally incompetent.
Precisely defining incompetence, however, is dicey.
For starters, mental health diagnoses and legal definitions often do not jibe. Even if it seems obvious to shrinks and the public that someone is "crazy," he or she still may not qualify legally as incompetent.
Final Exit Network's protocol also demands that someone who desires to commit suicide "must attest that all relevant family members or caregivers will not interfere with your wishes." The network also claims it will not assist in a suicide "when family, friends or caregivers know about the patient's plans and are strongly opposed."
The network doesn't address what happens when a member is estranged from his or her family and doesn't want it involved in the so-called death event.
In this instance, no one from the network ever contacted Jana's family to get their position on her apparent death wish. Instead, her exit guides abided by Jana's alleged wishes and kept the suicide plan hush-hush to the end.
Jana's closest family members insist they would have done anything to stop her from killing herself had they known what was up.
Wye Hale-Rowe, who long has been prominent in the assisted-suicide movement, tells New Times she doesn't believe that Jana was seriously mentally ill.
"Jana was in the throes of what we call existential suffering," says Hale-Rowe. "Even though their physical pain may be managed, just being alive is a burden. They're not able to function much with reference to other people.
"Jana knew what it was like to have had a very functional, active life, and that was part of her angst, that she had lost it and there was no way she could get any of it back."
But Wye Hale-Rowe seems truly tormented by this case, especially for having granted Jana's request not to inform family about the impending suicide.
"Working with families is one of my skills, and that didn't happen here," she says. "It's not a spot I like to defend, though not because I didn't understand her wish to die."
For the record, neither of the exit guides knew Jana Van Voorhis before she contacted the organization and pleaded for its assistance in doing herself in. The sum of Wye Hale-Rowe's "relationship" with Jana was a suicide practice session on the day Jana died and then a few minutes of dialogue before Jana killed herself.
Hale-Rowe's colleague, Frank Langsner, did spend time with Jana in the weeks before the April "death event" (as Final Exit Network calls it), starting at a February "intake interview."
In a June 6 taped interview with a Phoenix homicide detective, Langsner focused on Jana's physical ailments rather than her deep-seated mental issues. He claimed she'd been long-suffering from lung and back pain, possible breast cancer, an alleged lesion on her liver, and other problems.
Langsner apparently took Jana at her word because her medical records don't reveal a terminal illness or anything that serious physically.
"She had no relationship with her family," Langsner told the detectives. "She had nothing to do with her sister and she had a brother in Seattle. She was all alone. She didn't even bother with her neighbors . . . This was a person who wanted to die."
To help Jana succeed, Frank Langsner said, "You help get them in a frame of mind that they want to do it."
If the lead detective on the case got that quote right, it may well prove legally damning to Langsner. (The quote comes directly from a police report. New Times did not hear the actual interview, and the cops won't discuss the ongoing investigation.)
In stark contrast to Langsner, Wye Hale-Rowe says, "You never, ever encourage someone to hasten their own deaths. It's entirely their choice. You're only there because they've expressed this wish. Many people back off at the last minute, which is absolutely no problem for me."
Hale-Rowe is being represented by Phoenix attorney Mike Kimerer. Final Exit Network is footing the bills for Kimerer and for Frank Langsner's lawyer, Antonio Bustamante, also from Phoenix.
Bustamante strongly denies that Langsner ever uttered the "frame of mind" statement, though he, too, says he hasn't heard the police tape.
"I believe my client," he says.
Langsner's allegation that Jana's family had "no relationship" with her is ludicrous to Viki Thomas. Viki, who lives about three miles from Jana's townhouse, says she spoke with her sister almost daily, including on the day of the suicide.
Viki's increasingly worried calls to Jana before she and her husband found Jana's decaying body were preserved on an answering-machine message now in police custody.
"My sister had problems from early on, but her family loved her, and she knew it," Viki Thomas says. "For anyone to say otherwise is just wrong. I can't imagine how Jana felt in her head. But we think that if these people [Final Exit Network] hadn't come into her life, she wouldn't have done what she did."
That said, if Jana had lived, her increasingly severe delusions and paranoia may have led to an involuntary commitment in a psychiatric hospital, a lousy fate.
But did that give the Final Exit guides any right to become her Johnny-on-the-spot suicide advisors?
Wye Hale-Rowe wavers when asked to compare someone's overwhelming physical suffering to unbearable mental suffering.
"I'm not one to say we should treat mental illness the same as physical, because it's too easy to say and too hard to do," she says. "We're on pretty shaky ground, I think, and we have to be very, very careful in this area. I just went into a risky case, and now I'm stuck with what happened."
But equating Jana's mental despair with that of a person suffering a terminal physical disease is what Final Exit Network did. That and the failure of the exit guides to speak with Jana's family are what is at issue here.
Many people have known a person akin to Jana Van Voorhis. Though off-kilter much of the time, she nonetheless forged a spot as a beloved member of her family. Jana was a fourth-generation Phoenician, the middle child of Peter and Mary Jane Van Voorhis, and her sister Viki says she always seemed to struggle with life.
"She had talked about suicide since she was 10, though she never did anything about it," Viki says.
Jana was admitted into a psychiatric hospital while attending Camelback High School and underwent mental-health treatment for the rest of her life.
She was attractive and outgoing as a young woman, despite her psychological problems. Sadly, little of her physical beauty remained by the time she was an adult. And over time, because of her persistent troubles, she became a handful, even for those who loved her.
"She always had a hard time keeping friends," Viki Thomas says. "She was giggly and a little girlish, and she had this smothering personality that was difficult for a lot of people. But she also had a very loving side."
That side included a love of heart-shaped rocks, young children, animals, The Beatles, and many other musical artists. Later in life, she doted on her niece and nephew, great-nieces, and her many cousins.
But her physical illnesses, which apparently were far more often perceived by her than real, were the centerpiece to what was a distressed existence.
"She was always complaining about being sick, and it got worse over the years," Viki Thomas says. "She called her doctors constantly with lists of aches and pains. After speaking with her psychiatrist at one point, we learned it wasn't a good idea to drive her to the ER every time she called. I don't know how many times that the fire department went to her house because of an 'emergency.'"
But Jana was blessed to have been born into a family with enough money to meet her needs financially.
"She had someone to take care of almost every aspect of her life," her sister says. "Someone to take care of the books pay her bills a gardener, a housekeeper. She had an allowance. And she had family nearby. In that way, she was pretty lucky."
Though she would become more reclusive over time, Jana never was homebound. She drove her car, shopped for food, went to the movies, and had other trappings of a quasi-normal existence.
One of her lifelines was the telephone, because she didn't own a computer and wasn't conversant with the Internet.
She called people constantly, including her many doctors, family members, and politicians such as Governor Janet Napolitano the latter to complain about how her docs were mistreating and misdiagnosing her.
Unquestionably, Jana's mother was the most important person in her life. Mary Jane Van Voorhis was someone to whom Jana could endlessly rant without reservation, and she did.
But the onset of dementia in the mid-1990s necessitated Mary Jane Van Voorhis' move to an assisted-living facility, and Jana's own downward mental spiral accelerated from then on.
Psychiatrist Michael Fermo wrote of Jana on May 7, 2006, "She reports having depressed mood swings; periods of irritability; difficulty shutting off her mind, especially at night; erratic sleep; low energy; nervous; socially isolative; and an ongoing feeling that bugs are eating her."
Mary Jane Van Voorhis died in July 2006.
The following month, Jana officially joined Unity of Phoenix, a Christian church of about 1,200 parishioners at 16th Street and Greenway Parkway.
Unity senior pastor Richard Maraj tells New Times he never suspected that Jana was suicidal.
"Her death was a shock to me, and then to learn it was suicide was very upsetting," Maraj says.
The pastor may receive quite a windfall as a surprising byproduct of his connection with Jana.
County probate records show that Jana amended her 1999 will last January, leaving almost her entire estate of about $650,000 to Pastor Maraj personally, not his church. She left nothing to her siblings under the new provisions, though they previously had been the sole heirs.
Jana's brother and sister recently filed a challenge against the new will at the county courthouse, claiming she had been mentally incompetent when she'd altered it.
It's unclear where Jana was when she changed her will, or who was present.
Jana's family sought to unearth a connection between Final Exit Network and Pastor Maraj in recent months, to no avail.
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.
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.
"Getting worried about you," Viki said in another message sent Saturday, April 14. "Give me a call."
But Jana didn't return the calls. On the afternoon of April 15, Viki and Tom Thomas made the short drive over to East Hazelwood.
Jana didn't answer the doorbell, so the couple went to ask a longtime neighbor if she had a key, which she did.
The Thomases soon had the misfortune of finding Jana dead in her bed.
Police at the scene that day opened a sealed envelope on a table at the home. It was addressed to Jana's next-door neighbor, the lady with the key. Inside was a letter handwritten by Jana.
"I've been feeling so bad all day," it read. "It's the worst ever. Could you check on me tomorrow and call Viki . . . I love you. Jana."
Officer Gary Stockton interviewed the neighbor, an elderly woman. She said Jana had been talking about suicide when they'd spoken last, probably three or four days earlier.
"[She] had last heard this type of thing before from Jana and didn't think she was serious," Officer Stockton wrote. "Jana gave her a key to her house about a week prior and told her she might need it soon."
The police did not, at first, suspect foul play.
Viki Thomas told the officer that Jana had joined an unknown church months earlier, and recently had changed her will to make that church the prime beneficiary (the change actually favored Pastor Richard Maraj personally, not Unity of Phoenix).
Viki also noted that, two days earlier, April 13, she'd gotten a phone call from a woman who said she was "from the church" and had been trying to contact Jana. The caller suggested that Viki should check on her sister, but had declined to give her own name when asked.
The caller ID came back to a Frank Langsner, and Viki told the cop she knew of no such person.
Officer Stockton was sharp. He'd already seen a note attached to a glass window on the front door that said, "Frank and Wye, I put paper towels out to wipe shoes."
He suspected that the Frank on the note and the Frank Langsner on the phone call might be related. A crime-scene specialist impounded the note.
Despite the interesting twists, the investigation into Jana Van Voorhis' death soon would become a low priority for Phoenix police.
Jana's autopsy and toxicological testing turned up nothing that would have killed her and found no evidence of wrongdoing. A county pathologist later ruled the woman's manner of death to have been "natural," not suicide.
A few days after discovering Jana's body, her sister and brother-in-law returned to East Hazelwood. On this trip, they saw some literature from something called Final Exit Network that gave them pause.
The Thomases also found a receipt for the recent purchase of two helium tanks, a puzzler because no tanks were at the house and they knew no reason why Jana would have bought them.
Tom Thomas replayed Jana's phone messages, including one recorded on the afternoon of April 10, two days before the suicide:
"Hello, Jana, this is Frank. I tried to locate the company . . . We'll just have to wait a few more days to see if you get your hood."
Who was this "Frank" guy?
The couple began to hound the police about digging a little deeper. But it took almost two months for Phoenix detectives to pay a visit to Frank Langsner in Scottsdale.
On the morning of June 6, Lois Weiss and fellow homicide detective Jennifer Mellinger showed up unannounced at the home of Franklin Royal Langsner.
A native of New York, Langsner is a retired professor of health, physical education, and recreation from Morgan State University in Baltimore.
Weiss' written account indicates that Langsner agreed to be audiotaped. At first, he said he'd known Jana Van Voorhis but had never spoken with him about wanting to harm herself.
Weiss then brought up the off-putting April 13 phone call to Viki Thomas, ostensibly from the female church member worried about Jana's well-being. The detective told Langsner that it had come from a phone with a caller ID of a "Frank Langsner."
Langsner now suggested the call might have been made by a friend of his visiting from Colorado at the time.
Weiss upped the ante, telling Langsner that Jana's family had told her about Jana's interest in assisted-suicide groups such as Final Exit Network.
Langsner admitted he was a member of the network.
The professor said he'd met Jana through Final Exit and knew she'd been "in pain all of the time and she had all kinds of problems."
Weiss asked Langsner if he recalled phoning Jana's home to tell her that the "hood" hadn't yet been delivered to a local UPS store.
"What info do you want from me?" Langsner responded, according to the police report. "I don't know who assisted her or who might have assisted her. That's up to her. I'm called an exit guide."
Langsner said he last visited Jana at her home in early April, about a week before the suicide.
He soon mentioned the name Wye Hale-Rowe, his "friend" from Colorado whom he now said had made that call to Viki Thomas from his home.
Langsner went into great detail about Final Exit Network's program, and the role of an exit guide.
That's when he allegedly uttered the memorable quote, "You help get them in a frame of mind that they want to do it."
Langsner now said he had been assigned as an exit guide for Jana Van Voorhis.
"First of all, she had no relationship with her family," Langsner said. "She had nothing to do with her sister, and she had a brother in Seattle. She was all alone."
He said he'd taken a two-day training course to prepare him as a guide, and he said he'd previously been assigned to "assist" someone in Fountain Hills and two people in Tucson. All of them, however, ultimately chose not to kill themselves.
Langsner claimed he'd learned about Jana's death from Wye Hale-Rowe, and that Hale-Rowe had called Viki in an effort to learn whether anyone had found Jana's body at the townhouse.
He said Hale-Rowe had flown into town from Colorado on the morning of April 12. They had gone over to Jana's home early that afternoon for a walk-through in how to commit suicide with the helium.
Jana's hair kept getting in the way when she tried putting on the hood, which finally had arrived. Hale-Rowe had suggested that Jana put her hair up for the real deal, scheduled for later that evening.
Langsner said he and Hale-Rowe had returned around 9 p.m.
Jana soon told them that she was ready to die.
The pair looked on as the woman opened the valves on the helium tanks as instructed, put on her hood and sucked in the gas through a hose.
By Langsner's account, Jana Van Voorhis soon had slipped into unconsciousness and died about 15 minutes after the start of the grim process.
"This was a person that wanted to die," Langsner told the detectives.
He described how he and Hale-Rowe had taken the tanks and hood out to a car parked inside the garage, and then disposed of the evidence in different Dumpsters.
Langsner said he'd erred by leaving Jana's letter to the neighbor inside the house instead of dropping it in the next-door mailbox, as planned.
That surely would have led to an earlier discovery of the woman's body.
Weiss phoned Viki Thomas later that day to tell her about the remarkable interview with Frank Langsner.
What had started for the detectives as a perfunctory death investigation now had become a top priority. Armed with a search warrant this time, the police returned to Langsner's home on the morning of June 12.
A cooperative Langsner directed the cops to a briefcase in his master bedroom. It contained Jana Van Voorhis' file, including notes of Langsner's intake interview, Jana's obituary and, probably most important, a detailed "Final Exit log" signed by Wye Hale-Rowe.
In the log, Hale-Rowe describes what she calls a "get-acquainted" visit with Jana on April 12 the eerie suicide rehearsal.
"Jana seemed to need assurance a second and third time that the procedure would be painless and peaceful," Hale-Rowe writes. "Frank had obviously established a warm, supportive relationship with her and, after an hour together, she seemed willing to transfer trust to Wye. The volunteers left her, promising to return that night to have the death event. Jana was cheerful and upbeat."
After the suicide, Hale-Rowe continues, "The volunteers arranged [the deceased] Jana in a sleeping position, bagged the tanks and bag, and left by 10:15 p.m . . . Without creating suspicion, there was no way the volunteers could follow up and know what happened after the sister discovered Jana's body."
The day after they searched Frank Langsner's home, detectives Weiss and Mellinger flew to Denver to serve a search warrant on Wye Hale-Rowe.
In contrast with the garrulous Langsner, Hale-Rowe said little to the cops.
"What is being investigated here?" she asked the detectives according to the police report, as she perused the warrant. "Intentionally aiding another to commit suicide? How do you allege we did that?"
With the police present, Hale-Rowe spoke by phone to Final Exit Network president Ted Goodwin. After that call, Detective Weiss read Hale-Rowe her Miranda warning against self-incrimination.
Hale-Rowe said she had nothing to say to them.
The search of her apartment revealed a pile of Final Exit Network materials, including the same "log" of the Van Voorhis case that police earlier had seized from Frank Langsner's home.
Though she'd said little to the Phoenix cops, Hale-Rowe recently spoke to New Times twice for this story. In those interviews, she came across as thoughtful and quick-witted, but also deeply conflicted about what happened in Phoenix on April 12 and concerned about her own future.
She says her interest in assisted suicide had started long ago, when was a girl growing up as a rancher's daughter. There, she says, sick animals were routinely euthanized to spare them needless physical suffering. But when Hale-Rowe's mother became terminally ill and begged for help, nothing legally could be done to "hasten" her death.
Hale-Rowe says she got involved with the Hemlock Society after it was founded by Derek Humphrey in 1980. She is considered one of the national right-to-die movement's most experienced advocates.
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.
"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.
But it's not against the law to kill oneself.
So, how can someone who goes along with another person's suicide be convicted of manslaughter by "aiding" an act that's not a crime?
(Prosecutors in Arkansas last year did charge a man with assisted-suicide manslaughter after he allegedly helped a pal hang himself. In that pending case, the defendant physically assisted with the hanging, which is somewhat different than just standing around and watching as someone self-asphyxiates.)
Viki and Tom Thomas say they'd never given much thought to the ins and outs of assisted suicide before Jana died.
Now, the couple say they aren't against the concept under certain circumstances, such as when someone really is dying and is in great pain and wants to speed up the inevitable.
But Jana's case, they say, feels different to them, and not just because she was family and now she's gone.
"If the Final Exit Network had gotten ahold of me, I would have called Jana and gotten right over there," Viki Thomas says. "Sure, she had problems. But she was alive, and now she's not."
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