Hello, my friends. I'm Derek Humphry. I founded the Hemlock Society in 1980 ...
... and amongst other books, wrote that best-selling volume in 1991 called ...
... Final Exit: The Practicalities of Self-Deliverance and Assisted Suicide for the Dying.
What I'm going to talk to you about on this short video is the new and up-to-date version of this book.
But first, let me set the atmosphere of this whole, difficult subject ...
... by telling you briefly the story of how I helped my own first wife to her end when she was dying of cancer.
What Jean did is described in a little book called Jean's Way ...
... and it has more or less set the broad standard in the following 20 years ...
... for the practice of accelerated death by people with terminal illness.
When Jean realized that her breast cancer was spreading into the bones ...
... and she was not likely to live much longer ...
... she thought the matter over and came to me with a proposition.
Which was, "When the time comes and I am close to death ..."
"... if the pain and indignity are unbearable to me, I would like to kill myself."
"But I need your help. If you're willing, please go to a doctor ..."
"... and ask for lethal medications which we can keep until that time comes."
"I can only stand so much pain and stress," she said, "and I know I will want to hasten the end."
Instinctively, I agreed to help. This was truly a "death by request".
Fortunately, I knew a courageous doctor who understood Jean's situation ...
... and provided me with the deadly drugs. I told her that I had them stacked away.
Jean didn't want to die, she was 42. So she battled on for another ten months ...
... until the cancer invaded all of her vital organs. She kept fighting to live.
When she was taking so many painkillers, just to get an hour of comfort ...
... when she could no longer get to the bathroom on her own ...
... and when her bones were breaking spontaneously ...
... she asked me one morning, "Is this the day?"
I knew of course what she was asking. Had the time come to end it?
Our original pact the previous year had stipulated that it would be a joint decision ...
... in case her judgment was clouded with the numerous drugs she was taking to survive.
When I agreed that her end was close, she stated, "I shall die at one o'clock."
She had said goodbye to our teenage sons ...
... whom she had discreetly told of her plans the previous morning.
We spent quality time together, going over the past and the future ...
... and if she had not mentioned again that she wanted to die, I would not have brought it up.
But right at one o'clock, she said, "Look at the time. Go and get it."
I went into the kitchen and mixed the lethal drugs into a large mug of coffee ...
... laced it with plenty of sugar to reduce the bitter taste.
When I returned to her bedside, Jean said, "Is that it?"
"Yes," I told her. "Drink that and you will die."
I got on the bed, and we enjoyed a last hug and a kiss.
Then I set down beside her, and she lifted the mug to her lips.
She gulped the liquid down rapidly.
Then she just had time to say, "Goodbye, my love" ...
... before she passed out. Fifteen minutes later, she was dead.
I'm talking about self-deliverance for the terminally ill ...
... or in some rare cases, the irreversibly ill whose suffering is unbearable.
I am not talking about clinically depressed people or mentally ill people who wish to die.
That is another serious problem, best dealt with by others.
I am not uncaring about mental and emotional suffering, but it is not my field of expertise.
If anybody watching this video is thinking of killing themselves ...
... because of an emotional, mental or depressive problem ...
... please seek immediate help from your physician, a psychologist, a minister or a health professional.
Please get help.
And I must add this legal warning. While suicide is not a crime, nor is attempted suicide ...
... assistance in suicide remains technically a crime. That is so for both physicians and individuals.
Only the state of Oregon permits physician-assisted suicide for the terminally ill ...
... under strict conditions laid down by the law passed by the voters.
It is also permitted in Switzerland and the Netherlands, but you can't go there to get it.
What is meant by "assistance"? In these circumstances, it is providing and bringing the means of suicide ...
... a gun, heaven forbid, or the lethal drugs to the dying person.
Assistance is also helping physically to put the drugs into the person's mouth or body ...
... or putting a plastic bag over the head of the person.
In essence, any physical action to assist the voluntary death of the person.
What is not assistance? It is not assisting to be present when the person takes their life ...
... not is it assistance to discuss the suicide of a person.
Neither is it assistance to provide information about methods of self-destruction.
If it was, I would be doing life imprisonment, wouldn't I?
In the Right-to-Die movement, we hold it to be a fundamental principle ...
... that a dying person should not have to do this awesome thing alone.
It is a borderline felony to encourage someone to end his or her life.
Anyway, such promotion is totally immoral.
In our movement, we just don't do it. It must be a death by request.
Anyway, briefly, just so everybody knows, my overall goal is law reform.
Since 1978 I've argued and fought for lawful voluntary euthanasia and assisted suicide.
But until that day arrives, or unless we have a brave and cooperative physician ...
... willing to ignore the prohibitions, or happens to able to use the Oregon law ...
... we must tackle this ourselves.
The first thing to do is to ask a doctor.
Some doctors, not just doctor Kevorkian, have the courage to help a person die ...
... provided they can do it in the strictest confidence. It depends on the circumstances.
If lots of family is present in the house, forget it.
If the close family shows any disagreement with a voluntary, hastened death ...
... forget it so far as the doctor is concerned.
Doctors don't take risks.
To make use here of some famous clichés where assisted suicide is concerned ...
... small is beautiful, and silence is golden.
Friendship and absolute trust are necessary.
If the circumstances look propitious, by all means approach your doctor first. It might work.
Now, if you have to chose voluntary death for yourself or your loved one ...
... or your best friend, who has made such a decision and wants your support ...
... be adviced that careful planning is vital.
This can't be done easily or taken lightly.
And here, let me enter a caveat. It is prudent not to help a stranger to die.
You never really know what lies behind this reason to die ...
... or who in the family is a born-again and might object and make trouble.
If the person is new to you, stand clear.
Only help if you know the person's personal, domestic, and financial circumstances reasonably well.
You are in sensitive territory here, emotionally, ethically and legally.
Ideally, only help a person whom you love or are a true friend of ...
... and only help if you yourself, in your heart, feel absolutely comfortable in doing so.
This is a very serious decision, which the helper has to live with.
So, assuming you don't have a doctor's help, what now?
Of course, we in the Right-to-Die movement abhor any form of violence ...
... no guns, no knives or window ledges.
Car exhaust used to be dangerous, but today's high-tech models emit very little carbon monoxide.
It takes many hours to die in a garage full of fumes ...
... and there is a grave danger to other people, of fire, explosion or gas leaking.
Don't, I beg you, use a car for voluntary death.
It sounds nice sitting there in your favorite automobile, going off to the last sleep, perchance to dream ...
... and ay, there's the rub. If it shouldn't work, or the engine stalls ...
... or if you are interrupted by a caller and wake up ...
... the chance of brain damage and paralysis is very high.
Almost every terminally ill person has an abundance of morphine.
It's a superb painkiller. It is also lethal in overdose.
But it has one huge drawback.
If a patient has been taking it regularly, there develops a tolerance.
Then, too often, huge overdoses of morphine do not end life.
So what drugs do you use? More important, can you get them?
I'm being negative again, I know, but I must warn you ...
... that there are lots of drugs which will end life, but not pleasantly.
There are the tricyclic antidepressant drugs, which are lethal, but they are risky in their deadliness ...
... and worse still, have a terrible record of side-effects, particularly hallucinations and convulsions.
Chloroquine, the anti-malarial drug, also can be deadly ...
... but it can also fail in certain circumstances. Other drugs in the body can neutralize it.
Remember also that these tricyclics are prescribed to fight the patient's depression ...
... which is not a state of mind associated with rational suicide.
Nobody wants his or her death to be labeled a "depressive suicide" for posterity.
Now, once a decision has been made about a hastened, voluntary death ...
... then must begin the hunt for barbiturates.
The patient should ask the doctor for them.
Some physicians are able and willing to prescribe quietly, confidentially ...
... but do not wish to know any more about the matter to protect themselves.
In order of effectiveness, the drugs are.
Number one is Nembutal, which is pentobarbital.
The most lethal oral drug, it absorbs very quickly into the human system.
Number two is Seconal, which is secobarbital. This is also very lethal.
Number three is Phenobarbital. It's lethal, but slower acting.
Large doses of barbiturates put a patient to sleep within minutes, and usually kill within an hour or less.
But be warned, in some rare cases ...
... particularly if the patient still has a strong heart, although weakened in other respects ...
... death will not come for several hours. In rare cases, up to eight hours.
Thus great patience might be required in this very difficult time.
As they expire, the patient may snore loudly. That sounds unpleasant, but it is normal.
The drugs are working.
Even if the patient stirs once or twice, or mutters, the drugs are still probably working.
Now, I know you're going to ask me, "Barbiturates are so hard to get. Won't other drugs do?"
Yes, and they are listed in Final Exit.
But they are not so effective as barbiturates, and usually require a plastic bag to ensure a quick ending.
A light snack is necessary two to three hours before the time of the planned end.
Plain stuff. Tea and toast is ideal.
A full stomach slows down the effect of drugs ...
... whilst a small amount helps absorption and reduces the chance of vomiting.
Take a steady dosage of antiemetics beforehand, one every hour for at least three hours.
This is very important. In self-deliverance, vomiting the drugs is the greatest hazard.
We have learned that a good aid to speed death ...
... is for the patient to take six or eight beta-blockers just before the "hemlock" ...
... as these slow down the heart and make it vulnerable.
Lopressor is a typical prescription beta-blocker.
The other great hazard is of the patient falling asleep before ingesting enough lethal drugs.
If that happens, then there's trouble. The patient must bolt the drugs within two to three minutes.
Failure to do so could mean failure to die, because an unconscious patient can't swallow anymore.
One safeguard against this sleep problem is to acquire morphine patches ...
... which of course can be applied while the patient is comatose.
They will help achieve death if there is an unforeseen delay.
It is best to take about ten of the pills as they are ...
... washed down with a moderate amount of alcohol or water or non-carbonated lemonade.
But the bulk of them should be in powder form.
If the medications are in gel capsule form, open them up and pour them into a powder.
If they are in pill form, either grind them up by hand or put them in a food processor.
Then mix the mix the lethal powder into a pudding which the patient enjoys.
Could be yoghurt, apple sauce, fruit preserves. Whatever his or her taste buds like best.
Vodka is known to be by far the most superior alcohol to drink to wash down the pills.
It's strong, and it's plain. The alcohol will also strengthen the deadliness of the medications.
But don't overdo it, in case of an upset stomach.
Don't take carbonated drinks like 7 Up or Pepsi.
They slow down the absorption of the drugs into the system.
Plain lemonade or orange juice is preferable. Nothing fizzy.
Whether the patient has family with them, or the patient is unfortunate enough to be dying alone ...
... it is essential to leave a note which ...
1. Orders that no person move or resuscitate them if they are found still alive.
2. Explains why life is being taken. The disease, the suffering, and so forth.
3. Stating definitely no other person encouraged or assisted this action.
There's a sample letter in the book Final Exit.
Now, let me make this very clear. The only sure way to end life quickly, within minutes ...
... is by injection, into the veins, of lethal drugs.
That's universally known as "voluntary euthanasia". But that, of course, is not likely to be available to you.
Taking lethal drugs by mouth is also deadly ...
... but not with the same degree of speed, because of the time it takes for the body to absorb the drug.
Also, the human body is a strange mechanism.
Sometimes it reacts differently, uncharacteristically, to certain drugs.
Frail, older people with weak hearts will die fairly quickly ...
... but younger and middle-age persons with strong hearts will last longer.
The fifty-year-old son of friends of mine lasted seven hours ...
... after properly ingesting nine grams of liquid Seconal.
He had a brain tumor, but the remainder of his body was strong and healthy.
With hindsight, he should also have been given beta-blockers to slow the heart ...
... and vodka to magnify the toxicity of the Seconal.
The moral of this is, handle every case on its respective merits.
Nothing is standard in this field of voluntary death.
A common sense evaluation of the obvious medical, psychological, and family factors is necessary.
Hastened death requires forethought and planning to be sure of success.
If you can obtain a canister of carbon monoxide with a connecting hose ...
... and a fitting rubber face mask, using that is lethal.
But not everybody can get hold of such equipment, which is used mainly in industry and research facilities.
When is the time to die? Now, that's a very, very individual decision.
Don't do it too soon, because life is precious, both to you and those who love you.
On the other hand, if you wait too long ...
... you may become unconscious or incompetent and lose control.
Put some probing questions about your future to your medical advisors.
Consider your own levels of pain tolerance and necessary dignity.
Discreetly sound out those people closest to you, then make your own judgment about when and where.
Another tip. Be very cautious about telling others of your intentions to check out.
Medical people who oppose rational suicide might use a health law ...
... to slam you into the psychiatric ward of the local hospital as a "suicide risk".
Where do you get the lethal drugs? You can't start looking too soon.
Here are a few ideas.
Ask your doctor, just in case.
See if he or she will prescribe barbiturates in small doses over several prescriptions ...
... which you then hoard.
Look in medicine cabinets to see if there are any lethal drugs which match the chart in Final Exit.
See if you can get hold of veterinarian Nembutal, which is used to euthanize animals.
It's in liquid form, and two bottles should be lethal for a human.
If you are visiting a foreign country ...
... ask your local doctor for a prescription for a barbiturate because you can't sleep.
Pharmacies in Asian countries like Thailand and Hong Kong ...
... are sometimes willing to sell barbiturates without prescription.
It's worth trying if you're there.
Mexico used to be a source for serious medications ...
... but they have clamped down on the type of drugs we need for self-deliverance.
Using the plastic bag is not mine, nor anybody's idea of a dignified death ...
... but if a person is desperate to be sure to die, or has only mild sleeping pills ...
... then it is sometimes the death of choice.
The Final Exit Plastic Bag Technique. These are the materials needed.
First, get two rubber bands just big enough to stretch over the head and sit firmly around the neck.
Purchase a paper mask from a local hardware store.
Sometimes they're called "painter's masks" or "dust and particle masks". They cost a couple of dollars.
Then, find a clear plastic bag, just big enough to go over the head ...
... and then be secured by the elastic bands below the Adam's apple.
Some persons may prefer a larger bag, which works more slowly and may be more comfortable ...
... or an opaque bag, obscuring vision. It's all a matter of choice.
The best size is about 19 inches by 23 inches ...
... which can be purchased in the "foils and wraps" isle of a supermarket ...
... often marketed as "Oven Bags", turkey size, 19 inches by 23.5 inches.
This size bag is long enough to tuck under the elastic bands ...
... with space to spare for the paper mask.
Select your sleep aids and decide how many to put you to sleep ...
... in a short a time as possible, but no longer than thirty minutes.
Over-the-counter sleep aids will suffice if they work for you and are taken in sufficient quantity ...
... 10 to 20 at least.
Well before the time of the intended self-deliverance, when thinking clearly ...
... and in the company of any person who is supporting your action, do this.
Examine the bag for possible holes.
Blow into it. Put one bag inside another if doubtful.
Don the paper mask. This will stop the plastic bag from being sucked into the mouth and nostrils.
Put the two elastic band around the neck to check size and tightness.
They must not be too tight to be uncomfortable, or too loose to allow leaks.
Put the plastic bag on for less than a minute.
And then take it off. A few quick practice attempts often remove the discomfort some people feel.
Now make a decision about the size, shape, and color of the bag.
If you select a larger one, you must be willing for the self-deliverance to be slower.
Should you be bothered by the plastic on your forehead and eyes, wear a baseball hat with a stiff brim.
And now, the actual self-deliverance.
If a rational decision has now been made to end it ...
... because the dying process is too painful and protracted ...
... and if no physician is willing to help, then take the following steps.
Tell all close family and friends whom you trust will not stop you ...
... that you shortly intend to take your life using drugs and a plastic bag.
Such warnings minimize surprise and shock when it eventually happens.
They know what to expect. Also, thank them for their love.
Leave a note saying exactly why you are taking your life, name the disease ...
... and orders that nobody interferes with your action if you are discovered before death.
Carry out this procedure in a distinctly cold room. A warm environment might be uncomfortable.
Get into a comfortable sitting position, slightly tilted backwards ...
... for lying down is not the best position for this procedure.
Swallow all the sleep aids, and perhaps a few tranquilizers ...
... using alcohol or water to wash them down.
If you have beta-blockers, take eight to ten of them to slow the heart down.
Put the paper mask over the nose and mouth.
Put two elastic bands over the head, and settle them around the lower neck.
Place the plastic bag over the head and draw the rubber bands over the bag ...
... securing it firmly at around the Adam's apple area. There must be no leaks.
Or you could use pantyhose tied around the bag.
Now, the secret to this procedure is this.
With two thumbs, hold the elastic bands stretched out a few inches from the Adam's apple ...
... allowing a supply of air to get in.
And so that your arms will drop when you fall asleep, do not support your elbows on pillows or armrests.
Wait until the sleep aids take effect ...
... and as sleep overwhelms you, allow the hands to drop and the elastic bands to tighten around the neck ...
... and close off all air. Breathing inside will continue normally.
As long as there is no further intake of air ...
... death will follow in about thirty minutes after the onset of sleep ...
... and the simultaneous closure of the bag.
Breathing continues, but death follows due to the lack of oxygen.
If something has gone wrong during the procedures, take the apparatus off ...
... pause for careful reflection, and start again if the will to die still remains.
Only end your life if you are desperately ill and no other acceptable alternative remains.
Remember, it is much better to have a companion with you in self-deliverance.
Now, a point to bear in mind. It is the bag which is lethal. The drugs only make it more comfortable.
And don't drink or eat anything which might make you throw up.
Well, my friends, as you know, it's extremely difficult to get barbiturate drugs ...
... for self-deliverance from a terminal illness ...
... and they only work really well when injected, and that's even more difficult.
Now, in recent times, we have developed a method of ending your life peacefully, painlessly ...
... and not breaking the law and not requiring a doctor.
Now, this is the Helium Method.
If you make a personal decision to die in this way ...
... here is the equipment and the bits and pieces that you need to carry this out.
And remember, practice beforehand with dummy runs.
This is what you need if you choose this form of self-deliverance.
Two tanks of helium gas purchased from a toy store or a party store.
You remove the nozzles from the tanks with the little wrench.
You need a plastic bag of about this size.
You need four feet of vinyl tubing, 1/2 inch outside diameter, 3/8 inch inner diameter.
You need a plastic T-junction to join it together ...
... and the two tanks are tapped in together.
The piping runs into the plastic bag ...
... and you have everything ready to make your first practice.
Practice without turning the gas on, of course.
You have to go to a toy store or a party celebration store ...
... and purchase kits for inflating the party balloons.
These are tanks of helium, which is a non-flammable, non-explosive inert gas.
It is only dangerous in an enclosed space, like I'm going to demonstrate.
It is not dangerous in the general area.
It disperses extremely quickly in the air and is not dangerous.
Otherwise, how could you let children blow up balloons with it?
You have two tanks of this, and each tank has a nozzle on it for children to blow up the balloons.
You have to take this nozzle off. You need a wrench to just loosen it ...
... and then it becomes finger-loose, and you remove each nozzle ...
... and put them away. They have ceased to be of any use.
This point, you take your vinyl tubing and connect it with this T-valve, or T-junction.
You firmly put one side onto there ...
... the other side onto here ...
... and your kit is ready.
You make sure that everything is secure and fits well.
Take your time and practice this in advance.
Don't do it at the crucial moment when ending life.
Then, say your important goodbyes to people.
Make sure in your own mind that this is what you want, to bring a swift end to your life ...
... because of the suffering that you are enduring here ...
... and begin with the next move.
You have the plastic bag.
Now, let me point out helium gas or any inert gas is only deadly in a confined space.
It drives the oxygen out of your brain, and you become brain damaged.
A human brain cannot live without oxygen. The helium expels the oxygen from your brain.
This is not death by suffocation. This is death by severe, fatal brain damage.
So if you are ready to leave this world ...
... your next move is to put the bag on your head like this, over your forehead and back of the head.
Then it is advisable to squeeze the natural air out of the bag.
You got what you might call a "shower cap" appearance.
The tank is running up into it.
And at the moment you are ready to die, if that is still the decision ...
... you exhale as much air out as you can ...
... and you turn the tanks on.
It must be you who turns the tanks on to keep within the law.
Now, I'm going to turn them off because I don't wish this to be fatal, but I'll show you what you do next.
But I have turned the helium off for my own protection, and I'm going to release the helium.
But whatever helium in that bag, you would then ...
... and coma will come within seconds.
Death will take place within three to five minutes at the most.
It's quick, and fast, and painless, and you are the person who has done it.
It is your own responsibility because you have done this, and nobody else has assisted your suicide.
If you are making your own kit for this form of self-deliverance ...
... one way to hold the plastic bag onto the neck in a secure fashion ...
... is to purchase a sweatband from a sport store.
Thus.
Put the sweatband down over the neck.
Put the plastic bag ...
... this plastic bag without the ribbon on.
And put the plastic bag held in position by the sweatband.
Let me point out that was has been done here and what you might choose to do ...
... is entirely your own responsibility.
It is not the responsibility of the manufacturers of the tanks or the tubing ...
... or anybody involved in this.
Life is a personal responsibility.
Suicide is a personal decision ...
... personal self-determination, and you must take the accounting for that.
Again, I repeat, while it is advisable to have someone present ...
... they need not be physically involved with the Helium Bag Method, thus cleared of legal risk.
The patient switches on the gas by reaching down to the tank.
Suicide and attempted suicide, I repeat, are not crimes ...
... nor is it a crime to passively observe a suicide.
It can be felony to physically assist a suicide.
Okay, here are my last bits of advice.
After it is all over, those who are left behind should not dial 9-1-1 ...
... the police, fire, and ambulance emergency number.
To do so would almost certainly bring police cars racing up, sirens blaring.
Then paramedics arrive, and it is their duty to restore life.
So when it is certain that the patient is dead, first call the mortician whom the family intends to use ...
... and if they don't offer to call the patient's doctor for the death certificate, you call.
Treat it all very calmly. Take your time.
Say as little as possible to anybody.
Just something like, "This person has been terminally ill ..."
"... and appears to have taken their own life to avoid further suffering."
If anybody was obliged by the patient's poor physical circumstances to actively help the death process ...
... then that person should no longer be in the house when the authorities come.
Leave the patient's signed copy of Final Exit at the bedside.
The mere presence of this book is a well-known indication to the authorities ...
... that this was a considered self-deliverance from a terminal illness.
Also leave their Living Will and Durable Power of Attorney for Health Care ...
... plus any insurance policies in plain sight, another indication of planned death.
Well, friends, I hope this little talk has been of use to you in making plans for this.
Enjoy the rest of your life to the fullest. We only pass this way but once.
Take great care. Goodbye.