Death Watch: Final Exit's clandestine ways have put the assisted-suicide network on life support

James Hoggard has helped four people kill themselves. Or, as he and fellow members of the Final Exit Network prefer to say, he has hastened their exits.

The first time took place in a small northern Iowa town three years ago, just after Hoggard joined Final Exit and became what the network calls an exit guide.

The old man was terminally ill. Hoggard can no longer remember his age or diagnosis, though he does recall that, except for one hand, the man's limbs were completely paralyzed. The man and his wife learned of Final Exit on the Internet and called the group's 800 number. Then they explained their case to a volunteer, also known as a first responder.

James Hoggard, an exit guide and former Baptist minister, with his companion, Julia Peggs.
Jennifer Silverberg
James Hoggard, an exit guide and former Baptist minister, with his companion, Julia Peggs.

As network protocol dictates, the responder asked the man a series of questions, 25 in all. Where did he live? Did he have caregivers? Why did he want to end his life? Did his family know of his plans? Did they approve? Was he suffering from depression? Could he please send a list of his medications and a letter from his doctor confirming his diagnosis to the network's medical adviser?

A few weeks later, Hoggard and another exit guide made the journey to Iowa.

Hoggard is 74 years old. He grew up on a farm in Arkansas. For years he was a Baptist minister, until he realized his liberal inclinations were at odds, as he puts it, with a congregation accustomed to fire and brimstone. So he quit, moved to St. Louis and became an auto mechanic.

"I don't want life prolonged unnecessarily," says Hoggard. "I've always felt that people should be able to end their lives on their terms. I can't find anything in the Bible that condemns suicide."

The two guides arrived at the old man's house before dark. They left their car in the garage. "We don't like anybody to see a strange car parked outside," explains Hoggard, who won't identify the town. Again, following network procedure, they looked around for nosy neighbors or security devices that might alert police. Then they went inside.

"We had a long conversation. We talked about careers and neighbors. It was a normal conversation until we got to the purpose of our being there. He knew he didn't have much time left. We talked it over. He signed a paper indicating his intention to do this."

Then the guides left, promising to return a week later. They wanted to give their client time to pause, reflect and be certain of his decision. They also knew he had to buy the needed death supplies: two tanks of helium and an "exit hood," a clear plastic bag with a Velcro band that fastens around the neck, available for purchase over the Internet. Altogether, the helium and the hood would cost him less than $100.

When the guides came back, they brought a spare hood and extra helium, just in case the old man's equipment malfunctioned. They also came with a prepared statement — that he alone made the decision to end his life — for him to sign. Again, they sat in the living room with the man and his wife, chatting idly about neighbors and the weather.

"It was a normal conversation," recounts Hoggard. "I was surprised. Finally, he said, 'I'm ready now.' We went into the other room to give him and his wife a private moment. She did not want to be there when it happened."

Hoggard's bright blue eyes fill with tears. He pauses for a moment to collect himself.

"We went back in. He was lying on a bed. He was wearing the same kind of clothing you might wear at night. He was lying in the same position, like he was going to sleep. He pulled the hood down tightly over his face. He was able to use his hand, and he opened the two valves on the helium tanks.

"It seems to me there's some discomfort for the first minute or so," Hoggard continues. "He raised his head, like he was trying to get oxygen. But there was no more conscious behavior on his part. They're no longer conscious after 30 seconds. The doctors tell us this. After five minutes there was no more bodily action. He was still, but he kept his eyes open. He was the only one I've seen who kept his eyes open.

"We let the helium run out. [The other guide] was able to get the eyes closed. We told his wife he was dead. She sat there with him for a while. Then she told us she was ready for us to leave. We gathered up everything, the empty containers of helium, the hood."

Then they threw everything away, making sure to scatter the equipment in different Dumpsters around town. They instructed the man's wife to delete the e-mail and phone messages that would link his death to the Final Exit Network.

The next morning, after the body had grown cold, she would call the doctor and the undertaker. Helium leaves no traces. By all appearances, the old man had died in his sleep.

"We don't want the medical examiner coming in," explains Dr. Jerry Dincin, a clinical psychologist near Chicago and Final Exit's president. "Otherwise they can't get their insurance money."

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