Without Death With Dignity, The Answer For Some Are `Exit Bags'

In the Netherlands, "20 percent of those seeking self-deliverance through lethal doses of medications linger in a coma for up to four days," readers of the Hemlock Society's publication Time Lines learned in a recent issue. ("Self-deliverance" is the Hemlock Society's uplifting term for suicide.)

Some of those attempting suicide may not have the benefit of lapsing into a coma. The Washington Post's William Claiborne quoted Miles Edwards, a retired lung specialist in Oregon, who warns about taking an abundance of barbiturates for self-deliverance:

"The taste is terrible and anti-nausea medications don't work. The vomit goes halfway up the esophagus and down the windpipe. . . . I've seen patients with dreadful, horribly undignified deaths."

Accordingly, the Hemlock Society recommends plastic bags as a backup to oral medications. For $30, those planning suicide can buy a kit containing a clear, handmade plastic Exit Bag - the size of a garbage bag - with a soft elastic neckband that has Velcro fasteners so it can easily be removed if the customer changes his or her mind.

This customized last-exit bag "is designed to hasten death for the terminally ill in a secure, comfortable manner."

For an extra $10, an illustrated brochure is available that tells the Exit Bag user how to get the best results. I'm surprised that the brochure isn't included in the basic package. The large plastic bag, sized to prevent claustrophobia, does not itself

guarantee a "secure, comfortable death," but carefully written instructions might ease the user into eternity.

The Hemlock Society permitted the ad for the Exit Bag as a protest against the Supreme Court's refusal in its previous term to declare that physician aid-in-dying is a constitutional right.

Faye Girsch, the Hemlock Society's executive director, told the Sun-Sentinel in Florida that as state legislatures and high courts keep on blocking assisted suicide "the plastic bag will become to physician-assisted suicide what the coat hanger was to abortion activists." It will be a stark symbol of the official denial of a good death.

"We don't want people to have to die this way," she continued, "but if they want to die, it's one of the better ways available. I think there should be little signs printed for the kit that say: `I have resorted to this because I can't get help from my doctor.' "

Still, the Hemlock Society, to make its point, is helping to sell self-suffocation as a way to death with dignity, with the use of the Exit Bag only as a complement to the taking of terminating drugs.

When it's time for attempting suicide, the doctor is not present to deal with the often terrifying effects of a drug overdose. The patient administers death by himself or herself and the chances are - with Exit Bags or not - that, as Jack Kevorkian says, "botched suicides" will result.

Dr. Kevorkian is hardly a poster doctor for medical ethics in these matters, but he may be pointing the way to the future of foolproof physician-assisted suicide.

Instead of oral medications, Kevorkian says, the swift and sure approach to the final exit is lethal injection. And it may well be that in Oregon - the first state to legalize physician-assisted suicide - horrible deaths by drug overdoses will lead to a repeal of that section of the current Oregon law that forbids a doctor to aid suicide by direct lethal injection.

At that point, the slippery slope predicted by many opponents of assisted suicide would no longer be just a specter. Euthanasia will have become lawful, as it was in Germany and, as has been discovered recently, in Sweden for a time.

Until euthanasia becomes lawful, suicide by mail may indeed become a symbol like the coat hanger was in the pre-Roe-vs.-Wade campaigns to legitimize abortion.

Meanwhile, selling death through the Exit Bag is presumably legal.

Kathy Cerminara, a visiting professor at the St. Thomas University Law School in Miami says that to criminalize it, "You have to prove specific intent - that one person guided another in suicide, knowing the other person was susceptible."

But even if prosecution were possible in some jurisdictions, what jury would convict? The polls show a comfortable American majority for assisted suicide.

Ask Dr. Kevorkian how his trials came out. Most jurists saw him as a savior rather than a criminal.

Nat Hentoff is a nationally renowned authority on the First Amendment and the Bill of Rights.