For months, Jeff pondered how exactly he should die.
Should he use a string tied to his toe to trigger a shotgun? Should he fake a hunting accident in the woods?
His favorite idea was more romantic. “I’m going to rent a plane and fly out to the ocean,” he’d tell his wife, “and not come back.”
Each time he devised a plan, Donna cringed. She didn’t blame her husband for not wanting cancer to end his life, with strangers in hospital masks struggling to slow the inevitable.
She didn’t blame him for dreading the days he’d be too weak to bathe himself or walk from his bed to the toilet.
After all, he was an ambitious, athletic young man a decade ago when he learned that he and his new wife would not grow old together.
Donna didn’t blame him at all. But neither could she bear the thought of him dying alone in the water or the woods. “Come up with a plan where I can be involved,” she told him, “and hopefully not implicated.”
Jean Davidson, a retired nurse, doesn’t know Donna, but the two share a goal. They’ve both been at the bedsides of terminally ill people, and they’re convinced there’s a better way to die.
“I have seen so many people with a lingering death, where the quality of life is gone,” says Davidson, 76, who worked in nursing homes for decades.
Those images inspired the great-grandmother to join a Spokane group that favors legalizing doctor-assisted suicide for the terminally ill.
Few people know the Dying Well Network exists. Yet the group has met monthly, quietly, for more than a year.
In a church basement, the 15 or so members spend hours dissecting issues many people hate to even think about.
They’ve written bylaws and elected a president. Two days after Christmas, the group became a non-profit corporation, with Davidson and six others serving as board members.
This is not, however, a gathering of people with terminal illnesses. They’re counselors, social workers, nurses, psychologists, graduate students, a minister, a dental aide.
They know physician-assisted suicide is highly controversial - and illegal - in Washington. Many of them fought hard for a physician-assisted suicide law defeated by well over half the voters in 1991.
They think ending suffering by helping someone die is, in some cases, the loving and humane thing to do.
“We’re not going to run another campaign,” says Rob Neils, 50, a grief counselor and the group’s president. “We’re just going to try to help people.”
That help, in some cases, means providing recipes for lethal drug overdoses. In other cases, it means finding counseling, home nursing or hospice care.
They’ve had three clients so far - one with cancer, one with leukemia, and one with late-stage multiple sclerosis.
Dying Well members gave one client information on how to overdose; the other two received counseling and died “using the power of the mind,” says Neils.
Members are confident that someday assisted suicide will be legal in Washington.
If that happens, states the group’s brochure, the Dying Well Network will match terminally ill people with doctors willing to help them die. They’d also work with some people with painful, chronic illnesses.
Until then, the network can only give “information … without giving assistance.”
Some doctors find getting involved in the debate at all has high stakes.
Neils lost a third of his referrals from other doctors - and thus income - after publicly advocating assisted suicide. Pulmonologist Donald Storey abandoned the debate after fearing he’d lose his colleagues’ support.
The Rev. Robert Stevenson, director of the Samaritan Counseling Center, knows some of his peers will disapprove and argue that he’s playing God, but he has agreed to work with Dying Well clients anyway.
“We will not break the law,” says Stevenson, 56, who is also a United Methodist minister. “We can pray for people, tell them if they’re ready to go it’s all right. That has a lot of power.”
There are checks and balances, Stevenson says. Counselors make sure clients are mentally competent and not being pressured to do anything they don’t want to.
Stevenson joined the Dying Well Network because of his own views on death.
“I want the choice,” he says. “I want the freedom to say, ‘This has gone on long enough. I don’t want to waste money on stupid stuff at this hospital.”’
Years passed before Jeff was so sick he could hardly leave his bed.
Until then, he spent spare time traveling to favorite vacation spots, walking mountain trails and camping at Lake Roosevelt. He also started hoarding pain pills and sleeping pills in his medicine cabinet.
Jeff and Donna got the idea of a lethal overdose when they called the Hemlock Society, a group that supports euthanasia, for advice on how Jeff could kill himself.
Over and over, Hemlock Society counselors asked them: “Are you sure you want to do this? Are you sure you don’t want to see another sunset no matter how painful it is?”
Jeff was sure. He wasn’t watching sunsets. He could no longer bathe himself, could barely eat. Headaches and fever were incessant. He was so skinny, people gawked when he left the house.
Both Jeff and Donna worried their plan wouldn’t work. They worried doctors would do an autopsy, or Jeff would end up in a coma, or Donna would be arrested later for helping him.
The couple didn’t tell friends or relatives, either, afraid they’d interfere.
Even today, Donna fears arrest and agreed to talk about what happened only if their real names weren’t printed.
Finally, Jeff told his doctor that despite his condition, he refused to be hospitalized. Then he ventured a step further and explained his plan.
Donna was relieved when the doctor handed Jeff a final prescription for pain-killers, and then added, “We’ve never had this conversation.”
No one is sure how many doctors are willing to help dying patients kill themselves.
Dying Well members say quite a few would help if it were legal. Some Spokane doctors quietly do it anyway.
Doctors may prescribe pain pills liberally when patients are near death, says Storey, past president of the Spokane County Medical Society.
“They can say, ‘Be very careful you don’t take this bottle all at once, or you could die.’
“I think it happens,” Storey says, “and it’s not monitored.”
Johnny Cox, ethicist at Sacred Heart Medical Center, says most doctors would view such help as violating their roles as healers.
Cox, a Roman Catholic, is appalled at the idea of physician-assisted suicide.
Legalizing it, he says, would pressure some terminally and chronically ill people into thinking society is better off without them.
“This poses great jeopardy to the weakest in our society,” Cox says.
The Dying Well Network indeed can expect much opposition from Spokane churches.
Robin Garvin, pastor at Hamblen Presbyterian Church, began addressing assisted suicide after hearing parishioners debate the issue.
“Scripture seems to imply that God is sovereign and we do not have the right to end our life,” she says, “no matter what the circumstances might be.”
Neils, who recruited members for Dying Well, still holds out hope for support from the religious community.
He recently asked two pastors for a huge favor on behalf of future Dying Well clients who, for whatever reason, can’t kill themselves at home.
His request: Let them do it in the church.
Manito United Methodist Church leaders asked for more information. Now they’re planning a series of seminars on assisted suicide.
The Unitarian-Universalist Church of Spokane also may consider the proposal, says Linda Moulder, the church’s board president.
However, a decision could take months, says Moulder. She remembers the turmoil created when the church offered sanctuary for anyone refusing to fight in the Persian Gulf War.
No one accepted the offer, but a parishioner quit, outraged at the political stand.
“It caused a lot of anguish in the church,” Moulder says. “We’re a liberal church in a conservative community.”
Donna still doesn’t know what went wrong.
They’d planned everything to the last detail. Jeff made final telephone calls to his relatives. He chose music for his memorial service.
Donna drove him to Lake Roosevelt one last time. They even tried to have one last lunch together, but Jeff couldn’t eat.
Late one evening, Jeff and Donna said tearful goodbyes. Donna sat with him in their bedroom, her heart pounding as he took the pills that were supposed to keep him from gagging on the rest.
A few minutes later, she watched as he swallowed dozens of morphine and sleeping pills with fruit punch from a Big Gulp cup.
“I feel like I just swallowed a Thanksgiving turkey,” he mumbled.
When Jeff put on his stereo headset and closed his eyes, Donna lay wide-eyed on the bed beside him.
Into the night, she felt his pulse and listened to him breathe. Within hours, Jeff was unconscious. Still, he was breathing. He was still breathing at 3 a.m. and he was breathing at 6 a.m.
As the sun rose, Donna was sick with the realization that their plan didn’t work.
She couldn’t bring herself to put a plastic bag over his head - a backup plan suggested by their Hemlock Society contact.
Panicked, she called for an ambulance, knowing Jeff would not approve.
“I’m sorry you’re in a hospital!” she shouted, crying as Jeff was wheeled into an intensive care unit - the place he’d dreaded most.
Donna feared he would live on in a coma, but late that night, Jeff’s heart stopped beating. An autopsy was never performed.
Donna can’t stop wondering if he ever knew his plan didn’t quite work.
People on both sides of the assisted-suicide debate
agree most terminally ill people would choose to die naturally.
They also agree a lot can go wrong for people who try to commit suicide.
Cox warns that Dying Well Network members will encounter problems even if they stick to relaying information on lethal overdoses.
“There will be occasions when the attempt fails,” he says. “You end up with a person who often is in much worse condition than before.”
Such people could die far more peacefully if doctors used their expertise to help, Neils says. Now, they feel forced to lie to friends and relatives and die with few or no people around.
Perhaps no Dying Well Network member has more at stake in the debate than Jay Toews, an east Spokane psychologist.
Toews’ wife, Jean, talks openly about how she may one day end her life with an overdose of pain pills.
Multiple sclerosis has been slowly stealing her mental and physical abilities for 25 years.
Toews, a mother of five and former psychiatric nurse, lost the use of her legs nine years ago and spends her days in bed or a wheelchair, watching TV.
She suffers memory lapses but manages to live at home. Aides stay with her on weekdays while her husband works and on Saturday mornings when he goes grocery shopping.
Toews, 47, appears comfortable with her decision and says she’ll instinctively know when it’s time to die.
First, she says, she’ll tell herself it’s OK to go, that she got all she can out of life. If that doesn’t work, she will swallow pills.
She even jokes about it: “I don’t want to have to call for Kevorkian to come out here.”
Actually, Toews says, legalizing assisted suicide probably wouldn’t change her plans much. A neurologist has already promised to provide the drugs she’ll need.
“I think it’s a basic right everyone should have, like whether to live in the country or live in the city,” she says. “They’re just choices.”
MEMO: This sidebar appeared with the story: ASSISTED SUICIDE LAWS Washington: Promoting a suicide attempt is a class C felony, punishable by up to five years in prison and a $10,000 fine. The law is broken if someone “knowingly causes or aids another person to attempt suicide.” A federal district court judge overturned the law last year as unconstitutional, but that decision was reversed by a three-judge panel in the U.S. 9th Circuit Court of Appeals in March. Plaintiffs have petitioned for a rehearing by 11 judges of the 9th Circuit. Oregon: The first and only state to grant the terminally ill a right to physician assistance in dying. The law, however, was blocked last December by a federal judge in a ruling bound for the 9th Circuit Court of Appeals. Idaho: No law that specifically addresses assisted suicide.