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The New Doctor Death

Discussion in 'International Forum' started by MziziMkavu, Mar 21, 2010.

  1. MziziMkavu

    MziziMkavu JF-Expert Member

    Mar 21, 2010
    Joined: Feb 3, 2009
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    [​IMG] Courtesy of Dr. Lawrence Egbert
    Dr. Lawrence Egbert in a recent photo.Despite criminal charges in two states, the head of a radical right-to-die group insists his work is compassionate and necessary.

    In 2006 John Celmer's body began to break down. He was diagnosed with oral cancer and had to undergo surgery to remove the tumor and then radiation therapy to kill off any remaining malignant cells. The radiation ravaged his jawbone and the surrounding tissue, leaving a hole in his chin. Fluid leaked onto his clothes. His teeth began falling out. He had difficulty eating and speaking. As Celmer's jaw began severing from his face, doctors attempted moderate treatments, but all of them failed. So in 2008, they sought to reconstruct his chin and jaw using tissue from his chest and bone from his lower leg. The procedures appeared successful, but five days after the final operation, he was discovered dead in his Cumming, Ga., home.
    At first everyone assumed he'd died of natural causes. Yet as Celmer's wife, Susan, sifted through his belongings, she discovered several things that puzzled her: a receipt for two helium tanks, a handwritten note referring to his need to acquire a "hood," an entry on his calendar (May 7, 2008: "Claire here @ 1:30") that mentioned someone she didn't know. Susan also found paperwork referencing something called Final Exit Network (FEN). As she later learned, it was an organization that counseled people with serious ailments on how to commit suicide. She shared her findings with police, who launched an investigation and eventually concluded that the group had helped Celmer kill himself. Susan was devastated—and enraged. What right did FEN have to help usher her husband to his death? "We are not the Creator," she told NEWSWEEK. "We do not give life and don't have the option to take life."

    The man authorities say assumed that role is Dr. Lawrence Egbert. As FEN's medical director at the time of Celmer's death, he was the one who ultimately decided who the group would help end their lives. FEN is one of the most radical right-to-die organizations in the country. While most such groups advocate assisted suicide only for terminally ill patients, FEN's bar is lower. It's willing to help those who "have an incurable condition which causes intolerable suffering," according to its Web site—a requirement vague enough to potentially include people with many years left to live or with afflictions like depression. Egbert says the organization follows rigorous procedures to determine whether to approve an applicant, including examination of medical records and four levels of review. To those it accepts, FEN assigns “exit guides” which offer advice on how to "hasten death," but not physical help to do so. (FEN recommends filling a plastic bag, or hood, with helium and pulling it over one's head—a method that works quickly and leaves no trace in the body.) By not physically participating in the act, the group argues, it remains in compliance with the law, which in the vast majority of states prohibits assisting with a suicide. But the statutes are hazy on what exactly constitutes assistance.
    As a result of the Georgia Bureau of Investigation inquiry into Clemer's death, Egbert and three other members of the group were indicted March 9 on charges of racketeering, assisting a suicide, and tampering with evidence (their arraignment is scheduled for April 1; Egbert will plead not guilty, says his lawyer). In a separate case, the Maricopa County Attorney's Office in Phoenix indicted Egbert and three additional FEN members last May for conspiracy to commit manslaughter (Egbert pleaded not guilty). Authorities in Florida also investigated a suicide that they suspected was linked to the group, but in the end, didn't file any charges.
    Egbert is the only person charged in both Georgia and Arizona. An anesthesiologist by training, he says he reviewed every application FEN received during his tenure as medical director from 2004, when the group was founded, to 2009, when its legal troubles began (FEN halted its work last year, but resumed it in February). By his estimate, he approved about 80 percent of roughly 200 to 300 applications. At a time when assisted suicide is making headlines in the U.S. (Montana’s Supreme Court recently ruled it legal) and abroad (the British are feverishly debating when it should be allowed), Egbert is a polarizing figure. Supporters hail him as a hero who offers the sick a measure of autonomy. Critics denounce him as a killer who assumes God-like powers and prods desperate people to their deaths. Yet these are caricatures. The man himself is far more complicated—passionate and devoted, but also inscrutable and, at times, unsettling.

    White-haired and goateed, with a stilted gait and a gentle voice, Egbert, 82, comes across as a benign, somewhat befuddled grandfather. He doesn't own a car or a home computer or a cell phone. He tools around his city of Baltimore on a bicycle plastered with bumper stickers reading BIKES NOT BOMBS and DON'T WASTE OUR FUTURE, RECYCLE. He lives with his wife on a quiet, tree-lined street. Their home is filled with books and knickknacks gathered from sojourns in Iran, Japan, and Nicaragua. He's a member of the liberal Unitarian Universalist Church and has worked for groups such as Physicians for Social Responsibility. Until recently he taught a course on medical ethics at nearby Johns Hopkins University.
    Egbert's outlook seems colored, above all, by a deep-seated libertarianism. At a speech on right-to-die issues before the Baltimore Ethical Society last year, he carried a stack of bookmark-sized copies of the Bill of Rights in his blazer pocket and handed them out after his presentation. He spent part of his talk railing against the Patriot Act, airport security protocols, and other perceived incursions on freedoms. In his view, an individual's control of his or her body is inviolable. "You can choose when, where, and how" you die, Egbert told NEWSWEEK, in one of numerous interviews over the past year. "It's a right to make decisions for your own life."
    The role of the physician, he argues, is to reduce suffering. "When we can't help them fix the suffering, then we should help them get it over with," he says. That blunt statement puts him at odds with many doctors, whose profession has always emphasized curing and saving lives. Egbert, however, says, "I've never actually felt more like a doctor than [when I'm] doing this work." As FEN's medical director, he reviewed applications with essays that ranged from terse, single paragraphs to plaintive, 15-page testimonials. He had no set standard to guide him, but rather judged cases individually, taking patients at their word. "I'm looking to see that they have something potentially hopeless and miserable that they're unable to get proper care for," he says. He recalls approving one man with Lou Gehrig's disease who couldn't swallow because his throat muscles no longer functioned.
    But many situations aren't clear cut. Egbert says he signed off on one woman with multiple sclerosis who wasn't in all that much pain but had a difficult time relieving herself. After a friend of hers made some alterations to the bathroom, she canceled her suicide plans. Then there are the cases involving mental illness. Egbert's indictment in Arizona involves a woman named Jana Van Voorhis, who suffered from borderline personality disorder and bouts of depression. She was also, it seems, becoming more psychotic. According to a police report, she believed she had holes in her belly, feet, and liver, and that someone had tried to poison her with pesticides. Egbert confirms that he read Van Voorhis's application and, after deliberating with other members of FEN's medical committee, decided that she should be assigned an exit guide; she killed herself in 2007. Because of his legal entanglement, Egbert declined to answer an obvious question: given Van Voorhis's condition, what convinced him she had the faculties to decide it was best to end her life?