Doctor faces assisted-suicide charge in Georgia

Since the 1999 second-degree murder conviction of Jack Kevorkian, MD, the Michigan pathologist known as "Dr. Death," the assisted-suicide debate has shifted from criminal trials to whether doctor-aided deaths should be legally allowed.

Assisted suicide is now legal in Oregon, Washington and Montana. Meanwhile, Hawaii, New Hampshire and New Mexico are considering "death with dignity" legislation.

The late February arrests of four people for their alleged involvement in the helium-induced suicide of a Georgia man could hinder passage of physician-assisted suicide laws.

"Kevorkian and the publicity about him slowed the assisted-suicide push, and I think this will also slow it," said Kenneth R. Stevens, MD, who opposes doctor-aided death and is vice president of the Portland, Ore.-based Physicians for Compassionate Care Education Foundation. "I think people just realize this is wrong."

The American Medical Association "strongly opposes any bill to legalize physician-assisted suicide" because the practice is "fundamentally inconsistent with the physician's role as healer."

The Georgia Bureau of Investigation said those arrested and charged with assisted suicide, tampering with evidence and racketeering were: Lawrence D. Egbert, MD, MPH, and Nicholas Alec Sheridan, both of Maryland; Claire Blehr of Atlanta; and Thomas E. Goodwin of Punta Gorda, Fla. and Kennesaw, Ga. The maximum sentence for assisted suicide in Georgia is five years.

The four individuals are affiliated with the Highland Park, Ill.-based Final Exit Network. The group, founded in 2005, has aided about 200 people across the country seeking "exit," said Dr. Egbert, the group's medical director.

Law enforcement officials executed search warrants in six other states in collaboration with Georgia's ongoing probe of the Final Exit Network. Those arrested have pledged to fight the charges in court. The group will not aid any more deaths until the Georgia case is resolved, said Rosalie Guttman, PhD, a member of the group's advisory board.

Dr. Egbert, a retired Baltimore anesthesiologist, would not speak about the Georgia case. But he said the network advises its members on how to die peacefully using a helium gas tank and a plastic hood, both of which are easily accessible to nonphysicians. Volunteers, called "exit guides," are present, but Dr. Egbert said the people seeking death must initiate the death procedure and can change their minds at any time.

Dr. Egbert heads a multidisciplinary committee of a few physicians, psychologists and other professionals that evaluates applications for help. But while the Oregon and Washington laws only allow assisted suicide for terminally ill patients with less than six months to live, the Final Exit Network also offers its services to nonterminal patients with irreversible and debilitating conditions.

The suicide victim in the Georgia case, John Celmer, had oral cancer and an arthritic hip. In the GBI's affidavit, his oncologist was quoted as saying Celmer was "making a remarkable recovery" after two head and neck surgeries. Celmer was scheduled to see a psychiatrist three days after his June 2008 death.

Supporters of the doctor-assisted-death option argued the headline-grabbing arrests might bolster their cause.

The Georgia investigation is "good for the [aid-in-dying] movement, in a strange way, because it's symptomatic of how desperate people are, and we just have to say there's got to be a better way to deal with these cases," said Timothy E. Quill, MD, director of the University of Rochester Medical Center's palliative care program in New York. "Where don't you need the Final Exit Network? Oregon and Washington, because they have a forthright system."