Final Exit Network - Policies & Procedures

There is some misunderstanding about how Final Exit Network operates on a non-medical model to guide seriously ill patients on how to hasten their deaths.

This recent post to a discussion board helps clarify things. Richard MacDonald is former medical director of the Hemlock Society and later the Final Exit Network. He prepared the following in response to Phil Cheatle at UK's My Death, My Decision.

"The recent article . . . has some remarks about Final Exit Network in the U.S., that are not an accurate interpretation of what FEN offers to those who do not qualify for the restrictive and limited laws in the U.S. states, in which laws passed over the past 20 years, and for those in all other states without the right to request aid-in-dying."

"FEN is not just a group of amateurs who act in a disorganized program when offering information, specific to the needs of those who call us. We consist of volunteers, that is true. We charge no fees for what we offer unlike most organizations involved in these issues."

"However, what we offer is support from trained volunteers, with many physicians included, along with nurses, hospice workers and social workers.  When a person who is suffering a poor quality of life and has substantial health issues that have not been resolved by organized medicine, decides their life is no longer in keeping with their values, they may apply to our Support Program."

"After sometimes lengthy conversations with a Coordinator who has responded to their telephone call, they are advised that to qualify for receiving that support and information, there are steps they must take."

"First, they must send a letter explaining their health status and their reasons for wishing to hasten dying.  This must also include information about loved ones, family or close friends, whether there is support or resistance from them. They must also send medical statements from physicians and/or records of investigative procedures, to prove their statements."

"All this information is then reviewed by a panel of three or four physicians on our Medical Committee.  All must agree the case, medically, is appropriate for support by FEN. If one or more dissents, further review by a Medical Oversight Committee is sought, or more information is asked for from the applicant."

"If finally accepted for support, then volunteer guides, in most cases, a physician or other senior guide is assigned, along with another associate guide, either a new trainee or an experienced one, also, who have already been with numerous assignments."

"Only then is the person seeking aid provided with specific information and guide visits. An important difference from the patients who qualify under the laws in some states, when usually doctors merely write a prescription for sometimes complicated medications, but fail to attend in most cases, we are present when the individual chooses to hasten their own dying."