Updated 31 January 2003
Velma Howard, aged 76, knew her life was coming to an end. Lou Gehrig's Disease was taking away the use of her limbs one by one. Eventually it would affect her throat and she would be in danger of choking on her own saliva. This elderly, respectable, Middle American decided on rational suicide. The consequences of her decision resulted in an emotional ordeal for her family and a legal muddle typical of the mess in which America's laws on assisted death currently are.
Velma and Bernard J Howard were the 'sweet old couple' on the block of their community in Belleville, Illinois. She had been a kindergarten schoolteacher. He served as staff sergeant in the Marine Corps during World War 11. They were married on December 8, l945, and Bernard worked for 25 years with the Department of Defense until retirement. Their two sons were grown up and lived away, but children in the neighborhood all knew that the Howards always opened their door to 'trick or treaters' at Halloween. The day of their 50th wedding anniversary, a young couple who were neighbors knocked on the door with a bunch of carnations. "I can honestly say that I never met two nicer people in my life," another neighbor told the local newspaper. By no means loners, the Howards attended church regularly, enjoyed themselves at senior citizens' clubs, and went square dancing until Velma was taken ill.
With her left arm useless, her legs weakening, Velma began to think about an accelerated death. The pain from the neuromuscular disease, a degenerative condition medically known as Amytrophic Lateral Sclerosis (ALS), was increasing. But, most of all, she did not want to linger for months in steady decline, dragging down her aging husband at the same time. Velma read books on the subject, talked on the telephone long-distance with a right to die group, and discussed her plan with close friends and immediate family. Unable to write clearly, Velma made a three-minute audiotape outlining her reasons for deciding to die now rather than wait. On the tape she accepted full responsibility for her action, stressing that no one else should be blamed.
One son was a businessman in Plano, Texas, and another a judge in Lenexa, Kansas. Always considerate of not putting others to any trouble, Velma resolved that they would all drive to a central point, Joplin, Missouri, and celebrate the golden wedding on December 8, l995. The next day she would die. What Velma had not taken into account is that Joplin (pop. 40,961) is famous as "The Buckle of the Bible Belt". Missouri is one of only three American states which does not have a living will law. Joplin is a mere thirty minutes drive away from the place in Jasper County where the family of Nancy Cruzan, in a permanent vegetative state, struggled to get her disconnected from life support systems. In l990 the Cruzan case before the US Supreme Court enunciated the right to forgo medical treatment.
PARTY IN MOTEL
The older Howards checked into Room 305 of the Days Inn in Joplin and on Saturday, December 8 they partied with their two sons, Bernard Junior and Stephen, reminiscing about the past but saying little about the future. All present knew what would happen the next day and were in agreement with Velma's wishes.
When she was ready to die on Sunday, the trio helped Velma Howard and, from all accounts, her death was swift and peaceful. Then one of the sons informed the motel staff, who called the police. What happened then illustrates the strange attitudes towards rational suicide of the terminally ill in Missouri or any other state for that matter.
It was an easy case for Newton County police and the prosecutors because all three Howards made statements explaining exactly what happened. An immediate autopsy confirmed the presence of narcotics in the body. A few days later, Joplin's police chief David Neibur typified police bafflement about these suicides by describing the case as "very bizarre".
Suicide is not a felony in Missouri - nor any other American state. Velma had committed no crime. But in l984 the Missouri legislature passed a one line law (565.023.1(2), RSMo) stating that anybody assisting in suicide (or self-murder) was committing a Class B felony, which is punishable by five to fifteen years imprisonment. In its twelve years existence, nobody in the state had ever been tried for the offence, nor even investigated; thus there was no case law available for review.
CONVICTIONS IN NEW YORK
At the time nobody in America had been convicted of assisted suicide, although in l996 George Delury pleaded guilty in New York City to assisting his wife's suicide and received six months imprisonment. Being a plea bargain, there could be no appeal of the case to clarify the law. Many legal observers feel that had Delury defended the case a jury would have acquitted him. The only other known conviction for this type of offence was John Bement in l998 in New York who was convicted by a jury of 'assisted suicide' and received two weeks imprisonment (Dr.Kevorkian has been acquitted of assisted suicide three times in jury trials in Michigan; when he was sentenced in April l999 to 10-25 years imprisonment it was for 2nd degree murder, not assisted suicide.)
How Velma Howard died is vividly described in the actual complaint sheet produced shortly afterwards in court when the two of the three men were accused. (Stephen Howard was never charged with any offence, apparently because his physical involvement happened to be minor.)
Her husband, Bernard A Howard, 76, was charged with a class B felony in these exact words of the prosecuting attorney's complaint:
"The defendant knowingly assisted Velma Howard in the commission of self-murder by providing for Velma Howard orange juice used by her in filling a recipe for death outlined in a book containing instructions on self-murder, by reducing the temperature of the room in which Velma Howard committed self-murder as called for in the book, by providing Velma Howard rubbers bands which Velma Howard used to affix a plastic bag over her head, thus cutting off the supply of air to her body and by arranging chairs and items used by Velma Howard to commit self-murder into such proximity as to give Velma Howard access to such items, to wit: a container of orange juice laced with sleeping powder and alcohol, a container of food substance containing a narcotic, a plastic bag, a rubber band ligature, and a spring form pan, all used by Velma Howard in the commission of self-murder."
The charge sheet against her son, Bernard J Howard, aged 49, read much the same with the additions that also accused him of "reading from a book containing instructions on self-murder and by helping Velma Howard into a position in which she was in immediate proximity to several items which were used by Velma Howard to commit self-murder". The book was 'Final Exit' which has sold more than one million copies worldwide.
It was almost certainly the first time in history that anybody in America had been charged with reading a book, redolent of religious persecutions in medieval times. Could turning down the heat and moving chairs around also be a crime? They had not provided the drugs because Velma had her own supply of Dalmane. The case promised to be a field day for lawyers and judges if it ever got to court.
Early in the proceedings the older man decided to plead guilty but his son announced that he would prefer a trial. Both were granted bail.
The case attracted extensive media attention throughout Missouri, necessitating the county prosecutor, Greg Bridges, to call a press conference a month later. At this meeting Bridges revealed to reporters some of his doubts and fears about the case. "There are no other cases like this, there's no precedent to be guided by," he said. He was not unsympathetic to what happened but the law must be obeyed. Whereupon he read out the astonishing charges concerning, amongst other things, book reading and temperature alterations.
A MORAL ISSUE?
A reporter bluntly asked the prosecutor if this wasn't really a moral issue.
"This case doesn't have anything to do with whether it's right or wrong to commit suicide," replied Bridges. "It just happens to be illegal in Missouri to help somebody to do so." He added that he suspected there had been no previous prosecutions because "I suspect that some people are hesitant to prosecute it because of the emotional issues involved."
Prosecutor Bridges later told a local newspaper that since filing the charges he had received hate mail and been called names.
As the case was being prepared for trial, two influential high courts in America, the 9th and 2nd Circuit Courts of Appeal, both ruled that states could not ban assisted suicide for a competent, terminally ill person. (See Chapters 6 and 9). The rulings did not affect Missouri, which is in the 8th Circuit. But immediately Bridges, who never seemed aggressive in his prosecution of the Howards, saw these rulings as a way out of his dilemma.
"I'll sit on the case for one year to see if something develops," Bridges announced. "To go blindly ahead, prosecute them and maybe have the law overturned, wouldn't be fair to the family. We should wait for a determination from a higher court."
Subsequently, the Attorneys General of Washington and New York states appealed the lower courts' decisions to the U.S. Supreme Court. The high court overturned the 9th and 2nd Circuit Courts of Appeals and bans prohibiting PAS remained constitutional. Bridges could easily have proceeded to prosecute the Howards, since the Missouri felony law was firmly in place. He choose not to do so. When the case came up for review the following year, all charges were dropped.
This case exemplifies the discretion given to a prosecutor as well as the ambiguity they often feel when deciding how to handle a situation of this kind. The Howards were solid citizens, unanimous in their decision, with no hint of impropriety. In short, they were decent people, trying to handle a difficult situation in a cautious and dignified manner. Many see as an assisted death as an action of compassion and love. But not every one - especially the Roman Catholic Church and the National Right to Life, who can bring enormous pressure to bear. The prosecutor, with no legal precedent to follow, is torn with doubts and fear over the political, ethical and judicial practicalities of pressing for a conviction. The prosecutor also knows that after all the grieving family's anguish and expense, any court proceedings, as with the Howards, usually comes to naught in the end.
The above essay is an extract from the book 'Freedom to Die: People, Politics, and the Right-to-Die' by Derek Humphry and Mary Clement (St. Martin's Press, New York, l998.) © copyright Derek Humphry and Mary Clement, 1999.