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An Unlikely Best Seller Had A Rocky Backstory: The Controversial History Of Final Exit

(The following is by distinguished guest author Derek Humphry, author of Final Exit and several other books on the right to die, and co-founder of both Final Exit Network and its predecessor, The Hemlock Society. This article was first posted Final Exit Network’s Fall 2022 magazine, coming soon to the mailboxes of FEN’s members.)

One of the strangest stories in book publishing is that of Final Exit, which, after a bumpy 31 years, still sells 24/7. It has been condemned, admired, banned, and also a #1 New York Times best seller.

Sometimes called “the ultimate how-to book” or “the suicide book,” there have been 11 translations. It is in most libraries.

Yet the birth of this book in 1991 was a lopsided saga. My previous DIY book, Let Me Die Before I Wake, had been selling steadily for a decade by the old Hemlock Society (l980-2004), but by now the issue of choice in dying at life’s end had become more accessible, thanks in part to Dr. Jack Kevorkian (1928- 2011), who famously helped 130 people to die.

When written, Final Exit was offered by literary agents in New York and London to publishers without any response. One UK editor noted that she turned it down, but when she got home that evening, she found her father reading the original Hemlock version.

So, I decided to publish it myself. A contract was drawn up apportioning the hard-cover rights to Hemlock and all other rights to me. I printed 30,000 copies: I knew that most of the 40,000 Hemlock members would want it.

Over the next six months, I mailed 200 review copies to newspapers and magazines, but nobody even mentioned it. We had a national distributor, yet the book sat in bookstores gathering dust for months. It seemed I would have to rely on my membership audience.

Then, when I was on holiday in England, a call came from a reporter on the Wall Street Journal who said she’d been told by her editor to interview me about the book, which he’d heard interesting talk about at last night’s dinner table.

On July 12, 1991, a thoughtful, balanced article by Meg Cox appeared, prominently leading the newspaper’s Friday marketplace section. She quoted people who liked the book and said who would hate it.

By Monday, the copies languishing in bookstores were all sold. The distributor called and asked me for 100,000 more – and he kept on repeating this order.

By Aug. 11, it had shot to #1 of the New York Times best-seller lists and remained there for 18 weeks. Customers were frequently lining up in bookstores to get that week’s delivery.

Hardly anyone reviewed it, but cynical news columns about this scandalous “suicide manual” were numerous. One columnist opined that “only in New York would people take a number and line up to get a how-to book on suicide.”

The more it was condemned, the more people bought it who were not afraid to think about death.

For a month, I spent almost full time on TV, radio, and in print media interviews. Time and Newsweek devoted whole pages to it. At many dinner tables, the conversation centered on what negatively might be happening to America that such an unusual book could be so popular?

Its enemies made dire media predictions that the book would escalate the overall suicide rate. But official statistics later showed that the rate had not gone up, although there were more suicides using the plastic bag technique.

The Roman Catholic Church deemed it “a new low in publishing.” The Right to Life Committee called it “a loaded gun.” Canadian newspapers demanded it should not cross the border – which it then did in huge quantities. In contrast, the world’s most prestigious scientific journal, Nature, welcomed it on its front page as necessary for its time.

Cartoonists had a field day lampooning the book. I have a collection of 16 syndicated drawings, most rather corny, except the humorous one by David Levine accompanying an analytic article in the New York Review of Books.

Those who noted the book’s subtitle, “The Practicalities of Self-Deliverance and Assisted Suicide for the Dying,” and took the trouble to read it, saw its value. Fundamentally, the book is a vital briefing on death and dying for people who had not so far addressed it.

Many buyers opined that they had observed the awful dying of their parents and were looking for alternatives for themselves.

After the first year, the Hemlock Society said the book had earned it $1.1 million after expenses (money spent on legislative advocacy). And it was consistently selling. I sold the paperback rights to Dell/Random House and the translation rights in 11 languages.

When a French version arrived in Paris, somebody complained that such a book was against the law. So, it was banned, but when the police went to seize copies, the publisher was tipped off, loaded the entire stock on a truck, and shipped it to Belgium.

Final Exit was instantly banned in Australia. After we appealed, it was permitted in book stores, provided it was shrink-wrapped and kept on a high shelf (like girlie magazines once were).

Libraries complained that they had to keep buying more copies because of the abnormally low rate of customer return.

Still, today the book consistently comes in on Amazon’s sales chart at between 20,000 and 40,000. It sells on KINDLE and audio books. The eBook version, Final Exit 2020, is most popular.

Showing how widely the English language is spoken, ERGO’s Internet bookstore is accessed by customers in Australia, Japan, Finland, and Hungary, to name a few.

With all the translations, Amazon sales, and eBooks over 31 years, it is difficult to put a figure on how many total copies have actually sold. (The book was hugely stolen in pirated versions.) It’s likely to be at least 2 million books.

Final Exit got an inadvertent boost when it was mentioned in the Oscar-winning film Nomadland. In that 2020 Best Motion Picture, a character is having one of many “slice of life”-type conversations with a new friend who suddenly appears to be sick.

The friend explains that she has small-cell lung cancer, that it has metastasized to her brain, and that her doctors had given her seven or eight months to live.

Then she says, “I have this book called Final Exit by Dr. Kevorkian. Some people call him Dr. Death. It’s like various ways that you can end your life if you need to. It’s kind of like a recipe.”

The author, of course, is not Jack Kevorkian. But the mere movie mention sent book sales soaring.

It has not made me rich, but the consistent income from sales has been welcome, especially in my autumn years (born 1930).



Final Exit Network (FEN) is a network of dedicated professionals and caring, trained volunteers
who support mentally competent adults as they navigate their end-of-life journey.
Established in 2004, FEN seeks to educate qualified individuals in practical,
peaceful ways to end their lives, offer a compassionate bedside presence and defend
a person’s right to choose. For more information, go to www.finalexitnetwork.org
.

Payments and donations are tax deductible to the full extent allowed by law.
Final Exit Network is a 501(c)3 nonprofit organization.

Author Derek Humphry

More posts by Derek Humphry

Join the discussion 5 Comments

  • Ann Mandelstamm says:

    Everyone who wants to have autonomy and choice in dying owes a staggering debt of gratitude to Derek Humphry for his book and for his good sense and sound advocacy over the years. It is certainly not going to “speak” to everyone, but thousands and thousands of people all over the globe know its value and give thanks for
    Derek’s courage and his steady work in the right-to-die movement. We will be forever in his debt. Thank you, Derek.

  • Susan Labaj says:

    Like many readers, I encountered this book in the early ’90s after witnessing the wrenching cancer death of my mother. In retrospect, it looks like the last decade of the prior Millennium was a time when contemporary culture began to discuss & dissect the sociology of death, with both Mr Humphrey’s books and the work if Elizabeth Kubler-Ross.

  • GARY WEDERSPAHN says:

    It’s important readers for to use a up-dated version ( 3rd edition at least) because methods of self-deliverance have changed over the years). The digital edition is the most current. See: https://www.finalexit.org/ergo-store/ebooks-c-67/final-exit-2020-digital-edition-p-208.html

  • Carl Litzkow says:

    My favorite expression is: “I don’t want to end up lying in some urine soaked mattress, in some forgotten corner, of some forgotten warehouse, drooling and waiting for my jello”. I want people to be repulsed by this image and realize there is an alternative.

  • Constance Cordain says:

    Although I had meant to purchase the book, I just hadn’t got around to it yet. Then, as a member/volunteer at a Unitarian Universalist church, I found a stack of 8 copies in the back of a storage closet that I was cleaning. Thrilled to find this cache, I took them out and placed them in a prominent location in the church social area, after taking a copy for myself. All copies were taken, nearly instantly, when spied by the members of the congregation that Sunday. I have to presume these books were part of a church sponsored class from some time prior. Derek, I cannot thank you enough for finding and following your generous path to our salvation.

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