A Struggle to End the Suffering

Charles Hall is sitting in a wheelchair in the middle of his living room, smoking a menthol cigarette and peering out the window at a Federal Express deliveryman hustling up the walk. “Oh, I hope that’s the morphine,” says Hall in an anxious voice as a young medical aide named Chris heads for the door.

In Hall’s bedroom a guy in a hard hat is installing a second phone line for a computer hook-up, and a friend named Angel is waiting around to explain how the Internet works. She tells Hall, “You’ll be talking to people all over the place.”

“Great,” says Hall, ripping open the FedEx package to find a bottle of capsules, which he carefully inspects. “Great. This makes it tolerable.”

Last Wednesday afternoon there was a lot of life coursing through Hall’s small cement block home, but the operative motif here is death. Hall, 35, has AIDS and he is fading away. His weight has dropped from 170 pounds to about 105 pounds. He can swallow only liquids, and even that hurts.

“I spend 90% of my time in bed,” says Hall, who has close-cropped brown hair and a wispy goatee. “One day at a time. I don’t even like thinking about dying.”

Until a Florida Supreme Court ruling later that Wednesday, Hall was the only person in the United States ever to have a court-approved right to a doctor’s help to commit suicide. In a landmark Jan. 31 decision in a circuit court in West Palm Beach, Judge S. Joseph Davis Jr. had ruled that Florida had no business causing “the prolongation of Mr. Hall’s pain and suffering.”

Finding that “Mr. Hall is terminally ill and has little prospect of having extended periods of quality time before his death,” Davis ruled that Hall has a constitutional right to choose his time to die, and barred the state from prosecuting the physician who has volunteered to help him.

But the Supreme Court said no and set oral arguments on the matter for May 9.

For five days Hall had the right to die with a physician’s help.

“My friends and family would all be around me,” Hall said in court last month when asked to imagine his final moments. “You lie down and go to sleep. You never wake up again.”

The lawsuit that led to that decision was filed on behalf of Hall, a onetime fast-food restaurant manager, and Cecil McIver, a 74-year-old British-trained physician who has agreed to administer a lethal dose of drugs to Hall whenever he says he is ready. The lawsuit was filed by Robert and Florence Snyder Rivas, a husband-and-wife team of Boca Raton attorneys, and carefully planned and financed by the American Civil Liberties Union and the Hemlock Society, a national group that backs right-to-die issues.

Central to the arguments of Hall and his attorneys is the broad-based right to privacy approved by voters and added to the state constitution in 1980. That right to self-determination, Hall’s lawyers insist, outweighs a 128-year-old Florida law that makes helping anyone commit “self-murder” the second-degree felony of manslaughter.

Davis agreed. But two hours after his ruling, the state appealed and the decision was stayed. The stay was lifted Feb. 6. But then on Wednesday the state Supreme Court accepted the case for review and reinstated the stay.

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Despite his AIDS-related afflictions--his eyesight is failing, he has hepatitis, his legs ache and again he is coming down with pneumocystis pneumonia--Hall is still able to appreciate living. His wife, who has stayed anonymous and out of the news media spotlight beamed on this historic case, remains by his side, and Hall looks forward to Internet chats during his long sleepless nights.

But can he live long enough to win back his right to have help in dying? “I’m not close to doing it now,” says Hall, who has not walked in more than two years. “But I don’t want to suffer.”

He may seem an unlikely candidate to play the lead role in a wrenching drama that many see as a harbinger of individual court tests that are likely to pop up in other states with strong right-to-privacy provisions, such as California and New York. “I’m a hard-headed country boy,” he says, “and nobody can change my mind.”

Hall was born and raised here in Citrus County, an area of orange groves and low-rent retirement communities about 100 miles north of Tampa. His parents were from rural Georgia, Hall says, and he is one of nine children. He took up cigarette smoking at age 8. “The doctors say I ought to quit, that it’s bad for me,” says Hall, smiling ruefully. “But why put myself through withdrawal? Is it going to extend my life? No! This is about the only pleasure I have left.”

He was infected with the AIDS virus, Hall says, most likely through a blood transfusion in Texas, where he underwent surgery 16 years ago for a back ailment. After a series of restaurant jobs, he was working as manager of a pizza chain outlet in Chapel Hill, N.C., three years ago when he became ill with what he thought was a stubborn flu.

The diagnosis of AIDS shocked him, he says, and got him immediately fired by his bosses. Reeling from the effects of the disease and his dismissal, Hall says he and his wife came home to Citrus County, where his parents and some of his siblings still live.

Even as his own health declined, Hall says, he watched friends and relatives slowly die of AIDS and cancer. “My grandmother died from cancer, and my mother spent two years with her,” he says. “She should never have had to do that. I don’t want her to have to do that with me.”

Living on his $700-a-month disability check and the $500 a month his wife makes working in a department store, Hall helped found an AIDS support group, and passed the time crocheting afghans and sewing sleep shirts for others who are terminally ill.

Hall had no history of joining clubs or civic activism. He hardly watched the news, he says. But when he heard about the Hemlock Society’s plan to challenge the state’s assisted-suicide ban, he volunteered. Two other original plaintiffs in the lawsuit, both cancer patients, died before the case came to trial.

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Hall admits that his wife and his parents do not endorse his quest for an assisted suicide. “I think one of the biggest reasons they are against it is that they don’t want to lose me,” he says. “But it is inevitable.”

A friend with AIDS died while Hall was talking to him on the phone, he says. “I saw my grandmother,” he goes on. “Nobody should have to suffer like that. The pain I have . . . I wouldn’t wish that on my worst enemy.”

That phrase “worst enemy” brings to mind the state’s assistant attorney general, Michael Gross, who argued at trial that the right to privacy did not extend to breaking the law.

“ ‘The pain can be managed.’ That’s what Mr. Gross said in court,” Hall says bitterly. “Where he gets that from I don’t understand. I would love for him to walk in my shoes, to know what I go through on a daily basis.”

Hall’s ice blue eyes cloud over with anger as he recalls Gross’ assertions. “I could rip his throat out at this point,” he says. “His little shenanigans, his procrastinations. You know, I called his office once, to ask him why he was doing this to me. It was after Mr. Castonguay [one of the three original plaintiffs] died. I told him I had had enough. He just said, ‘You have to talk to your attorney.’ ”

Gross denies that the state engaged in any delaying tactics, and adds: “I have the greatest sympathy for him and his illness, and the position that the state has taken is not a reflection of a lack of compassion.”

Tears well in Hall’s eyes as he continues, his spindly upper body stiffening in his wheelchair. “I don’t know if I will kill myself. But I should have the right. No one tells Charles Hall how to live his life, not my wife or my parents. I am a human being before I am a husband or son. I make my own decisions.”

The decision to end one’s life in the face of extraordinary pain or incapacity poses for modern society ethical dilemmas of stunning complexity. Every plea for dignity, autonomy and freedom heard during the lawsuit brought by Hall and McIver brought counterarguments that invoked danger, euthanasia and the metaphorical slippery slope. Among groups who decried Davis’ decision were the Florida Catholic Conference, the Florida Commission on Aging with Dignity and Not Dead Yet, a national advocacy group for the disabled.

The state’s Board of Medicine, a disciplinary panel, warned doctors not to flirt with assisted suicide. “We are not going to give the Dr. Kevorkians an open door to come to Florida,” said board chairman Edward A. Dauer.

If the state Supreme Court--in May or June, perhaps--upholds Davis’ ruling, the case is over, says Robert Rivas, one of Hall’s lawyers. And if Hall is alive and wants to die, he can come back to Palm Beach County--the only judicial district where Davis’ ruling applies --and ask McIver to overdose him with drugs.

If the state Supreme Court reverses Davis, Rivas said he would seek an appeal to the U.S. Supreme Court, where two other similar cases are pending.

In the meantime, if Hall’s condition worsens, Rivas fears his client “might read up on how to take the existing pain-killing medication he has. I believe he would do that. He’ll have a tremendous struggle with himself. It is such a profoundly personal decision. And that’s exactly why the government has no business in this.”

If Hall dies before the state high court rules, Rivas says the case would live on as a precedent for the next challenge, which is sure to come. “That,” says Rivas, “will be Charles Hall’s legacy.”

Even if the final court decision goes against him, Hall says he is proud of his courtroom pioneering. But legal history seems a cold comfort right now.

Hall is scared. He is scared of how he might die. “I refuse to leave this earth that way, with machines, tubes,” he says, reaching for another cigarette. “That’s not living; that’s existing. No one should be put through that torment in their final days. I told my wife I would come back and haunt her if she let that happen.

“I had to come to grips three years ago with the fact that I was going to die. I don’t want friends standing over me as I lay withered in my bed. I don’t want to be remembered that way.

“I just want to know that I can die in peace, and not have to suffer.”