The 'final exit counselling' given by George Exoo may land him in an Irish prison. Denis Staunton, in the US, hears opinion in his home town
Among the dozens of churches and prayer halls in Beckley, in the heart of the Appalachian coal- mining region of West Virginia, the brown-brick home of the Unitarian Universalist Fellowship usually attracts little attention. These are turbulent days for the tiny congregation, however, as its former minister, George Exoo, waits in jail to hear if he will be extradited to Ireland for allegedly aiding and abetting the suicide of Rosemary Toole in January 2002. If convicted, the 65-year-old minister could face up to 14 years in prison.
"He is still a member here and when he is no longer in the situation he is in right now, he will be more than welcome here as a member. There are several of us here who care about George and we all wish him well," says Kelly Kaufman, who succeeded Exoo as minister in 2005.
Despite her good wishes, Kaufman is eager to distance the congregation from Exoo's Compassionate Chaplaincy Foundation, through which he claims to have ministered to more than 100 people as they ended their own lives. "George is a part of our community," she says. "But we are not part of his cause."
It may be weeks before US district magistrate Clarke VanDervort rules on the Exoo case, which could set an important precedent in US extradition law as well as raising difficult questions about assisted suicide and the right to die with dignity.
Under the extradition treaty between Ireland and the US, only offences that are "punishable under the law of both Contracting Parties by imprisonment of more than one year" are extraditable. Aiding and abetting a suicide has been a crime in Ireland since 1993, when suicide itself was decriminalised, but it is not an offence in West Virginia or under US federal law.
Federal prosecutor Philip Wright argues that, if assisting a suicide is a felony in a majority of US states, Exoo should be extradited - although he admits that this may never have been done before. "I haven't been able to find a case where they actually went to that stage," he says.
Exoo flew to Dublin with his partner, Thomas McGurrin, on January 20th 2002 after Toole contacted him through a Canadian right-to-die group. A 49-year-old former bank official whose marriage had broken up, Toole had attempted suicide at least once and had frequently expressed her wish to die.
Although Exoo maintained that she was suffering from Cushing's Syndrome, the Director of Public Prosecutions claims that, although she was severely depressed, she had no other serious illness.
By the time Exoo and McGurrin arrived, Toole had imported from Canada an "exit bag" - a plastic bag to be placed over the head and filled with helium. In interviews he gave in the days after her death, Exoo said that Toole had far more helium and a much greater quantity of drugs than she needed to kill herself.
"I gave her instructions, but that's what we do. And provided spiritual support for her," he told a West Virginia newspaper.
Toole paid Exoo and McGurrin $2,500 (€1,815) to cover their travel expenses and she left 5 per cent of her estate to the Compassionate Chaplaincy Foundation, although Exoo said he didn't know about the bequest in advance and he has never claimed it.
The Irish authorities claim that, despite his insistence that he offered no more than comfort and spiritual support to Toole, Exoo actually helped her to take her own life. They point to his account of her smoking a cigarette after she had taken a cocktail of sedatives and vodka but before she pulled the helium bag down over her face.
"The last thing she did before she pulled down the bag was take one last toke on the cigarette. I said: 'Okay, Rosemary, time to put down the cigarette, if you don't mind,' " he told the Charleston Gazette newspaper.
In an interview with Ireland on Sunday, Exoo went further: "I think just before the bag came down I was pulling the cigarette away from her mouth, as I recall it. 'It's time to stop smoking, Rosemary, we've done enough'," he said.
Lawyers have advised Exoo, who has been in jail since his arrest in June, not to speak to the media now, and South Carolina historian Richard Côté, who acts as Exoo's representative, maintains that Irish media coverage has been overwhelmingly hostile, homophobic and riddled with inaccuracies.
"From a point of journalistic ethics, collectively, reading the stories by the Irish press makes me want to vomit," he says. "The Irish press has already convicted George Exoo of the crime he is alleged to have committed and the Irish press is simply looking around for the right tree to hang him from."
Côté, who has known Exoo for almost 30 years, believes that his work as a "final exit counsellor" is entirely consistent with a lifetime spent helping others.
"He provides compassionate care and pastoral counselling for people who are either terminally ill or in pain situations which are unbearable, irreversible and untreatable and for whom life has lost all meaning," Côté says.
In 1977, four years after being ordained, Exoo took charge of a congregation in Charleston, South Carolina. While there, Exoo launched a campaign to improve Aids education and awareness, calling for condom dispensers to be installed at highway rest stops where men met one another for sex. The authorities ignored his call and clamped down on the gay cruising areas instead.
It was just before he moved to Beckley in 1996 that Exoo started his Compassionate Chaplaincy Foundation, inspired by the experience of comforting a friend with Lou Gehrig's disease as the man ended his life with an overdose of sedatives.
"When we hired George, we knew about his compassionate chaplaincy. He told us about that," says Beverly Kinraide, his predecessor as minister in Beckley.
Kinraide says that, far from being the "angel of death" portrayed in some media reports, Exoo has spent much of his time and a lot of his own money helping people to stay alive. "He has given cars away to people so that they can get work and so that they can get to work, so that they could keep a job. He's done this on at least three occasions that I know of. He has taken people into his house, he has allowed them to live with him for days and weeks and months, and in some cases he has paid for people to be in apartments, he has paid for their living expenses so that they can get through a hard time. They have called saying: 'I want you to be with me. I'm going to do this. I've got to do this, but I need you.' But he's gone and persuaded them not to do it. He has determined that, in fact, their problem is something that can be solved with a little bit of time, a little bit of help."
Kinraide, who fears that Exoo would not survive a long prison sentence, says he had attempted to establish a board to oversee his work as a "final exit counsellor" but nobody was willing to serve on it.
Côté favours legal assisted suicide within a regulatory framework, but he believes that, in the absence of such regulation, people like Exoo will still be needed.
"To die alone is a terrible thing and to have someone there to pray with you, to talk to you as you are making the transition from here to the other side, there is nothing in the world that can replace that," he says. "I was talking to a woman today who, probably 72 hours from now, will be on the other side. I've been talking to her for months.
"This woman has no one who is willing to be with her at the time of her death. She has gone through insufferable pain for 17 years and has no George Exoo to be at her side - and she will probably end up taking her own life alone in her car in the middle of nowhere someplace. That's no way to go. I'd go for an unregulated George Exoo over that any time."
Ministerial journey: the Exoo creed
Born into a Methodist family in Ohio in 1942, George David Exoo studied English and social science at Boston's Emerson College before taking a theology degree at Harvard Divinity School and a PhD in religion and society at the University of California at Berkeley. In 1973, he was ordained as a minister by the First Unitarian Church in Boston and, four years later, took charge of a congregation in Charleston, South Carolina. Although rooted in Christianity, the Unitarian faith includes people from a broad spectrum of spiritual movements. According to the Unitarian Universalist Association, 19 per cent of American Unitarians don't believe in any god. In 1996, Exoo started his Compassionate Chaplaincy Foundation.