Final Exit Network

Final Exit has placed a billboard like this one in San Francisco

A new billboard in San Francisco is drawing criticism from suicide-prevention experts, who fear it may encourage desperate people to take their own lives.

The sign, which went up last week at Howard and South Van Ness, reads: “My Life My Death My Choice.” It provides a Web address for Final Exit Network, a New Jersey-based organization that supports people who wish to end their lives to alleviate suffering from debilitating or fatal illnesses.

Final Exit Network paid for the billboard and said it hoped it would provoke discussion about “the right to die.”

But suicide-prevention experts say that the billboard could lead those who are suicidal over the brink. 

“This is irresponsible and downright dangerous; it is the equivalent of handing a gun to someone who is suicidal,” wrote Lanny Berman, president of the International Association of Suicide Prevention, in an email. “This message, communicated to thousands of vulnerable individuals, suffering from psychic and or physical pain that is treatable, invites a tragic and final solution to problems that most often can be solved with proper evaluation and treatment.”

Suicide is the 11th leading cause of death in the United States, according to the American Association of Suicidology, a nonprofit organization aimed at preventing suicide. There are about 100 suicides a year in San Francisco, according to San Francisco Suicide Prevention, which provides emotional support for people in crisis.

Forty-five years ago, San Francisco had the highest suicide rate in the world. In 1962, the city developed the first crisis hotline in the United States, a model now replicated around the country. Since then, the annual suicide rate in San Francisco has dropped by half.

Local suicide prevention experts see the billboard working against continuing efforts to prevent suicide. Last February, plans were approved to install a barrier at the Golden Gate Bridge, where more than 1,300 people have taken their lives. But it’s not yet clear where the $50 million needed for the barrier will come from.

“Regardless of what someone might feel about assisted suicide, I feel the message behind this billboard is confusing and dangerous,” wrote David Paisley, deputy director of San Francisco Suicide Prevention, in an email.

“It assumes people will understand that it is a billboard about assisted suicide or they will go to the website,” he wrote. “In reality, most people who see the billboard from the street or car will not go to the website, but are left with a message that could be interpreted very tragically by someone in crisis and acting impulsively.”

Frank Kavanaugh, a spokesman for Final Exit Network, disagreed.

“There is nothing on the billboard that says suicide,” he said. “All it does say is life, death and choice.”

Members of Final Exit Network, which was founded in 2005, have been present at the deaths of about 130 people. “They are people who are suffering from an intractable and irreversible disease who feel that they can no longer bear the suffering that they are enduring,” Kavanaugh said.

Eight members of the group are facing charges related to assisted suicide, including cases in Georgia and Arizona. In the United States, assisted suicide is legal only in Oregon, Washington and Montana.

“We don’t even think that what we do is suicide,” said Kavanaugh. “What we’re about is assistance in dying. We’re dealing with mentally competent people who are rational. People who are suicidal are severely depressed, psychotic, acting impulsively. We would never touch anybody in that kind of a situation.”