Suicide Pacts: Some Say Ultimate Act of Love

"It was a difficult conversation for people who come from a religious Christian background," he said. "There is a feeling that, 'Gee, suicide is something that locks you out of heaven.' It's a tough one for a lot of them."

His particular interests are the topics where "science, religious and morality all come together," and end-of-life care is just that, he said.

"Science can keep you alive beyond where most people want to be and it creates moral issues for the next of kin, especially if people have not talked about it with their spouse or children," he said.

Sometimes, he said, "If you want to die a good death, you have to be proactive in your own death," said Jose.

Sometimes suicide efforts fail.

Last year in Britain, a terminally ill doctor survived a suicide pact that killed his wife because a bag he tried to suffocate himself with was too small.

Dr. William Stanton, 79, and his wife of 52 years Angela, 74, both pulled bags over their heads while lying in bed together. He initially was charged with murder, but died of cancer before the case was resolved. The couple had been happily married for 52 years, said his children.

But for the Gutes, a community came out to celebrate their lives at a recent memorial service. Witte said her father and mother died with all their affairs in order. Her father even chose 2010, the zero-tax year for the wealthy to die.

"Since he left this world, my admiration has gone sky-high for this guy," she said. "He was a very controlling person, a surgeon with a little bit of narcissism, but he was literally devoted to my mother."

Witte, who had her political differences with her father, finds his ultimate choice inspirational.

"My father, a total right-wing conservative, pulled a true libertarian act of defying the law," she said. "He didn't feel like he had to march off to Oregon."

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