May 2, 2011 -- The package in the mail might have been anything: a simple white box decorated with a butterfly. But inside were the simple tools 29-year-old Nicholas Klonoski used to end his life, according to the Daily Beast.
But even after Klonoski reportedly used one of Sharlotte Hydorn's homemade suicide kits to end his life in December, the 91-year-old entrepreneur said she makes no apologies for his death.
"I cannot take all the sadness of the world on my shoulders," said Hydorn from her home in La Mesa, Calif. "I feel so sorry for the mama, but I'm not at fault. That's his choice, not my choice."
Hydorn said the homemade kits, which she has been selling for four years, are intended to assist the death of those who are terminally or in severe chronic pain. But anyone can request the $60 kit, and she does not screen her clients before sending out the device.
Business doubled after Klonoski's death made headlines, according to Hydorn, and she plans on continuing to grow her small company.
Hydorn first became interested in assisted suicide after watching metastatic colon cancer take over her husband's body in 1977. He died in the hospital, instead of at home, where Hydorn said he belonged.
"It's always been in my mind that people should have the right to die at home with a family around them, not in a strange place surrounded by strangers," she said.
But the Daily Beast reported that Klonoski was not terminally ill, and would not have qualified for lethal prescriptions eligible to Oregon residents under the Death with Dignity Act. Oregon is only one of three other states in which assisted suicide is legal.
Hydorn was sure to look into the legal side of things before starting her mail-order business, by making sure that she would not be implicated in any potential legal woes.
"The attorney told me, 'you're just the bag lady,'" she said. "So long as I'm not present when death occurs, and I'm not telling them to shut up and pull the bag down already, I am not accountable."
Hydorn Meets Humphry
Three years after her husband's death, Hydorn met Derek Humphry, author of Final Exit and founder of the right-to-die organization, the Hemlock Society. Hydorn believed in Humphry's mission and began to volunteer, and ultimately became a board member, for the organization.
"I assume her purpose is Kevorkian-like-- to help people with terminal illness feel empowered," said Dr. Ken Robbins, clinical professor of psychiatry at the University of Wisconsin and director of psychiatry at Stoughton Hospital nearby.
But even if a person believes assisted suicide is ethical, Robbins said it is essential for a clinician to thoroughly screen patients to be sure they are not suicidal because of depression.
"You have to make sure they don't want to end their life because they are depressed because depression is treatable." said Robbins. "If the person goes through a good evaluation with a clinician, it's not that hard to decipher."
"If they have depression that is temporary due to the illness, or from the mental condition itself, part of the symptom is to feel hopeless," said Robbins. "People have to know that it will get better through treatment."
"For people in emotional pain, I don't know how anyone could argue that it is ethically appropriate to help them commit suicide," Robbins added.
Hydorn said people call or write to her to request a kit, which includes a customized plastic bag and a tube intended to be connected to a tank of inert gas. Often times customers provide little detail of their intentions. They usually tell her their name, the number of desired kits and the address where they'd like the kit to be sent. They enclose a check for the appropriate amount and sometimes include extra postage if they want the package delivered overnight or sent internationally.
Hydorn said she has received requests for kits from all over the world.
No Screening, No Follow-Up
After hearing of Klonoski's death, Hydorn said she went through her invoices to see whether she could find his written request. She could not find a letter from the name, Klonoski, but she did find a correspondence with an unclear recipient and address.
"It was a P.O. box," said Hydorn. "People can really give me any name they want. It could be Joe Blow and I wouldn't know the difference. I just have to trust people."
Hydorn also said that the Daily Beast insinuated that, along with her kit, she sends the recipient a copy of Final Exit, the how-to handbook for terminally ill people who wish to end their lives, written by Humphry. Hydorn said she does not sell the book, but Humphry told her that Klonoski had bought the book more than a year before he ended his life.
Hydorn said many of her clients are referred by Humphry.
Frank Kavanaugh, a spokesman for Final Exit Network, said that the organization screens clients with physical and mental health exams to determine whether the network will help to supply information and counsel people on how to end their lives. Clients must be determined by a doctor to be in the last six months of their lives.
"One of the advantages of counseling is that, if a person makes it through preliminary checks, they're very carefully counseled to make sure what they're doing is successful," said Kavanaugh. "If you're not counseled, it can lead to a problem."
But, when asked whether Kavanaugh believes it is a problem that Hydorn does not screen her clients, he said: "I don't think she is being irresponsible. We don't have control of other people."
Some psychiatrics disagree. Dr. Eric Hollander, clinical professor of psychiatry and behavioral sciences at Albert Einstein College of Medicine in New York, said it is critical that individuals with psychiatric disorders resist acting on suicidal thoughts or impulses by helping them view their situation in a more realistic perspective.
"The problem is that with increased access to such a device to terminate life, some individuals might be enabled to act on a whim or impulse to kill themselves, whereas if this was not readily available, patients might obtain help for their underlying mental disorder, or view their situation from alternative or more realistic perspectives," said Hollander.
But Hydorn doesn't see it that way, and the grandmother wipes her hands free of repercussions after her kit is sent out.
"Again, if someone gets hurt, I'm sorry, but that's their decision," said Hydorn. "Somebody closer to them than me could have helped that person. It's not my responsibility to help emotionally sick people. There's local help for that."
Not In it for the Money
The Daily Beast reported that Hydorn makes $98,000 per year through her company, but she said that fact is wrong.
"I have no idea where they got that number," said Hydorn.
Either way, Hydorn said she is not in it for the money.
"I get emotional satisfaction out of being able to help people," she said. "My motivation is to help people. If they misunderstand that, then so be it, but I'm not at fault for other people's choices."
If you or someone you know has contemplated suicide, please call the National Suicide Prevention Lifeline at 1-800-273-8255. Lines are open 24 hours a day, 7 days a week.