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The Internet group linked to Minnesota’s "suicide nurse"
By Jennifer Martin–Romme
Zenith City Weekly
In the criminal complaint filed against William Melchert–Dinkel, who pleaded not guilty last November to charges of aiding two suicides, police link the 48–year–old Faribault nurse to an obscure Internet group that describes itself as "pro–choice suicide."
Melchert–Dinkel is accused of "being an internet advisor in suicide methods" and "encouraging" the deaths of 32–year–old Mark Drybrough in Britain, who hanged himself in July 2005, and 18–year–old Nadia Kajouji in Canada, who drowned herself in April 2008.
However, the Internet forum in question claims to have prevented more suicides than the dozen or so completed ones to which they have been publicly linked.
The UseNet group identified in the complaint—alt.suicide.methods—is actually a lesser–used offshoot of its parent group, alt.suicide.holiday, referred to by participants as "ASH."
Known to one another as "ashers," they share a belief that "every person has the right to choose to take his/her own life, if and when (s)he chooses," according to an informational website about the group, AshSpace.org.
"The ash subculture does not encourage suicide…However, we believe that people have a right to commit suicide and thus, in general, do not try to dissuade people from doing so.
"There is no evidence that open discussion of suicide increases the risk of suicide. But it is often difficult to talk openly about suicide in a culture that regards suicide as a taboo.
"The effect, then, of the approach of delegitimizing suicide is to further alienate the suicidal and discourage them from participating in traditional support newsgroups…These people might otherwise feel they had no place to express those thoughts.
"In fact, many ashers report that participating in a.s.h. makes them feel better, and eases their urges to act on their suicidal thoughts. And that may in fact cause a reduction in the number of suicides—even though that is not the object of the newsgroup."
Email to the site’s owner, Min Hrafnsdottir, was returned as "no longer actively monitored." No other spokesperson for ASH is publicly identified.
Tom Jensen, Manager of Outpatient Adult Behavioral Health at Essentia (formerly Miller Dwan) stops shy of saying suicidal ideation is "always" irrational, but "in my experience, yeah, there’s always depression or another mental illness," he says, noting that his experience is in a medical setting.
"Within a psychiatric clinic, suicide is not an option. It’s our number one killer."
While Jensen believes groups like ASH could reduce the social isolation or impulsivity associated with suicide, the risk of such groups remains high, especially for those who are acutely vulnerable.
"The evidence is there. When people say, ‘This [group] has really helped me,’ you can’t argue with that experience. But that non–judgmental support can be lethal," particularly in an unmoderated Internet setting where the risk of self–harm is not being evaluated.
ASH was started in 1990 by Andrew Beals, a California computer programmer, who told the San Francisco Chronicle in 2003 that he never intended it to be "a fly trap for the suicidal."
He initiated the group to discuss the phenomenon of increased suicide rates during the holidays. Over time, it morphed into a support group (of sorts) for those who share his belief that ending one’s own life can be a legitimate personal choice.
While he reaffirmed this belief to the Chronicle in 2003, Beals said he left the group in the mid–’90s, after he "got a divorce, got happier and got a dog."
Yet ASH continues to thrive, with currently over 116,000 messages and an additional 33,000 in alt.suicide.methods. An unknown number of posts in both forums are not archived and ashers have since branched out into Internet Relay Chat, YahooGroups, and DALnet, making it impossible to estimate their numbers.
UseNet’s lack of a central server has allowed the forum to dodge attempts at shutting them down or holding anyone responsible for the content and consequences of their discussions.
The unmoderated free–for–all makes it equally impossible to ban disruptive participants, leading to a high volume of off–topic chatter, repetitive advertising, and abusive or annoying behavior.
On any given day, ten or more spam posts are broken up by a request for information on the best way to hang oneself or a ponderous debate about whether to live or "catch the bus"—the group’s slang for suicide.
In contrast to a handful of media reports portraying them as murderers–by–proxy, the forum is often mutually supportive and sometimes surprisingly funny.
"Lonely Lola" has already attempted suicide once with an overdose of Tylenol. She feels guilty and confused about her continued desire to die.
"Suicidal thoughts consume me," she posted on December 11. "I have no real reason to feel this way."
She describes herself as attractive and working a "stable full–time job," but she’s also bulimic and an "excessive" marijuana user.
Adopted in infancy, she says her family is the only reason she has not yet followed through on the suicidal feelings that have dogged her since adolescence.
Within the hour, other ashers jump in to greet Lola: "Welcome to ASH, sorry you’re here." It’s the group’s traditional, gallows–humor greeting.
One response challenges Lola about "piling" guilt on herself. Another assures her she won’t be subjected to attempts at cheering her up (anyone who does this is disparaged in ASH–lingo as a "shiny–happy").
One reply suggests she might not have given mental health treatment enough of a chance yet. Another points out that, "sometimes while exploring your reasons for dying, you’ll find reasons for living."
Opinions of the mental health system tend to be cautious, if not cynical, but ashers appear to reserve more contempt for involuntary hospitalization than for medication or "p–docs" [mental health professionals], whom some regard as helpful on a case–by–case basis.
AshSpace maintains that pathologizing suicide hampers the ability to make a fully informed choice and forces counselors into irrationally pro–life positions (e.g., that any hope of improvement is sufficient reason to live, even if such hope is objectively negligible).
The group’s philosophy relies on "rational choice," including a page dedicated to the option of choosing not to commit suicide. "Being pro–choice goes both ways. We believe exiting [suicide] is legitimate, but continuing to live is also definitely a valid choice."
Jensen says he’s treated patients who view suicide this way. "I think every practitioner has. It may be even more common, but they just didn’t find an audience for it…For them, it’s a legitimate debate, but they don’t get much responsiveness from mental health providers.
"It can’t be a taboo subject in the context of therapy, but you’d be hard–pressed to find [a therapist] who would entertain suicide as a legitimate option.
"The presumption in psychiatry is that suicide is irrational and prompted by mental illness," leading to "a legal, moral, and medical obligation to intervene."
In addition to platitudes from "shiny–happies," ASH is sometimes disrupted by attempted intervention. One such "troll" is currently posting the IP addresses of anyone who expresses suicidal thoughts in the hopes that law enforcement will seek out their offline identities and hospitalize them.
Which is similar to the way William Melchert–Dinkel was apprehended. Celia Blay, a 65–year–old British woman, befriended another woman online who said she had entered into a "suicide pact"—an agreement between two or more people to kill themselves together.
Concerned for her friend, Blay sleuthed out what she believed to be the identifying information of the person on the other end of the pact, whom Blay claimed had entered into similar pacts with others, sometimes asking them to "use a webcam to allow him to view the death."
But Scotland Yard wasn’t interested, according to Blay. The case raised thorny questions about jurisdiction—not to mention free speech—and laws against aiding a suicide had rarely been applied to people who were even in different rooms, let alone in different parts of the world.
By the time she contacted St. Paul police, Blay claimed 20 to 30 people had been approached online by a man posing as a woman—identified in the complaint as Melchert–Dinkel—"an online predator using deception to manipulate people to commit suicide."
Incidentally, the screen names police say belonged to Melchert–Dinkel were generally disdained by other ashers, even before charges were filed.
As far back as 2005, his alleged screen names were met with skepticism, passed around the group in warnings, and chastised for attempting to persuade others—a violation of the group’s "pro–choice" norms.
In addition to conversation, ASH offers advice on planning one’s own funeral (advised against, because funerals are for the survivors) and suicide notes (avoid ambiguity and don’t dissuade survivors from their healthy feelings of grief).
An "agony calculator" rates suicide methods by pain, speed, and likelihood of success.
But the group is best known for its "methods file"—a wiki–like list of gruesome activities that would undoubtedly prove at least harmful, if not deadly.
The file is neither easy to find nor easy to take entirely seriously. Suggestions also include starting World War III, bringing about the end of the world, and hiring the mafia to take out a hit on yourself.
In 2003, the group came under sharply critical press attention after the death of 19–year–old Suzy Gonzales, a northern California native, attending her freshman year at Florida State University.
In the months before her suicide, she actively participated in ASH, where she discussed the reasons she wanted to die and the elaborate method she’d chosen.
Posing as a jeweler, she obtained a lethal amount of potassium cyanide (used for buffing precious metals) and poisoned herself in a Tallahassee motel room.
Gonzales’ levelheaded planning is chilling for its macabre attention to detail. She obtained a pH meter to assure the concoction would not burn her throat and, two days before her death, posted to the group that she had "stopped eating so my tummy will be nice and acidic."
A fellow asher proofread her suicide note, which was delivered to her friends, family, and the police via time–delayed email. When her body was recovered, she had neatly repackaged everything containing residue of the poisonous compound.
In one of her earliest posts to ASH, two months before she died, Gonzales complained that her order for the cyanide was already a week late.
In an unsigned press release to CNN, the group pointed to this post as evidence that, though they supported Suzy Gonzales’ decision to die, they had not instructed her in how to do it.
It’s a distinction central to ASH, but that matters not at all to her parents, who consider the group directly and morally responsible.
Mike and Mary Gonzales lobbied for the Suzanne Gonzales Suicide Prevention Act, which would have amended interstate commerce law, making it a crime to "promote" suicide on the Internet.
The bill has been stalled in committee since 2007, charged by its critics as unconstitutionally vague and already addressed by state laws against aiding a suicide.
"Plainly, the First Amendment will protect even the most reprehensible speech," says media lawyer Mark Anfinson (who represents the Minnesota Newspaper Association, of which the Zenith is a member).
"Where you tend to start getting into territory where courts will reject the free speech argument is when it involves identifiable, specific individuals.
"Brandenburg [vs. Ohio] is still the legal standard," but few cases have tested the 1969 Supreme Court decision, which distinguishes between "generally advocating" criminal behavior, which is protected speech, and "advocacy of imminently lawless action," which is not.
For entirely different reasons, the letter of the law also matters a great deal to groups who support the legalization of "aid–in–dying," commonly referred to as "physician–assisted suicide" or "euthanasia."
Such groups have tended to distance themselves from ASH whenever the high–profile suicide of an otherwise healthy person forces them both into a media spotlight they’d rather not share.
"We don’t have a position on such folks," says Steve Hopcraft, Director of Media Relations for Compassion & Choices, which advocates aid–in–dying for "mentally competent adults with a terminal illness."
The non–profit does not even use the word "suicide," which implies the patient is taking his or her own life, rather than already dying of a disease.
For the purposes of Medicare hospice eligibility, "terminal illness" is defined as six months or less to live. Hopcraft says other medical definitions extend that to a prognosis of one year or less.
"Mental competence is critical and central to every medical procedure. To have a tooth pulled, you have to be mentally competent to agree to the procedure."
He declined comment as to whether those who are not terminally ill could be mentally competent to end their own lives. The organization does not deal with that question nor work with such individuals.
"The issue isn’t whether you’re sad, or even depressed, that you’re dying…The issue is, are you mentally competent to control your own medical care?
"We’re totally opposed to people encouraging otherwise healthy people to commit suicide. That nurse? That’s just criminal."
Compassion & Choices issued a press release last May after the charges against Melchert–Dinkel once again put them on the defensive:
"Reporters have been calling Compassion & Choices for comment, perhaps with the expectation that we would not condemn the alleged behavior. Nothing could be further from the truth…Our movement for end–of–life choice does not condone assisted suicide, and it never has."
When drafting legislation, "we were careful to preserve and maintain the felony of assisting a suicide" to protect those "with poor mental health and disordered thinking from anyone who would encourage and facilitate their attempts to harm themselves. Laws against assisted suicide are good laws that should stay on the books in every state where they appear."
Compassion & Choices may take the hardest line of all, their press release rhetorically concluding, "Who can read these charges without feeling shock and disgust and knowing a crime has been committed?"
But the courts have yet to decide whether Melchert–Dinkel committed a crime or how the law will apply to these unique situations raised by the global hyper–connectivity of the Internet age.
Nor does psychiatry—a field still in its infancy in terms of human history—know how to help when anonymous people share their darkest impulses with total strangers halfway around the world.
"Suicide is the final act," says Jensen, "the loss of everything. Recovery is about reconnecting. If a group like [ASH] is reconnecting, again, you can’t argue with experience.
"But I don’t think it’s an issue about happiness at that point. It’s about hope. I can’t give [my clients] the hope I have for my life…Sometimes we have to wade through the darkness with our patients to find it. It’s about acceptance."