Direct for Chris Jenkins
Please state your name
What is your occupation? I am an oncologist with a private practice in Tucson.
What is your educational background? I got a Bachelor of Sciences in Biology from the University of Arizona in 1986, and got my medical degree from Harvard University in 1990. I did an internship and residency in internal medicine at St. Joseph’s Hospital in 1992. I wen t to Tucson in 1992 to do my Fellowship in oncology with Dr. Kim Sikora at the University Medical Center.
Did you know the deceased Steve Cole? Yes, he was my patient.
Why did he see you? His annual physical the previous day revealed bladder cancer.
Who referred Mr. Cole to you? His daughter Alex referred him to me.
Did you know Alex? Yes. We were friends during our undergraduate days in college.
Who was the attending physician in the case? I was.
Who made the determination that the patient, Mr. Cole, was terminal? I did.
What was the diagnosis for Mr. Cole? He had advanced bladder cancer, that had passed through the wall of the bladder and invaded the surrounding organs and lymph nodes.
How severe was the cancer? It was very severe, and removal was impossible. The cancer was irreversible.
What was your prognosis? he wouldn’t live more than six months but we could extend his life with some treatment.
Did Mr. Cole have any options? Yes.
What options did the two of you discuss? We talked about retarding the cancer’s advance and lengthening his survival time with aggressive chemotherapy and radiotherapy.
Were there risks involved? Yes
What were the risks? He could have side effects from the therapy, and it would never totally relieve all the cancer symptoms.
Did you inform Mr. Cole of the risks? Yes.
What did Mr. Cole decide to do? Mr. Cole elected to go ahead with treatments. He asked me to call Alex.
Did you call Alex? Yes.
What was the purpose of the call to Alex? I wanted to inform Alex about Mr. Cole’s decisions regarding the cancer.
What did you tell Alex? I explained the situation.
What was Alex’s reaction to the news? She declared she was going to go home and take care of the father.
Did you have a reaction to the declaration?
What was your reaction? I was mildly puzzled- When we were both at the University, Steve and Alex never seemed very close. It even seemed like Alex blamed her father for her mother’s death.
Did you continue to see Steve Cole? Yes, intermittently.
Did anyone accompany him? Yes
Who went with him? Alex
What did Alex do during the visits? She usually sat in the waiting room even though I encouraged her to come in with her father and me.
How did Mr. Cole’s condition progress over time? He was emaciated and in frequent and relatively severe pain from both the disease and the chemotherapy and radiation treatments. He even experienced hair loss, chronic fatigue, and nausea among other things from the treatments.
Were any pain medications prescribed? Yes, but they provided only minimum relief from pain.
Did you speak with Alex during this time? Yes, I confirmed the original prognosis for Alex, that her father was terminally ill, and also told her it was still to soon to tell the effects of the therapy.
Did Alex have a reaction to this information?
How did Alex react to your information? She seemed to become agitated and said that she had some business decisions to make that were dependent upon her father’s death.
What were the nature of these decisions? She wanted me to help persuade Mr. Cole to execute a Power of Attorney to give her access to his funds. He was refusing to do so.
How did you react to this? I told her I could not do it. Mr. Cole was gravely ill, but he was still fully competent to manage his own affairs. Such a step was unwarranted at this time.
Did you offer her any suggestions? Yes- I suggested she talk to a lawyer about a Power of Attorney that would take effect only upon her father’s incompetence.
How did Alex react to your advice? She became more upset and said she might need access to the money sooner, and then started wondering if I would consider an assisted suicide for her father.
What was your response to Alex? I said her father had never mentioned such a possibility, but that if he did, I would of course discuss it with him.
What was Alex’s response? Alex suggested that she might help me with funding the cancer center I’ve been dreaming about for a long time, if her father would die in time for the Prescott deal.
What decision did you make after this? I told her her suggestion was out of line and ended the conversation. Then I showed her out of my office.
Did you continue to treat Mr. Cole? Yes, through May.
Describe Mr. Cole’s condition: There was no discernible improvement, and he seemed to be in more pain.
Can you describe his mental state? He appeared to be losing hope and began to speak about wanting to give up.
Did Mr. Cole ask for assistance in hastening his death? No.
Did you take action? No.
What did you recommend to Mr. Cole? I suggested he might benefit from a few visits t a counselor to help with dealing with the pain.
What did Mr. Cole decide to do? He didn’t want to because he didn’t have the energy.
Did you inform Alex about the decision? Yes.
What was Alex’s reaction? She became noticeably cool.
***Did you say anything else? I didn’t press the matter- there wasn’t any despondency to necessitate the treatment.
Did you speak to Mr. Cole after that? Yes.
When was that? On the May 20th visit.
What was the cause of the discussion? Mr. Cole came out and said he was sick of all the medicine and treatments and pain, and that he wanted me to help him die.
What did you do for Mr. Cole at that time? I discussed the matter with Mr. Cole at length.
What was the purpose of the discussion? This was the fifth time I’ve been asked to assist a person in dying, and it’s always been excruciating every time. I’ve assisted two, but I have also dealt with two patients that I referred to other doctors and one patient who changed their mind. I wanted to make sure Mr. Cole understood his decision.
What did you discuss with Mr. Cole? We talked about his medical diagnosis and prognosis, the potential risks and results of medications I would prescribe to him, and also the feasible alternatives to assisted suicide.
What was Mr. Cole’s decision? He still wanted to go through with it.
Was any undue influence exerted on Mr. Cole? No. Although Mr. Cole mentioned he though he was a burden on Alex, I cautioned him that his decision was his and his alone.
How did Mr. Cole respond to your warnings? He strongly reaffirmed his desire for assisted suicide.
What did you do at that point? I decided to proceed with it.
*******Did you believe that life would be worthwhile for Mr. Cole? No. Mr. Cole’s cancer was incurable and irreversible, and he has so much chronic and intractable pain that he perceived he could not enjoy or experience the activities that make life worthwhile.
Did Mr. Cole act voluntarily? I believe he was doing so.
Was Mr. Cole capable of making an informed decision to hasten the end of his life? Yes.
Did you discuss Mr. Cole’s decision to end his life with Alex? Yes.
What did you say to Alex? I explained Mr. Cole’s decision and the procedure for ending his life, and we talked about the setting and location.
What date and location were decided upon? He wanted to die at home and as quickly as the law would allow. We picked June 11, pending the second physician’s opinion as required by the Aid in Dying Act.
Did you refer Mr. Cole to a second physician? Yes, Dr. Sikora, the best oncologist I know.
What did Dr. Sikora look at? She examined both the patient, Mr. Cole, and his medical records.
What did she determine? She confirmed my results in entirety.
Did you see Mr. Cole fill out a written request for medication? Yes.
Did a doctor witness the signing? Yes, Dr. Sikora.
Was there another witness present to the signing? Yes, Alex was in the room.
Would Mr. Cole have been able to back out of the request for medication? Yes, he could rescind it at any time even after signing the request.
Did you inform him of this? Yes.
Did you continue with the procedures for assisted suicide? Yes, we made an appointment for June 9th.
What was the purpose of the appointment? It was to make the prescription for morphine to end his life with.
What did Alex do when Mr. Cole made the appointment? She did nothing. Later I would receive a troubling phone call from her.
When was the phone call? Three days prior to the appointment.
Did you talk to Alex then? Yes.
What was the phone call with Alex like? She took a long pause as if gathering her thoughts right at the beginning, and then said that her dad couldn’t bear the pain any longer and that I had to help.
How did you respond to Alex? I told Alex some indecision is natural in these cases, but that I would help out if I could. I also reminded Alex that the decision was her father’s to make.
How did Alex react to this? She muttered that everything was being ruined, or something like that, and she hung up.
Did Mr. Cole return on June 9th? Yes.
Did Alex come with Mr. Cole? Yes, but she stayed in the waiting room as usual.
Did you write the prescription? Yes.
Did you discuss the suicide with him? Yes.
Did you give him a chance to back out? Yes, I checked to make sure he was still sure about his decision.
Was he sure? Yes.
Did you discuss his dying experience? Yes, at his request I agreed to fill the prescription by myself and be with him at his house when he took it on June 11.
Did you attend Mr. Cole’s death on June 11? Yes.
Can you describe what happened when you first arrived at the Cole residence? Mr. Cole was in bed, and I saw him talk to Alex briefly. Alex left the room and told me she couldn’t take it anymore.
Did you speak with Mr. Cole at that point? Yes, I asked him one more time if he was sure of his decision and reminded him of his right to change his mind.
What happened next? Mr. Cole reaffirmed his decision to die and asked me for the drug.
Did you give him the drug? I handed the drug to him, he took it, and then he drifted into unconsciousness.
What did you do after that? I summoned Alex to come in, and she sat with her father until he died.
Is all information regarding the suicide recorded correctly? Yes, with the exception of the fact that my medical records do not reflect my offering Mr. Cole one last opportunity to rescind his request to end his life.
Why wasn’t the information transcribed? I don’t know.
Did you originally record the information? Yes, I offered Mr. Cole that opportunity, and I dictated it into his records as well.
Did you act in good faith? Absolutely. In my best professional judgment, I was convinced that Steve Cole’s decision to die a death with dignity was completely his own.
Did you have any misgivings about assisting Mr. Cole’s suicide? I have some now, but I didn’t have them then and I don’t believe that I could have had them.
What misgivings do you have now? I feel that Alex Cole drove her father to his death for her own pecuniary gain. But it is only through hindsight that I can find any patterns in the indications that were there in the past.
Did you do the best possible service for your patient? I am a doctor, and I relieved my patient’s suffering in the best way I knew how.
Did you influence Steve Cole to take his own life? With God as my witness, I did nothing whatsoever to influence Steve Cole to take his own life.
