A few days before he committed suicide with his wife of 53 years, Daniel Gute, a retired physician, wrote a note explaining their mutual decision to die.
The two-page handwritten letter is dated July 16, and it is signed by both Gute and his wife, Katherine, whom he calls "Kitty." Kitty Gute had been diagnosed with Alzheimer's disease more than a year before.
The note describes Kitty Gute's failing health, daily indignities and chronic pain. It touches on their determination not to allow the vibrant life they had shared come to an end in a nursing home, where they feared their deaths would be no better than dragged out and wrested from their control.
"I am hoping that sometime this weekend I will have the guts to act to deliver us both from a more dismal situation," he writes.
"I have been thinking about this for a long time. It will not be easy. However, as time goes by it will not get any better."
One of their three daughters, Mary Witte, found Daniel and Kitty Gute's bodies Sunday.
The two were inclined toward each other in the front seat of Kitty Gute's car, which was parked in the garage of their River Hills home. They had asphyxiated themselves with helium, an inert gas they pumped into plastic bags that covered their heads.
Kitty Gute was 78. Daniel Gute would have turned 80 on Aug. 4.
A search of their home made clear that the Gutes had been planning their deaths for years. Besides numerous suicide notes, investigators found several pieces of literature associated with the right to die movement, including a DVD of Derek Humphry's "Final Exit," as well the book "To Die Well" by Sidney Wanzer, a physician whose wife had been close friends with Kitty Gute when they were in college.
The notes indicate that the Gutes struggled not so much with decision to kill themselves, but rather when.
Daniel Gute feared that he would grow too frail to carry out their decision or that Kitty Gute's dementia would progress to a point that it would obliterate her ability to form will or intent.
In an undated note titled "Dying with Dignity or 'To Die Well,' " Daniel Gute writes:
"I hope I am making the right call in dying in the very near future; dying well when I am able to act.
"There has been a great amount of emotional turmoil, which I hope to control at the finish line."
Daniel Gute writes that his reason for dying is different from his wife's:
"As I have expressed before - I do not want to carry on in life without Kitty," he writes.
Mary Witte called her parents' deaths courageous.
"I am very proud of them," she said Thursday. "I hope I can be as bold for my own children."
Witte said she had tried to call her parents several times Sunday. After getting no response, she and her son went to their home. Having discovered their bodies, she called the Gutes' longtime friend, cardiologist Bruce Wilson.
In an interview, Wilson called the Gutes' death "a teachable moment."
"The big concept here is that American culture in particular has been deluded about the inevitability of death," he said.
For doctors in particular, he said, "It feels to us like a failure."
"We've become so good at extending life that what we don't realize is that what we are doing is prolonging death," he said.
"We are so intent on extending the date of death that we minimize the opportunity for it to go well."
"Yes," said Arthur R. Derse, director of the Center for Bioethics and Medical Humanities at the Medical College of Wisconsin, "we are death denying."
But, said Derse, who is a physician and a lawyer, people may take steps to control what he called "the medicalization of death."
Advance directives, he said, should be used to control life-prolonging intervention.
By employing such instruments as a living will or a power of attorney for health care, people can proactively direct end of life decisions, such as artificial nutrition and hydration, heroic procedures and pain control.
"We have the right to control the prolongation of death," he said, "but not the acceleration of death."
Daniel Gute didn't see it that way.
In one of the notes found Sunday, he wrote:
"I am sorry for whomever finds us, but it was time to end our lives. In this random world, it was our free choice."