Jack Kevorkian

Jack Kevorkian has become the most well-known advocate in the United States for the cause of physician-assisted suicide. Having helped an estimated 130 terminally or chronically ill individuals kill themselves between 1990 and 1999, Kevorkian sparked a national debate on the ethical issues involved in EUTHANASIA, or mercy killing. Although Kevorkian has argued that his actions have prevented needless suffering for patients in pain and that it has allowed them to die with dignity, others see his work as a violation of the medical profession's most cherished ethical principles affirming life over death. Working in an area of vexing ethical issues, Kevorkian was championed as a breaker of unnecessary taboos surrounding death. His crusade ended in 1999 when a Michigan state court convicted him of second-degree murder.

Kevorkian became a focus of national attention in 1990, after he assisted the suicide of Janet Adkins, a 45-year-old woman who was suffering from Alzheimer's disease, a degenerative disease of the brain that causes memory loss and intellectual impairment. Adkins had heard through the media about Kevorkian's invention of a "suicide machine" that allowed individuals who were ill to administer a lethal dose of poison to themselves. The machine, which Kevorkian assembled out of $45 worth of materials, consisted of three dripping bottles that delivered successive doses of three fluids: a harmless saline solution; a painkiller; and, finally, a poison, potassium chloride. When Adkins contacted Kevorkian about using the machine on her, Kevorkian agreed to assist her. Kevorkian diagnosed Adkins as suffering from Alzheimer's and arranged to perform the assisted suicide in a public park, in his rusting, 1968 Volkswagen van. After Kevorkian had inserted an intra-venous needle into her arm, Adkins pressed a red button that caused the machine to administer the painkiller and then the poison. Within five minutes, Adkins died of heart failure. Within days, Kevorkian had become a national media celebrity, appearing on such television shows as Nightline, Geraldo, and Good Morning, America.

This first of Kevorkian's assisted suicides illustrated the objections that many observers raise toward Kevorkian's methods. Although she had begun to show early signs of Alzheimer's, Adkins was otherwise in good health and was not terminally ill; she committed suicide more out of fear of future suffering than out of current suffering. She had joined the Hemlock Society—an organization that advocates voluntary euthanasia for terminally ill patients—even before she became ill. In addition, Adkins's Alzheimer's might have impaired her ability to make decisions. Some observers wondered

Jack Kevorkian.
AP/WIDE WORLD PHOTOS

whether she was also suffering from depression, a treatable mental illness. Moreover, in cases in which a terminally ill patient has expressed a desire to die, established rules of medical ethics require that two independent doctors must confirm that the patient's condition is unbearable and irreversible; Kevorkian had ignored this requirement.

Kevorkian was charged with first-degree murder in the Adkins case, but a judge ruled that prosecutors failed to show that Kevorkian had planned and carried out Adkins's death. Attempts to prosecute Kevorkian were hampered by Michigan's lack of any law against physician-assisted suicide. Most other states have laws that make this act a felony.

In early 1991, a Michigan judge issued an INJUNCTION barring Kevorkian's use of the suicide machine, and in the same year, the state of Michigan suspended his medical license. Kevorkian defied such legal actions and continued to help ailing people to end their lives. Now that he no longer could prescribe drugs, Kevorkian assisted with suicides by providing a contraption that administered carbon monoxide through a gas mask. As he practiced assisted suicide and published on the subject—describing it in his own terms as "medicide" or "planned death"—he continued to be surrounded by controversy. For example, an autopsy that was performed on the body of the second person whom he had helped to commit suicide, a patient who had complained of a painful pelvic disease, found no evidence of any disease.

In 1992, the Michigan Legislature passed a bill outlawing assisted suicide, designed specifically to stop Kevorkian's activities (Mich. Comp. Laws § 752.1021). This law was used to charge Kevorkian with assisting in the death of Thomas W. Hyde, Jr., in August 1993. Kevorkian was jailed twice that year, in November and December. During his second jail stay, he embarked on an 18-day fast in which he protested his arrest by drinking only juice. His bail was reduced and was paid by Geoffrey Fieger, a flamboyant lawyer who has done a great deal for Kevorkian's cause as his friend and legal counsel. Kevorkian was found not guilty.

Kevorkian then attempted to place before Michigan voters a ballot initiative, Movement Ensuring the Right to Choose for Yourself (MERCY), which sought to amend the Michigan Constitution in order to guarantee competent adults the right to request and to receive medical assistance in taking their own lives. However, he failed to garner enough signatures to put the initiative on the 1994 ballot. In December 1994, the Michigan Supreme Court upheld the law that had made assisted suicide a crime, and in 1995 the U.S. Supreme Court refused to hear Kevorkian's appeal.

Kevorkian continued to assist in suicides even as prosecutors in his home county unsuccessfully attempted to convict him on charges of murder or assisted suicide. On May 14, 1996, an Oakland County Circuit Court jury again acquitted Kevorkian of assisted suicide. In that case, the prosecution had argued that assisted suicide was a crime under Michigan COMMON LAW. After the acquittal, county prosecutors suggested then that it was unlikely that they would take Kevorkian to trial again.

In his actions and his statements, Kevorkian flouted the ethical standards of the medical profession on the issue of assisted suicide. The AMERICAN MEDICAL ASSOCIATION, a national professional association of physicians, specifically forbids the practice of physician-assisted suicide. Many doctors deplore Kevorkian's techniques and see them as endangering the trust that must exist between physician and patient. Even the Hemlock Society opposes Kevorkian's actions, citing his lack of typical procedural precautions.

In 1998, Kevorkian allowed the CBS television program 60 Minutes to tape the lethal injection of Thomas Youk, a patient who was suffering from Lou Gehrig's disease. After the broadcast, county prosecutors again brought a second-degree murder charge against Kevorkian, who served as his own counsel in his trial. On March 26, 1999, a jury in Oakland County convicted him of second-degree murder and illegal delivery of a controlled substance. He was sentenced in April 1999 to 10 to 25 years in prison. During the next three years, he sought to appeal the conviction to appeals court in Michigan. However, the Michigan Court of Appeals affirmed the conviction, and the Michigan Supreme Court declined to review the appellate court's decision. Lawyers representing Kevorkian sought to appeal the case to the U.S. Supreme Court, but it declined to review the case.

Kevorkian's efforts in the cause of assisted suicide were only the latest in a series of his unconventional, even morbid, attempts to make a name for himself in the area of medical research. Kevorkian had earned the nickname Dr. Death in 1956, only three years after obtaining his medical degree, when he began making what he called death rounds at the Detroit-area hospital where he was employed. During those rounds, he examined dead bodies in order to collect evidence supporting his contention that the time of a person's death could be determined from the condition of the person's eyes. Kevorkian caused more controversy—and lost his job at the University of Michigan—in 1960, when he published the book Medical Research and the Death Penalty, in which he argued for the vivisection (i.e., the conduct of medical experiments on live subjects) of prisoners who had been sentenced to death. Claiming it would be "a unique privilege … to be able to experiment on a doomed human being," he outlined a plan in which the prisoner-subject would be anesthetized at the time of execution, then used for scientific experiments lasting hours or months, and finally executed using a lethal overdose. According to Kevorkian, this practice would create both a more painless execution and greater advances in medical research. The use of condemned prisoners for medical experimentation and organ donation has remained a consistent theme for Kevorkian. His 1991 book Prescription: Medicide: The Goodness of Planned Death rehashes these same arguments while also making a case for assisted suicide. In another unsuccessful venture, Kevorkian re-created experiments in which Soviet scientists had taken blood from recently deceased individuals and transfused it to live patients.

In a later article that set forth his plans for assisted suicide, Kevorkian suggested setting up suicide clinics: "The acceptance of planned death implies the establishment of well-staffed and well-organized medical clinics ('obitoria') where terminally ill patients can opt for death under controlled circumstances of compassion and decorum." As his use of the terms obitoria and medicide indicate, Kevorkian has a penchant for coining words. He dubbed his first suicide machine alternately a mercitron or a thanatron—the latter from the Greek word for death, thanatos—and has used the word obitiatry to indicate the medical specialization in death.

Kevorkian was born May 26, 1928, in Pontiac, Michigan. Named Murad Kevorkian at birth by his Armenian immigrant parents, he was the first of his family to attend college. He attended the University of Michigan Medical School and did his internship at Detroit-area hospitals. Acquaintances of Kevorkian testify to his prodigious intellect. The retired physician has demonstrated talent as a writer, painter, and composer. A series of 18 paintings that he made on such grisly topics as GENOCIDE, hanging, and cannibalism created a stir in Michigan during the 1960s. Kevorkian also has commented that his unconventional ideas have been influenced by the history of his Armenian ancestors, particularly the genocide in which 1.5 million Armenians were killed during WORLD WAR I by the Turks. Kevorkian has never married.

Although many deplore his actions, Kevorkian has increased public awareness of some of the most difficult ethical issues surrounding DEATH AND DYING. With medical technology's increasing ability to prolong life have come more situations that bring great pain and suffering. Kevorkian's efforts to assist people in their deaths, although often falling short of accepted professional standards of diagnosis and care, have sparked a needed discussion on these issues. Nevertheless, even supporters of euthanasia sought to distance themselves from Kevorkian's practices after his convictions, drawing distinctions between his practices and their own beliefs in physician-assisted suicide