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  • Doctor Who Helped End Lives

    The New York Times
    June 4, 2011 Saturday
    Late Edition - Final


    Doctor Who Helped End Lives

    By KEITH SCHNEIDER


    Dr. Jack Kevorkian, the medical pathologist who willfully helped
    dozens of terminally ill people end their lives, becoming the central
    figure in a national drama surrounding assisted suicide, died on
    Friday in Royal Oak., Mich. He was 83.

    He died at William Beaumont Hospital, where he had been admitted
    recently with kidney and respiratory problems, said Geoffrey N.
    Fieger, the lawyer who represented Dr. Kevorkian in several of his
    trials in the 1990s.

    Mayer Morganroth, a friend and lawyer, told The Associated Press that
    the official cause of death would most likely be pulmonary thrombosis,
    a blood clot.

    In arguing for the right of the terminally ill to choose how they die,
    Dr. Kevorkian challenged social taboos about disease and dying while
    defying prosecutors and the courts. He spent eight years in prison
    after being convicted of second-degree murder in the death of the last
    of about 130 ailing patients whose lives he had helped end, beginning
    in 1990.

    Originally sentenced in 1999 to 10 to 25 years in a maximum security
    prison, he was released after assuring the authorities that he would
    never conduct another assisted suicide.

    His critics were as impassioned as his supporters, but all generally
    agreed that his stubborn and often intemperate advocacy of assisted
    suicide helped spur the growth of hospice care in the United States
    and made many doctors more sympathetic to those in severe pain and
    more willing to prescribe medication to relieve it.

    In Oregon, where a schoolteacher had become Dr. Kevorkian's first
    assisted suicide patient, state lawmakers in 1997 approved a statute
    making it legal for doctors to prescribe lethal medications to help
    terminally ill patients end their lives. In 2006 the United States
    Supreme Court upheld a lower court ruling that found that Oregon's
    Death With Dignity Act protected assisted suicide as a legitimate
    medical practice.

    During the period that Oregon was considering its law, Dr. Kevorkian's
    confrontational strategy gained wide publicity, which he actively
    sought. National magazines put his picture on their covers, and he
    drew the attention of television programs like ''60 Minutes.'' His
    nickname, Dr. Death, and his self-made suicide machine, which he
    variously called the ''Mercitron'' or the ''Thanatron,'' became fodder
    for late-night television comedians.

    In 2010 his story was dramatized in the HBO movie ''You Don't Know
    Jack,'' starring Al Pacino as Dr. Kevorkian. Mr. Pacino received Emmy
    and Golden Globe awards for his performance. In his Emmy acceptance
    speech, he said he had been gratified to ''try to portray someone as
    brilliant and interesting and unique'' as Dr. Kevorkian. Dr.
    Kevorkian, who was in the audience, smiled in appreciation.

    Given his obdurate public persona and his delight in flaying medical
    critics as ''hypocritical oafs,'' Dr. Kevorkian invited and reveled in
    the public's attention, regardless of its sting.

    The American Medical Association in 1995 called him ''a reckless
    instrument of death'' who ''poses a great threat to the public.''

    Diane Coleman, the founder of Not Dead Yet, which describes itself as
    a disability-rights advocacy group and that once picketed Dr.
    Kevorkian's home in Royal Oak, a Detroit suburb, attacked his
    approach. ''It's the ultimate form of discrimination to offer people
    with disabilities help to die,'' she said, ''without having offered
    real options to live.''

    But Jack Lessenberry, a prominent Michigan journalist who covered Dr.
    Kevorkian's one-man campaign, wrote in The Detroit Metro Times: ''Jack
    Kevorkian, faults and all, was a major force for good in this society.
    He forced us to pay attention to one of the biggest elephants in
    society's living room: the fact that today vast numbers of people are
    alive who would rather be dead, who have lives not worth living.''

    In the late 1980s, after an undistinguished career in medicine and an
    unsuccessful try at a career in the arts, Dr. Kevorkian rediscovered a
    fascination with death that he had developed during his early years in
    medicine, only now his interest in it was not as a private event but
    as a matter of public policy.

    As a student at the University of Michigan Medical School, from which
    he graduated in 1952, and later as a resident at the University of
    Michigan Medical Center, Dr. Kevorkian proposed giving murderers
    condemned to die the option of being executed with anesthesia in order
    to subject their bodies to medical experimentation and allow the
    harvesting of their healthy organs. He delivered a paper on the
    subject to a meeting of the American Association for the Advancement
    of Science in 1958.

    Gaining Attention

    In the 1960s and '70s, Dr. Kevorkian shelved his quixotic campaign to
    engage death for social purposes and pursued a largely itinerant
    career as a medical pathologist. Though his friends described him as
    funny, witty, personable and engaging in private, those he met in work
    and social situations portrayed him as awkward, grim, driven, quick to
    anger and unpredictable.

    Fiercely principled and equally inflexible, he rarely dated and never
    married. He lived a penurious life, eating little, avoiding luxury and
    dressing in threadbare clothing that he often bought at the Salvation
    Army. In 1976, bored with medicine, he moved to Long Beach, Calif.,
    where he spent 12 years painting and writing, producing an
    unsuccessful film about Handel's ''Messiah,'' and supporting himself
    with part-time pathology positions at two hospitals.

    In 1984, prompted by the growing number of executions in the United
    States, Dr. Kevorkian revisited his idea of giving death row inmates a
    choice. He was invited to brief members of the California Legislature
    on a bill that would enable prisoners to donate their organs and die
    by anesthesia instead of poison gas or the electric chair.

    The experience was a turning point. Energized by the attention of
    lawmakers and the news media, he became involved in the growing
    national debate on dying with dignity. In 1987 he visited the
    Netherlands, where he studied techniques that allowed Dutch physicians
    to assist in the suicides of terminally ill patients without
    interference from the legal authorities.

    A year later, he returned to Michigan and began advertising in
    Detroit-area newspapers for a new medical practice in what he called
    ''bioethics and obiatry,'' which would offer patients and their
    families ''death counseling.'' He made reporters aware of his
    intentions, explaining that he did not charge for his services and
    bore all the expenses of euthanasia himself. He showed journalists the
    simple metal frame from which he suspended vials of drugs --
    thiopental, a sedative, and potassium chloride, which paralyzed the
    heart -- that allowed patients to end their own lives.

    First Patient

    He also talked about the ''doctrine'' he had developed to achieve two
    goals: ensuring the patient's comfort and protecting himself against
    criminal conviction. He required patients to express clearly a wish to
    die. Family physicians and mental health professionals were consulted.
    Patients were given at least a month to consider their decision and
    possibly change their minds. Dr. Kevorkian videotaped interviews with
    patients, their families and their friends, and he videotaped the
    suicides, which he called medicides.

    On June 4, 1990, Janet Adkins, an Oregon teacher who suffered from
    Alzheimer's disease, was the first patient to avail herself of Dr.
    Kevorkian's assistance. Mrs. Adkins's life ended on the bed inside Dr.
    Kevorkian's rusting 1968 Volkswagen van, which was parked in a
    campground near his home.

    Immediately afterward Dr. Kevorkian called the police, who arrested
    and briefly detained him. The next day Ron Adkins, her husband, and
    two of his sons held a news conference in Portland and read the
    suicide note Mrs. Adkins had prepared. In an interview with The New
    York Times that day, Dr. Kevorkian alerted the nation to his campaign.

    ''My ultimate aim is to make euthanasia a positive experience,'' he
    said. ''I'm trying to knock the medical profession into accepting its
    responsibilities, and those responsibilities include assisting their
    patients with death.''

    By his account, he assisted in some 130 suicides over the next eight
    years. Patients from across the country traveled to the Detroit region
    to seek his help. Sometimes the procedure was done in homes, cars and
    campgrounds.

    Prosecutors, jurists, the State Legislature, the Michigan health
    authorities and Gov. John Engler seemed helpless to stop him, though
    they spent years trying. In 1991 a state judge, Alice Gilbert, issued
    a permanent injunction barring Dr. Kevorkian from using his suicide
    machine. The same year, the state suspended his license to practice
    medicine. In 1993, Michigan approved a statute outlawing assisted
    suicide. The statute was declared unlawful by a state judge and the
    state Court of Appeals, but in 1994 the Michigan Supreme Court ruled
    that assisting in a suicide, while not specifically prohibited by
    statute, was a common-law felony and that there was no protected right
    to suicide assistance under the state Constitution.

    None of the legal restrictions seemed to matter to Dr. Kevorkian.
    Several times he assisted in patient suicides just hours after being
    released from custody for helping in a previous one. After one arrest
    in 1993 he refused to post bond, and a day later he said he was on a
    hunger strike. During another arrest he fought with police officers
    and seemed to invite the opportunity to be jailed.

    He liked the attention. At the start of his third trial, on April 1,
    1996, he showed up in court wearing Colonial-era clothing to show how
    antiquated he thought the charges were.

    >From May 1994 to June 1997, Dr. Kevorkian stood trial four times in
    the deaths of six patients. With the help of his young and flamboyant
    defense lawyer, Mr. Fieger, three of those trials ended in acquittals,
    and the fourth was declared a mistrial.

    Mr. Fieger based his winning defense on the compassion and mercy that
    he said Dr. Kevorkian had shown his patients. Prosecutors felt
    differently. ''He's basically thumbed his nose at law enforcement, in
    part because he feels he has public support,'' Richard Thompson, the
    prosecutor in Oakland County, Mich., told Time magazine in 1993.

    But on March 26, 1999, after a trial that lasted less than two days, a
    Michigan jury found Dr. Kevorkian guilty of second-degree murder. That
    trial came six months after Dr. Kevorkian had videotaped himself
    injecting Thomas Youk, a patient suffering from amyotrophic lateral
    sclerosis (Lou Gehrig's disease), with the lethal drugs that caused
    Mr. Youk's death on Sept. 17, 1998.

    Dr. Kevorkian sent the videotape to ''60 Minutes,'' which broadcast it
    on Nov. 22. The tape showed Dr. Kevorkian going well beyond assisting
    a patient in causing his own death by performing the injection
    himself. The program portrayed him as a zealot with an agenda. ''They
    must charge me; either they go or I go,'' he told Mike Wallace. ''If
    they go, that means they'll never convict me in a court of law.'' The
    broadcast, which prompted a national debate about medical ethics and
    media responsibility, also served as prime evidence for a first-degree
    murder charge brought by the Oakland County prosecutor's office. In a
    departure from his previous trials, Dr. Kevorkian ignored Mr. Fieger's
    advice and defended himself -- and not at all well. It was an act of
    arrogance he regretted, he said later.

    'Stopped'

    ''You had the audacity to go on national television, show the world
    what you did and dare the legal system to stop you,'' said Judge
    Jessica R. Cooper, who presided over the trial in Oakland County
    Circuit Court. ''Well, sir, consider yourself stopped.''

    On June 1, 2007, Dr. Kevorkian was released from prison after he
    promised not to conduct another assisted suicide.

    He was born Murad Kevorkian in Pontiac, Mich., on May 26, 1928, the
    second of three children and the only son born to Levon and Satenig
    Kevorkian, Armenian refugees. His father founded and owned a small
    excavation company.

    The young Jack Kevorkian was described by his friends as an able
    student interested in art and music. He graduated from the University
    of Michigan, where he pursued a degree in engineering before switching
    to medicine.

    He was the author of four books, including ''Prescription: Medicide,
    the Goodness of Planned Death'' (Prometheus, 1991). He is survived by
    his sister, Flora Holzheimer. Another sister, Margo Janus, died in
    1994.

    Mr. Fieger said that Dr. Kevorkian, weakened as he lay in the
    hospital, could not take advantage of the option that he had offered
    others and that he had wished for himself. ''This is something I would
    want,'' Dr. Kevorkian once said.

    ''If he had enough strength to do something about it, he would have,''
    Mr. Fieger said at a news conference Friday in Southfield, Mich. ''Had
    he been able to go home, Jack Kevorkian probably would not have
    allowed himself to go back to the hospital.''

    Dr. Kevorkian was a lover of classical music, and before he died, his
    friend Mr. Morganroth said, nurses played recordings of Bach for him
    in his room.

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