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'Dr. Death' led crusade for physician-assisted suicide

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  • 'Dr. Death' led crusade for physician-assisted suicide

    The Washington Post
    June 4, 2011 Saturday
    Suburban Edition


    'Dr. Death' led crusade for physician-assisted suicide

    BY: Sindya N. Bhanoo


    Jack Kevorkian, 83, the zealous, straight-talking pathologist known as
    "Dr. Death" for his crusade to legalize physician-assisted suicide,
    died June 3 at a hospital in Royal Oak, Mich.

    He had been hospitalized since last month with pneumonia and kidney
    problems, close friend and attorney Mayer Morganroth told the
    Associated Press.

    Dr. Kevorkian spent decades campaigning for the legalization of
    euthanasia. He served eight years in prison and was arrested numerous
    times for helping more than 130 patients commit suicide from 1990 to
    2000, using injections, carbon monoxide and his infamous suicide
    machine, built from scraps for $30. Those he aided had terminal
    conditions such as multiple sclerosis, amyotrophic lateral sclerosis
    and malignant brain tumors.

    When asked in a 2010 interview by CNN's Anderson Cooper about how it
    felt to take a patient's life, Dr. Kevorkian said, "I didn't do it to
    end a life. I did it to end the suffering the patient's going through.
    The patient's obviously suffering - what's a doctor supposed to do,
    turn his back?"

    Dying, he believed, should be an intimate and dignified process,
    something that many terminally ill people are denied, he said.

    He garnered a fair amount of support from other medical practitioners,
    although most thought he was an extremist. In 1995, a group of doctors
    in Michigan publicly voiced their support for Dr. Kevorkian's
    philosophy, stating that they supported a "merciful, dignified,
    medically assisted termination of life."

    Shortly after, a study in the New England Journal of Medicine found
    that many doctors in Oregon and Michigan supported some form of
    physician-assisted suicide in certain cases.

    One of his greatest victories occurred in March 1996 when a U.S.
    Circuit Court of Appeals in California ruled that mentally competent,
    terminally ill adults have a constitutional right to die with the aid
    of medical experts and family members. It was the first federal
    endorsement of its kind.

    But ultimately, Dr. Kevorkian's impact was not in the U.S. legal
    system but in raising public awareness about euthanasia and the
    suffering of the terminally ill.

    In the 1990s, the peak of his time in the limelight, he notoriously
    tried publicity stunts of all sorts to draw attention to his cause. In
    one instance, he showed up at trial dressed in Colonial attire. He
    also taped one of his patient's deaths and gave the video to CBS' s
    "60 Minutes" for broadcast.

    During this period, his face was frequently on television and in
    newspapers, and he gladly agreed to a barrage of news media interviews
    so he could share his views. His crusade and antics were documented
    last year in an HBO movie, "You Don't Know Jack," in which Al Pacino
    portrayed him as a passionate, but intolerably single-minded crusader.

    "He was involved in this because he thought it was right, and whatever
    anyone wants to say about him, I think that's the truth," said Arthur
    Caplan, a professor of bioethics at the University of Pennsylvania.
    "He didn't do it for the money, he didn't do it for the publicity, he
    wasn't living a luxurious life - he wanted change."

    Despite his best efforts, Dr. Kevorkian was, for the most part, a lone
    soldier who had an abrasive personality. Although he was the
    best-known figure in fighting for euthanasia's legalization, the
    legislative results of his efforts were largely unsuccessful, if not
    counterproductive.

    His goal was to make it legal for a doctor to actively help a patient
    commit suicide. But to date, no state has made this legal and only
    three states, Washington, Oregon and Montana, have legalized any form
    of physician-assisted suicide. To the contrary, the state of Michigan,
    where Dr. Kevorkian did much of his work, explicitly banned
    physician-assisted suicide in 1993 in direct response to his efforts.

    "I think Jack Kevorkian was like a flare on the battlefield - he lit
    up the issue and everyone paid attention," Caplan said. "He got to
    absolute center stage, but he didn't have the nuance to take it
    forward the way he wanted to."

    Dr. Kevorkian's path to becoming a doctor was not as unusual as his
    career that followed. Born on May 28, 1928, in Pontiac, Mich., he
    wanted to be a baseball radio broadcaster, but his Armenian immigrant
    parents encouraged him to pursue a more practical path. He graduated
    from the University of Michigan's medical school in 1952 and began a
    residency in pathology.

    It was about this time that his obsession with death began. In the
    1950s, he first received the nickname "Dr. Death" when he began
    photographing patients' eyes to determine the exact time of death.

    He also campaigned to use the bodies of death-row inmates for medical
    experimentation.

    And then, facing the sorrowful faces of terminally ill patients as a
    pathology intern, he became convinced that there was a place in the
    medical profession for euthanasia.

    "Euthanasia wasn't of much interest to me until my internship year,
    when I saw first hand how cancer can ravage the body," he wrote in his
    1993 book "Prescription Medicine: The Goodness of Planned Death." "The
    patient was a helplessly immobile woman of middle age, her entire body
    jaundiced to an intense yellow-brown, skin stretched paper thin over a
    fluid-filled abdomen swollen to four or five times normal size."

    His life after this was devoted to the cause. Dr. Kevorkian, who lived
    alone in a small apartment in Michigan, never married and had no
    children. The people most closely associated with him were his defense
    attorney Geoffrey Fieger, who represented him without a fee; and one
    of his faithful, longtime assistants, Janet Good.

    When, on one occasion, Good backed out of letting Dr. Kevorkian use
    her home for an assisted suicide, he temporarily turned his back on
    her.

    To help a patient commit suicide, Dr. Kevorkian often used a homemade
    machine that sent a saline drip into the person's arm. When ready to
    die, the patient could press a button that would trigger the release
    of a potent chemical that would bring sleep. One minute later, a timer
    on the machine would send a dose of potassium chloride into the
    patient's body, causing the heart to stop.

    Dr. Kevorkian faced trial four times in Michigan for his actions but
    was acquitted in three instances because of then-unclear laws on
    whether physician-assisted suicide was illegal. His fourth trial was
    declared a mistrial.

    Unlike Michigan, most states do not have explicit laws banning
    physician-assisted suicide, and nearly always, Dr. Kevorkian was
    careful not to administer the fatal medication himself, although it
    was his hope that within his lifetime, the law would allow him to do
    so. He was thus able to escape jail for a long time.

    But after he recorded his assistance in the death of Thomas Youk and
    allowed the recording to be aired on "60 Minutes" in 1998, Dr.
    Kevorkian was arrested and convicted of second-degree murder in
    Michigan.

    Youk, who was in the final stages of ALS, known as Lou Gehrig's
    disease, was too ill to administer the drugs himself, so Dr. Kevorkian
    had done it for him.

    During the trial, Dr. Kevorkian vehemently denied any wrongdoing.

    "He calls it a murder, a crime, a killing," Dr. Kevorkian said,
    referring to the prosecutor. "I call it medical science. Tom Youk
    didn't come to me saying, 'I want to die, kill me.' He said, 'Please
    help me.' There was medical affliction. Medical service is exempt from
    certain laws."

    Dr. Kevorkian was sentenced to 10 to 25 years in prison but was
    paroled in June 2007 for good behavior after promising not to assist
    in any more suicides.

    "It's got to be legalized. That's the point," he told a Detroit TV
    reporter shortly after his release from prison. "I'll work to have it
    legalized. But I won't break any laws doing it."

    Ultimately, Dr. Kevorkian said his belief regarding a patient's right
    to die had a simple premise: It was in the Constitution, unwritten but
    guaranteed by the Ninth Amendment, which states that Americans are not
    excluded from rights that are not specifically enumerated in the
    Constitution.

    "There have been many constitutional scholars over time that have
    believed that the Ninth Amendment deserves more respect, but Dr.
    Kevorkian took it further than most lawyers and most constitutional
    scholars would take it," said Alan Dershowitz, a Harvard professor and
    lawyer who was an adviser in several of Dr. Kevorkian's legal battles,
    and corresponded with him while he was in prison.

    "He was part of the civil rights movement - although he did it in his
    own way," Dershowitz said. "He didn't lead marches, he didn't get
    other people to follow him, instead he put his own body in the line of
    fire, and there are not many people who would do that. In the years
    that come, his views may become more mainstream."

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