"Dr. Death" Jack Kevorkian Dies at Age 83

June 03, 2011

June 3, 2011 — Jack Kevorkian, who made the cover of Time magazine in 1993 as "Dr. Death" on account of his pugnacious advocacy of assisted suicide, died this morning in Beaumont Hospital in Royal Oak, Michigan, where he had been hospitalized for heart and kidney problems. He was 83.

Dr. Jack Kevorkian

In the end-of-life movement, he was the equivalent of the 19th-century abolitionist John Brown — a wild-eyed extremist to some, and a hero to others who say the terminally ill should be able to choose a painless death. He lived to see physician-assisted suicide legalized in Montana, Oregon, and Washington.

A pathologist who was stripped of his license by the state of Michigan in 1991, Dr. Kevorkian helped at least 130 people kill themselves during the 1990s. In many cases, the instrument of death was a homemade contraption of dangling tubes and bottles — what he dubbed the "Merciton" — that dispensed lethal drugs. Other patients breathed carbon monoxide through a mask. In either case, they administered the deadly agent to themselves. Most died in the back of Dr. Kevorkian's Volkswagen van. Michigan authorities prosecuted him on 4 separate occasions but could not make any murder charges stick.

In the 1998 assisted suicide of former race car driver Thomas Youk, who had amyotrophic lateral sclerosis, Dr. Kevorkian took a different approach: he injected the lethal drugs himself, crossing a line in the minds of many. To provoke another courtroom showdown, he videotaped the death and then allowed the CBS television show 60 Minutes to broadcast it.

"I've got to force them to act," Dr. Kevorkian told news correspondent Mike Wallace. "They must charge me. Because if they don't, that means they don't think it is a crime."

Dr. Kevorkian was charged with second-degree murder, convicted, and sentenced in 1999 to 10 to 25 years in prison, where he served 8 years. He promised to give up the practice of assisted suicide, but he remained outspoken against what he called a tyrannical system that denied people the right to die.

More Heat Than Light

Barbara Coombs Lee, president of an end-of-life advocacy group called Compassion and Choices, told Medscape Medical News that Dr. Kevorkian's bizarre career helped pave the way for the legalization of assisted suicide in Montana, Oregon, and Washington.

"He highlighted the severity of the problem," said Lee. "He made it clear that [terminally ill] people are really, really desperate for a peaceful way out."

Lee said her group supports what she calls physician-assisted death — not suicide, since that term implies the terminally ill are mentally ill — as long as the physician merely provides the patient the means of a self-administered death. What Dr. Kevorkian did in the case of Thomas Youk, she said, was euthanasia because Kevorkian administered the lethal drugs himself.

"We don't think euthanasia is good public policy," said Lee. "For us, the [terminally ill] person being in control from beginning to end is crucially important."

Lee describes Kevorkian as a "flamboyant provocateur" rather than a legitimate spokesperson for a careful, legal practice of assisted suicide. "He never said to other physicians, 'Let's develop a standard of care.' "

Linda Emanuel, MD, PhD, an expert on palliative care and a medical ethicist at Northwestern University in Evanston, Illinois, told Medscape Medical News that Dr. Kevorkian "contributed more heat than light" to the discussion on how clinicians should care for the dying.

"I don't think he promoted his position very well," said Dr. Emanuel. Nor does she agree with it.

"There is such a thing as intractable suffering, but I don't see physician-assisted suicide and euthanasia as a better alternative to palliative care," she said. "They create their own level of anxiety and suffering."

The American Medical Association takes a similar stance, condemning physician-assisted suicide as unethical. However, in an online survey conducted by Medscape last year, 45.8% of physicians answered yes to the question, "Are there situations in which physician-assisted suicide should be allowed?" Another 40.7% answered no, while 13.5% said, "It depends."

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