THE DOCTOR WILL ASSIST YOU NOW
BY JEFF HOOTEN

Jack Kevorkian insists he is not obsessed with death.

During his medical residency, Kevorkian donned a black arm band and asked to work the night shift because more patients died then. The young pathologist carted around a camera in an attempt to photograph patients’ eyes at the moment of death. Co-workers nicknamed him Dr. Death, and he jokingly called his late-night quest “the death rounds.”

But he’s not obsessed with death.

An accomplished artist, Kevorkian’s paintings are filled with detached organs and severed heads. Maggots, blood and bullets. Skulls and suffering. Cannibalism. His artistic rendering of Christmas shows Santa’s boot crushing a baby lying in a fireplace. Religion is a favorite target: In a painting titled “Give Us This Day,” a half-man/half-baby is shown eating the flesh off a decomposing corpse.

But he’s not obsessed with death.

Early in his career, Kevorkian advocated medical experimentation on death-row inmates campaign that cost him his job at the University of Michigan Medical Center. He has since expanded on the idea by suggesting that condemned prisoners be allowed to auction off their internal organs. At one point he proposed that anyone sentenced to more than three years in prison be given the option of assisted suicide.

Over at Pontiac General Hospital, he experimented with transfusing blood from corpses into live patients. (Former guinea pig Neal Nicol once got such a severe case of hepatitis from cadaver blood that his eyeballs turned orange.) Kevorkian even mixed cadaver blood with his own and used it to paint the frame for one of his works.

But he’s not obsessed with death.

The call came into the office shortly before noon. The date was Nov. 8, 1995, and the voice on the phone said there was a body in a car outside.

The corpse was 58-year-old Patricia Cashman. The location was the Oakland County, Mich., medical examiner’s office. The car was Jack Kevorkian’s.

Dr. Death had struck again.

“They call that dying with dignity?” asked Pamela Hill, who has worked for the last 21 years as a secretary in the medical examiner’s office. A polite, bespectacled woman with a smattering of gray and a no-nonsense demeanor, Hill was clearly irked by Kevorkian’s delivery site-as it turned out, just a few feet from her usual parking space.

“Leaving them in a car-I wouldn’t do that to my dog, much less a loved one,” she said. “It’s undignified and uncaring.”

Cashman’s was the 26th death associated with the famous “suicide doctor” who treats pain with deadly gas, who assuages suffering with a lethal injection, who single-handedly turned southeast Michigan into Assisted Suicide Central.

It was the second time that year that Kevorkian had dropped off a body outside the medical examiner’s office. Kevorkian’s proficiency has made the macabre seem mundane: When a third body was discovered at the same location-this time in Kevorkian’s 1968 Volkswagen van-about 10 weeks later, Oakland County Sheriff John F. Nichols jokingly dubbed the spot “Kevorkian Drive.”

Since that November day, Kevorkian has presided over the deaths of at least 14 more people, bringing the total as of this writing to 40. (Kevorkian said last month that he has assisted additional suicides that have gone unreported.)

Kevorkian delivered the last several bodies to Oakland County hospitals,- some in a second-hand wheelchair he reportedly purchased for $60. As with all Kevorkian “patients” who die in Oakland County, the autopsies are the jurisdiction of Hill’s boss, Chief Medical Examiner L. J. Dragovic, M.D. Though the cadavers eventually arrive at her office, Hill is relieved that bodies are no longer turning up unannounced in the parking lot.

“Whenever I see someone sleeping in their car, I want to make sure they’re breathing.”

Public support is high for Kevorkian’s crusade. According to a recent Gallup poll, about 75 percent of Americans now favor physician-assisted suicide.

While his cause grows in acceptance, suicide’s poster boy remains a favorite target of editorial cartoonists. He’s a late-night host’s dream come true.

Yet to many he is a compassionate–albeit somewhat eccentric-man who wants nothing more than to end people’s suffering. But do those same people know the Jack Kevorkian who once tried to organize an exhibit of Adolf Hitler’s artwork; the Kevorkian who said carbon monoxide gives corpses a “rosy glow”; the Kevorkian who said Jesus Christ would have been better off dying in the back of his rusty van?

Kevorkian has been generating corpses at an accelerated pace since May, when he was acquitted for a third time of violating Michigan’s ban on assisted suicide. In mid-August, Kevorkian broke his own record by performing four so-called “medicides” in a one-week span.

“Now he really feels he’s off and running, and no one can stop him,” said Yale Kamisar, a University of Michigan constitutional law professor and expert on the issue of assisted suicide.

“You can’t convict Kevorkian because he controls the facts,” Kamisar told Citizen. “He controls all the friends, all the relatives, all the spouses, all the children-he’s got them all in his pocket. So when the prosecutor gets there, it’s too late. Everybody has signed up on Kevorkian’s side.”

“It’s unlikely that he’ll ever be convicted unless he makes a mistake.”

Mistakes? Critics say he’s made plenty. Since his most recent acquittal in May, Kevorkian has seemed a bit careless.

Take the case of Rebecca Badger Kevorkian suicide No. 33. The 39-year-old mother of two was depressed and in pain. Her doctors diagnosed her with multiple sclerosis. On July 9, Kevorkian “treated” her.

One problem. Badger didn’t have MS.

“I was surprised myself,” said Dr. Dragovic, the medical examiner. “I didn’t find any evidence of multiple sclerosis.”

Medical experts agree that a diagnosis of MS can only be confirmed by an autopsy, but that hasn’t stopped Kevorkian lawyer-cumpress secretary-cum-agent Geoffrey Fieger from calling Dragovic “a liar and a fanatical religious nut.” (This from a man who considers Jesus Christ to be “just some goofball who got nailed to the cross.”)

And what are Dragovic’s religious convictions? “I believe firmly in facts and truth,” he told Citizen. To prove his point, Dragovic has saved Badger’s brain and spinal tissue. Skeptics are invited to see for themselves.

“In pathology.. it’s the findings that dictate the diagnosis,” Dragovic said. “You don’t have a debate-if it’s there, it’s there. With Rebecca Badger, it’s simply not there.”

A Yugoslavian immigrant with a 13 page resume and an accent as thick as his mustache, Dragovic is accustomed to Fieger’s taunts. “Professor Fieger knows everything,” Dragovic scoffed. “There are no secrets in medicine for him.”

When the flamboyant attorney offered to wager $1 million that Badger did indeed have “severe and crippling MS,” the medical examiner responded with a laugh.

“Could he double the stakes”” he asked. “With $2 million we could improve the building here.”

Would better pain management have changed Badger’s mind? Don’t ask Kevorkian-he and Fieger rejected the assistance of two experts in pain management who offered, at no cost, to help alleviate the suffering of Margaret Garrish, a 72 year-old woman with rheumatoid arthritis.

Kevorkian dismissed both doctors as publicity seekers. Fieger claimed their offers were “insincere.” Garrish became No. 21. just five weeks after Badger’s death, critics said Kevorkian blew it
again. This time, the patient was 42-year-old Judith Curren. Fieger said Curren suffered from chronic-fatigue and immune-deficiency syndromes, as well as muscle disorder fibromyalgia. But the medical examiner said he could find no evidence of any disease in Curren. Even if he had, none of Curren’s maladies are considered fatal.

Dragovic said he did find a woman likely worn out from carrying 269 pounds on a 5-foot-l-inch frame. Curren probably experienced depression-90 percent of chronic-fatigue sufferers do. She took
potentially addictive drugs. Reports also surfaced that Curren had accused her husband of domestic abuse.

Fieger, who tightly controls Kevorkian’s access to the media, would not allow Citizen to speak with his client. Despite two formal interview requests and repeated phone calls, Fieger also declined to speak.

The Jack & Geoffrey Show did go on TV. As always, Kevorkian said he’d done nothing wrong in Curren’s death. “If I made a mistake, I’d admit it,” he told Dateline NBC.

What went through Kevorkian’s mind as Curren’s life ended? “Relief,” he said. “It’s over; suffering’s ended. You feel a sense of accomplishment.”

But what if Curren in fact wasn’t terminal? “It has nothing to do with lethality,” Kevorkian said. “It’s quality of life.”

“Quality of life” questions have dogged Kevorkian from the beginning. Doctors said Alzheimer’s patient Janet Adkins, 54, was still in the early stages of the disease and could have lived for 10 years or more when in 1990 she became the test case for Kevorkian’s “suicide machine.” She had reportedly beaten her 33-year-old son at tennis only days before she died.

Perhaps no case was more problematic than that of patient No. 13: 70-year-old Hugh Gale, a retired sailor with emphysema and congestive heart disease. Oakland County officials had confiscated Kevorkian’s suicide machine-which delivered a lethal injection-after only two uses. Kevorkian instead turned to carbon monoxide gas. Trouble was, Gale needed supplemental oxygen to breathe.

On Feb. 15, 1993, sitting in his own living room, Gale removed his oxygen canula from his nose and Kevorkian helped him put on a gas mask. Gale pulled a clip and started the deadly flow. After about 45 seconds, he became flushed and said, “Take it off!” The mask was removed and the nasal oxygen resumed.

Within minutes, Gale wanted to give it another try. This time, however, the nasal oxygen stayed. Gale again donned the mask and pulled the clip.

What happened next is up for debate. Eight days after Gale’s death, pro-life activist Lynn Mills retrieved a discarded document labeled “Final Action.” The patient was listed as Hugh E. Gale. The form was signed by Jack Kevorkian.

It contained Kevorkian’s account of Gale’s final moments:

“In about 30-35 seconds he again flushed, became agitated with moderate hyperpnea [abnormally rapid or deep breathing]; and immediately after saying ‘Take it off!’ once again, he fell into unconsciousness.

The mask was then left in place.”

The questions were obvious: Did Kevorkian knowingly ignore Gale’s wishes, leaving the mask on even after Gale asked that it again be removed? Did Kevorkian let a patient die who-at least at that moment was not ready to? Could he be charged with manslaughter, or even murder?

If nothing else, Kevorkian had violated one of his own written principles-that anyone who ever expressed any hesitation could never again be a candidate for assisted suicide. After Gale asked to stop the procedure the first time, according to Kevorkian’s own words, he should have been “eliminated from further consideration.”

When police searched Kevorkian’s apartment, they found another copy of the document. Only this time, 37 words had been whitened out. In their place, Kevorkian reconstructed part of two sentences. The new version contained no mention of Gale’s second “Take it off” plea.

Fieger acknowledged that Kevorkian had typed up both forms, but said the first one was a mistake-a “typo.”

“Oh, come on,” Mills said. “A typo is one or two letters, not 37 words.”

Gale’s death was atypical in that it occurred in Macomb County; but as usual, none of the witnesses was talking. So Macomb County Prosecuting Attorney Carl J. Marlinga struck a deal: By granting immunity to Gale’s wife Cheryl, as well as Kevorkian friend and assistant Neal Nicol, Marlinga hoped to learn the truth about what took place in Gale’s living room.

Both testified that Hugh Gale never said “Take it off” a second time. Without any witnesses to corroborate the original document, Marlinga concluded that trying to convince a jury would likely fail. He decided not to charge Kevorkian.

Marlinga told Citizen, however, that without assessing guilt, he still has “severe doubts” about the case. After all, Kevorkian is known for keeping meticulous records.

“Because of Jack Kevorkian’s own words, you have to wonder what he was really intending at the time,” Marlinga said. “Was he guided solely by the patient’s desire, or was there a time that he may have slipped up?”

Perhaps most troubling was Fieger’s explanation-or lack thereof. “Geoffrey Fieger is a terribly creative attorney, and the fact that all he could say was that it was a typo causes one to wonder,” Marlinga said. “That explanation is so weak and so lame.”

Jack Kevorkian was born 68 years ago in J Pontiac, Mich., the son of Armenian immigrants. Some suggest that his parents’ experience as holocaust survivors-the Turks massacred more than a million Armenians in the early 1900s-left an indelible mark on young Jack.

“His parents told him a lot of stories about the atrocities that Ws family suffered at the hands of the Turks,” said Michael Betzold, a one-time Detroit Free Press reporter and author of Appointment with Doctor Death. “What emerges is a person whose life is dedicated to trying to defeat death … by winning some sort of victory over it.”

Betzold said Kevorkian achieves one such victory simply by scheduling each suicide-“very much like an executioner controls the circumstances of a death. But in this case, it’s a self-execution procedure.”

Kevorkian became Betzold’s primary assignment back in 1991. Two years later, Betzold’s work and his private life collided when his 41-year-old cousin, Martha Ruwart, became Kevorkian suicide No. 15.

It was a million-to-one coincidence. Had he not been on vacation at the time, Betzold likely would have shown up for the usual post-suicide press conference. Instead, Betzold said, “I learned about it like everybody else.”

Betzold said he’s seen Kevorkian change-grow more caustic-in recent years. In the spring of 1994, during Kevorkian’s first assisted-suicide trial, Betzold wrote an unflattering story about the patient in question. Dr. Death turned on him.

Recalled Betzold: “I hear him talking about me … and he’s saying, ‘Look at him. See that face? That’s the face of Satan! And he’s pointing at me.”

Up until that point, Betzold had usually defended Kevorkian. Now he’s not so sure. “It was crazy for an adult person to act this way … It was very juvenile.”

Supporters, friends and family members of the victims say Kevorkian is just misunderstood. Carol Poenisch, daughter of suicide patient No. 19, Merian Frederick, described Kevorkian as a kind yet cerebral man who cares little what others think of him. “He’s a very intelligent person-very consumed with ideas,” she said.

In her mother’s memory, Poenisch is working with a group called “Merian’s Friends,” which is attempting to enlist support for a 1998 Michigan ballot initiative in favor of assisted suicide. (A similar petition drive spearheaded by Kevorkian himself fell far short of its goal in 1994.)

Janet Good formed the Michigan chapter of the Hemlock Society, America’s leading right-to-die group, after reading about Kevorkian’s suicide machine. When Janet Adkins and her husband Ron wanted to contact Kevorkian, they began with a phone call to Good. Nowadays, the self-avowed feminist (“Say that you’re talking to Janet Good, dedicated feminist,” she said) prefers a more high-tech approach.

“Everyone is contacting me through the Internet,” said Good, who estimates that she has attended more than a dozen assisted suicides. In many cases, Good screens prospective patients for Kevorkian. “I do it with him,” she said proudly. “I know him very well. I’m probably Ms best friend.”

Good is counting on Kevorkian’s assistance in the near future. She was diagnosed last year, at age 72, with terminal pancreatic cancer.

Does she Ian one lo her best friend’s services? “I certainly do,” she said. “I hope he’ll not turn me down.”

Good is more than a friend-she’s a fan. When Kevorkian recently told an audience at the National Press Club that “Had Christ died in my van… it would be far more dignified,” Good agreed. His van, she explained, is neat, clean and private.

As she thought about it, Good seemed to get an idea. “I wouldn’t mind having the dignity of dying in that van right today,” she proclaimed.

Upon further reflection, she added: “I would consider it an honor.”

The public elevator in the Oakland County Prosecutor’s Office only goes to the third floor. To reach the spacious fifth-floor office of Prosecuting Attorney Richard Thompson, you have to be invited.

Paneled cabinets, leather-backed chairs and a desk the size of Texas befit the stature of the job-Thompson oversees a staff of nearly 100 assistant prosecutors. But the man who three times tried to put Kevorkian behind bars must soon vacate his plush surroundings, and some-including Thompson himself-cite Dr. Death as a reason why.

You see, Thompson was convincingly defeated in the Aug. 6 Republican primary, and both his Republican opponent and the Democratic challenger have vowed not to prosecute Kevorkian,

“The decisions I made regarding Jack Kevorkian are the decisions that most people say caused my defeat in the election,” Thompson said.

It appeared for a while that Thompson would never get his nemesis on the stand. judges dismissed murder charges against Kevorkian in 1990 and again in 1992.

Thompson waited two years for the Michigan Legislature to pass a ban on assisted suicide-then another two for the Michigan Supreme Court to uphold the law. The court also ruled that assisted suicide was illegal under common law. The final decision: Kevorkian would stand trial twice in Oakland County, for the assisted suicides of four people.

While the Oakland County proceedings inched along, Kevorkian was tried and acquitted for suicide No. 17 in neighboring Wayne County.

The Oakland trials took place in the spring of 1996, and Kevorkian was in rare form. He arrived at the courthouse for his arraignment wearing stocks, for his second trial dressed in Colonial garb; he stormed out of the courtroom in disgust, threw tantrums and answered prosecutors’ questions with his own- and in the midst of the second trial-after spending the day on. the witness stand-assisted another suicide.

Several times proceedings were interrupted as prosecutors appealed rulings from the bench. “We were not only fighting Kevorkian and his attorneys, but in many cases we were fighting the trial judge,” Thompson said.

The prosecution stood little chance in either trial. It was later revealed that the first jury’s foreman, Methodist Bishop Donald Ott, had written a 1993 article in favor of assisted suicide. At the
conclusion of the second trial, jurors asked for Kevorkian’s autograph and posed for pictures with him.

Fieger’s strategy included exploiting a loophole in the law: His client’s intent was not to cause death, but to merely treat suffering. That the jury agreed continues to frustrate Thompson.

“The obvious problem here is that carbon monoxide has no medical purpose at all,” he said. “Its only purpose is to kill.”

On the night of Thompson’s primary defeat, Kevorkian delivered another body to a Pontiac hospital. When Michigan Gov. John Engler ventured that suicide No. 34 was timed to coincide with the election, Fieger had a warning for the governor:

“She chose the date, and if Mr. Engler wants to push it, he’ll be the next result of an assisted suicide.”

Will Dr. Death ever quit? After his third acquittal, Kevorkian said the only way to stop him would be to burn him at the stake.

Legal experts say the issue of assisted suicide is on a collision course with the U.S. Supreme Court. Two lower courts last spring struck down bans on assisted suicide in New York and Washington state.

Kevorkian joined the fray in July, asking the high court to overturn a still-standing, yet never enforced, Michigan injunction prohibiting him from assisting in any suicides.

Michael Modelski, a former Oakland County assistant prosecutor who successfully argued for the injunction in 1990, admits the best time for enforcing the injunction has passed. Still, he notes, it’s the only case prosecutors have won against Kevorkian.

“It would be a lot easier to lock him up for contempt of court than to start another criminal trial,” Modelski said.

Modelski said his former boss was defeated for a myriad of reasons, and Thompson’s choice of election-night scapegoat actually hurt the chance of future Kevorkian prosecutions.

“By saying that he lost because of his position on Kevorkian, politicians will be afraid of Kevorkian that much more,” Modelski argued.

Thompson has hinted that before he leaves office, he might try charging The Terminator one last time. “I’d love to see him go after Kevorkian,” Modelski said, “when he has no political repercussions to worry about.”

Opponents of physician-assisted suicide insist that Jack Kevorkian is an anomaly-a bizarre man on the fringe of medical practice. Even as Kevorkian grabs headlines, other, more “respectable” health-care workers are doing essentially the same thing.

With one difference: They’re doing it in secret. A recent survey of intensive-care nurses revealed that one in five admitted to performing euthanasia, assisting in a suicide, or withholding life-sustaining treatment. Another 40 percent said they wanted to help patients die but didn’t, typically for fear of getting caught.

Of the 852 nurses who responded to the survey, 58 said they had taken a patient’s life at least once without the patient’s urging.

Kevorkian and other “right to die” supporters say America merely needs to implement strict guidelines like those in the Netherlands, where physicians have practiced euthanasia for more than a decade.

Studies have shown, however, that the guidelines are routinely ignored. Some Dutch doctors have administered lethal drugs without the patient’s consent. Citizens have taken to carrying “Do not euthanize” cards in case they are rendered unconscious or comatose. Perfectly healthy patients have requested aid in dying simply because they were depressed.

Rita Marker, executive director of the International Anti-Euthanasia Task Force said Jack Kevorkian has already reset the boundaries of acceptability in the United States. In comparison to Kevorkian, a suicide doctor with a Marcus Welby-like demeanor will seem eminently reasonable.

“There will be those who will be Kevorkian with class,” Marker said. “They will look respectable. They will sound respectable. Their patients will be just as dead.”

Welcome to the slippery slope.

Who lives, who dies

Reporters routinely refer to Dr. Jack Kevorkian as a “retired pathologist.” Truth is, Kevorkian hasn’t worked in a hospital since 1989, he was even turned down for a paramedic. As one critic said, “the only thing he retired from was unemployment.”

Kevorkian’s questionable choice of patients hasn’t helped his cause. For example, several bodies into his assisted -suicide crusade, observers began to notice something about Dr. Death’s clients: They were all women,

Kevorkian’s first eight assisted suicides were females. His tally at press time stood at 27 women and only 13 men, with females accounting for 10 of the last 11 deaths.

As of 1994, three out of four completed suicides in America were men. Kalman J. Kaplan, a clinical psychologist and director of the Suicide Research Center at Chicago’s Columbia Michael Reese Hospital, said more women than men attempt suicide, but fewer succeed.

“If [Kevorkian’s] patients followed normal patterns, there would be three times as many men as women,” Kaplan said. So why the discrepancy?

“Women’s motivation oftentimes is not to die… but to indicate how miserable they are,” Kaplan said. “Women may be coming to Kevorkian for something, maybe to open a dialogue … [but] he’s converting that into a final solution.”

Kevorkian says he discourages most people who approach him from committing suicide. Stanley Levy, M.D., a Kevorkian friend and member of Physicians for Mercy-a group of doctors who support physician-assisted suicide-told Citizen that Kevorkian only helps about 15 percent of those who seek his aid in dying.

“They all want his services,” Levy said. “He’s not scrounging them up, he’s not offering them gift stamps.”

Yet Kaplan’s research, compiled with the help of assistant Kristin McTigue, reveals that the majority of Kevorkian’s female patients were not suffering from terminal diseases. Their findings also indicate that only around half were in severe or constant pain.

Oakland County Medical Examiner L. J. Dragovic, M.D., routinely labels Kevorkian’s patients as homicides, because most lacked access to canisters of carbon monoxide or intravenous drugs. Others were physically incapable of administering them.

“They were substantially incapacitated,” Dragovic said, “and unable to self-inflict, which defines them as homicides.”

“Someone else prepared everything … and guaranteed the flow of deadly fluids into the body.”

How Kevorkian is able to obtain deadly drugs at all is a mystery. After all, he was stripped of both his medical licenses several years ago.

Medical ethicists say Kevorkian is out of control. Disability groups demonstrate outside his home. The American Medical Association calls him “a reckless instrument of death.”

No matter. Kevorkian denounces them all, as is his wont. Speaking at the National Press Club in July, Dr. Death flayed religious believers as “irrational,” the government as “lying,’ the court system as ‘corrupt,” and the medical establishment as “insane.”

During the same speech, Kevorkian reiterated his plea for doctors to come forward and establish guidelines for physician-assisted suicide. Thus, the same people who Kevorkian says are not to be trusted are the ones we should trust to decide who must live and who can die.

Of course, he adds, only doctors like himself should have this power. Of course.

TALKING POINTS: PHYSICIAN-ASSISTED SUICIDE

Aren’t doctors being compassionate when they help end the lives of patients suffering from incurable diseases?

Doctors who offer death by assisted suicide as a medical option communicate hopelessness, not compassion. They send the message to the disabled and dependent citizens that their lives are not worth living.

Shouldn’t terminally and chronically ill patients be given the opportunity to escape their misery, even if that means death?

Doctors take an oath to be healers, not killers. In seeking to remedy pain, physicians are obligated to utilize medical alternatives to death-alternatives that do exist. Today’s pain-management offer true death with dignity by safe- guarding terminally ill patients from suffering a painful death.

Hospice care is another alternative to physician-assisted suicide. Hospices address not only the physical challenges of dying patients, but the emotional and spiritual needs as well.

Doesn’t everyone have a right to die? Shouldn’t patients have control over their own lives?

This debate isn’t about the right to die; it’s about the right to help patients kill themselves. Although patients may request to be euthanized, doctors are the ones being granted a radical new
authority: deciding whether or not patients should continue living. In other words, instead of going autonomy to patients, assisted suicide is about giving a powerful option to physicians, enabling them to directly participate in ending another person’s life.

If a patient is terminally ill, why be concerned if a doctor helps end her life a few months earlier than when she would have succumbed to age or illness?

Predicting death is an inexact science at best, Doctors can and often do make mistakes. Consider a survey of Oregon physicians published in the Feb. 1, 1996, issue of The New England Journal of Medicine. Researchers found that one half of the nearly 2,800 physicians responding were not confident they could predict that a patient had less than six months to live.

How about the patient who has given up on life and is bent on committing suicide anyway? Why not permit professional assistance?

By agreeing to help a patient commit suicide, a doctor is ignoring what may be a legitimate cry for help. Suicidal thoughts often indicate the presence or a condition that is treatable: severe depression. A study of terminally ill hospice patients found only those diagnosed with depression considered suicide or wished death would come early. Patients who were not depressed did not want to die.

Yet one third of the physicians who responded to the New England Journal survey indicated an uncertainty about their ability to recognize depression in patients who requested a lethal dose of
medication. These are the same doctors who, under Oregon’s “Death with Dignity Act,” are allowed to assist in patients’ deaths, provided the doctors can recognize depression and predict that death will occur within six months.

What right do you have to force someone to stay alive?

There is a vast difference between relinquishing efforts that delay death and imitating procedures that cause death. Being pro-life does not necessarily mean advocating the forcible postponement of an impending natural death. Medical ethics do not require doctors to use all means of artificial life support available to extend the life of someone who is dying. (Providing nourishment and sustenance to a comatose patient is not Considered artificial life support.) A patient’s sincere request to terminate further death-delaying treatment should be honored.

By refusing assistance to a patient who wishes to die, aren’t you sending the message that her wishes are irrelevant?

No. Rejecting suicide as an option is a way of expressing value for life. A society that embraces physician-assisted suicide will inevitably lead many patients to believe that they have a “duty” to die. Already, there are voices in our society calling on the sick and elderly to die as a “reasonable” means of Curbing health-care costs.

Don’t your efforts interfere with the doctor/patient relationship?

This question misses the more important issue. The practice of physician-assisted suicide itself threatens to destroy the delicate trust relationship between doctor and patient. Patients demonstrate their faith in the medical profession every day by taking medications and agreeing to treatment on the advice of their physicians. Patients trust that the doctors’ actions are in their best interest, with the goal of protecting life. Physician-assisted suicide endangers this trust relationship.

“Physician-assisted suicide is a private matter that doesn’t impact you.”

“Why don’t you mind your own business?”

Physician-assisted suicide is not a private act. The debate is a matter of public concern because it involves one person facilitating the death of another. A major concern is that acceptance of assisted suicide will likely lead to involuntary euthanasia– the direct and intentional killing of a patient by a physician without the patient’s knowledge or consent. A case in point is in the Netherlands, where doctors have practiced physician-assisted suicide and euthanasia for more than a decade. In an attempt to determine the extent of abuses, the Dutch government commissioned a study in 1990. Researchers found nearly 6,000 cases in which patients died at the hands of physicians-without the patients’ consent.

ENDNOTES:

1. K.M. Foley, The Treatment of Cancer Pain.’ The New England Journal of Medicine. vol. 313, July 11. 1985, pp. 84-95.

2. Ire R. Byock, “Kevorkian; Right Problem, Wrong Solution,’ The Washington Post, Jan. 17 1994, p. A23.

3. Don Colburn, ‘Assisted Suicide: Doctors Ethicists Exam re the Issues of Pain Control. Comfort Care and Ending Life,” The Washington Post, Sept. 14, 1993 p. Z7.

4. Melinda A. Lee, Heidi D. Nelson, Virginia P. Tilden. Lina Ganzini, Terri A Schmidt and Susan W. Tolie, “Legalizing Assisted Suicide–Views of Physicians in Oregon,” The New England Journal of Medicine, vol. 334 Feb, 1 1996, pp. 310-315.

5. James Henderson Brown, Paul Henteleff, Samia Barakat and Cheryl June Rowe. “Is It Normal for Terminally ill Patients to Desire Death?” American Journal of Phsychiatry, vol. 143, February 1986. pp. 208-211.

6. Lee

7 J van der Maas, J.J.M. van Deldon and L Plgenborg. Euthanasia and, Other Medical Decisions Concerning the End Of Life, An Investigation Performed Upon Request of the Commission of Inquiry Into the Medical Practice Concerning Euthanasia. Elsevier Science Publishers. Amsterdam 1992 pp. 73 75, 181 182.

THE ABOVE MATERIAL WAS PUBLISHED BY FOCUS ON THE FAMILY CITIZEN, OCTOBER 21, 1996, PAGES 1,2,3,4,7. THIS MATERIAL IS COPYRIGHTED AND MAY BE USED FOR STUDY & RESEARCH PURPOSES ONLY.