Often regarded as a controversial figurehead of the previous two decades, Dr. Jack Kevorkian, M.D., has received large amounts of media attention due to his fascination with death and his resultant death related medical practices which, in turn, positioned him to serve as somewhat of a spokesperson for the rights of physician-assisted suicide. Plainly stating that “[he has] always had a profound fascination with death,” Kevorkian initially exemplified this fascination in the late 1950’s with his much-rejected proposal to perform experimental medical surgery on death-row prisoners on a voluntary basis.[1] Receiving great amounts of controversial debate in addition to high levels of rejection, this proposal eventually led Kevorkian to lose his pathology residence in the University of Michigan Pathological Department. Furthermore, during the ensuing two decades, Kevorkian’s additional research regarding the pupil dilation of dying patients, research that found Kevorkian literally staring eye-to-eye with terminally ill patients and eventually cadavers, was deemed very disturbing, invasive, and disrespectful by several on-lookers.[2] Some respect was returned to the doctor, however, as Kevorkian exposed seemingly life-benefiting aspects of his plan as he lobbied for legislation that would allow the organs of executed prisoners to be donated to others in need.[3] However, similarly to his previous ambitions, Kevorkian was denied both the respect and attention needed to stimulate these motives.

Resultantly, it was not until Kevorkian began his notorious, yet vastly controversial, practice of physician-assisted suicide that he truly received the ethical gravity now associated with his career. His 1987 advertisement campaign for “death counseling” was centered on his belief in voluntary euthanasia, a minimally painful termination of life in which the patient takes the final action resulting in his or her own death.[4] Kevorkian carried out this voluntary euthanasia by means of his own invention named the “Thanatron,” or death machine.[5] The device functioned through an intravenous injection producing a seemingly painless death in mere minutes. After an initial dripping of a saline solution, the patient attached to the device would willingly trigger the delivery of sodium thiopental to initiate a coma. Around one minute later, the device would then automatically deliver a fatal dose of potassium chloride capable of stopping the heart within minutes, thus, allowing for an unconcious, painless, death. Using this machine in addition to the “Mercitron”, a device employing a carbon monoxide canister and a gas mask to accomplish death, Kevorkian assissted in nearly 130 suicides between the years of 1990 and 1998, despite an injunction forbidding him to do so and a revoking of his medical liscense in 1991.[6] A vast majority of Kevorkian’s clients, as it must be noted, however, were terminally ill with diseases such as Alzheimer’s, ALS Lou Gehrig’s, and various forms of cancer, like patients Janet Adkins, Susan Williams, and Thomas Hyde, and Kevorkian, as often stated would “never proceed without full consent of [his] client.”[7]

From the onset of his career as suicide assistant, Kevorkian faced several incidents in which he was charged with both murder and with the violation of assisted suicide laws, including three trials in which he was acquitted from homicide and an additional fourth trial which was declared a mistrial on technicality, all of which allowed Kevorkian to penetrate throught the legal system. It was not until his fifth trial, however, that Kevorkian was actually held accountable and, in turn, sentenced with ten to twenty-five years in prison on grounds of second-degree murder. The contrasting standards set in this trial emerged from Kevorkian’s controversial action in which Kevorkian himself made the lethal injection for Thomas Youk, an action differentiating from previous cases in which a more voluntary euthanasia occurred as Kevorkian permitted his client to carry out the final action.[8] Kevorkian was eventually parolled on December 13^th, 2006, as he was coming down with Hepatitus C.[9]

Dr. Kevorkian’s medical practices were based on his well-rooted beliefs in one’s “right to die.”[10] Accoring to Kevorkian, the role of a physician is to “help patients maintain or regain health and to avoid suffering” and, in addition, “to determine the legitimacy of the patient’s wants in regards to his or her medical needs.”[11] “If a physician,” accoring to Kevorkian, “determines that a patient’s want is legitimate, then the physician, resultantly, must determine at what point is his or her intervention necessary in accordance with his or her duty to help the patient maintain or regain health and…avoid suffering.”[12] Kevorkian thus determined the legitimacy of a client’s desire to commit suicide based on his or her conditions and state of mind, and, resultantly, refused  approval of his services for several of his clients on grounds of illegitimate desires for death. Kevorkian believed that an objective right has always existed, but has rarely been honored. This right, “the right to choose not to suffer….when it’s not necessary and cannot be remunerated” was the basis for Kevorkian’s pracitices of physician-assisted suicide.[13] These beliefs are mirrored in Kevorkian’s famous quote “Dying is not a crime” and were evident in the defense tactics of Kevorkian’s trials.[14]

It was this platform, centered around one’s right to choose not to suffer, that won Kevorkian much needed support and even gained him the title of “hero” by many. Initial support for Kevorkian’s actions undoubtably emerged from the public’s emotional sympathy towards several of his suffering clients as made evident by Kevorkian’s videotaped sessions with his dying patients. Aware of the depressed, traumatic, and worn-out states of both Kevorkian’s clients and their families, a vast majority of the observing public recognized the physician for “truly ending their suffering,” and thus deemed him a brave, compassionate person.[15] Serving as one of the stronger arguments for Kevorkian’s practices,  the idea of compassion in assisted suicide stems from the belief that a physician has the duty to “alleviate suffering,” a suffering that, like in many of Kevorkian’s cases, can lead to anguish, loss of dignity or control, fear, and most certainly, physical pain. Evidently, it was the sympathy of the general public towards Kevorkian’s clients that permitted them to view him as a “compassionate hero.”[16] It must be noted, however, that this sympathy may have also emerged from the public’s own expectancy of the same rights offered by physicians like Kevorkian in future times. Many who had previously witnessed harsh deaths or who could imagine potentially intolerable end-of-life situations for themselves welcomed the reassurance that Kevorkian’s assisted suicided offered, and therefore, pushed for the cause.[17] Additionally, Kevorkian received great support from the families and friends of his clients including people like Sarah Holmes who called him “the most honest person [one] will ever meet.”[18]  Still, in addition, several others attributed additional heroic qualities to Kevorkian, accrediting his willingness to go to jail for his beliefs, his readiness to challenge the law and healthcare professionals on trying issues, and his boldness that brought definate visibility to the entire end-of-life movement, calling Kevorkian “a pioneer for an unavoidable trend.”[19]

However, despite several accounts of positive support for the controversial physician, Kevorkian additionally received bitter criticism from several various social and religious institutions regarding his medical practices.

Relgious institutions such as the Roman Catholic Church articulated vast amounts of criticism condemning Kevorkian. Critical of Kevorkian’s abuse of every human’s “right to life,” the Roman Catholic Church deemed Kevorkian “a doctor who, under the guise of compassion, refused to work to restore health to the individual, but rather advocated death through assisted suicide.”[20] Countering Kevorkian’s theory of a physician’s duty to “alleviate suffering,” several Catholics stated in regards to this idea that “suffering not only has potential in aiding character development and maturity, but also is something that must be endured because no man is allowed by God to be afflicted with more than he can withstand, with God’s grace.”[21] Furthermore, Roman Catholics futhur criticized physician-assisted suicide reminding Christians that no doctor has any jurisdiction over the life of his patient, but instead, has the very obligation to aid his patient in regaining health.[22] Fundamentally, however, Roman Catholics based these principles off of the Fifth Commandment which forbids the destruction of life, be it one’s own or that of one’s neighbor. Pope John Paul II primarily summarized the Church’s view of Kevorkian stating that many have begun to “lose [their] sense of man, of his dignity and of his life,” and evidently, this is leading to a secularized “culture of death.”[23] This respect for all human life in any stage formed the basis for Roman Catholic criticism regarding Kevorkian.

In addition to the religious, catechism-based arguments of the Roman Catholic Church and other religious institutions, critcism from the secular end of the spectrum also surrounded this controversy as well. Called a “serial killer” or “murderer” by angry critics, several claimed that Kevorkian pressured his patients into accepting their own deaths, statements immediately rejected by Kevorkian himself. In addition, anti-euthanasia activists pushed claims that several of Kevorkian’s patients possessed curable diseases such as Multiple Sclerosis, a disease typically cited to show a course of exacerbation and remission, or no terminal disease at all, and, therefore, were not provided with sufficient oppurtunity for recovery during their lifetimes.[24] Furthermore, organizations like the American Medical Association lobbied for laws forbidding any form of physician-assisted suicide, arguing that “it could easily be abused to administer death to those who do not want it or have changed their minds.”[25] Kevorkian additionally was criticized for his lax, uncaring attitude and overall disrespect for the law and the delicate matters of human life.

While definate, well-shaped opinions emerged on both sides of the Kevorkian issue, a great majority of the public remained in a less defined area of opinion. Furthermore, several acquired opinions from both ends of the spectrum, arguing for an ideal health care system in which the patient would be provided excellent palliative care, committed clinical relationships throughout the dying process, and a predictable last resort choice for the really trying cases.[26] These people recognized that Kevorkian presented a stark choice between intolerable suffering and a physician-assisted death, a choice that potentially missed the promise of palliative care. However, they also recognized that many patients desire the reassurance of an escape if suffering got too severe in spite of this palliative care. This belief of an ideal, humane, health care system drew its opinions from both Kevorkian and his opponents.

While Kevorkian himself claims that he “will never do it [assisted suicide] again” in order to avoid prison time, this controversy leaves one curious about the way our culture will deal with this seemingly “unavoidable trend.”[27]