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BMJ hails Kevorkian

Jack Kevorkian, the renegade doctor who has assisted in countless suicides has been hailed "a medical hero" by the prestigious and usually conservative British Medical Journal. They quote the Oxford English Dictionary (2nd edition):

The hero "is a man of action rather than thought and lives by a personal code of honour that admits of no qualification. His responses are usually instinctive, predictable and inevitable. He accepts challenge and sometimes even courts disaster."

Whilst the British Medical Association has always expressed condemnation of assisted suicide, the BMJ occasionally differs: on this occasion they have shown a rare stroke of liberalism. They point out that no one has demonstrated any discernible motive from him except that he believes his work is right. Greed for money is absent because he has charged no fees. Greed for fame, too, seems unlikely because he has shunned the media except to explain his position. And no one has accused him of sadism in ending the lives and, according to him, the suffering of his patients.

Kevorkian began his right-to-die crusade in Michigan in June 1990 when he helped Oregon resident Janet Adkins end her life in the back of his battered, 1968 Volkswagen van with his lethal injection machine, the "mercitron" (formerly called the "thanatron").

There have been many critics of Kevorkian, not least by right-to-die activists who have seen him as "rocking the boat" or expressed concern at apparent lack of safeguards. But these are words from people who talk - Kevorkian acts. He has acted to end what he perceived as suffering and then turned to the law and said, "I dare you to stop me." And he seems to have won his dare. In the name of the people of the state of Michigan, prosecutors sought to jail him six times, and the juries that represent the people of Michigan six times said "No."

Kevorkian has lived "by a personal code of honour that admits of no qualification." His actions have been "instinctive, predictable, and inevitable." He has accepted challenge and even courted disaster.

"Consider how rare such heroism is in medicine." says the BMJ. "Conservatism is usually a noble path, especially when we consider the harm that we can do. Secrecy, too, is usually a virtue that protects the vulnerable patient. But doctors see injustice every day from patients suffering pain unnecessarily to those who cannot afford doctors' care to those who are sick due solely to the ills of society."

The BMJ puts him in a long line of heroes who have been reviled in their time. To be a hero, it says, means being honest with yourself and acting on your own morality, risking the fall from the pinnacle on which society has placed doctors. "We need the hero to make us uncomfortable... Medicine needs heroes today."

Years before he reached national prominence around 1990, Kevorkian was known in medical ethics circles for his curious beliefs regarding death and dying.

In a 1960 book he published "Medical Research andthe Death Penalty," in which he posed arguments in supportof medical experiments using prisoners condemned to death. The prisoners could be rendered unconscious, hesuggested, and could be experimented on for weeks beforetheir execution, permitting research not otherwise possible. Kevorkian had widespread support from prisoners on death row, many of whom saw his plans as a way to leave some lasting good after a life of crime. Kevorkian remains fairly neutral on the morality of capital punishment, but has written at length exposing the inhumanity of many methods of execution.

In 1961 Time magazine ran an article on his proposal toexsanguinate dead bodies and use the blood intransfusions. Critics say such proposals show that Kevorkian is obsessed with death. Kevorkian was in fact firstnicknamed "Dr. Death" as a medical school student at the University of Michigan in the early 1950s after he reportedly roamed hospital corridors, seeking dying patients so he could be present at the moment of death.

More recently, some of his critics have taken to calling him"Mr. Death," since his licenses to practice medicine in Michigan and California have been revoked. But Dr Kevorkian maintains that making the dead useful forthe living, not death itself, informs his work. Hiscause, he said, prompted him to send letters todeath-row inmates, encouraging them to donate their organs, if the method of execution permitted.

Kevorkian has called for a new medical subspecialty for assisted death ("obitiatry") and a chain of suicideclinics ("obitoria"). He has also proposed ideas that have repelled even some of the most fervent supporters of the assisted suicide movement. He wantedto exhibit paintings by Hitler, later explaining that theshow would have included works by Churchill andEisenhower as well and that the idea would be that viewers would try to tell who painted which.

Kevorkian is an accomplished painter and musician himself. His own dark paintings evoke the nightmarish masterpieces of Hieronymous Bosch, and his private musical concerts in Michigan are well received.

In February, he struck back at his critics by filing a lawsuit for $10 million against the American Medical Association for calling him a "killer". He plans to use any damages he might receive from the lawsuit to help fund his "Mercy Clinic." Kevorkian wants to set up the clinic as a place where sick people could come to die with a physician's assistance.

On May 14th Kevorkian was acquitted yet again on charges of assisting suicides. Even opponents conceded this time that he is unlikely to be charged again. The Oakland County Circuit Court jury acquitted him again, accepting his argument that he intended to relieve pain and suffering, not cause death (The same defence also won him acquittals last March, and in 1994.)

Just before the Oakland jury announced its verdict, Kevorkian, a retired pathologist, said over lunch in the courthouse cafeteria that he was beginning to fear he would be convicted. Moments later, his meal was interrupted by news of the verdict. "What this proves is that while this may be a sin to you," Kevorkian said to reporters minutes later, "one thing is clear: For any enlightened human being, this can never be a crime."

Lawrence Bunting, the chief assistant prosecutor who argued the case, would not say whether his office would again charge Kevorkian, who had assisted in Canadian campaigner Austin Bastable's suicide by slipping away between sessions on the witness stand.

For several years, 53-year old Ontario resident Austin Bastable, a tool-and-die maker crippled by multiple sclerosis, had fought unsuccessfully to change Canadian law to permit a doctor to help him die. Soon after the Michigan court recessed for the night, Bastable, who by this time could move only his head and part of his left arm, was driven across the Detroit River to the suburban home of Janet Good (herself a right-to-die activist who is dying of pancraetic cancer.) In a small room off the garage, Kevorkian, with Austin's wife, Nina, a tank of carbon monoxide gas and five sympathetic physicians at his side, granted Austin Bastable's last wish.

A friend of Kevorkian's provided a death certificate, and a funeral director from Windsor, just across the border in Canada, retrieved the body. Cause of death was listed as "patholysis" -- a term invented by Kevorkian for medically-assisted suicide.

"I owe my release from suffering to two people," Bastable said on a videotape in Toronto. "To Dr. Jack Kevorkian, who is one of the most courageous but misunderstood physicians in America, and to John Hofsess of the Right to Die Society of Canada. Together they gave me hope, and a practical plan for action."

Michael Modelski, a former Oakland County assistant prosecutor who is a Kevorkian foe, thought that this would probably be the last time Kevorkian would be tried for assisting in a suicide. Prosecutors have not filed charges against him in any of the last eight suicides he has attended; this was the last outstanding legal proceeding against him. Legal experts, including Oakland County's just-defeated prosecutor, Richard Thompson, said the U.S. Supreme Court will ultimately have to decide whether there is a constitutional right to assisted suicide.

All jurors said they were moved by the videotapes made by two women assisted by Kevorkian, in which they talked of their misery, and begged to be allowed to die. None said they thought the fact that the women were not terminally ill was an issue.

Kevorkian, who turned 68 last May 19th, declined to attend a victory dinner, saying, with a grin, "It's my poker night."

Report compiled by Chris Docker