Jack Kevorkian has become the most well-known advocate in the United States for the cause of physician-assisted suicide. Having helped over thirty terminally or chronically ill individuals kill themselves since 1990, Kevorkian has sparked a national debate on the ethical issues involved in euthanasia, often called mercy killing. Though Kevorkian has argued that his actions have prevented needless suffering for patients in pain and allowed them to die with dignity, others see his work as a violation of the medical profession's most cherished ethical principles affirming life over death. Working in an area of vexing ethical issues, Kevorkian has championed himself as a breaker of unnecessary taboos surrounding death.
Kevorkian became a focus of national attention in 1990 after he assisted the suicide of Janet Adkins, a fifty-four-year-old woman suffering from Alzheimer's disease, a degenerative disease of the brain that causes loss of memory and intellectual impairment. Adkins had heard through the media about Kevorkian's invention of a suicide machine that allowed individuals who were ill to administer a lethal dose of poison to themselves. The machine, which Kevorkian assembled out of $45 worth of materials, consisted of three dripping bottles that delivered successive doses of three fluids: a harmless saline solution; a painkiller; and, finally, a poison, potassium chloride. When Adkins contacted Kevorkian about using the machine on her, Kevorkian agreed. Kevorkian diagnosed Adkins as suffering from Alzheimer's and arranged to perform the assisted suicide in a public park, in his rusting 1968 Volkswagen van. After Kevorkian had inserted an intravenous needle into her arm, Adkins pressed a red button that caused the machine to administer the painkiller and then the poison. Within five minutes, Adkins had died of heart failure. Within days, Kevorkian had become a national media celebrity, appearing on such television shows as Nightline, Geraldo, and Good Morning, America.
This first of his assisted suicides illustrated the problems many observers have with Kevorkian's methods. Though she had begun to show early signs of Alzheimer's, Adkins was in good health and was not terminally ill; she committed suicide more out of fear of future suffering than out of current suffering. She had joined the Hemlock Society—an organization that advocates voluntary euthanasia for terminally ill patients—before she even became ill. In addition, Adkins's Alzheimer's may have impaired her ability to make decisions. Some observers wondered if she was also suffering from depression, a treatable mental illness. Moreover, in cases in which a terminally ill patient has expressed a desire to die, established rules of medical ethics require that two independent doctors must confirm that the patient's condition is unbearable and irreversible; Kevorkian had ignored this requirement.
Kevorkian was charged with first-degree murder in this case, but a district judge ruled that prosecutors failed to show that Kevorkian had planned and carried out Adkins's death. Attempts to prosecute Kevorkian were hampered by Michigan's lack of any law against physician-assisted suicide. Most other states have laws making this act a felony.
In early 1991, a Michigan judge issued an injunction barring Kevorkian's use of the suicide machine, and in the same year, the state of Michigan suspended his medical license. Kevorkian defied such legal actions and continued to help ailing people end their life. Now that he could no longer prescribe drugs, Kevorkian assisted suicides with a contraption that administered carbon monoxide through a gas mask. As he practiced assisted suicide and published on the subject—describing it in his own terms as "medicide" or "planned death"— he continued to be surrounded by controversy. For example, an autopsy performed on the body of the second person he helped to commit suicide, a patient who had complained of a painful pelvic disease, found no evidence of any disease.
In 1992, the Michigan Legislature passed a bill outlawing assisted suicide, designed specifically to stop Kevorkian's activities (Mich. Comp. Laws §752.1021). This law was used to charge Kevorkian for assisting in the death of Thomas W. Hyde, Jr., in August 1993. Kevorkian was jailed twice that year, in November and December. During his second jail stay, he went on an eighteen-day fast in which he protested his arrest by drinking only juice. His bail was reduced and was paid by Geoffrey Fieger, a flamboyant lawyer who has done a great deal for Kevorkian's cause as his friend and legal counsel. Kevorkian was found not guilty.
Kevorkian then attempted to place before Michigan voters a ballot initiative, Movement Ensuring the Right to Choose for Yourself (Mercy), which sought to amend the Michigan Constitution to guarantee competent adults the right to request and receive medical assistance in taking their own life. However, he failed to garner enough signatures to put the initiative on the 1994 ballot. In December 1994, the Michigan Supreme Court upheld the law making assisted suicide a crime, and the following year, the U.S. Supreme Court refused to hear Kevorkian's appeal.
Kevorkian continued to assist suicides even as prosecutors in his home county unsuccessfully attempted to convict him on charges of murder or assisted suicide. On May 14, 1996, an Oakland County Circuit Court jury again acquitted Kevorkian of assisted suicide. In this case, the prosecution had argued that assisted suicide was a crime under Michigan common law. After their loss, county prosecutors admitted it was unlikely that they would take Kevorkian to trial again.
In both his actions and his statements, Kevorkian has flouted the ethical standards of the medical profession on the issue of assisted suicide. The American Medical Association, the professional association of physicians, specifically forbids the practice of physician-assisted suicide. Many doctors deplore Kevorkian's techniques and see them as endangering the trust that must exist between physician and patient. Even the Hemlock Society opposes Kevorkian's actions, citing his lack of typical procedural precautions.
Kevorkian's efforts in the cause of assisted suicide are only the latest in a series of his unconventional, even morbid, attempts to make a name for himself in the area of medical research. Kevorkian earned the nickname Dr. Death in 1956, only three years after obtaining his medical degree, when he began making what he called death rounds at the Detroit-area hospital where he was employed. During these rounds, he examined dead bodies in order to collect evidence supporting his contention that the time of a person's death could be determined from the condition of the person's eyes. Kevorkian caused more controversy—and lost his job at the University of Michigan—in 1960 when he published the book Medical Research and the Death Penalty, in which he argued for the vivisection (the conduct of medical experiments on live subjects) of prisoners sentenced to death. Claiming it would be "a unique privilege … to be able to experiment on a doomed human being," he outlined a plan in which the prisoner-subject would be anesthetized at the time of execution, then used for scientific experiments lasting hours or months, and finally executed using a lethal overdose. According to Kevorkian, this would create both a more painless execution and greater advances in medical research. The use of condemned prisoners for medical experimentation and organ donation has remained a consistent theme for Kevorkian. His 1991 book Prescription: Medicide: The Goodness of Planned Death rehashes these same arguments while also making a case for assisted suicide. In another unsuccessful venture, Kevorkian re-created experiments conducted by Soviet scientists by taking blood from recently deceased individuals and transfusing it to live patients.
In a later article setting forth his plans for assisted suicide, Kevorkian suggested setting up suicide clinics: "The acceptance of planned death implies the establishment of well-staffed and well-organized medical clinics (‘obitoria') where terminally ill patients can opt for death under controlled circumstances of compassion and decorum." As his use of obitoria and medicide indicate, Kevorkian has a penchant for coining words. He dubbed his first suicide machine alternately a mercitron or a thanatron—the latter from the Greek word for death, thanatos—and has used the word obitiatry to indicate the medical specialization in death.
Kevorkian was born May 26, 1928, in Pontiac, Michigan. Named Murad Kevorkian at birth by his Armenian immigrant parents, he was the first of his family to attend college. He attended the University of Michigan Medical School and did his internship at Detroit-area hospitals. Acquaintances of Kevorkian testify to his prodigious intellect. The retired physician has demonstrated talent as a writer, painter, and composer. A series of eighteen paintings he did on such grisly topics as genocide, hanging, and cannibalism created a stir in Michigan during the 1960s. Kevorkian has also commented that his unconventional ideas have been influenced by the history of his Armenian ancestors, particularly a genocide in which 1.5 million Armenians were killed in World War I by the Turks. Kevorkian has never married.
Though many deplore Kevorkian's actions, he has increased public awareness of some of the most difficult ethical issues surrounding death and dying. With medical technology's increasing ability to prolong life have come more situations in which the extended life is one of great pain and suffering. Kevorkian's efforts to assist people in their death, though often falling short of accepted professional standards of diagnosis and care, have sparked a needed discussion on these issues.
