The Magazine

Dr. Death Rides Again

Jack Kevorkian's movement has done better -without him.

Jun 4, 2007, Vol. 12, No. 36 • By RITA L. MARKER and WESLEY J. SMITH
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What do cicadas have in common with Jack Kevorkian? They share a cacophonous anniversary. In June, after 17 years, cicadas are expected to crawl from underground across the Midwest. These grim insects produce such a din that just one can overpower other sounds. Also in June, exactly 17 years after he first made international headlines for assisting the suicide of 54-year-old Janet Adkins, Jack Kevorkian is scheduled to emerge from prison. Already, his release has become a media circus, likely soon to produce a din of its own.

Kevorkian's release may actually be bad news for assisted-suicide advocacy. Since his imprisonment for the 1998 murder of Thomas Youk, advocates for assisted-suicide legalization have strived mightily to put a benign, professional veneer on the hard business of authorizing doctors to intentionally participate in the termination of their patients' lives. With Kevorkian in prison, his gaunt visage was no longer the public face of the movement. Today's activists are far more likely to be impeccably dressed, upper middle class women who spout focus-group-vetted sound bites. (Hence the effort by the former Hemlock Society--renamed Compassion & Choices--to convince the media to drop the descriptive term "assisted suicide" for the pabulum phrase "aid in dying.")

Contemporary advocates also have worked hard to make assisted suicide appear bland. The so-called "medical model" permitted by Oregon's Death with Dignity law has been ubiquitously touted in recent years by assisted-suicide promoters as an approach to mercy killing that can avoid a Kevorkian-style slippery slope. Legalization bills have been repeatedly filed in Hawaii, Vermont (where legislators killed them), and California, which is in the midst of its fourth political battle in eight years over assisted-suicide legalization.

But with Kevorkian soon to appear on 60 Minutes and in other high-profile media venues, the assisted-suicide movement will find it much harder to conceal the many similarities between Dr. Death's approach during the 1990s and the legalized Kevorkianism being carried out in Oregon today.

Take, for example, one of the primary "protective" guidelines or safeguards for permitting death-doctoring in Oregon. In 1990, when Kevorkian began conducting post-mortem press conferences, he assured the nation his "patients" had to be terminally ill, and his attorney maintained that Kevorkian required proof of a terminal condition. As the body count mounted, the press maintained the myth. Even today, Kevorkian is often described as the doctor who assisted the suicides of the terminally ill.

Because assisted suicide is illegal in Michigan, however, authorities couldn't take Kevorkian's word for it, and had autopsies performed revealing that more than half of Kevorkian's 130 known victims were not terminally ill. Most were disabled with conditions such as multiple sclerosis. In fact, several had no serious physical illnesses that could be determined upon autopsy.

Under Oregon's assisted-suicide law, to qualify for assisted suicide, a patient is supposed to have a terminal condition, defined as a life expectancy of six months or less. As of the last official report, there have been 292 reported deaths under the law that transformed the crime of assisted suicide into a medical treatment. And how many of those who died actually had a terminal condition? Nobody knows. Oregon does not require autopsies of people who die there by legalized assisted suicide, so we don't know their actual underlying conditions.

Yet the words of one Oregon physician who regularly assists suicides indicate a cavalier attitude towards the law. Dr. Peter Rasmussen, an advisory board member of the Oregon chapter of Compassion & Choices, acknowledges his involvement in deaths numbering in the double digits. He said that predicting life expectancy is rife with inaccuracy but dismissed that as unimportant. He explained,

[W]e can easily be 100 percent off, but I do not think that is a problem. If we say a patient has six months to live and we are off by 100 percent and it is really three months or even twelve months, I do not think the patient is harmed in any way.

Being far off the mark in predicting life expectancy certainly occurred in the case of cancer patient Michael Freeland, who was provided with a prescription for assisted suicide nearly two years before he died naturally. This apparent abuse was not reported by the state but in an article in the American Journal of Psychiatry. Perhaps the state's failure is due to the fact, as Dr. Katrina Hedberg and others responsible for issuing Oregon's official reports have acknowledged, that the assisted-suicide law does not authorize investigations into how physicians determine their patients' prognoses.