assisted suicide

Who Decides Death? Looking At Assisted Suicide, Post-Kevorkian

Photo courtesy of RecordRat via Flickr, modified by Curiousmatic.

25 years ago, Dr. Jacob “Jack” Kevorkian performed his first assisted suicide — the first of 130 euthanizations of the terminally ill, which briefly landed him in prison.

Kevorkian’s story and the ongoing controversy of assisted suicide all comes down to variations of a singular question: Who decides death? Is it nature, or God? Your doctor, or yourself?

Dr. Kevorkian, sometimes called “Dr. Death” for his polarizing medical opinions on euthanasia, is known for tackling these questions; nay, placing them in literal death machines for answers. In his opinion, physicians have the responsibility to assist their patients in death as well as life.

According to the Guardian, esteemed physicist Stephen Hawking agrees with Kevorkian’s ideas:

“To keep someone alive against their wishes is the ultimate indignity,” Hawking, 73, told his interviewer, the comedian Dara O’Briain. “I would consider assisted suicide only if I were in great pain or felt I had nothing more to contribute but was just a burden to those around me.”

Four years past Kevorkian’s own death, clearly, the subject bears further exploration. Here’s a look at the history of assisted suicide, and where we are today on it.

Assisted suicide: What it is

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By definition, assisted suicide is a suicide performed with the aid of another person, typically with the help and guidance of a physician.

Also known as physician-assisted dying, the practice is illegal in most countries and U.S. states, but remains the subject of legal and ethical debate. It’s related to, but not to be confused with euthanasia; through assisted suicides, patients end their own lives, as opposed to death at the doctor’s hand for patients too immobile to do so.

In all cases, its aim is to end life in order to relieve suffering — present or future.

The Kevorkian story

Dr. Kevorkian is perhaps the most famous figure associated with assisted suicide. A Michigan-born Armenian-American pathologist (as well as an oil painter and jazz musician), Kevorkian developed unique ideas about death early in his career.

These included transfusing the blood of the dead to help the living, advocating for prisoners to choose their fates, and eventually, “death counselling” and assisted suicide for those suffering.

Kevorkian performed his first assisted suicide on June 4, 1990 for Janet Adkins, a woman with Alzheimer’s disease. Subsequent charges of murder were dropped, there being no laws related to assisted suicide in Michigan at the time, but in 1991 his medical license was revoked.

In spite of this, between 1990 and 1998 Kevorkian assisted 130 people in their deaths, through two machines of his own making and naming: the Thanatron (“death machine)” and the Mercitron (“mercy machine”), which patients would trigger themselves.

Kevorkian was, eventually, found guilty of first-degree murder by a Michigan jury in 1999, and served just eight of his 10-25 year sentence. He was released on the condition he never perform an assisted suicide again.

Perception

Kevorkian has been viewed as both monster and hero, as both reckless murderer and champion of rights. In the HBO drama You Don’t Know Jack, Kevorkian was depicted by Al Pacino, who attempted to portray him as “brilliant and interesting and unique.”

But there are many, still, who have called his methods both fanatical and fatally irresponsible. An investigation by the Detroit Free Press attested that, contrary to Kevorkian’s claims and guidelines, 60 percent of his patients weren’t terminally ill, at least 13 reported no pain, among other failures in terms of counseling and alternatives.

Exactly what the truth was may not be clear, but by most accounts his intentions were crystal: to respect patient autonomy, and to fulfill a doctor’s duty to end suffering, even if it meant ending life.

Today and beyond

Internationally, assisted suicide is legal in the Netherlands, Switzerland, and Luxembourg; nationally, in Oregon, Washington, and Vermont and New Mexico. Laws vary, but typically are limited to terminally ill, mentally competent patients.

Kevorkian is credited with not only bringing national attention to assisted suicide and dying with dignity, for better or worse, but with lifting taboos on the legalities surround death and disease and better prioritizing end-of-life care.

Kevorkian died at age 83 on June 3, 2011 — a day shy of 21 years since he assisted his first patient, Ms. Adkins, in death.

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Jennifer Markert