Time - Man of the Year/Time_Man_of_the_Year_Compact_Publishing_3YX-Disc-1_Compact_Publishing_1993.iso/moy/122892/1228620.000

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                                                                                ETHICS, Page 36

Mercy's Friend or Foe?


As Dr. Kevorkian takes on the state of Michigan over physician-
assisted suicide, he may be undermining his own crusade

By NANCY GIBBS -- With reporting by Andrea Sachs/New York


    Dr. Jack Kevorkian has spent much of his medical life
searching for ways to make better use of human bodies,
especially dead ones. Thirty years ago, as a young pathologist
in Pontiac, Michigan, he became the first doctor to transfuse
blood directly from a corpse into a live patient. He marveled
at the possible uses -- on battlefields, for instance, or during
a natural disaster -- and lamented the fact that public distaste
for the procedure would probably preclude its clinical
acceptance.

    Over time he turned his attention to patients who were
soon to be dead, looking to salvage whatever he could. The
execution of condemned murderers seemed an extravagant waste,
since controversial drugs and surgical techniques could be
tested on criminal volunteers. The prisoner's brain provided a
unique opportunity to study a criminal mind -- "an intact,
living" brain, he emphasized. Further, from each prisoner might
be harvested enough organs to save half a dozen lives. He has
proposed an auction market in which rich people would bid for
organs, and the money could be used to provide them to the poor
for free.

    Before long he found that his pathological interests
precluded his being hired by any hospital. His ostracism,
however, did leave him more time to rummage around flea markets,
looking for old toys with small gears that he could use to build
his inventions. His first "Mercitron," a precursor to the
carbon-monoxide delivery contraption he provided to two more
suicidal women last week, now sits in his lawyer's office. "He's
very skilled in mechanical engineering," says Geoffrey Fieger.
"He's very talented, in everything he builds."

    Forced retirement also left him more time for painting, a
hobby he has enjoyed for many years. His artistic tastes run to
the surreal; one painting is called Nausea. Another, Coma. A
third, an allegorical study of genocide, is set in a frame that,
by various accounts, was either painted red to look like blood
or painted in actual human blood that Kevorkian salvaged from
outdated samples at the local blood bank, and from his own arm.

    Kevorkian has become the kind of fanatic who could prompt
people who share his views to change their minds. Two out of
three Americans say they think doctors should be allowed to help
desperately sick patients commit suicide, a cause for which
Kevorkian has become the most celebrated champion. But as he
appears on television after each new death, invoking a higher
moral authority and ignoring court orders and judges'
instructions, Kevorkian begins to embody all the warnings about
how euthanasia, once unleashed, could get out of hand. "It's
almost become obligatory for people who write or speak about the
subject to distance themselves from Kevorkian," says Professor
Yale Kamisar at the University of Michigan law school, who has
followed the doctor's career for years. "They say, `I'm not in
favor of what Kevorkian is doing, but . . .' "

    For one thing, Kevorkian has made clear his intention to
work outside the law. When a Michigan judge dismissed murder
charges against him but advised him against continuing his
crusade, Kevorkian replied that he would never shirk his
"medical duty. If my colleagues won't work with me, I will work
alone." In 1988 Kevorkian suggested to founder Derek Humphry
that the Hemlock Society, which supports euthanasia for the
terminally ill, join forces with him and set up a suicide
center. Humphry's response was "We're not lawbreakers, we're law
reformers." But he recalls that Kevorkian insisted that such a
center would get them publicity. "There are many people in the
Hemlock Society who admire him," says Humphry. "My reservations
are that he never talks about changing the law, and doctors
won't follow him until the law is changed."

    Even passionate supporters of euthanasia argue that there
must always be safeguards -- second opinions from disinterested
doctors, psychological evaluations, family consultations --
before any decision is made. Though Kevorkian is adamant about
the precautions he takes, his enthusiasm for testing new
techniques and promoting his cause has naturally raised concerns
about his neutrality in counseling potential clients. A
pathologist by training, he is not in the best position to make
a judgment about patients when they are still alive.

    The law rushed to Governor John Engler's desk last week,
which would temporarily ban physician-assisted suicide until a
commission can make a recommendation, is aimed directly at
Kevorkian. But the doctor says it makes no difference to him if
Michigan's elected representatives turn him into an outlaw. "He
has told me that even if this does become a law, he would
violate it," says Fieger. The problem is that once zealots claim
the right to choose which laws they'll obey, all the underlying
trust that permits professionals, and especially doctors, to
function disappears.

    Then there is the discomfiting pattern that, though men
are three times as likely as women to commit suicide, so far
all of Dr. Kevorkian's suicide patients have been female. It's
not that he has any special fondness for watching women die,
but rather, he has explained, because "women are just far more
realistic about facing death and have got the guts to do it."
Kevorkian considers his treatment a form of toughlove. He
recalls his first client, Janet Adkins, a vibrant 54-year-old
just diagnosed with Alzheimer's who sought out Kevorkian because
she was terrified of what the disease would do to her. "I loved
that woman," he told the Washington Post. "And what I had to do
was tough."

    That doesn't satisfy his critics particularly. "He's more
like a serial killer than a physician," says Professor George
Annas of Boston University's school of medicine. There is
already some evidence that Kevorkian's relentless grandstanding
is raising alarms among euthanasia supporters. Last year the
State of Washington debated Initiative 119, which would have
allowed physician-assisted suicide. In early October the measure
was heavily favored. Two weeks later, Kevorkian helped his
second and third clients, both chronically but not terminally
ill, to kill themselves. The ammunition he provided euthanasia
opponents may well have helped defeat the measure in November.

    It is unlikely that lawmakers in Michigan would have acted
had Kevorkian not forced their hand. When his sixth client, a
45-year-old cancer patient, came to Michigan to consult with him
and killed herself on Nov. 23, the bill that had stalled swiftly
sailed through the legislature in less than 10 days, on
overwhelming votes in both the upper and lower chambers. "It's
just the outright assisting in a killing that this bill will
prohibit," says representative Joseph Palamara, a Democratic
state legislator from Wyandotte. "It doesn't affect whatsoever
doctors who withhold or withdraw food."

    In fact the law will indeed affect other doctors, because
Kevorkian's crusade has in some way touched them all. In recent
years the leaders of the hospice movement, specialists in pain
management and depression, have been transforming the dying
process, much as the natural-childbirth movement did to
childbearing over the past generation. In a sense they are
racing against the radicals. Once they can offer a more gentle
and dignified alternative to either a life ground down by pain
or a death in a high-tech hell, the demand for Dr. Kevorkian's
service will disappear.