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People v. Kevorkian: The Right to Die in the Public Eye
<i> Tom? Tom, are you ready to go through with this? (…Yes…) Shake your head yes if you’re ready to go through with this… </i>
Thomas moved slightly in his wheelchair, shaking his head.
Thomas Youk was a former Air Force sergeant who went to college in 1974 and received his accounting degree. He got married to his wife Melody later that decade, and she would stay with him until the end. He began to restore old cars, and loved it so much; he started a business selling vintage cars. Around age 50 he tried amateur racing, and became the Ohio Valley Champion.
Then he received the diagnosis. The doctors told him that he had Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig’s Disease), an incurable disease, which progressed over time until all voluntary motor function ceased.
His prognosis was grim. He had three to five years to live, and these final years of his life would be spent suffering. After a few months, his only moveable joints were his first two fingers and his thumb, and speaking took most of his energy. Shortly after, he lost the ability to feed himself, and had a feeding tube put into his stomach. His breathing slowed greatly; his lung function decreased over 25 percent. Thomas didn’t want to be hooked up to machines the rest of his life.
Tom asked his family to call Dr. Kevorkian.
<i> Shake your head yes if you want to go…Alright. </i>
Jack Kevorkian was born on May 26th, 1928 in Michigan to Armenian refugees Levon and Satenig Kevorkian. After high school, Jack enrolled in civil engineering school at the University of Michigan in Ann Arbor. While the other freshman enjoyed the social life, and partied often, Jack made the library his second home. However, his dedication was futile; he made straight As while he was in high school, but here, he was only in the middle of his classes. He enjoyed university, especially the foreign language classes, soaking up Japanese, German, and Armenian easily. When an instructor informed him that medical school only took 90 course hours, and in his three semesters he had already racked up 57, he set his sights on becoming a doctor, and began excelling in his science related courses.
He was advised to wait at least another year before applying to medical school, due to the fact that there were almost 2,000 applicants for 150 positions, and Jack still had 33 credits to complete before he met their admission requirements. However, they were impressed with his grades, and set up an admission interview.
During the interview, the interviewer was concerned that he might drop out of medical school like he had engineering, or that Jack would find the course loads overwhelming. Jack replied, “You might think I’m cocky for saying this, but the reason seems obvious to me. I’m one of the smartest guys you’ll ever see walk through your door, but I’m not doing this because of my ego. I’m doing this because medicine needs me. You let me get into medical school, and I’ll prove it’s the best decision you’ve ever made.”
His acceptance letter came a few months later.
During his stint at medical school, he became enthralled with his pathology course. That was it for Jack; he would choose pathology as his specialty. He applied for his internship at the Henry Ford Hospital in Detroit.
It was at this hospital where he first thought about Physician Assisted Suicide. As he wrote in his book, Prescription: Medicide:
“Euthanasia wasn’t of much interest to me until my internship year, when I saw first-hand how cancer can ravage the human body. The patient was a helplessly immobile woman of middle age, her entire body jaundiced to an intense yellow-brown, skin stretched paper-thin over a fluid-filled abdomen swollen to four or five times normal size. The rest of her was an emancipated skeleton… The poor wretch stared up at me with yellow eyeballs sunken in their atrophic (withering) sockets… It seemed as though she was pleading for help and death at the same time. Out of sheer empathy alone I could have helped her die with satisfaction. From that moment on, I was sure that doctor-assisted euthanasia and suicide are and always were ethical, no matter what anyone says or thinks.”
It would be almost 40 years later before he would help assist Janet Adkins to die.
<i> I’m going to have you sign your name again and we’re going to date it today, ok? </i>
Jack Kevorkian was by no means the first to advocate Aid in Dying, nor was he the first one to practice it. In America, the first attempt to legalize the individual’s right to end their life with assistance failed in the Ohio legislature in 1906. The issue went quietly for a while until 1938, when the Euthanasia Society of America was founded, however, the group was ahead of its time, and changed its focus towards the right to refuse medical treatment.
The movement again was slow, again, until the 1970s when the In re Quinlan (1976) was decided. Karen Quinlan overdosed on drugs and alcohol when she was 21, and as a consequence, one day she passed out at a party. After she stopped breathing several times for more than 15 minutes, paramedics finally arrived and took Karen to the hospital. Sadly, however, they found Karen to be in a vegetative state that she didn’t come out of. She was kept alive on a ventilator for several months hoping for some improvement, but when it didn’t come, her parents asked to have her taken off life support. The hospital refused to do so, and this resulted in a legal battle that eventually sided with the parents. (Although she was taken off her ventilator in 1976, she continued to live for over 10 years before dying of pneumonia.) The significance as recognized by the advocacy group Compassion and Choices:
“…the Court for the first time recognized that a patient (or in this case a family member) and not a paternalistic medical profession, was in the best position to make decisions as to the type of medical care and treatment that was appropriate, even if such decision included the withholding or withdrawal of life sustaining equipment.”
A similar dilemma was faced much later in 2000, when Michael Schiavo wanted to withhold nutrition from his wife Terri, who was in a vegetative state after a car accident in the early ‘90s. After countless treatments, including experimental thalamic stimulator implants, her condition did not improve. When Michael asked for nutrition to be withheld, Terri’s parents took the matter to court. (Nutrition, or food and water, is now considered a “medical treatment” due to the minor procedures that physicians have to take when they insert a feeding tube in through the nose or the stomach.) Terri’s parents argued that Terri, who was somewhat responsive, was able to recognize people she knew and that withholding nutrition from her is much different than withholding it from a “typical” patient in a vegetative state, who normally wouldn’t be as “responsive” as Terri was.
This case, which received national media coverage, sparked many Right to Life organizations to organize protests against taking Terri off life support. The US Congress also intervened, passing a bill in which George Bush flew up from Texas at 1:00 AM to sign. Jeb Bush, then governor of Florida, offered asylum. However, this entire public outcry was in vain, as Michael was allowed to have his wife’s nutrition stopped.
Terri Schiavo passed away on March 31st, 2005.
Terri’s case may have been shocking, or a wake up call to many Americans, but the practice of withholding nutrition is commonplace in many countries, including America.
<i> …And we’re ready to inject, we’re going to inject you in your right arm… </i>
In 1980, Derek Humphry founded the Hemlock Society, a right-to-die organization that advocated Physician Aid-In-Dying, or Physician Assisted Suicide as it is sometimes called, and published several books that gave guidance on effective ways to take one’s life. Humphry says:
“The right to choose to die when terminally or hopelessly ill is to me the ultimate civil and personal liberty. People are not a free people unless they are able die according to, and at the time of, their selection…
You may ask: why don’t people just kill themselves if that’s what they want? Answer: Here we are not talking about mentally ill people whose agonies drive them to seek death by gun or jumping; we are referring to dying or hopelessly ill people whose bodies are by now decimated and their strength and mobility limited. Anyway, they do not want a violent death -- they wish it to be gentle and most likely in the presence of their loved ones.”
The Hemlock Society existed for many years until it was merged with another right-to-die organization, Compassion in Dying, and became Compassion and Choices. Humphry, and other members and directors of the now former Hemlock Society were dissatisfied with the merger. Up until the merger, a minority of the Society was disillusioned with the name, the Hemlock Society, which was a reference to either a conifer tree or a waterweed, both of which were used in Greek and Roman times to commit suicide. Socrates in 329 BC chose to end his life this way; as Derek Humphry puts it, “…his death was a noble and self-chosen one…”
The “Hemlock” however was not seen this way; it was seen as a tad macabre to some, and as a staffer of the Society wrote:
“We [also] need access to the halls of government in the states and in Washington DC – access that the name Hemlock is currently denying us. The name Hemlock has a history of earnest defiance but much of it is also baggage, baggage that we can no longer afford to have weighing us down or interfering with our being able to partner with such important and powerful organizations as AARP”.
It was for this reason that the Hemlock Society ceased to exist. Compassion and Choices still exists today, although without the guidance of its predecessor’s founder Derek Humphry. Humphry along with others formed their own groups, his being the Euthanasia Research and Guidance Organization.
<i> Okay? Okey-doke [sic]. Sleepy, Tom? </i>
It was while the Hemlock Society was still in existence, however, that Dr. Jack Kevorkian began his own quest to legalize Doctor Assisted Suicide and Euthanasia.
In 1986, Jack was continuing his pet project that he had began when he was a resident, which was medical experimentation on death row inmates. These healthy inmates’ lives, he believed, were being wasted and not used to their full potential. Although he is against the death penalty, he felt that if it had to be continued, the inmates could at least be used for medical research before they were to die. With consent, the inmates would be put under anesthesia while at the prison, and then transferred to a research facility, and when the body has been used, they are given an overdose of anesthesia, which will end their life. (A large majority of inmates loved this idea; they felt that if their body would be used for the benefit of society, they themselves would finally be doing something good in their lives.) He wanted to understand how doctors conducted euthanasia, so he traveled to the Netherlands to observe and learn from physicians that had been doing such a thing since the 1970s.
While Jack was in the Netherlands, he gave up on his idea for the death row inmates, instead opting for a “much more significant cause, and one that had a chance of being accepted in the States.” Jack was determined. He would not let terminally ill patients die in pain, when a solution to their pain is so simple, and is much more dignified than dying in pain.
In 1989, after Jack returned to Michigan, a story ran in the local newspaper about a 38-year-old quadriplegic that lived in the southern portion of the state. His name was David Rivlin, and after suffering a spinal-cord injury and could no longer move his arms nor his legs, ended up in a nursing home where he was put on a respirator. After being on the respirator for three years, he felt he had enough and asked to be disconnected. The doctors and the nurses that worked at the nursing home refused to do so. This is where Jack triumphantly walks in. He visited David in the nursing home, and was appalled at the physical state in which he lived. He wanted to help David; his solution? A suicide machine.
Jack went to the nearest Salvation Army store and picked up some various odds and ends, including a discarded erector set, for around $3. (He is a very frugal person; between his social security and his pension he makes very little, and he has to budget his money.) The suicide machine he constructed, and called Thantron (“Death machine” in Greek), had two steps to the process. (See Appendix II.)
Before Jack returned to Rivlin with the completed machine, however, he had been moved to a private home, and with a court order now secured, the doctors were forced to take him off life support. Jack would have to wait before his machine went into use.
<i> Tom, are you asleep? </i>
Janet Adkins, a 54-year-old woman stricken with Alzheimer’s, came to Dr. Kevorkian in 1990, asking for help in ending her life. After being diagnosed just a year earlier, her family members began to notice the early signs of the disease present in her. She came to the Good Doctor pleading, telling him that she wanted to die while she still remembered her family members, and more importantly, herself.
After searching for two days in vain to find a location, Jack reluctantly decided on his Volkswagen van. After installing a cot in the back and curtains on the windows, and after Janet said goodbye to her husband Ron, Jack and his supportive sister Margo, along with Janet, drove to a nearby campground.
Janet’s last word before pulling the switch was “Hurry.” Jack, who is an atheist, but respects Janet’s Christian beliefs, responded “Safe journey.”
The heart monitor he set up in his van flat lined after six minutes. Janet Adkins, loving wife and mother, was dead.
<i> Tom, are you asleep? You asleep? </i>
Fast forward several years later, when Jack receives a FedEx letter asking for his assistance. The letter comes from a man named Thomas Youk, a patient who suffers from debilitating ALS, and who asks for Dr. Kevorkian’s assistance to end his life. Jack immediately calls up the Youk family and schedules an interview.
Jack, who was now a national celebrity and given the nickname Dr. Death, had assisted 129 of his patients in ending their life; Up until this point, the patient is the one who flips the switch. The memory of his trip to the Netherlands still lingers in his mind, and over there, doctors are allowed to directly inject their patient with the lethal poison. Although he realizes that his assistance up to this point has been “game changing” and ballot measures calling for legalized assisted suicide are already popping up in various states across the country, he feels that the progress is slow and wants to push the debate towards direct, active euthanasia. But who would be the perfect patient to usher this in? Enter Youk.
In the interview, Thomas is obviously in pain, and struggling to talk or do much of anything. Jack had seen enough. At the end of the interview, Thomas’ final appointment with Dr. Kevorkian was scheduled two weeks from that date.
Before dawn the next morning, Jack receives an urgent call from Melody Youk, Thomas’ wife. She tells him that Thomas does not want to wait; he wants to die now. He throws on his clothes, gathers the supplies, grabs his video camera, and rushes to Thomas’ house.
Thomas Youk died on the morning of September 17th, 1998.
<i> He’s Asleep. </i>
Jack, who had videotaped the death, felt that if he was convicted of the death of Thomas Youk, which he directly participated in, he could appeal his conviction all the way to the Supreme Court of the US, who would rule his conviction unconstitutional, thus legalizing euthanasia and doctor assisted suicide. So, as a way to “turn himself in” while garnering even more public support for his cause, he sent the video tape of him killing Thomas Youk to the television show 60 Minutes.
Across millions of televisions around the country, Dr. Death’s final words resounded with a bang:
<i> …Now I’ll quickly inject the potassium chloride…His heart is stopped. </i>
Jack was charged with first-degree murder, and later convicted of second-degree murder. His plan to appeal his conviction never came to fruition; his appeal date in the Michigan courts was on 9/11/01, and after 40 minutes appealing, the World Trade Center was bombed, and he wasn’t allowed to take his appeal any further. He was sentenced to 10-25 years in prison; but he was released early in 2007, due to his Hepatitis C, and he wasn’t expected to live much longer.
The Right-to-Die movement continues, with the same passion that the pioneers of the movement had to begin with. Compassion and Choices has thousands of members, and advocates the usage of Advance Directives (Living Wills) to make sure that one’s wishes on death, whether they be elongated or hastened, are looked after. And while they don’t directly assist in any deaths, they do help council people, and if it is legal in their state, help them obtain the life ending drugs that they wish to take.
In Washington, Montana, and Oregon, one can obtain these drugs without fear of punishment. In Oregon, Ron Adkins, the husband of Janet, whom Dr. Kevorkian helped to die, spearheaded the ballot measure campaign.
And while Compassion and Choices stresses that they do not support the Doctor’s decision in euthanizing Thomas Youk, they do acknowledge the recognition he has given to the cause, saying, “[Dr. Kevorkian’s contribution was that he] made bringing end of life suffering to the public’s attention, as well as the need to legalize aid in dying…However, we totally disagree with his decision to euthanize Thomas Youk.”
Derek Humphry writes in his book Freedom to Die:
“Kevorkian’s essential contribution to the right-to-die movement was the enormous scope of the publicity he attracted…[I] believe that Kevorkian’s role in making Americans aware of the right-to-die issue was a crucial factor in the [legislative] victories.”
Right-to-Life activists continue to convey that all human life is sacred, and that by taking your own life, you are ‘playing God.’ The Right-to-Die activists are quick to retort, however, as Betty Rollin says, “Some people want to eke out every second of their life—no matter how grim—and that is their right. But others do not. And that should be their right.”
As for Jack? Well he still lives in Michigan, where he has lived most of his life. Although he says that he will not be assisting any more suicides, he does say that he will continue to advocate for the “patient’s right to self determination”, a cause that he will continue to support…until the day he dies.
**This article was written approx. 3 months before Jack Kevorkian passed away on June 3rd, 2011.