Possibly a hero, but not a medical oneBMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7051.227a (Published 27 July 1996) Cite this as: BMJ 1996;313:227
- James Gilbert
- Lecturer in palliative medicine Postgraduate Medical School, University of Exeter, Exeter and District Hospice, Exeter EX2 5JJ
EDITOR,—John Roberts and Carl Kjellstrand's editorial contains several uncontroversial assertions: that those who are dying need our commitment to stay with them throughout their journey, that few of those who write about ethics and decisions concerning the end of life have direct responsibility to people in need, and that Jack Kevorkian has been a man of action who has lived by a personal code of honour that admits of no qualification.1 The editorial also states that neither greed for money nor fame, in the conventional sense, is a discernible motive for Kevorkian's actions. His motives might be interpreted as courage against injustice or reckless moral self indulgence, but in either interpretation the thrill of turning to the law (and not just any law) and saying “I dare you to stop me” should not be underestimated. Calling Kevorkian a hero might alter our perception of the term hero as much as our interpretation of Kevorkian's behaviour.
Even those who find the title hero apt should consider carefully whether Kevorkian is in any important sense displaying medical heroism. As a response to personal and social suffering, which Roberts and Kjellstrand allege are rising, there are those believers in unfettered autonomy who would advocate euthanasia on demand. Indeed, a coherent social policy could be developed in which persistence and rationality need be the only prerequisites for the kind of help that Kevorkian has offered. It is important to recognise, however, that if this is genuinely needed it could be provided as an entirely non-medical service.2 Seen in this light, Kevorkian's actions are those of a non-judgmental, even uncritical, technician rather than those of a doctor. His important contribution to the debate would then rightly be seen as one of separating clearly the social service of ending people's lives at their own request from the unambiguous provision of medical care. Although to some people (though not to me) he might then be a hero, he would, importantly, not be a medical one.
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