Jack KevorkianBMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d4100 (Published 29 June 2011) Cite this as: BMJ 2011;342:d4100
- Ned Stafford
The world could not agree who Jack Kevorkian was during his lifetime, nor after his death.
To his supporters, Kevorkian was a humane hero who courageously fought for the rights of suffering people to fulfil their death wishes. Neal Nicol, who was Kevorkian’s friend for half a century and helped in many of Kevorkian’s more than 130 assisted suicides, said that Kevorkian “was the most compassionate individual I have ever met.” Nicol added: “I worked closely in the medical field for 54 years or so, met many doctors, worked with and for many. Dr Kevorkian had a bedside manner that was the nicest I was ever exposed to. The patients loved him.”
But in the eyes of the law, Kevorkian was a murderer. He was convicted in 1999 for giving a lethal injection to a sick man who had asked Kevorkian to help him die. The judge, who sentenced Kevorkian to prison, told him: “You’ve defied your own profession, the medical profession.”
The Catholic church saw Kevorkian as a sinner. Hours after he died, the Archdiocese of Detroit issued a statement saying, “May God have mercy on his soul and on the scores of confused, conflicted, and, at times, clinically depressed victims he killed.”
One aspect of Kevorkian’s life, though, cannot be disputed: his one man crusade during the 1990s, which included arrests and time spent in jail as well as publicity stunts and standing trial several times, put on the national agenda the issue of whether doctors should be allowed to help people die.
“He was so far outside the mainstream that he paradoxically opened up the middle ground,” said Timothy E Quill, professor at the University of Rochester School of Medicine in New York (state) and director of the Center for Ethics, Humanities, and Palliative Care.
Kevorkian was born in 1928 in Pontiac, Michigan, the son of Armenian refugees. After qualifying as a doctor in 1952 from the University of Michigan in Ann Arbor, he began a residency in pathology, but was drafted by the US Army, serving in the Korean war as a medical officer.
After discharge, he resumed his residency, becoming fascinated by death. He photographed the eyes of terminally ill patients to try to pinpoint the moment of death, publishing a paper about it in 1956. In 1958 he delivered a paper at a Washington conference proposing that convicted murderers be allowed to volunteer for painless medical experiments that would begin while they were conscious. After execution with anaesthesia, their organs could be harvested. In the early 1960s and assisted by his friend Nicol, a medical technologist, Kevorkian experimented with the idea of transfusing blood from corpses into living patients. Both men transfused themselves with cadaver blood and both contracted hepatitis C.
Until the early 1970s, Kevorkian worked as a pathologist at several hospitals before establishing his own clinic, which failed. He moved to California, working part time at two hospitals while writing, painting, and producing an unsuccessful film of Handel’s Messiah. He lived frugally, wearing used clothing and at times sleeping in his car. In the mid-1980s, with executions on the rise in the US, Kevorkian returned to Michigan and began writing papers on organ donations from convicts. He learnt that doctors in the Netherlands were helping people die by lethal injection, and his crusade began.
In 1987, he advertised in Detroit newspapers as “physician consultant” for “death counselling.” He spent $45 to build a “suicide machine” that delivered successive intravenous doses of a saline solution, a painkiller, and finally potassium chloride. In 1990 in his old Volkswagen van, Kevorkian hooked Janet Adkins, a 54 year old Portland woman with Alzheimer’s disease, to the machine and watched as she pushed the fatal button. After her death, Kevorkian telephoned police and was arrested, triggering front page headlines. The murder charge was later dismissed by a judge before going to trial.
Kevorkian’s Michigan medical licence was revoked in 1991, but Kevorkian continued to assist in suicides, with some patients using his new carbon monoxide machine and some dying in motel rooms. From 1994 to1997, Kevorkian was acquitted in three trials while a fourth ended in mistrial. Meanwhile, public support for physician assisted suicide was growing. An Oregon law legalising it was upheld in a 1997 voter referendum.
Professor Quill, a board member of Death with Dignity National Center in Portland, Oregon, said that Kevorkian did not have the “clinical skills” necessary to evaluate “such desperate patients,” adding that some “had illnesses that were as much psychological as physical. Clearly his approach was the wrong one. It was always as much about Kevorkian as it was about the patients.”
In 1998 a new Michigan law criminalising physician assisted suicide took effect. Kevorkian went a step beyond assisted suicide to euthanasia. Professor Quill said, “He was part crusader and part martyr who was looking for the edge of what would be tolerated. I don’t fully understand his motives.” Kevorkian videotaped himself giving a lethal injection to a man with amyotrophic lateral sclerosis and gave the video to a popular national television show. After its broadcast in November 1998, Kevorkian was charged with second degree murder. He acted as his own defence attorney, which he later regretted. He was convicted and sentenced to 10-25 years in prison.
He was released in 2007 after serving eight years and having promised never again to assist in suicides. In 2008 he unsuccessfully sought election to Congress. In 2010 his story was told in a TV movie, You Don’t Know Jack, starring Al Pacino. In failing health, he spent his final weeks of life in hospital. Kevorkian, who never married, leaves a sister.
Jack Kevorkian (b Pontiac, Michigan, 26 May 1928; q Michigan 1952), died on 3 June 2011 from pulmonary thrombosis in a hospital in Royal Oak, Michigan, where he was being treated for kidney, heart, and respiratory problems.
Cite this as: BMJ 2011;342:d4100