By S. Van McCrary, Health Law & Policy Institute
A few months ago I commented in these pages about the negative implications of Dr. Jack Kevorkian's proposal to furnish organs for transplantation derived from persons who died as a result of assisted suicide (Bioethics/980715Kevorkian.html). Yesterday, Dr. Kevorkian was sentenced by a Michigan state judge to serve from 10 to 25 years in prison for the death by injection of Thomas Youk, a 52-year-old accountant suffering from amyotrophic lateral sclerosis, or Lou Gehrig's Disease. Judge Jessica Cooper of the Oakland County Circuit Court stated in a very serious tone of voice her view that the trial was about the "lawlessness" of Kevorkian personally, rather than about the morality of euthanasia. Cooper also remarked to Kevorkian that he had "the audacity to go on national television, show the world what you did, and dare the legal system to stop you. Well, sir, consider yourself stopped" (New York Times, April 14, 1999).
Interestingly, an unscientific poll conducted on the web site of CNN reported, 24 hours after sentencing, that 67 percent of respondents think the sentence was too harsh (48,072 votes out of 71,951 persons surveyed--See http://cnn.com/POLL/results/125591.html). Surviving relatives of Mr. Youk appeared to agree, and refused to characterize Youk as a victim. His widow Melody, who was not allowed to testify at the trial, severely criticized the prosecutors after sentencing and portrayed Kevorkian as a person who was carrying out the wishes of her husband, a person who was experiencing terrible suffering.
It is still my view that Dr. Kevorkian's initial civil disobedience played a necessary role in the process of advancing public debate about the difficult issues related to hastening death. Had Kevorkian not defied the Michigan law openly, the issues would have remained merely the topic of discussion between physicians and bioethicists except for particular suffering patients who wished to end their lives. When viewed in this light, the sentence may be considered extreme. However, it will have the practical effect of preventing Dr. Kevorkian from further inflaming the social discourse through highly visible public acts of assisted death, which seemed to be designed more to gain notoriety for himself than to preserve the dignity of tormented patients.
The broadening of this discussion should allow us to focus our attention on issues of controlling pain and other discomfort related to life-threatening illnesses, as well as determining a range of proper roles for both physicians and the legal system in the dying process. Ironically, Dr. Kevorkian's removal from this debate may permit it to proceed in a less volatile atmosphere and, thus, to make progress more quickly toward accommodating a range of views on these controversial topics. If so, Kevorkian's peculiar crusade followed by his incarceration may have the salutary long term effect of promoting patients' general well-being. After all, this was the goal he claimed to seek.