Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, May 8, 1994 TAG: 9405060078
SECTION: EXTRA PAGE: 1 EDITION: METRO
SOURCE: Cody Lowe
DATELINE: LENGTH: Long
Sliding through a loophole in the Michigan law that prohibits physician-assisted suicide, Kevorkian was acquitted of criminal charges against him last week. The jury decided that, when Kevorkian slipped a plastic mask attached to a supply of carbon monoxide to Thomas Hyde's face last summer, he was only trying to relieve Hyde's suffering, not kill him.
There is a fine distinction.
The law has to deal in fine distinctions, of course. But it seems ludicrous to compare the application of carbon monoxide - which as far as I know has no medicinal use - with the prescription of bona fide medications that may be used in dosages approaching the threshold between ending pain and ending life.
The Kevorkian case - emotionally charged as it was and is - really isn't about physician-assisted suicide, of course.
Almost any poll, worded the right way, will find a significant majority of Americans saying they believe physicians should be able to help terminally ill people - particularly those in constant, unrelievable pain - end their own lives.
As a society, we are in the middle of a great debate over what the boundaries for action on that belief should be.
Most rational people know there are limitations to what we can reasonably expect of medical science. We generally agree that it is foolish to attempt to extend life merely because we have the capacity to keep lungs breathing and a heart beating when there is no indication that the brain is still\ functioning.
We debate the question of when physicians may deny treatment to dying people, recognizing that every day physicians and patients - and patients' families - decide to let death come sooner rather than later by avoiding or ending so-called ``futile" treatments.
Many of us have known of cases in which physicians played more active roles, providing prescriptions for powerful medications that a patient might ``accidentally" overdose at fatal levels when suffering becomes unbearably intense.
The moral appropriateness of a rational human being taking his or her own life is different from the question of assisting in that act. The debate over that issue started not with physicians but with family members who took the life of a suffering loved one.
There have been highly publicized cases in which one spouse killed the other to end the pain of terminal disease.
In those cases, the husband or wife at least has the defense of acting out of love for another human being. We can hear testimony to that effect. We can count the years of marriage or commitment. We can understand how that might happen, how heartbreaking it must have been. Many of us can - reluctantly, perhaps - rationalize ``mercy killings" in specific circumstances.
That seems a very different thing from calling in a specialist in death who has no loving commitment to the person who seeks to die, who does not even have the benefit of a tried and tested physician-patient relationship.
And that, ultimately, is what the ``Dr. Death" debate is about.
Kevorkian is a renegade obsessed with death who decided society could no longer debate this issue. He has the right answers, and the rest of us are compelled to listen to them.
The rogue doctor charged onto the field in his lethal, rusty van and imposed his own rules for a game of death. His decisions are always right, he tells us, and we have no right to question him.
Like hell, we don't.
I have lots of unanswered questions, beyond the obvious ones of who appointed Kevorkian to be God - and what is the etiquette for billing in advance for such a service?
For instance, where are the boundaries for appropriate action by a physician? Could a doctor shoot a suffering patient? Must additional pain-relievers be attempted before the final act? Does mental illness - severe depression, for instance - qualify as a disease a physician could ethically act to end by assisting suicide? What toxic agents are permissible for such uses? Should decisions to assist a suicide be subject to review and by whom? Can family members appeal such a decision? Must a patient be suffering a ``terminal" illness? How imminent must death be before allowing suicide assistance? Should a waiting period between the decision to commit suicide and the act itself be mandatory - and how long should it be?
Those who advocate legalization of physician assistance at suicides - as well as those who oppose it - should be concerned about questions such as those. Kevorkian obviously doesn't care - at least doesn't care as much as he should - about any of those.
This is about as sticky an issue imaginable. As with all tough ethical/moral questions it defies simple black-or-white, yes-or-no answers, although many citizens will insist - like Kevorkian - that their answers are the only correct ones.
There is still deep division over the very question of whether any suicide - assisted or not - is ethical. We can debate whether the state has any legitimate interest in preventing suicides.
We should worry when a demagogue like Jack Kevorkian can so nearly totally control the debate on an issue that deserves a reasoned, thoughtful, public response.
We must find a way to take the initiative back - talking to our own physicians, our lawmakers, our religious leaders. The consequences are too serious, potentially too dangerous, for us to hand over the control of our very lives to the Kevorkians.
by CNB