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Dr. Jack Kevorkian dies at 83; 'Dr. Death' was advocate, practitioner of physician-assisted suicide

Crime, Law and JusticeHealthMedical ResearchCrimeLaws and LegislationSocial IssuesEuthanasia

He was known as Dr. Death, a Michigan physician who helped his patients kill themselves.

In doing so, Jack Kevorkian inflamed a nationwide debate in the 1990s over a terminally ill patient's right to die. And he served eight years in prison for second-degree murder for administering the lethal injection rather than helping the patient do it himself.

Kevorkian began his crusade mindful of his own mortality.

"You don't know what will happen when you get older," he said in a 1998 interview with "60 Minutes." "I may end up terribly suffering. I want some colleague to be free to come and help me when I say the time has come. That's why I'm fighting, for me. And if it helps everybody else, so be it."

In the end, Kevorkian's own death early Friday came pain-free and peacefully in a hospital in Royal Oak, Mich. He was 83.

Kevorkian had been hospitalized for pneumonia and kidney problems last month for four days and returned about a week later. He developed pulmonary thrombosis late Thursday, said Mayer Morganroth, Kevorkian's lawyer and friend.

During Kevorkian's final hours in the intensive care unit, the music of his favorite composer, Johann Sebastian Bach, was played over a computer.

"We did it because we knew it would make him happy," Morganroth said.

Kevorkian said he assisted in the suicides of more than 130 people from 1990 to 1998.

From the beginning, his actions thrust the right-to-die issue into the national spotlight, with Kevorkian at the center of what Time magazine called "a media barrage that ricocheted from 'Crossfire' to 'Nightline,' 'Good Morning America' to 'Geraldo.' "

"I'm trying to knock the medical profession into accepting its responsibilities, and those responsibilities include assisting their patients with death," Kevorkian told reporters at the time.

Derek Humphry, executive director of the Hemlock Society, a right-to-die group that supports the concept of doctor-assisted suicide, told The Times in 1990: "If we are free people at all, then we must be free to choose the manner of our death."

Critics challenging Kevorkian on moral and procedural grounds were equally vocal.

"What he did is like veterinary medicine," Dr. John Finn, medical director of the Hospice of Southeastern Michigan in suburban Detroit, told The Times in 1990. "When you take your pet to the vet, he puts the pet to sleep. I think human beings are more complicated than that. I think he should have his license revoked."

Dr. Melvin Kirschner, co-chairman of the joint committee on medical ethics of the Los Angeles County Medical Assn. and the Los Angeles County Bar Assn., complained in a 1990 Times interview: "Kevorkian did this without any guidelines whatsoever. Physicians cannot just, willy-nilly, assist someone in killing themselves."

In 1997, Oregon became the first state to implement a law that allowed mentally competent, terminally ill patients to request lethal medications from their physicians; Washington and Montana have followed suit.

Janet Adkins, a 54-year-old Portland, Ore., mother of three adult sons in the early stages of Alzheimer's disease and unwilling to let it progress further, was the first of Kevorkian's assisted suicides.

When Adkins and her husband, Ronald, met with Kevorkian in Michigan, he already had begun receiving media attention for his untested "suicide machine," a homemade device he called the "mercitron."

On June 4, 1990, as Ronald Adkins waited in a motel room, Kevorkian's sisters, Flora Holzheimer and Margo Janus, drove Janet Adkins to Groveland Oaks County Park, where Kevorkian was waiting for her in his rusty white 1968 Volkswagen van.

He had tried to find a more suitable setting, he told People magazine later that month, "and every place turned me down. But Janet didn't care what the environment was."

With Adkins in a bed in the back of the van, Kevorkian connected her to a heart monitor and inserted a needle into her arm to start the flow of a harmless saline solution.

As chronicled in People, Adkins asked Holzheimer to read passages Adkins had brought with her, including the 23rd Psalm and a message from her closest friend.

Then Adkins pressed the button on Kevorkian's machine, which began sending anesthetic thiopental sodium through her veins to put her to sleep and then potassium chloride to stop her heart.

"Thank you, thank you so much," Adkins reportedly told Kevorkian as the anesthetic began taking effect.

"Have a nice trip," he said.

After the line on the heart monitor went flat less than six minutes later, Kevorkian called the authorities and told them what he had done.

A few days after his wife's death, Ronald Adkins said he believed assisted suicide was a more dignified way to die.

"It's not a matter of how long you live, but the quality of life you live, and it was her life and her decision, and she chose this way to go," he was quoted as telling his local TV station.

In December 1990 a Michigan judge dismissed a first-degree murder charge against Kevorkian, noting that Michigan law did not forbid suicide or assisting in it.

Unable to legally obtain drugs for his suicide machine after losing his Michigan medical license, Kevorkian turned to rigging canisters of carbon monoxide to face masks and had his patients release a clamp to start the deadly flow of gas.

In the immediate aftermath of Adkins' death, The Times reported that some supporters of physician-assisted suicide said that Kevorkian's interest in death and suicide was too obsessed and too fanatical for him "to try to set compassionate and safe guidelines for euthanasia in the future."

Humphry, who met Kevorkian in 1988 and rejected his offer to set up an illegal "suicide clinic" for the terminally ill in Los Angeles, described him to The Times in 1990 as "a zealot" and "a strange bird."

The maverick doctor, whom columnist Ellen Goodman described in 1992 "an ethical outlaw, a freelance death dealer providing paraphernalia and know-how to the users," was no stranger to controversy throughout a medical career in which he developed an early fascination with death and dying.

The son of Armenian refugees, Kevorkian was born in Pontiac, Mich., on May 26, 1928.

While studying at the University of Michigan in Ann Arbor, where he excelled in languages — Japanese and German — he decided on a career in medicine and chose to focus on pathology, the study of disease.

A 1952 graduate of the University of Michigan Medical School, Kevorkian volunteered for the Army and served as a medical officer in Korea.

After his discharge in 1955, he began his first year of residency in pathology at the University of Michigan Medical Center, where he began conducting independent death-related research: He received permission to set up an electrocardiogram and a small camera next to patients so he could record changes in the retinas of their eyes to pinpoint the exact time of death.

"His theory could assist pathologists, forensic psychiatrists and police forces in solving homicides and convicting perpetrators," Neal Nicol and Harry Wylie wrote in their 2006 book "Between the Dying and the Dead: Dr. Jack Kevorkian's Life and the Battle to Legalize Euthanasia."

The nurses, finding Kevorkian's research "creepy," began referring to his research as "the doctor of death's death rounds," Nicol and Wylie wrote. Soon, they were simply referring to Kevorkian with the nickname that would take on new meaning decades later: Dr. Death.

Kevorkian wrote an article about his findings in the American Journal of Pathology in 1956. "Unfortunately, the research was never picked up or expanded upon," the two authors wrote.

In 1958, he made news and created a stir in medical circles when he presented a research proposal at a conference in Washington, D.C., for conducting medical experiments on consenting death row inmates while under deep anesthesia just before an executioner administered a final overdose.

In 1961, he published an article in the American Journal of Clinical Pathology that detailed his experiments with direct transfusions of cadaver blood into volunteers, which he viewed as having potential benefits for battlefield casualties in Vietnam. The military rejected his proposal.

Kevorkian switched jobs over the years, once serving as a staff pathologist at the Beverly Hills Medical Center in Los Angeles in the early 1980s.

He returned to Michigan in 1982, after a stint as assistant to the chief pathologist at Pacific Hospital of Long Beach. That was the last hospital in which he was known to have been employed, The Times reported in 1990, after Adkins' death.

By then, as depicted in The Times story, Kevorkian was a "lifelong bachelor living off his savings in a tiny, ill-furnished, walk-up apartment in Royal Oak, Mich., not far from his boyhood home in Pontiac" — a doctor who had even been turned down for a paramedic job two years earlier and whose thoughts, The Times reported, had become "increasingly dominated by the issue of suicide for the terminally ill."

Kevorkian made his suicide machine out of scrap parts. For his new business cards, he borrowed from the word "obituary" to call himself an "obitiatrist": a doctor of death. "The world's first," he told The Times in 1990.

Kevorkian failed in his attempts to run advertisements for his new service in Detroit-area newspapers and in medical journals, but the Detroit Free Press and a few other publications ran short stories on Kevorkian and his bizarre fledgling enterprise.

A brief item about him in Newsweek magazine caught the attention of Ronald and Janet Adkins.

In 1997, the Detroit Free Press reported the results of its investigation into the lives and deaths of 47 people whose deaths had been publicly linked to Kevorkian since 1990. The paper said Kevorkian's assertions that he followed strict guidelines for physician-assisted suicide, including consulting psychiatrists to determine a patient's mental state, "do not hold up."

The investigation also showed that "at least 60% of Kevorkian's suicide patients were not terminal. At least 17 could have lived indefinitely and, in 13 cases, the people had no complaints of pain."

In an effort to curtail Kevorkian's assisted suicides, the Michigan Legislature passed a bill in 1992 that temporarily banned the practice.

Two years later, the Michigan Supreme Court ruled that assisting in suicide was a crime, based on common law. And in 1998, a new state law made assisting a suicide a felony punishable by up to five years in prison or a $10,000 fine.

By then, Michigan prosecutors had charged Kevorkian four times with assisting suicide. But the cases ended in three acquittals and a mistrial.

In 1998, Kevorkian was charged with first-degree murder after he personally gave a fatal injection to Thomas Youk, a 52-year-old accountant from a Detroit suburb who had amyotrophic lateral sclerosis, or Lou Gehrig's disease.

Kevorkian videotaped himself injecting Youk, then gave the tape to the CBS News program "60 Minutes," which broadcast the footage.

In an accompanying interview with Mike Wallace, Kevorkian said he made the tape to move the public debate from physician-assisted suicide to euthanasia — death directly triggered by a doctor — and dared prosecutors to charge him with a crime.

Prosecutors charged him with first-degree murder, which requires premeditation.

During a brief trial in Michigan in 1999 in which Kevorkian defended himself, he appealed to the jury to send a message that laws against euthanasia and assisted suicide were unjust.

In 1999, the white-haired, 70-year-old Kevorkian was convicted of second-degree murder and was sentenced to 10 to 25 years in prison.

"You had the audacity to go on national TV, show the world what you did and dare the prosecution to stop you," Oakland County (Mich.) Circuit Judge Jessica Cooper told Kevorkian after sentencing him. "Well, sir, consider yourself stopped."

After serving eight years, Kevorkian was released from prison in 2007, with one of the conditions of his two-year parole being that he not conduct any more assisted suicides.

In an interview with the New York Times two days after his release, Kevorkian proved to be as fiercely combative as ever, complaining that during his time in prison no new laws had been passed that would allow assisted suicide.

The government, Kevorkian said, was "the tyrant" and the public were "sheep." As for his severest critics, he said they were "religious fanatics or nuts."

During the peak of his notoriety in the 1990s, the eccentric, Bach-loving Kevorkian revealed other sides of himself.

He was a jazz musician and composer, who played flute and organ on a limited-release CD performed with the Morpheus Quintet and featuring his own compositions, "The Kevorkian Suite: A Very Still Life."

And, more in keeping with his Dr. Death image, he was an oil painter of surrealistic, often gruesome, canvases depicting medical conditions and social commentary — paintings of what Vanity Fair writer Jack Lessenberry described as "such merry scenes as a child eating the flesh off a decomposing corpse and Santa crushing a baby in a manger."

Kevorkian, who wrote a number of books, ran as an independent candidate for Michigan's 9th Congressional District in Oakland County in 2008; he received less than 3% of the votes.

In 2010, Al Pacino delivered an Emmy Award-winning performance as Kevorkian in the HBO biopic "You Don't Know Jack."

"He turned away the vast majority of people who came to him, he didn't take money for what he did, and he did not see these patients as people he was killing," Pacino told the New York Times before the film's premiere. "He saw them as people whose pain he could relieve."

Asked by CNN's Anderson Cooper at the time if he regretted taking up a cause that sent him to prison, Kevorkian replied: "No, why would I?"

Kevorkian is survived by his sister, Flora Holzheimer.

dennis.mclellan@latimes.com

Copyright © 2014, Los Angeles Times
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