Kevorkian’s Elaborate Plan

Meet “Wanda Endittal.”

She is 45 and suffers from multiple sclerosis, which is why she wants to, well, end it all.

Ultimately, she does with help from two doctors named “Will B. Reddy” and “Shelby Dunne”--despite the objections of her parents, “Flo N. Tiers” and “Justin Tiers.”

Wanda is the hypothetical subject of Dr. Jack Kevorkian’s elaborate and some say appalling plan for a national medical service: medicide --a word Kevorkian invented for “medically assisted suicide.”

Kevorkian outlined his proposal early this year in the respected American Journal of Forensic Psychiatry. Under the plan:

* A medical specialty would be created: obitiatry (pronounced oh-bit-EYE-a-tree), literally “death doctoring.”

* As in psychiatry and other specialties, this one would have a residency program, certification board, and its own journal to document what’s new in the field. Pioneers such as Kevorkian would be “grandfathered in” without additional training.

* Michigan, for example, would be divided into 11 geographical death zones. “For the obitiatrist’s convenience and ease of control,” wrote Kevorkian, zone headquarters would be located near the center of each zone.

* All requests for medicide would be “forwarded to headquarters in writing by patients’ personal physicians--never by patients themselves.”

* There would be five obitiatrists in each zone: three to decide whether medicide is justified, two to carry it out. They would be assisted by “para-obitiatrists,” the medicide equivalent of paralegals.

* If the patient shows any degree of ambivalence about dying, the process would be stopped immediately and the patient could never again be a medicide candidate.

Some who read Kevorkian’s plan were surprised at how dramatically it contrasts with “the death doctor’s” actual practice: Kevorkian, for the most part, operates alone, and his patients are always self-referred.

When New York psychiatrist Douglas Anderson finished reading an advance copy of Kevorkian’s plan, he says his blood ran cold.

“(But) as I wandered through Dr. Kevorkian’s new bureaucratic maze . . . with its succession of cute names, I stumbled onto what Dr. Kevorkian was really doing--he was pulling my leg!” wrote Anderson, one of 13 psychiatrists asked to critique the article for the forensic journal. The commentaries, which expressed skepticism, revulsion and even ridicule, appeared simultaneously with Kevorkian’s article.

“He couldn’t really be serious,” Anderson said. “After all, my mother lives in Michigan!”

In fact, Kevorkian is serious. That, concluded Anderson and others, is what makes it so chilling. Dr. Kenneth Karols, a U.S. Navy psychiatrist, called the Kevorkian system “truly horrifying.”

“In the final analysis,” wrote Anderson, “each of us must make up his or her own mind with respect to Dr. Kevorkian’s modest proposal. Is he a hero, a villain, a pioneer, or a misunderstood eccentric genius?

“Or is he merely suffering from a serious lithium deficiency?”