Kevorkian Is No Answer

Jack Kevorkian was his usual ghoulish self on “60 Minutes” earlier this week, arrogantly hawking a videotape showing him giving a lethal injection to a 52-year-old Michigan man suffering from Lou Gehrig’s disease. Kevorkian should be prosecuted: He flagrantly violated laws against what is known in the medical community as “active euthanasia.”

Convicting Kevorkian will be difficult, even though this case goes further than his earlier, apparently more passive assistance in suicides. Judges have dismissed murder charges against the retired pathologist in earlier trials, and three juries have failed to convict him on lesser charges.

Some of those jurors have said they saw Kevorkian as a friend of the terminally ill. Their sympathy was misplaced. Kevorkian’s flouting of medical and legal ethics offers little genuine succor to patients. He even opposed a Michigan ballot measure to legalize assisted suicide, saying he did not want to be bound by its strict patient protections. And he has shown little concern for the problem that drives many patients toward suicide: treatable mental illness or excruciating pain.

Correct as it is to prosecute Kevorkian, trying him will do little to improve the way America cares for its terminally ill. Roughly three-quarters of Americans expire in hospitals or nursing homes, often helpless and stuck full of tubes. According to a study by the National Institute of Medicine, more than a third of Americans die in pain that could be eased. Physician groups need to formulate “best practice guidelines” on how to improve palliative care of the terminally ill.

The issue of doctor-assisted suicide pits deeply rooted American values, like religious convictions about the sanctity of life and legal protections of individual liberty. It’s not a matter that courts, legislators or doctors can or should decide alone.

In California, binding “health care consent forms” allow patients and families to make their own highly personal decisions about end-of-life treatment--telling doctors, for instance, how long they should try to keep patients alive with respirators or other machinery. These consent forms should be looked on by medical personnel as seriously as wills; they are too often ignored.

Better end-of-life care could eliminate much of the rationale for assisted suicide. For the wrenchingly difficult cases that remain, a serious debate about how to ease the last days of the terminally ill is needed. Kevorkian, however, is not part of the solution.