This article appears in the May 1999 edition of the Catholic Medical Quarterly
LETTER FROM AMERICA
For the first time in five trials, Dr. Jack Kevorkian was convicted of a felony on March 26 for his involvement in a client's death. The Pontiac, Michigan jury deliberated more than a day before finding Kevorkian guilty of second-degree murder and delivery of a controlled substance in the death of 52- year-old Thomas Youk. While not convicted of first degree murder, which would have carried a mandatory life sentence, Kevorkian was sentenced to between 10 and 25 years in prison.
While Kevorkian has claimed involvement in over 130 deaths, the Youk case was different in two respects: Kevorkian himself gave the lethal injection, instead of arranging for the patient to self administer a lethal dose, and he recorded the event in a video-tape aired on CBS 'Sixty Minutes' on November 22. His aim in giving the lethal injection was to provide 'a final solution to incurable agony'; a case where assisted suicide cannot be accomplished and euthanasia is regarded as the only option. The prosecution initially brought a charge for assisted suicide, which is illegal in Michigan, but withdrew it when Judge Jessica Cooper ruled that the charge would allow Kevorkian to present evidence on Mr. Youk's pain and suffering which would have swayed jurors.
Kevorkian says the verdict 'proves how corrupt society is, and how malevolent are those who run it'.
The State of Oregon's report on its first year of legalised assisted suicide, intended to resolve questions about the law's 'safeguards', has raised new possibilities regarding the regulation of the practice. Published in the February issue of the New England Journal of Medicine, it finds only 15 patients died by lethal overdose in the first year, and reports no evidence that the guidelines were violated. Closer scrutiny, however, reveals that the report was by no means comprehensive:
All reporting was by suicide assisters themselves, and the Health Division had no way to' verify their claims. 'We did not interview the patients or their families, or other physicians who provided care at the end of life'. (p 578)
Physicians had the option of not reporting a case if it involved the violation of a guideline. We cannot determine whether a physician-assisted suicide is being practised outside the framework
of the "Death with Dignity Act". (p. 583)
The most common factor leading to assisted suicide was not unrelieved pain or even seriousness of illness, but concern about 'loss of autonomy' or 'loss of control of bodily functions'. Many of the patients 'had been decisive and independent throughout their lives' (p.582) and could not cope with, being weak or independent. Only 4 of the 15 received any psychological assessment. (p. 579)
The most decisive social factor was never having married, a factor 24 times more likely among these patients than a control group. (p. 580) Loners without family support are choosing assisted suicide.
Regarding the time it took for lethal drugs to cause death: 'although the majority of patients died within the hour, four died more than 3 hours after taking the prescribed medications, and one died 11.5 hours afterwards'. All used Federally controlled substances, generally barbiturates.
In 40% of cases (6 out of 15) patients were turned down by one or more physicians before finding one who would write a lethal prescription. (p.582) In the first reported case, two physicians had refused, and one had made a diagnosis of clinical depression, before the patient was referred to a willing physician by a pro-suicide group. Assisted suicide patients, on average had known their physician about one tenth as long as control patients (69 days as against 720 days). (p. 581)
At a briefing for Congressional staff, on February 25, in Washington, D.C., Dr. Katrina Hedburg of the Oregon Health Division conceded that suicide advocacy groups had counselled patients or otherwise played a role in 10 or 11 of the 15 cases.
We are grateful for this report, based on Life at Risk; A Chronicle of Euthanasia trends in America.