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Dr. Death has slipped by again. Because...


Dr. Death has slipped by again. Because Michigan law does not specifically rule out assisting in a suicide, murder charges against Dr. Jack Kevorkian were dismissed in the cases of two of the four seriously ill women who have used devices invented or acquired by Dr. Kevorkian to commit suicide.

To some, Dr. Kevorkian is an angel of mercy, providing help no one else dares to offer. To others, he is the zealot who puts a face on the fears of those who see in assisted euthanasia the first step down a very slippery slope.

Some of the doctor's harshest critics are those who agree that people should be allowed to seek the assistance of a physician when the time comes to die. It's easy to see why.

Last fall, less than two weeks before residents of Washington state were to vote on a landmark legislative initiative that would have legalized assisted suicide under carefully controlled conditions, Dr. Kevorkian grabbed headlines by helping Sherry Miller, 43, of Roseville, Mich., and Marjorie Wantz, 58, of Sodus, Mich., to kill themselves in a Michigan park.

Ms. Miller used a machine similar to one used in June 1990 by Janet Adkins, a device that allowed the women to flip the lethal switch themselves. Ms. Wantz died by inhaling carbon monoxide. Both women clearly wanted to die, and they sought out Dr. Kevorkian to help them do it.

None of these deaths would have been approved by the Washington state proposal. Even so, these stories may well have frightened enough Washington state voters to assure defeat of the referendum.

That raises the question: If Dr. Kevorkian believes so strongly in assisted suicide, why does he continue to draw headlines by participating in deaths in ways that no responsible society can condone?

If physician-assisted suicide is justifiable -- and there are responsible, conscientious doctors who believe that under certain circumstances it can be -- the issue deserves debate. Dr. Kevorkian is providing diversions from the serious questions by continuing to take advantage of Michigan's legal loopholes.

Dr. Kevorkian represents to many people a precious freedom -- the chance to free oneself of bodily pain and suffering should that need occur. But as many others recognize, there is a thin ethical line here. And it deserves more thought than Dr. Kevorkian is apparently willing to give.

If assisted suicide is ever justifiable, it should meet certain basic conditions. First, the physician involved should have an established relationship with the patient. He should know how ,, family and friends would be affected by this death. He should know the medical and psychological histories of the patient, as well as the prognosis. (It's worth noting that the women who died with Dr. Kevorkian's help were seriously ill, but not terminally ill. A terminal diagnosis means that death is expected within a defined period of time, usually six months.)

He should confer with other doctors. Most patients would want a second opinion before undergoing major surgery. Shouldn't death require two, or even three?

There should be other people involved in the decision as well -- clergy or others who have given serious thought to matters of life and death. Confining the process to one doctor, who has no established relationship with the patient, turns a serious matter into a circus. With "friends" like Dr. Kevorkian, the Washington state referendum hardly needed opponents.

(Do you have a question for Sara Engram? You can write to her in care of Universal Press Syndicate, 4900 Main St., Kansas City, Mo. 64112. Questions of general interest will be addressed in future columns.)

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