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Greasing the Ethical Skids


Boston. -- This time, Jack Kevorkian is sending out formal invitations. He is welcoming others to be present when he assists his next suicide.

"Put a group together -- a judge, a philosopher, a garbage collector, a housewife," said the self-described obitiatrist or death doctor last week, "and have the whole group be with me right there to the end."

He wants a circle of observers to be there for the counseling. He wants an audience to be there for the death day. RSVP, if you please.

Nobody ever called Jack Kevorkian shy. A renegade or crusader, maverick or martyr, he has brought the issue of physician-assisted suicide onto the public stage in the most dramatic way possible. Four women have now died with the help of the man who says, "My motto is a rational policy of planned death." One woman had Alzheimer's, another multiple sclerosis, a third and fourth suffered from intractable pain. None was terminally ill.

Just a week before he issued this invitation, a Detroit judge dismissed a first-degree murder charge. The state couldn't prove that Dr. Kevorkian had done more than provide the means of death. No law was broken because there is no law against physician-assisted suicide.

The last time I wrote about Jack Kevorkian, in May, I called him a serial mercy killer who had stepped outside the boundaries of this ethical debate about the right to die. He was a free-lancer in the death-delivery business.

The protest letters that I got -- well over a hundred -- came from Americans who fear dying more than death, people who wrote about mercy and about autonomy, about technology and humanity. Many were elderly, like the man from Scotia, New York, who wrote, "I am an 84-year-old man. I have emphysema, prostate cancer and a few other things including a gradual loss of memory. Kevorkian sounds like someone I should keep in mind."

Many regarded Dr. Kevorkian as a patron saint of medicine. "From my perspective," wrote a reader from Apex, North Carolina, "Kevorkian was and is an angel of mercy."

"You call Kevorkian a serial killer, " wrote a Boulder, Colo., woman. "I call him a man of compassion." "You call Jack Kevorkian an ethical outlaw," wrote a Bloomington, Ind., man. "I call him an ethical hero."

If you are in favor of allowing physicians to assist in suicide, my correspondents believe, you must be in favor of Dr. Kevorkian. If you are opposed to him, you must be opposed to a gentle death.

I beg to differ. I believe that suicide can be a rational choice. I understand and share the desire for a gentle death, avoiding the clutches of technology. I believe that physicians should be allowed to assist in some suicides of the terminally, painfully ill.

I also believe that this is an ethical terrain with all sorts of slippery slopes. Instead of proceeding carefully, Dr. Kevorkian has poured grease over the surface.

This pathologist, who never treated a live patient before he went on call for death, has decided that he can tell who needs help dying and who needs help living. That he knows who is depressed and who is rational. That he can say when aiding suicide is merciful and when it is murderous. He dismisses cautious colleagues trying to establish guidelines as "arrogant, greedy, deceitful, hypocritical wimps."

On his own agenda, Dr. Kevorkian has done more harm than good to the cause he claims as his own.

Last fall, Initiative 119, a carefully constructed death-with-dignity proposal, was on its way to passage in Washington. Just two weeks before the election, news of another Kevorkian strike lent credence to the opposition's image of doctors as uncontrolled agents of death.

This November, Californians will vote on a similar proposition allowing physicians to help the terminally ill die. The supporters of that ballot question properly regard Dr. Kevorkian as a threat, not a hero.

In Michigan, there is fear that Dr. Kevorkian's challenge will force the legislature to enact a hasty or harsh law. Even the judge who dismissed the homicide charge appealed to Dr. Kevorkian directly, "This judge . . . respectfully requests that you forgo any other activities. . . . To continue I fear hurts your cause."

Unlike my correspondents, I believe you can favor guidelines that allow doctors to assist in some suicides, and yet be opposed to this obitiatrist, Jack Kevorkian. The two views are not only compatible; they're essential.

As for the invitation to his next assisted suicide, I must send my regrets.

Ellen Goodman is a syndicated columnist.

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