Dr. Jack Kevorkian, the central figure in the tumultuous national drama surrounding assisted suicide, died Friday in a Michigan hospital. He was 83 and lived in Bloomfield Hills, Michigan.
The cause of his death was not immediately known, but local media reported that he had suffered from kidney and respiratory problems and that his condition had been worsening in recent days. His death was confirmed by Geoffrey Feiger, the lawyer who represented him during several of his trials in the 1990s.
Dr. Kevorkian, a medical pathologist, challenged social taboos about disease and dying, willfully defied prosecutors and the courts, actively sought national celebrity, and spent eight years in prison after being convicted of second-degree murder in the death of the last of the more than 100 terminally ill patients whose lives he helped end.
From June 1990, when he assisted in the first suicide, until March 1999, when he was sentenced to serve 10 to 25 years in a maximum security prison, Dr. Kevorkian was a controversial figure. But his critics and supporters generally agree on this: As a result of his stubborn and often intemperate advocacy for the right of the terminally ill to choose how they die, hospice care has boomed in the United States, and physicians have become more sympathetic to their pain and more willing to prescribe medication to relieve it.
In 1997, Oregon became the first state to enact a statute making it legal for physicians to prescribe lethal medications to help terminally ill patients end their lives. In 2006 the United States Supreme Court upheld a lower court ruling that found that Oregon's Death With Dignity Act protected a legitimate medical practice.
During the nine years between the law's passage and the court's ruling, Dr. Kevorkian's confrontational strategy consumed thousands of column inches in national newspapers, graced the covers of national magazines and drew the attention of "60 Minutes" and other television news programs. His nickname, Dr. Death, and his self-made suicide machine, which he variously called the "Mercitron" or the "Thanatron," became fodder for late-night television comedians.
Given his obdurate public persona and his delight in flaying medical critics as "hypocritic oafs," Dr. Kevorkian invited and reveled in the public's attention, regardless of its sting.
The American Medical Association in 1995 called him "a reckless instrument of death" who "poses a great threat to the public."
Diane Coleman, the founder of Not Dead Yet, a right-to-life advocacy group that once picketed Dr. Kevorkian's home in Royal Oak, a Detroit suburb, attacked his approach. "It's the ultimate form of discrimination to offer people with disabilities help to die," she said, "without having offered real options to live."
But Jack Lessenberry, a prominent Michigan journalist who closely covered Dr. Kevorkian's one-man campaign, said: "Jack Kevorkian, faults and all, was a major force for good in this society. He forced us to pay attention to one of the biggest elephants in society's living room: the fact that today vast numbers of people are alive who would rather be dead, who have lives not worth living."
In the late 1980s, after an undistinguished career in medicine and an unsuccessful try at a career in the arts, Dr. Kevorkian rediscovered the fascination with death, not as a private event but as a focus of public policy, that had marked his early years in medicine.
As a student at the University of Michigan Medical School, where he graduated in 1952, and later as a resident at the University of Michigan Medical Center, Dr. Kevorkian proposed giving murderers condemned to die the option of being executed with anesthesia in order to subject their bodies to medical experimentation and allow the harvesting of their healthy organs. He delivered a paper on the subject to a meeting of the American Association for the Advancement of Science in 1958.
In the 1960s and 1970s, Dr. Kevorkian shelved his quixotic campaign to engage death for social purposes and pursued a largely itinerant career as a medical pathologist. Though his friends described him as funny, witty, personable and engaging in private, those he met in work and social situations portrayed him as awkward, grim, driven, quick to anger and unpredictable.Fiercely principled and highly inflexible, he rarely dated and never married. He lived a penurious life, eating little, avoiding luxury and dressing in threadbare clothing that he often bought at the Salvation Army and Goodwill. In 1976, bored with medicine, he moved to Long Beach, California, where he spent 12 years producing an unsuccessful film about Handel's "Messiah," painting and writing, supporting himself with part-time pathology positions at two hospitals.
In 1984, prompted by the growing number of prison executions in the United States, Dr. Kevorkian revisited his idea of giving death row inmates a choice. He was invited to brief members of the California Legislature on a bill that would enable prisoners to donate their organs and die by anesthesia instead of poison gas or the electric chair.
The experience was a turning point. Energized by the attention of lawmakers and the news media, he became involved in the growing national debate on dying with dignity. In 1987 he visited the Netherlands, where he studied techniques that allowed Dutch physicians to assist in the suicides of terminally ill patients without interference from legal authorities.
A year later, he returned to Michigan and began advertising in Detroit-area newspapers for a new medical practice in what he called "bioethics and obiatry," which would offer patients and their families "death counseling." He made reporters aware of his intentions, explaining that he did not charge for his services and bore all the expenses of euthanasia himself. He showed journalists the simple metal frame from which he suspended vials of drugs — thiopental, a sedative, and potassium chloride, which paralyzed the heart — that allowed patients to end their own lives.
He also talked about the "doctrine" he had developed to achieve two goals: ensuring the patient's comfort and protecting himself against criminal conviction in a court of law. He required patients to clearly express a wish to die. Family physicians and mental health professionals were exhaustively consulted. At least a month was needed to give patients time to consider and change their minds. Dr. Kevorkian videotaped interviews that he conducted with patients, their families and their friends. And he videotaped the suicides, which he called "medicides."
On June 4, 1990, Janet Adkins, a teacher from Oregon who suffered from Alzheimer’s disease, was the first patient to avail herself of Dr. Kevorkian's assistance. Mrs. Adkins's life ended on the bed inside Dr. Kevorkian's rusting 1968 Volkswagen van, which was parked in a campground near his home.
Immediately afterward Dr. Kevorkian called the police, who arrested and briefly detained him. The next day Ron Adkins, her husband, and two of his sons held a news conference in Portland and read the suicide note Mrs. Adkins had prepared. In an interview with The New York Times that same day, Dr. Kevorkian alerted the nation to his campaign.
"My ultimate aim is to make euthanasia a positive experience," he said. "I'm trying to knock the medical profession into accepting its responsibilities, and those responsibilities include assisting their patients with death."
Over the next eight years Dr. Kevorkian said that he assisted in some 130 suicides. Patients from across the country traveled to the Detroit region to seek his help. Their bodies turned up in homes, cars, campgrounds, apartments and hospitals across southeast Michigan.
Prosecutors, jurists, the state Legislature, the Michigan health authorities and Gov. John Engler seemed helpless to stop him, though they spent years trying. In 1991 a state judge, Alice Gilbert, issued a permanent injunction barring Dr. Kevorkian from using his suicide machine. The same year the state suspended his license to practice medicine. In 1993 Michigan approved a statute outlawing assisted suicide. It was declared unlawful by a state judge and the state Court of Appeals, but in 1994 the Michigan Supreme Court ruled that assisting in a suicide was a common-law felony, and that there was no protected right to suicide assistance under the state Constitution.
None of the legal restrictions seemed to matter to Dr. Kevorkian. In several instances he assisted in patient suicides just hours after being released from custody for helping in a previous one. After one arrest in 1993 he refused to post bond, and a day later he said he was on a hunger strike. During another arrest he fought with police officers and seemed to invite the opportunity to spend time in jail.
He obviously liked the attention. At the start of his third trial, on April 1, 1996, he showed up in court wearing Colonial-era clothing to show how medieval he thought the charges were.From May 1994 to June 1997, Dr. Kevorkian stood trial four times in the deaths of six patients. With the help of his young and flamboyant defense attorney, Mr. Feiger, three of those trials ended in acquittal and the fourth was declared a mistrial.
Mr. Feiger based his winning defense on the compassion and mercy Dr. Kevorkian showed his patients. Prosecutors felt differently. "He's basically thumbed his nose at law enforcement, in part because he feels he has public support," Richard Thompson, the prosecutor in Oakland County, Michigan, told Time magazine in 1993.
But on March 26, 1999, after a trial that lasted less than two days, a Michigan jury found Dr. Kevorkian guilty of second-degree murder. That trial came six months after Dr. Kevorkian had videotaped himself injecting Thomas Youk, a patient suffering from amyotrophic lateral sclerosis (Lou Gehrig's disease), with the lethal drugs that caused Mr. Youk's death on Sept. 17, 1998.
Dr. Kevorkian sent the videotape to "60 Minutes," which broadcast it on Nov. 22. The tape clearly showed Dr. Kevorkian going well beyond assisting a patient in causing his own death. The program portrayed him as a zealot with an agenda. "They must charge me. Either they go or I go," he told Mike Wallace. "If they go, that means they'll never convict me in a court of law."
The broadcast, which prompted a national outcry about medical ethics and media responsibility, also served as prime evidence for a first-degree murder charge brought by the Oakland County prosecutor’s office. In a departure from his previous trials, Dr. Kevorkian ignored Mr. Feiger's advice to seek professional counsel and defended himself, not at all well. It was an act of arrogance he later said he regretted.
"You had the audacity to go on national television, show the world what you did and dare the legal system to stop you," said District Judge Jessica R. Cooper, who presided over the trial. "Well, sir, consider yourself stopped."
On June 1, 2007, Dr. Kevorkian was released from prison after he assured authorities he would never conduct another assisted suicide.
Murad Kevorkian was born in Pontiac, Michigan, on May 26, 1928. He was the second of three children and the only son born to Levon and Satenig Kevorkian, Armenian refugees. His father founded and owned a small excavation company.
The young Jack Kevorkian was described by his friends as an able student interested in art and music. He graduated from the University of Michigan, where he initially pursued a degree in engineering before switching to medicine.
He was the author of four books, including "Prescription: Medicide, the Goodness of Planned Death" (Prometheus, 1991). He is survived by his sister Flora Holzheimer, who lives in Germany.