Dr. Death Faces Off With Prosecutors Once Again

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Get ready for another Dr. Death spectacular. On Monday jury selection began in the fifth death-related trial of Dr. Jack Kevorkian, this time on first-degree murder charges. Having escaped conviction four times before for helping terminally ill patients commit suicide, Kevorkian may be facing his most sensational legal battle yet. It combines shocking TV drama -- Kevorkians videotaped killing of Thomas Youk, a 52-year-old suffering from Lou Gehrigs disease, which was aired on "60 Minutes" last year -- with a high-stakes legal issue: Should Kevorkian be found guilty on charges of first-degree murder for not just helping someone take his life, as has been the case in the past, but actually killing the patient by personally administering a lethal injection? How sad that this crucially important issue should be forced by a cowboy, says TIME medical columnist Christine Gorman.

The issues raised by this case deserve a more reasoned airing than that which will be provided by the flamboyant Kevorkian, who obtained judicial permission to represent himself on Monday. There is a strange glee about the way Kevorkian conducts his business, which makes it more difficult to talk about assisted suicide, says Gorman. There are no checks and balances on him. Kevorkians all-or-nothing approach glosses over many issues. A very important one is pain. It turns out, says Gorman, that many terminally ill patients will not consider the option of death if their pain can be treated adequately. Another important matter is peace of mind. The death option is not one very many terminally ill patients actually intend to exercise. Mostly the choice serves as a palliative, says Gorman, by just letting people know theres another way out. Which is why the Oregon model is the one that should be studied. Oregons doctor-assisted suicide law provides a carefully calibrated decision mechanism that is safe, reasonable and ethical, says Gorman. No one has rushed, or was rushed, to die in the year since the Oregon law went into effect; so far, 15 terminally ill patients have chosen to die. Few really know whether Dr. Kevorkians freelance work involved a similar, careful deliberative process.