Rx For Death

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Kevorkian's new stealth strategy may simply be a means of self-preservation. Indeed, his chances of avoiding prison improved enormously at the end of the week, when Judge Cynthia Stephens, citing a technicality, struck down the Michigan law that threatened to curtail Kevorkian's efforts. Stephens also found that two terminally ill plaintiffs in the A.C.L.U. case had a right to die. She wrote, "This court cannot envisage a more fundamental right than the right to self-determination.' '

The ruling left Kevorkian's opponents flabbergasted. "If I were a gambler, I'd bet that Kevorkian will kill someone tomorrow," said local Operation Rescue activist Lynn Mills after hearing the decision. "He's really out of control."

Over the years Kevorkian has been generous to his adversaries in the church, - the press, the medical profession, even the euthanasia movement. Every time he speaks or writes he hands them ammunition to dismiss him as a psychopath. "If I were Satan and I was helping a suffering person end his life, would that make a difference?" he asks. "Any person who does this is going to have an image problem." That larger-than-death image grew with each story of his early experiments transfusing blood from cadavers to live patients, his paintings of comas and fevers, his bright-eyed enthusiasm for his "Mercitron" machines. With his deadly humor and his face stretched tight around his skull, he has become a walking advertisement for designer death.

The Mansur case, like those that preceded it, captures the worst fears of opponents of doctor-assisted suicide. By operating outside the law, they say, doctors like Kevorkian go unregulated, unsupervised, abiding only by those safeguards they impose on themselves. They alone make judgments about the patient's state of mind; about what means, short of death, might relieve the suffering. They transform the image of the doctor from pure, emphatic healer to something more ambiguous, even sinister, whose purpose at the patient's bedside is no longer clear.

But in the eyes even of some who disagree with his methods, Kevorkian has become the devil that doctors deserve. Arthur Caplan, director of the University of Minnesota's Center for Biomedical Ethics, puts it succinctly. "I'll give him this," he says. "He tells us exactly where the health- care system stinks." Even some doctors reluctantly agree. "A significant percent of the American public sees Kevorkian as a reasonable alternative to modern medicine," says professor George Annas of Boston University's School of Medicine. "He's a total indictment of the way we treat dying patients in hospitals and at home. We don't treat them well, and they know it."

This mistreatment, he says, is a combination of deceit, insensitivity and neglect. "First we don't tell them they are dying. We do tell them their diagnosis and all the alternative treatments available. But we don't tell them their prognosis. We tell them 'You have cancer, and you can have surgery, radiation, chemotherapy, or all three together, or even any two.' We don't tell them that no matter what we do, it's almost certain they are going to die soon."

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