Rx For Death

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Kevorkian says that he always tries to talk people who come to him out of killing themselves. But some circumstances, he believes, produce the mental anguish that may justify suicide. "You can't dope up a quadriplegic," he argues. "There's no pain to alleviate, but the anguish in the head is immense, especially after five or 10 years of lying on your back looking up at the ceiling." He says he would love to debate the critics who charge that he is too hasty in deciding who may die. "I will argue with them if they will allow themselves to be strapped to a wheelchair for 72 hours so they can't move, and they are catheterized and they are placed on the toilet and fed and bathed. Then they can sit in a chair and debate with me."

Somewhere between the prospect of a slow death in intensive care and a quick death at the hands of a doctor lies the vast middle ground. It is this middle ground, his critics charge, that Kevorkian in his single-minded focus on death, too often fails to explore. "Our experience says the great majority of the time these people are lonely, isolated and actually in need of better medical care rather than somebody to euthanatize them," says Harris of the American Academy of Medical Ethics.

A few months ago, if asked about Dr. Kevorkian, Solomon Mirin, 81, of Boca Raton, Florida, would have gladly joined in the crusade. "There are too many sick and hurting people in pain, with no quality of life, just waiting to die." But by Jan. 12, his thinking had changed forever. That was the day his wife died.

Just before Christmas, Maxine Mirin began to complain about being tired all the time. On Christmas Day, she was diagnosed with acute myeloid leukemia, and doctors gave her one week to live. She lasted for two. That was all the time it took, Mirin said, to "come 180 degrees in my attitude. I can still intellectualize why people seek out a person like Kevorkian. But I've come to understand that the lives of even the terminally ill are precious and matter, right up to the last second of breath. There is such a thing as dying with grace, dignity, compassion and support, and there are alternatives to the kind of suicide Kevorkian proposes."

The alternative was a hospice in Atlanta, where the Mirins' nephew lived and where they had already purchased their grave sites. Metro Hospice brought to their nephew's home a wheelchair, hospital bed, special padding, oxygen. They provided care and pain medication during Maxine's last four days. "She was not able to talk, but she was able to hold her hand out to me. She knew I was there and that I loved her and valued her life." Mirin was charged "not even 10 cents" for the service; it was all covered by Medicare.

In the past five years, hospitals have recognized the need to set up hospices, but "hospice doctors are considered to be on the margin of medical practice," says Annas. "They are not thought of as real doctors because they don't try to cure people, they just help them die. So many physicians either don't refer patients to hospices or wait until the last week of life before they do it."

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