Choosing to end life: Kevorkian or no, the debate continues


February 25, 1993|By ALICE STEINBACH

As their days dwindle down to a not-so-precious few, scores of panicked, dying people are flooding Michigan physician Jack Kevorkian with letters begging for his help in ending their lives.

Time, they are aware, is now running out not only for them but for Dr. Kevorkian as well.

They know that after March 30, Dr. Kevorkian -- dubbed "Dr. Death" for his role in assisting 15 dying people to end their lives -- will face criminal charges if he participates in another doctor-assisted suicide.

The law, signed by Michigan Gov. John Engler, was passed after several attempts to prosecute Dr. Kevorkian were rebuffed by the courts.

It is this law, apparently -- one which carries the possibility of a prison sentence -- that accounts for the number of dying people now trying to contact Dr. Kevorkian.

"People are becoming more desperate," Michael A. Schwartz, one of the doctor's lawyers, told the Washington Post. "They're concerned that the law will prevent them from getting the help they need, that he'll be in jail when their time comes."

But while the March 30 deadline may bring to an end Dr. Kevorkian's actions, there is little doubt that the heated debate over "right-to-die" issues is just beginning.

Indeed, given the country's aging population and the kind of medical technology capable of prolonging life beyond, perhaps, a reasonable point, the right-to-die controversy may well emerge as the major issue of the 1990s.

It has already become a political issue. About 27 states have laws that make assisted suicide a crime. Other states, however, are working in the opposite direction: While right-to-die initiatives recently failed in California and Washington, similar measures will be introduced this year in Ohio and New Hampshire.

What began in the 1970s as a concept called "death with dignity" -- in other words, the right to refuse life-sustaining treatment in the event of terminal illness -- has now broadened in scope. The Kevorkian approach represents the right of a hopelessly ill patient to terminate life by suicide, with the aid of a doctor.

It is an idea that seems to have struck a responsive chord. According to a 1991 Gallup poll, 58 percent of those responding said a person has "the moral right" to end his or her life when the person "has a disease that is incurable." And 66 percent said a person had the same moral right when suffering "great pain" with "no hope of improvement."

In some ways, it is unfortunate that Dr. Jack Kevorkian has emerged as a key figure in the doctor-assisted suicide debate. An abrasive and arrogant man, some of his ideas seem eccentric and out of the mainstream. It is a combination guaranteed to derail any reasoned discussion of the question that lies at the heart of the right-to-die issue.

Which is: Does a person have the fundamental right to determine when he or she wishes to end life?

Many people will answer such a question based on religious belief. And, of course, there is no way to challenge such a position.

But there are also those who oppose the idea of a person's right-to-die based on the assumption that such requests are made by depressed people suffering great pain. Treat the depression, they say, control the pain through drugs, and they won't want to die anymore.

But many of us who have watched someone we love go through a terrible end-of-life struggle know there are other, darker outcomes as well.

We know that sometimes the depression centers on the knowledge that all the pain and suffering can only end in death. And we who have watched the pain escalate to unbearable levels in the dying know that drugs are an unsatisfactory answer.

But it is the "slippery slope" argument that at bottom dominates the debate: Once you begin down this path, the argument goes, you are on a slippery slope that could lead to grave abuses.

Life, it seems to me, is always a slippery slope. And every step we choose is capable of placing us in danger. But choose we do.

And by accepting death as a part of life -- as a process over which we continue to exercise some choice -- we honor the notion that humankind represents civilization at its best.

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