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Dr. Jack Kevorkian died a couple of days ago. Has he been vindicated as a "man ahead of his time" by the passage of medical ethanasia laws in the US and elsewhere, or is what he did still ethically and legally unacceptable?
asked Jun 04 at 08:47AM in Other
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First: sorry for my english. I think that almost everything in euthanasia matter is not black or white, is grey. Pasive euthanasia is much frecuent as we honestly say.Julio C Campuzano MD commented Jun 18 at 07:52AM
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1Votes
answered Jun 04 at 09:09AMIt depends on whom you ask. I believe the view of him and his method has to do with the moral conscience of that particular individual and community.
As the saying goes, "One man's enemy is another man's friend."
Time will be the ultimate judge.-
God will be the Ultimate Judge Brendan ;-)Ros Freemantle commented Jun 05 at 11:30PM
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answered Jun 04 at 11:10AMI agree with Brendan, it is too early to know the answer to your question. For example, even what is called "terminal sedation" in hospice practice,to relieve all awareness and pain until the patient dies with or without termination of supportive therapy or hydration is still open to controversy.
One note of correction to Kim's question. There are no laws passed in the United States which supports the practice of euthanasia which classically would mean the direct and immediate act of a physician to provide a "peaceful death" at the patient's request. The laws passed in Washington State and Oregon, permit the physician to prescribe pills representing a lethal dose of a drug to be ingested or not ingested at the will and at the time set by the patient by the patient's own hand and is termed "physician-assisted suicide"(PAS).. Even PAS is not uniformly accepted as ethical practice in the United States. As a physician, I don't find my professional responsibility is to allow, by my intent and cooperation with the patient, the patient to commit suicide. If society is in favor of assisted suicide, then society should provide patients with technicians given the legal ability to write prescriptions for such patients. ..Maurice. -
0Votesanswered Jun 04 at 02:24PMI think what Dr. Kevorkian did openly, is probably what actually goes on in hospital acute and intensvie care wards every day all over the world, when a patient is suffering intensely and close to death. Some would think this is unethical, others, physicians easing patients out of their suffering, if that is what they have said they want, with or without an actual assisted suicide law.
Also, I think there is a very fine line between "assisted suicide" and "medical euthanasia".
Euthanasia has so much historical baggage associated with the term, that "assisted suicide" is more palatable for those taking part in it, in my view. -
1Votesanswered Jun 04 at 03:01PMKim, suicide should not be confused with euthanasia. Euthanasia is when a patient suffering from an illness requests to die and a second person (generally a physician) will accept the request and at the time for death directly administer a lethal drug with the intent that the patient's request is met and the patient dies peacefully. Suicide is the voluntary killing of oneself. Physician-Assisted Suicide which is the only form of medical suicide legalized within the United States (Oregon and Washington State) is as I described in my response above and should not be made equivalent to euthanasia since the physician is not supervising, encouraging or directing the final act. ..Maurice.
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0Votesanswered Jun 04 at 04:08PMShould physicians or anyone else be facilitating suicide for any reason, or is that directly contradictory to the "do no harm" principle of the Hippocratic Oath? Secondly, please enlighten me on the difference(s) between what Dr. Kevorkian did, and a physician in Washington or Oregon providing patients the means to kill themselves? Is state sanctioning the only difference?
One person goes to prison and another is told by the state that a simlar act is ok? It is like the state sanctioned murders on death row, compared to an individual doing the same thing out on the streets of America. Or am I wrong..... -
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answered Jun 04 at 10:15PMI agree with Kim that this is a practice that exists, but is one that dare not be spoke of for fear of repercussion.
How is respect for autonomy different when someone makes an educated decision to participate in physician-assisted death?
It is odd that humans are not allowed avoid suffering, when this is clearly the humane solution for other species. -
0Votesanswered Jun 04 at 11:07PMI am not against the autonomous desire for or the final act of suicide if the individual has the non-depressed and rational explanation for the desire or the act. If significant depression is present, diagnosed and appropriately treated and the patient recovers and after rationally evaluating his or her life situation still desires to die at the patients own selected time, I have no qualms about that. I do think however that even with a rational decision, that decision for suicide should not be kept to the individual's own thoughts but shared with others (friends, family, physicians) who might help and find ways to mitigate for the person the issues which has led to that decision.
I am not sure of all the factors which led to Dr. K.'s conviction and prison sentence. However, his actions were not fully comparable with the Washington State or Oregon's physician-assisted suicide. I don't recall that he had anyone else evaluate the patient's mental state and rationale for suicide other than himself. He was present with his "gadget" at the very time the patient had planned to die and I am sure set up the intravenous lines or whatever and I am sure would be monitoring that the system was working. Though it is said that the "patient pressed the button" to begin the suicide act, I am sure that Dr. K was there to help and facilitate. This is entirely different than the physician-assisted suicide state laws, where the prescribing physicians are required to follow a legal protocol of evaluation and confirmation before writing a prescription for the lethal drug dose. Also, once the prescription is written, the physician is no longer part of the further process in the decision of the patient as to whether or when to take the pills and is not present when the pills are taken and the patient either dies or the attempt misfires. In the latter case, the physician is not present to give the patient another attempt. To my understanding, that is the difference between Dr.K's role in his participation and the role of the physician in the legal physician-assisted suicide. ..Maurice.-
By the way, Kim as you recall, I presented the interesting scenario of an attempt suicide with the Question "Must a physician be required to participate in completing a yet uncompleted suicide attempt by following the patient’s refusal for life-saving treatment?" which can be reviewed at this link: http://www.medpedia.com/questions/1245-must-a-physician-be-required-to-participate-in-completing-a-yet-uncompleted-suicide-attempt-by-following-the-patients-refusal-for-life-saving-treatment
You, I and Eric Shore discussed that Question last year. ..Maurice.Maurice Bernstein MD commented Jun 04 at 11:20PM -
Yes, there was a similar discussion. That said, I am interested in people's views of Jack Kevorkian's stance in light of other discussions and legal developments. It is not a "resolvable" issue, like many we discuss, due to the myriad viewpoints, none of which are "wrong".Kim M Robinson commented Jun 05 at 07:59AM
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0Votesanswered Jun 05 at 08:07AMAs a Registered Counselor in Washington State for several years, I was sent the legal definition of assisted suicide by the Washington Department of Health. Dr. Bernstein is correct in his description. Some key points: two physicians must be involved, the patient CANNOT have diagnosed clinical depression, and there is a waiting period between the request and the provision of medication for ending one's life. There are enough checks and balances to satisfy my personal criteria that it is a sound law. Those points were of course missing in the Kevorkian case. That said, the overally principle seems the same to me, as one is still facilitating a suicide. How it is gone about, and by whom, is different. Finally, does Kevorkian deserve the designation he is stuck with in perpetuity, "Dr. Death"? And what does naming him such say about our society's views on death, assisted suicide, and medical ethics?
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1Votes
answered Jun 06 at 06:29AMAssisted suicide is legal in many EU countries like Switzerland and Netherlands. As Kim has stated this practice is hidden but done often to relieve suffering and pain in terminal phase of life.
In Ayurveda, doctors accompanied patients in the terminal phase of life and the reincarnation or perpetual cycle of life and death made it easily acceptable to the patient and families. Dr. Kevorkian was probably moved by the pain and suffering of his patient and should be credited with initiating a movement for legal assisted end of life in terminal patients.-
A courageous comment, considering how Dr. Kevorkian has been demonized and criminalized over the years. Perhaps there is also a cultural aspect as you point out, Krishan, as North America tends to be death denying, whereas Indian and other societies with different traditions and religions such as Buddhism and Hinduism, affirm death as part of life and reincarnation. Just a thought....Kim M Robinson commented Jun 06 at 07:56PM
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0Votesanswered Jun 12 at 12:53PMFrom a Medscape article on "Dr. Death" AKA Jack Kevorkian:
http://www.medscape.com/viewarticle/743977?sssdmh=dm1.693273&src=nldne
"The American Medical Association takes a similar stance, condemning physician-assisted suicide as unethical. However, in an online survey conducted by Medscape last year, 45.8% of physicians answered yes to the question, "Are there situations in which physician-assisted suicide should be allowed?" Another 40.7% answered no, while 13.5% said, "It depends."
The article makes a distinction between "physician assisted death" and "physician assisted suicide". If the AMA is against the actions of Dr. Kevorkian as unethical, why is it then that the survey noted a high number of physicians in favour of an unethical "physician assisted suicide"? Of course it is only one survey, and who knows how many took part. Are the results significant?
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The content on or accessible through Medpedia.com is for informational purposes only. Medpedia is not a substitute for professional advice or expert medical services from a qualified health professional.
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