The conviction for murder of Jack Kevorkian brings into stark relief a major moral issue of our time. Do we value more strongly a reverence for life, regardless how painful? Or, do we hold more dearly our right to control our own bodies, our right to death as a fundamental element of our right to "life, liberty, and the pursuit of happiness?" Like all troubling moral questions, this one provokes differing responses from reasonable and moral people.
Our society is clearly divided. Only one state, Oregon, permits assisted suicide. Thirty-six states explicitly outlaw the practice. Although Michigan voters approved a law banning assisted suicide, four juries of Michigan citizens refused to convict Kevorkian in earlier trials. Even the courts cannot agree. Five Michigan judges ruled that Americans have a constitutional right to assisted suicide before the Michigan Supreme Court disagreed. Two federal appeals courts have ruled that Americans have a constitutional right to determine the time and manner of their death. The American public is equally divided, with a majority believing that Kevorkian should have been tried, but a majority also believing that he should have been acquited. And, although a fifth Michigan jury convicted Kevorkian on Friday of murdering Thomas Youk, Youk's family believes the conviction is wrong and immoral.
What are the prevailing concerns that so divide us? The most extreme of those who oppose the concept of doctor-assisted suicide believe that all life is sacred, and that no living thing has the right to end a human life created in God's image. Others worry about systemic abuses: the possibility that the poor and uninsured will be subtly encouraged to consider a painless end to a squalid life. Still others believe that individual abuses will occur, with avaricious relatives taking advantage of mentally unstable or emotionally depressed patients who could, with better treatment, find some joy in their final days. Other opponents believe that assisted suicide will take the place of effective end-of-life care, and that it is immoral to support the taking of life before all other options, including better palliative care and depression treatment, are universally available. Finally, some believe the societal cost of legal assisted suicide, including family conflict and legal challeng
es, will outweigh any potential benefits.
Proponents of assisted suicide argue that individuals have a right to control their own lives, including the right to end it. To whom, they say, does one's life belong? The courts have ruled it legal to accept a patient's wish to end life-sustaining treatment, others point out, so why is it not acceptable to help patients end a pain-filled life through more active means? If we believe we have adequate means to consider the mental stability and vibrancy of patients who choose to switch off life support systems, why are we unable to make the same judgments about those who choose to end their lives through more active means? Still others point out that more than 10% of physicians admit they have prescribed medications to help patients die. Wouldn't it be better, they say, to make this practice legal so that it could be openly discussed and managed with adequate safeguards?
I have a personal point of view. In 1991, my brother died a slow and painful death with AIDS. I remember well one visit during the spring before he died. He asked me if I would help him gather information from the Hemlock Society, an organization that supports the right of terminally ill patients to end their lives, and provides information on methods and medications. I remember being silent for a long time after he asked me this question. I couldn't accept his death so easily. I finally promised him that I would learn more.
After I left him that day and flew back to my home in Colorado, I couldn't stop thinking about his request. I called the Hemlock Society and read their material. I talked more to my brother on the telephone. On my next visit, my last when he could still talk, he told me not to worry. He told me that a doctor (one of the 10 percent) had already prescribed drugs that could end his life if he chose to do so. He could see that I was torn by this, and in his courageous way of helping me and others come to terms with his death, he explained how comforting and important it was to feel some control over the horrific process of dying with AIDS. "I will probably never use those drugs," he said, "but I rest more easily and live more comfortably knowing they are there." Would I convict his doctor of murder? Not on your life.
