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Jack Kevorkian drove the debate on physician-assisted suicide

Jack Kevorkian, who died Thursday, was a controversial figure who confronted one of society’s most profound ethical issues: Should a physician be able to help a person commit suicide?

By Staff writer / June 3, 2011

Pathologist and assisted-suicide advocate Jack Kevorkian whose controversial tactics earned him the nickname 'Doctor Death,' died Thursday in Michigan, where he had spent eight years in prison.

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Ashland, Ore.

Jack Kevorkian was a highly controversial figure who confronted one of society’s most profound ethical issues: what happens at the end of an individual’s human life and whether or not a physician should take an active role in hastening that process.

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Dr. Kevorkian, who died Thursday, spent eight years in a Michigan prison, but not before he had been directly involved in the suicide of more than 130 people – sometimes in the back of his old Volkswagen van using a device he had invented to administer lethal substances.

But beyond his own history of sometimes outrageous behavior as he challenged the legal and medical establishments, Kevorkian also drove the debate on physician-assisted suicide – a political and legal fight involving state courts and legislatures, the US Justice Department, and the US Supreme Court.

The first known instance of Kevorkian using his “suicide machine” involved an Oregon woman in 1990. The last was in 1998, videotaped and broadcast on “60 Minutes,” and the case for which Kevorkian was convicted of second-degree homicide.

Between those dates, the effort to legalize controlled suicide involving help from a medical doctor took form with advocacy organizations like the Hemlock Society and Compassion & Choices.

'Death with Dignity' law breaks new ground

After two ballot measures in which voters approved the procedure (the second time in a rebuff to the state legislature), Oregon’s “Death with Dignity” law became the first in the country.

The Oregon law, enacted in 1997, strictly prohibits “lethal injection, mercy killing, or active euthanasia.” But it allows mentally competent adults who declare their intentions in writing, and have been diagnosed as terminally ill, to take a doctor-prescribed lethal drug themselves, orally, after a waiting period.

Critics had predicted that vulnerable patients could be pressured by doctors or family members to end their lives, and they also warned that out-of-staters might rush to Oregon to take advantage of its law.

Apparently, neither has happened. Since 1998, 525 patients have taken their own lives under the law, averaging about 60 a year for 2008-10.

At the same time, what medical practitioners consider ideal end-of-life care has increased here, including palliative treatment for discomfort, hospice care, and care that allows patients to spend their last days at home with families and friends.

Oregonians are also more likely to have "living wills" – documents in which they ask not to be kept alive by artificial means if recovery seems improbable – and medical directives on file, and they're more likely to decline medical treatments (including feeding and hydration tubes) that prolong life.

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