Showdown For Doctor Death

By ADAM COHEN

Dr. Jack Kevorkian's televised killing of Thomas Youk, 52, on 60 Minutes last week had the familiar dramatic arc of an infomercial. Act I presents the vexing problem--baldness, cellulite or, in this case, Youk's advanced-stage Lou Gehrig's disease. In Act II the host touts a miracle solution--hair transplants, Taekwondo or a shot of heart-stopping potassium chloride. In the final act come the gushing testimonials. Youk couldn't play the role of satisfied customer himself--by Act III he was dead--but his wife Melody stepped in. "I don't consider it murder," she told the viewers at home. "I consider it humane."

After centuries of bad p.r., Death has a media strategy. And its chief spin doctor is named Kevorkian. He's too demonic to be an ideal pitchman. When he bent over Youk with a syringe and asked, "Sleepy, Tom?," the image was bloodcurdling. But he has an unerring sense of what excites journalists--and incites prosecutors. Three days after the 60 Minutes story aired on CBS, Kevorkian got what he had explicitly wished for: he was charged with first-degree murder. Though he has been acquitted three times of helping patients end their life, this time he crossed a significant line: he administered the lethal injection himself. And thus Kevorkian has single-handedly moved the national debate over the right to die a wrenching step farther: from doctor-assisted suicide to mercy killing.

The televised death of Youk, a vintage-car restorer from Waterford Township, Mich., set off a round of finger pointing over the motives behind the performance. Oakland County prosecutor David Gorcyca, who filed the murder charges last Wednesday, accused Kevorkian of airing the video to satisfy his "attention-starved ego." CBS, meanwhile, faced accusations of exploiting the death for ratings. The segment did help boost the show's numbers--the household rating was up 20% over the season average--during the critical fall sweeps period, which sets local advertising rates. Don Hewitt, 60 Minutes' executive producer, insisted his show wasn't pandering for ratings. "I have a low threshold for discomfort, and I was not made uncomfortable by the moment of death," he says. "I didn't see anybody writhing in agony. I didn't see anything that would make me turn my face away." With euthanasia being so hotly debated, he adds, "the story we put on the air, exactly as we told it, was a fit and proper one for 60 Minutes."

The video gave ammunition to both sides in the debate. "This was a very ill man dying a gentle, peaceful death in the time and manner he requested," says Faye Girsh, executive director of the Hemlock Society USA, a group that promotes physician help in dying. "I think we should see more people dying this way." Opponents saw it differently. "I certainly didn't see any compassion," says Ned McGrath, spokesman for the Roman Catholic Archdiocese of Detroit. "His last moment on earth, and he's left in a room with Jack Kevorkian and a video camera. What a horrible way to leave the world." Critics say that since Kevorkian made the video himself, it is impossible to know precisely how sick Youk was and what he knew when he consented.

Polls suggest that up to 75% of Americans back mercy killing, though most state efforts to make it legal have not succeeded. Voters in Oregon passed a Death with Dignity Act by a 60% majority last year, making it the only state to legalize assisted suicide. California and Washington defeated "aid in dying" referendums in the early 1990s. And Michigan rejected an assisted-suicide initiative this year by a landslide of 71% to 29%. (No state allows the sort of mercy killing that Kevorkian aired last week.) Courts have largely bowed out of the issue. In 1990 the Supreme Court held that patients have a right to refuse medical treatment. But in a pair of 1997 cases it ruled that the Constitution takes no position on the thornier issue of physician-assisted suicide. There is no right to it, the court said, but states are free to permit it.

The dirty little secret about euthanasia is that it's common in hospitals, hospices and nursing homes even in the 49 states where it's illegal. It just isn't talked about. A study published in the New England Journal of Medicine this year found that 1 in 21 doctors surveyed had administered a lethal injection to end suffering. A doctor in the anonymous survey reported having done it 150 times.

Kevorkian, however, is the only one who has stepped forward to proclaim himself a mercy killer on national TV. A retired pathologist, he first came to prominence in 1990 when he helped a relatively healthy 54-year-old woman with Alzheimer's disease kill herself with a suicide machine of his invention. Since then he has assisted in more than 130 suicides. "He's the Tom Paine or the Martin Luther King of our movement," says Girsh. "He's willing to break the law for the cause." But to his critics he is an unrepentant killer who harbors an unhealthy fascination with death. Kevorkian does little to dispel such suspicions. Asked by Mike Wallace if there isn't something "ghoulish" about his approach, he responded, "I can't argue with that--maybe it is ghoulish."

Kevorkian taunted the prosecution into arresting him for Youk's death. "Do you have to dust for fingerprints?" he said on 60 Minutes. Even so, prosecutors waited until they had viewed the unedited video of Youk's death (not just the excerpts that 60 Minutes broadcast) before deciding to bring charges. Kevorkian, who at times smiled giddily at his arraignment, was released on a personal bond until the trial, which could take place in the spring. If the facts are as they appear in the video, Kevorkian could put together a fairly compelling case. He can invoke Youk's enfeebled state--he had lost the use of his arms and legs, had trouble breathing, was barely able to speak and frequently choked on his saliva, according to family members. And a jury may be swayed by the fact that Youk and his family all asked for the death.

Technically, none of this is a defense to a murder charge. But jurors have long engaged in "jury nullification" in mercy killings, declining to convict even when the facts and law are damning. Still, juries are hard to predict. Last year a Louisiana man, David Rodriguez, rejected a plea bargain in the mercy killing of his Alzheimer's-ridden 90-year-old father. He was convicted and sentenced to life in prison. Complicating matters for Kevorkian is that he seems intent on representing himself--a move his former attorney, Geoffrey Fieger, says could be disastrous.

If Kevorkian is acquitted, it will be a major p.r. victory for the right to die. If he loses, he has vowed to starve himself to death in jail. Either way, Death will get plenty of headlines--but his spin doctor will probably get even more.

--With reporting by Julie Grace/Waterford Township and William Tynan/New York

With reporting by Julie Grace/Waterford Township and William Tynan/New York