Vol. VII, No. 3 - Summer 1998

Charlotte's Corner

"Civil Rights Documents and Cases" (www.courttv.com/library/rights/) has many documents germane to the intensely debated and litigated issue of patholysis in general and to Dr. Jack Kevorkian's role in medically-assisted suicides. To start a simulated conference with a bang, so to speak, one might begin with the rather fiery debate between Geoffrey Fieger, one of Dr. Kevorkian's defense attorneys, and prosecutor John Skrzynski, as appears in www.courttv.com/library/rights/rtdebate.html.

In replying to the question if any countries have legalized medically-assisted suicide, the prosecutor states: "The one that I am most familiar with is the Netherlands. It is not legal there, but the law is simply not enforced. Studies have been done on the Netherlands and show that patients are being euthanized even against their will. So-called assisted suicide is being abused by doctors in the Netherlands. That is the true danger of assisted suicide: There is no meaningful way to regulate it. Once you open the floodgates, you lose control. . .If assisted suicide becomes an option, I believe that there is a strong financial incentive to substitute assisted suicide for extended health care for those with chronic and terminal illnesses." Fieger: "Everything the prosecutor said is bunk. To think that the Netherlands, a progressive western democracy, is liberalizing euthanasia even though the prosecutor claims it is being abused, is absurd. Euthanasia and assisted suicide are legal in the following countries and geographic areas, either on a de facto or a de jure [basis]: Netherlands, Northern Territories of Australia, Germany, Norway, nine western states of the U.S., including Oregon, California and Washington, New York and the other eastern states which make up the Second Circuit Court of Appeals district. . .The prosecutor mouths the lies of [the] right-to-life [movement] and the moneyed medical society. Can you believe that in America in 1996 we have people like the Oakland County prosecutor not only saying that when we are suffering we can be kept alive against our will, but also that they can take all our money from us while they are keeping us alive?"

Fieger's claims to the existence of strictly controlled, merciful patholysis are substantiated in "The Rules for Assisted Suicide" (www.courttv.com/library/rights/medassist.html) released by Physicians for Mercy for "obitiatrists" (a medical specialty not yet recognized). At our simulated conference, a speaker supporting the "physician for mercy" position could quote these guidelines and the interpreter student would have to translate them simultaneously.

Medical terminology is, of course, an essential part of doctor-assisted suicide cases, and using this terminology in context becomes part of an integrated training approach. Thus, in "Federal Judge Declares Assisted Suicide Not a Constitutional Right" (www.courttv.com/library/rights/kevrule.html), we find a description of Dr. Kevorkian's "suicide machine": "[Kevorkian's] 'suicide machine' consists of a frame holding three chemical solutions fed into a common intravenous line controlled by a switch and timer. Defendant admitted that he inserted the intravenous line needle into Ms. Adkins' arm, but testified that Ms. Adkins activated the switch that turned on the machine. . . The device consisted of a board to which one's arm is strapped to prevent movement, a needle to be inserted into a blood vessel and attached to IV tubing, and containers of various chemicals that are to be released through the needle into the bloodstream. Strings are tied to two of the fingers of the person who intends to die. The strings are attached to clips on the IV tubing that control the flow of the chemicals.

As explained by one witness, the person raises that hand, releasing the drug called methohexital, which was described by expert witnesses as a fast-acting barbiturate that is used under controlled circumstances to administer anesthesia rapidly. When the person falls asleep the hand drops, pulling the other string, which releases another clip and allows potassium chloride to flow into the body in concentrations sufficient to cause death."

At www.courttv.com/library/rights/assist.html, the first case of its kind to be decided by a Circuit court sitting en banc regarding the right to patholysis, we find detailed descriptions of the medical conditions of three mentally competent adult patients who, together with Compasion in Dying (a Washington non-profit organization), Harold Glucksberg, M.D., and three other physicians, sued the state of Washington and its Attorney General because of the state's ban on medically-assisted suicide, which the Plaintiffs-Appellees claimed violated the constitutional rights of mentally competent, terminally ill adults to have a "dignified and humane death." The three patients, named in this lawsuit as Jane Roe, John Doe and James Poe in order to safeguard their privacy, wished to die because of the suffering caused by their heart-rending conditions. Jane Roe was a 69-year-old retired pediatrician who had suffered through seven years of cancer, which at the time of the trial had metastasized throughout her body. She had undergone both chemotherapy and radiation. Her doctor had referred her to hospice care (for which only patients with a life expectancy of less than six months are eligible). She was bedridden and in severe pain whenever she moved. John Doe, a 44-year-old artist was dying of AIDS, had experienced bouts of pneumonia, severe skin and sinus infections, seizures, and was going blind, so he could no longer paint. His long-term companion had died of AIDS. James Poe was 69 years old, suffered from emphysema, was connected to an oxygen tank at all times, and was regularly administered morphine for pain in his legs and to calm the panic reaction to a a constant feeling of suffocation. All three patients died before a decision was rendered in the lawsuit.

Both court decisions articulate strong and at times spell-binding arguments on both sides of the issue. The Ninth Circuit's ruling was favorable to patholysis and to the position advocated by Dr. Kevorkian's attorney, although the District Court had agreed with the prosecution, that a terminally ill or intractably suffering adult who is mentally competent does not have a liberty interest protected by the Fourteenth Amendment's Due Process Clause in assisted suicide. Arguments and documents relating to the death penalty and to tobacco litigation, and their pedagogical uses, will be examined in Part V, in the next issue of Proteus.

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