My first impression was curiosity at the fact that he did not choose to end his life in the way that he had chosen for others. He died in a hospital, apparently with plans for surgery to remove lesions from his lungs. He did not hasten his death, rather he was actively planning for life. That reminded me of a physician friend whose father had been an advocate for the Netherlands' laws for assisted suicide but who, when terminally ill, fought "tooth and nail" for every chance at life. Everyone approaches death in their own unique way and Kevorkian was no different, I suppose. But it is a curiosity . . .
My second impression was that, although his death-administering practices were rightly and highly questionable - he did not require second medical opinions or psychological counseling of his "patients" - he did us all the service of bringing to the fore what many in our society have been thinking but unable to say. If we work so hard to control the quality of our lives, can we not also work to control the quality of our deaths? What does it mean to "let go and let God" have control in this critical last moment of our life story? My grandmother stockpiled medicines in order to "end it" when she was ready. The stockpile was discovered in a bedside table and she was whisked away to spend her last two years in a nursing home, slowly but inexorably declining toward a death that was not particularly "good".
And my third impression was that Kevorkian's legacy will be one of advancing the necessary discussion in halls of government, corporate board rooms, and family rooms - and that is definitely a good thing. A Huffington Post blog entry speaks in the same breath of Palliative Sedation and Physician-Assisted Suicide . . . the Community Ethics Committee has submitted a report encouraging access to Palliative Sedation for those who are terminally ill in intractable pain - we called it Continuous Sedation to Unconsciousness as Comfort Care until Death. We viewed it as a merciful and appropriate treatment option. The sedation does not kill, it treats pain; it is the underlying terminal disease that brings about the patient's eventual death. In contrast, Physician-Assisted Suicide's primary focus is to treat pain by killing the patient - something different and troubling. The Committee has written an article that will be coming out soon in the American Journal of Bioethics - the heading is "Palliative Sedation is to caring as Physician-Assisted Suicide is to killing". When it is published, we will share the citation.
In the end, we probably die as we live. Kevorkian died as a doctor - in a hospital, trusting in yet more medical interventions. I hope as the dialogue about death continues in our society, we will find ways to ensure we die in the ways we choose - most of us desire to be at home, free of pain and fear, surrounded by loved ones. A "good" death. I hope that is what Kevorkian had.