Correspondence

Dr. Jack Kevorkian and Cases of Euthanasia in Oakland County, Michigan, 1990–1998

N Engl J Med 2000; 343:1735-1736December 7, 2000

Article

To the Editor:

Analyses of data from Oregon1,2 and elsewhere3-5 have begun to clarify the characteristics of patients who seek a physician's assistance with suicide or euthanasia. We report on a descriptive clinical analysis of the 69 persons who died with the assistance of Dr. Jack Kevorkian in Oakland County, Michigan, between 1990 and 1998. Kevorkian, a retired pathologist, assisted in the deaths of over 100 people. In 1999, he was sent to prison after being convicted of second-degree murder. We analyzed data from the medical examiner's files, including autopsy findings, for the 69 deaths that were investigated by the Oakland County district office. Since the procedures of medical examiners vary, we excluded deaths investigated and studied at autopsy elsewhere.

Most patients in the United States who receive assistance from a physician in committing suicide or who undergo euthanasia are terminally ill men over the age of 65 years who have cancer, neurologic disease, or end-stage heart or lung disease.3,4 The patients who died with Kevorkian's assistance had similar diagnoses; however, only 25 percent were terminally ill, according to the autopsy findings (Table 1Table 1Characteristics of 69 Persons Who Died with the Assistance of Dr. Jack Kevorkian in Oakland County, Michigan.). Seventy-two percent of the patients had had a recent decline in health status that may have precipitated the desire to die. Seventy-one percent were women, a finding that is noteworthy because suicide rates are usually lower among women than among men.

Persons who were divorced or had never married were overrepresented among those who died with Kevorkian's help, suggesting the need for a better understanding of the familial and psychosocial context of decision making at the end of life. Altogether, our findings underscore the vulnerability of women and groups of men (i.e., those not married and those coping with serious illness) to physician-assisted suicide and euthanasia, particularly when clinical safeguards are lacking.

Lori A. Roscoe, Ph.D.
Julie E. Malphurs, M.A.
University of South Florida, Tampa, FL 33612-3899

L.J. Dragovic, M.D.
Office of the Medical Examiner, Pontiac, MI 48341-0438

Donna Cohen, Ph.D.
University of South Florida, Tampa, FL 33612-3899

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Citing Articles (4)

Citing Articles

1. 1

   David P. Schenck, Lori A. Roscoe. (2009) In Search of a Good Death. Journal of Medical Humanities 30:1, 61-72
   CrossRef

2. 2

   DAVID LESTER. (2002) CULT SUICIDE AND PHYSICIAN-ASSISTED SUICIDE. Psychological Reports 91:7, 1194
   CrossRef

3. 3

   James V Lavery, Joseph Boyle, Bernard M Dickens, Heather Maclean, Peter A Singer. (2001) Origins of the desire for euthanasia and assisted suicide in people with HIV-1 or AIDS: a qualitative study. The Lancet 358:9279, 362-367
   CrossRef

4. 4

   Richard Horton. (2001) Euthanasia and assisted suicide: what does the Dutch vote mean?. The Lancet 357:9264, 1221-1222
   CrossRef