Free to Die

“Manslaughter, I could understand how they would arrive at that. But murder? This? They must have been an astonishingly cruel jury!” Jack Kevorkian told reporter Jack Lessenberry. “You tell them I said this,” he went on. “I don’t want to be a martyr. I want to be free. And that’s why I am doing this, and you should print that. I need to be free to die.”

Free to die. Curiously, when Franklin Roosevelt listed his four freedoms, the freedom to die somehow escaped his attention. But in Jack Kevorkian’s cri de coeur, uttered on the threshold of the imprisonment that will likely prove to be––ah, the delicious irony!––a life sentence, he has revealed the secret passion that undergirds both his own warped career and that of the euthanasia movement itself.

Kevorkian has spent his life in morbid fascination with death. Long before coming to public attention, he had earned the sobriquet “Dr. Death” from his colleagues in postgraduate hospital training for his habit of staring with an ophthalmoscope into the eyes of patients as they were dying. (At the moment that the heart stops beating, the blood in the easily visualized retinal arteries stops moving. Then, agonal spasms of the arteries divide the column of blood into segments often called boxcars, because the segments of blood move slowly along their track as the site of arterial spasm shifts along the artery.) In general, medical house staffs are fairly tolerant of morbid curiosity, and will justly attribute a few such observations to the needs of medical training. But they can recognize a voyeur when they see one.

Kevorkian’s occasional forays into academic publication all reflect his abiding fascination with death. Typical of the lot is a 1985 article in which Kevorkian describes a variety of experiments that have been conducted on executed humans. In one particularly disquieting section, he speculates at length concerning how long consciousness may persist after beheading.

Even his artwork, painted with a surreal exactitude, is but one long memento mori (several examples of his artwork may be found at www.kevorkian.com). One representative piece, entitled “Nearer My God to Thee,” shows a terrified naked man, digging his nails into the walls of a stark chamber in a vain effort to prevent his falling into the yawning abyss beneath him. Kevorkian’s description of the painting may tell as much about his ideas as does the image itself:

This depicts how most human beings feel about dying––at least about their own deaths. Despite the solace of hypocritical religiosity and its seductive promise of an afterlife of heavenly bliss. Most of us will do anything to thwart the inevitable victory of biological death. We contemplate and face it with great apprehension, profound fear, and terror. Sparing no financial or physical sacrifice, pleading wantonly and unashamedly, clutching any hope of salvation through medicine or prayer. How forbidding that dark abyss! How stupendous the yearning to dodge its gaping orifice. How inexorable the engulfment. Yet, below are the disintegrating hulks of those who have gone before; they have made the insensible transition and wonder what the fuss is all about. After all, how excruciating can nothingness be?

Kevorkian’s fascination with death has not been limited to that of other people. (Many psychologists would argue, of course, that in fact the obsession is not about other people at all.) Suicide, not just assisted suicide, has been a recurrent theme of his speech, writing, and presumably thought for many years. Shortly before his conviction for the murder of Thomas Youk, Kevorkian reiterated his view that he saw himself involved in a mortal struggle. “Either they go or I go,” said the aging defrocked physician. “If I’m acquitted, they go because they know they’ll never convict me. If I am convicted, I will starve to death in prison. So I will go.”

Michigan prison authorities recently revised their policies, and now will not force-feed an inmate who refuses to eat. Despite that, Kevorkian has not yet carried out his threat of suicide. Nonetheless, this threat has been repeated so often in recent years as to become the leitmotif of his raging twilight. It bears special consideration, for within it is the key to understanding the most notorious serial mercy killer in history.

It would be a mistake to think that Kevorkian’s suicide by starvation in prison would be an act of martyrdom. A martyr, after all, chooses a worse fate in order to promote a cause that will live after him. For Kevorkian and other euthanasiasts, however, suicide is not the worse fate. It is living within the divinely ordained limits of human freedom that is the intolerable alternative. Just as rape is not about sex, so euthanasia is not about comforting the dying. It is about power. What is intolerable to the euthanasiast is not suffering or dying, but not having control over life and death. The essence of the movement is to defy our human limits and mortal destiny, not by avoiding death, since that is impossible, but by choosing its time and circumstance. “If I am not free to die,” goes this logic, “then I am not free.” Suicide for Kevorkian would be an act not of self-sacrifice but of self-aggrandizement.

Although his opponents have often lost sight of his purposes, Kevorkian himself has never veered from his target. Promotion of legalized euthanasia, just as his earlier promotion of vital organ transplants from condemned criminals, was never an end in itself. Rather, as he unabashedly described in his book Prescription: Medicide, legalized lethal human experimentation has ever been the cold star guiding his macabre life voyage. Even that, however, had a metaphysical subtext. Had science truly been the purpose of his ghoulish zealotry, then his ardor would have faded when no scientist stepped forward with an important scientific question that only such experiments could answer. No, the question gnawing at Kevorkian’s faithless heart has always been a philosophical one. What is it that separates life from death? What is the vital essence, that immeasurable something that is here one minute, and gone the next, and with it gone all of subjective existence? He thought that by peering into the eye, or perhaps the brain, or perhaps the pituitary or anyone––but––God knows what, he might discover the awful secret of life and death. His career has been as tragic as that of the chemist who thought he could understand a love letter by performing an analysis of its ink.

Now that he is at the close of his bizarre quest, Kevorkian realizes that the only lethal human experiment he will be able to perform is on himself. That, as much as the limits imposed by incarceration, explains his choice of starvation as a technique of suicide. The hunger would pass in a few days. After that, he could slowly drift toward death, and leisurely study the changes occurring within him as it approaches. Only starvation would give him the time to observe the changes both subjective and objective that occur at the border between life and death. Perhaps he longs for a final insight that will allow him to leave the world possessing a secret, if brief, triumphant knowledge that he alone could attain.

It is not lost on Kevorkian, of course, that his carrying out the threat of suicide by starvation in prison would make the state of Michigan an unwilling enabler in his scheme. He has never been able to see the moral distinctions among allowing someone to die, helping him kill himself, and administering the coup de grâce personally. How satisfying, then, it would be for him to force his nemesis, the legal authorities of the state he decries as “plutocratic and theocratic,” to be apparent accomplices in his suicide. It would add another flourish of power to his final act.

Such is the twisted ruination of a life that has mistaken carbon monoxide for a pain-reliever and lethal injections for lovingkindness. Such can only be the result when mere men, whose origin is dust and destiny is dust, try to snatch the power that rightly belongs only to their Creator.

Perhaps it would have been different if Kevorkian had ever married and fathered children. Those who have known such love can more easily see an intrinsic worth in life that perdures despite ailment and disability. Even atheists can recognize a holy value in life when they gaze in love upon their children. Whether Kevorkian’s deathly narcissism was the cause or the effect of his isolation we may never know. One can and should condemn a criminal who has arrogantly flouted the law and cold-bloodedly taken a life. But at some level one must feel tremendous pity for a man whose greatest love in life has been death itself. How utterly tragic. In his enduring fascination with death, Kevorkian has never really lived.

Eric Chevlen, M.D., is Director of Palliative Care at St. Elizabeth Hospital, Youngstown, Ohio.