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Assure options for life before a 'right to die'


Jack Kervorkian got his wish and was arrested for ending the life of Thomas Youk. Dr. Kevorkian says he is fighting for a patient's right to die - but he's forgotten a patient's right to live. It is ironic that, at the moment he was arrested, Kevorkian, now a criminal defendant, was given more options than he afforded his patients.

Before being questioned, Kevorkian was likely given warnings informing him of his rights. He would have been told he could remain silent, consult a lawyer, and could stop talking at any time.

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Shouldn't someone like Kevorkian at least give his patients a list of other comfort options - everything from psychological and spiritual counseling to painkilling and anti-depression medications - before the patient decides to end his life?

Next, if Kevorkian decided to give a statement to an officer, the method for taking the statement will be reviewed in court at a suppression hearing. A judge will listen to evidence from both sides and determine if his statement is reliable or if his will was overborne. This is significant because a recent study found at least 60 cases in which a defendant sitting on death row had given a false confession. Often these people were weak and allowed an officer to talk them into confessing to things they did not do.

This is exactly the kind of person Kevorkian is "assisting." His patients are often depressed, desperate people willing to listen to anyone who will take their pain and suffering away. Shouldn't a judge or other neutral party at least review the process by which Kevorkian or someone like him came to receive consent to end life?

After being charged, Kevorkian will have a period of at least 70 days in which he can decide whether he wishes to plead guilty. If he decides to plead guilty, he will undergo a thorough examination by a judge to determine if his plea is voluntary or if he has been talked into pleading guilty by his lawyer, family members, prosecutors, or police. The judge must also determine if Kevorkian knows what he is pleading to and acknowledges the allegations are true. Finally, the judge must determine if Kevorkian has a mental illness or other psychological problem that makes him incompetent to make a plea. Only when the judge is satisfied that the decision is the defendant's alone will he accept the plea.

Shouldn't any assisted suicide, let alone active euthanasia, merit at least a waiting period?

Even Kevorkian gave lip-service to such a waiting period, but it quickly evaporated as Kevorkian agreed to shrink the period from a month, to a week, to two days. What's the rush? And why not have such a decision reviewed by a neutral party to determine voluntariness?

We'd like to believe doctors have their patients' best interest at heart, but doctors like Kevorkian are hardly neutral parties. Driven by the fervor of a cause, they often forget their patients. Even Kevorkian admitted, "I'm doing this for me."

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Death penalty false-confession cases show the importance of process in evaluating decisions about life and death. Likewise, when a doctor takes on the role of ending life actively or by assisting suicide, anything less than absolute certainty about the wishes of the patient is disastrous. Unfortunately, even the safeguards we afford criminal defendants sometimes don't prevent the abuse of this process. It may be impossible to design such a process, and this argues against the entire concept of doctor-assisted suicide. If, however, juries remain unwilling to convict doctors like Kevorkian, it may be time to at least regulate the use of "services" like his.

Again, one can't avoid the irony that in coming weeks Kevorkian will have more choices as a criminal defendant than he is willing to offer the patients whom he hastens off to death.

If he is interested in the plight of those who wish to speed death, he might pay attention to the process rights afforded him in his criminal case.

* Matthew J. Miller is a federal law enforcement officer in Sioux Falls, S.D.

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