Sunday, August 11, 1996
Dr. Death opens debate about life

BY LAURA PULFER
The Cincinnati Enquirer

Jack Kevorkian, M.D., has made us think about suicide again.

Elizabeth Mercz of Colerain Township was the 34th person to make the trip to Michigan's Dr. Death, to the place he once called the ''obitorium.''

You have heard of him, I'm sure. Perhaps you have listened to him on Larry King Live. Maybe you saw photos of him in homemade stockades and a Colonial costume. There are at least four Kevorkian home pages on the Internet, not to mention hats and T-shirts. His attorney is getting his own talk show.

A lot of people think Dr. Kevorkian is an angel of mercy. I think he looks like he's having way too much fun.

An oddball symbol

Since 1990, Dr. Kevorkian has been an oddball symbol, a headline on a story that begs for more thoughtful treatment. He has been acquitted five times in three trials. The death of Mrs. Mercz, who suffered from Lou Gehrig's disease, has been ruled a homicide. No charges have been filed against the 68-year-old pathologist, who says nothing short of being ''burned at the stake'' will stop his crusade.

Jack Kevorkian wants us all to think about suicide, specifically suicides assisted by a physician. So let's do it. Let's think about it. Even better, let's think about it with somebody else. Somebody like Terry Perlin, for instance.

He is one of the country's most respected experts in medical ethics, a professor at Miami University, a fellow of the Scripps Gerontology Center, a consultant to Jewish and Children's hospitals here.

All I ask, I told him, is for you to clear up this debate over dying. A thoroughly nice man, he did not laugh at me.

Instead, he tried to say gently that he cannot know what is the ''right thing'' for every person in every circumstance. This, of course, is most uncomfortable news. It appears that we are going to have to decide this for ourselves.

''Ethical stuff is always borderline,'' he says. Yes, well, thanks but I was looking for easy answers.

Desperate people

Finally he said, ''I think suicide is a bad idea, almost all of the time.''

He does not hide behind books and theories. He spends time with some very sick people, people who are desperately unhappy, who ask to die. ''We have to pay attention to these people,'' he says. ''It doesn't mean you have to help them die. But you have to help them.''

Maybe they are afraid of unbearable pain. That's one of the benefits of the debate, he says. ''It's accelerating the emphasis on pain control, pain management. Generally, we under-treat pain in this culture. We're very puritanical.''

OK, so what if pain is not in the equation? What if somebody just thinks their future is impossibly bleak, medically? He recounts the story of the Georgia man, a quadriplegic, who won a court battle to refuse efforts to keep him alive.

''He got a lot of attention during the trial, met some very nice people. And decided to live.''

My new friend Dr. Perlin says what we have to do is decide how we feel about life. And tell the people we love and trust. And in every available way, try to take charge of our death. So no one else has to.

Some of it is paperwork. Advance directives, as they are delicately called, are documents that spell out your intentions in living wills and durable powers of attorney. But you have to talk to people, too.

If suicide is a bad idea ''almost all the time,'' what about the other times? What about legalizing euthanasia, as Dr. Kevorkian wants? Dr. Perlin says if physician-assisted suicide is lawful, it can be regulated. ''Abuses are more likely to be done under the table.''

Until then, we still have to make up our own minds.

A few years ago, I read a tormenting book by newscaster Betty Rollin. Her mother, dying of cancer, asked her family to help her commit suicide. Betty Rollin did as her mother asked.

So would I. I know I would. I adore my mother. So much that I couldn't say no. And she loves me so much that she would never ask.

Laura Pulfer's column appears in The Enquirer Sundays, Tuesdays and Thursdays. Call 768-8393 or fax at 768-4340. She can be heard Monday mornings on WVXU radio (91.7 FM) and on National Public Radio's Morning Edition.