The Kevorkian Verdict

FRONTLINE Show #1416
Air Date: May 14, 1996

ANNOUNCER: Today in Michigan another jury returned its verdict on Dr. Jack Kevorkian, deciding if he had committed a criminal act or performed an act of mercy. Tonight FRONTLINE goes inside the Kevorkian trial to examine his impact on the right to die. Has he brought America to its senses or has he taken us too far? Tonight "The Kevorkian Verdict."

NARRATOR: This spring, at the Oakland County court house in Pontiac, Michigan, Dr. Jack Kevorkian strode theatrically back on stage for what all the players believed would be his last trial and perhaps the final act in his quest to establish the right of a physician to assist in the death of his patients.

Dr. JACK KEVORKIAN: [press conference] First of all, do any of you here think it's a crime to help a suffering human end his agony? Any of you think it is? Say so right now. Well, then, what are we doing here?

ARTHUR CAPLAN, Ph.D., University of Pennsylvania: He was an explosion that came out of nowhere, a feisty doc basically saying, "I'm going to take on the medical establishment. I'm going to take on the legal establishment and I'm going to do something unheard of. I'm going to assist people in dying_ publicly, aboveboard, say that's what I'm going to do and then I'm going to dare somebody to come and prosecute me for it."

NARRATOR: In the last six years, Kevorkian had helped 27 people die. He had been charged with murder three times. Those charges were dropped, but he was brought to trial three more times for violating a Michigan law banning assisted suicide. Each jury found him not guilty.

Dr. JACK KEVORKIAN: [press conference] And you know I don't persuade to suicide.

REPORTER: [unintelligible]

Dr. JACK KEVORKIAN: Then what am I doing here?

ARTHUR CAPLAN: I think he's turned up the heat on this debate and, in some ways, will be remembered as the central figure who made America grapple with the question of assisted suicide and not allow them to turn away. At the same time, the tone and the tenor of the debate, the theater, the politics, the stridency, the militancy and, if you will, going out on the fringe and dealing with individuals who very few people would want to have the right to die_ I think we can blame him for that, too.

NARRATOR: In seeming desperation, Michigan prosecutors had built their final case against Jack Kevorkian on a legal oddity. The temporary Michigan statute on assisted suicide had expired, but Kevorkian was being tried anyway under an unusual court ruling, that the unwritten "common law" made it a crime to help anyone commit suicide.

Technically, the case would hinge on Kevorkian's motive. Was he guilty because he intended to help his patients commit suicide? Or was he not guilty because he only intended to end their pain and suffering?

GEOFFREY FEIGER: [in court] His motive is to be a good physician, to be a dutiful physician, to be there when the patients want him. And his intent is to end suffering.

When you return a verdict and find that the prosecutor may not prosecute an innocent man, you will have done justice. You will have found truth.

NARRATOR: Ultimately, the verdict in this case, like all the others, would come down to a deeper moral judgment about Kevorkian himself. Had he helped the right people? Had he done the right thing?

ARTHUR CAPLAN: There were some clear-cut cases where I think the majority of Americans easily are going to step forward and say, "Thank goodness that Jack was there to help." There are some others where people, once they understand what those cases are, are going to step forward and say, "If he's helping them, am I next? Are we going down some slope that takes us to places where other societies have gone in this century and we don't want to be?" He carries both of those legacies, I think, as_ as his impact on the debate.

NARRATOR: This time Kevorkian was on trial for one of his first and most sharply debated cases, the double suicide of two women almost five years ago.

Dr. JACK KEVORKIAN: [home video] This is a videotape recording on Tuesday_ on Tuesday, October 22, 1991, at around 8:00 P.M.

NARRATOR: Kevorkian had recorded his final consultation with his very controversial patients, women who had suffered deeply, but who were not terminally ill.

Dr. JACK KEVORKIAN: [home video] _actually, what's called physician-assisted suicide. And we're here to discuss the wishes of Sherry Miller and_

NARRATOR: Forty-three-year-old Sherry Miller had multiple sclerosis.

Dr. JACK KEVORKIAN: [home video] _and Mrs. Marjorie Wantz.

NARRATOR: Fifty-eight-year-old Marjorie Wantz had suffered with acute pelvic pain for years.

Dr. JACK KEVORKIAN: [home video] Sherry, have you thought this over well?

SHERRY MILLER: Yeah, I have. I've thought about it a long time. A long time. Yeah, I have. And I have no qualms about my decision to do it. I could do it tonight.

Dr. JACK KEVORKIAN: You realize, of course, the implications of your decision?

SHERRY MILLER: Yeah, I do.

Dr. JACK KEVORKIAN: What is the implication of your decision?

SHERRY MILLER: There's no turning back.

NARRATOR: In the corner of the room was Sharon Welsh, Sherry Miller's best friend since childhood. As adults, Sharon and Sherry had remained friends, sharing the good times and then, about 12 years ago, the worst news of all.

SHARON WELSH: My mom called me one day and said, "Sherry's ill and she has M.S." and we just cried. We just cried.

NARRATOR: As Sherry's disease worsened, her husband asked for a divorce and she lost custody of her two young children. Unable to live alone, Sherry moved back in with her parents.

GEOFFREY FEIGER: [in court] Could you state your name for the court and jury, please?

JUNE MILLER: June Miller.

GEOFFREY FEIGER: Why wouldn't her life be ended peacefully, just letting the disease take its course on her?

JUNE MILLER: Well, the way I understand it, it wasn't going to be that peacefully. She was having a hard time swallowing. She was having a hard time eating, having a hard time talking, really, is what she's having too. And it was going to get worse.

GEOFFREY FEIGER: Do you_ did you know a person by the name of Sherry Miller?

Dr. STANTON ELIAS: Yes, I did.

NARRATOR: Dr. Stanton Elias, a neurologist, became Sherry's doctor in 1986.

Dr. STANTON ELIAS: Well, when I first saw her, she was crying and_ as soon as I walked into the room and I really could not take a history from her for about two hours because she couldn't stop crying each time I went in to try to talk to her.

NARRATOR: Sherry told Dr. Elias she wanted to die.

Dr. STANTON ELIAS: [in court] Can I read from the dictated note exactly what I said, which was, "She's very anxious, crying a lot and describes depression. She states that sometimes she thinks of suicide, but she would not actively attempt this. If she did, she feels she would use pills."

GEOFFREY FEIGER: And her_ what you describe as suicide is not because she was having a bad hair day but because her body was failing, right?

Dr. STANTON ELIAS: [in court] That's_ she was primarily depressed over her loss of function.

Dr. JACK KEVORKIAN: [home video] Sherry, when did you first contact me with your desires?

SHERRY MILLER: It was February or March of 1990.

JUNE MILLER: And she told us that there was this doctor that she had contacted and that he helped people commit suicide and that she was going to have him help her end her life. And I really got shook up. I really did. And I ran over to my next-door neighbor and I_ "Can I used your phone?" I called my son in Texas. I said, "Gary," I said, "there's a doctor here in Michigan that will help people commit suicide and Sherry said that he's going to help her end her life." And he said, "Oh, Mom, don't get shook up. There's nobody that can do that. Nobody."

NARRATOR: But there was somebody. Since 1987, Dr. Jack Kevorkian, a retired pathologist, had been promoting his services to help desperate people end their lives. He had even invented a suicide machine.

Dr. JACK KEVORKIAN: ["The Phil Donahue Show," April 26, 1990] _you are revived. So it's not bad.

PHIL DONAHUE: So this puts you to sleep, then. This puts_

Dr. JACK KEVORKIAN: That puts you to sleep and then the_ and then the_

PHIL DONAHUE: Yeah. Well, yeah, the audience feels a lot better now, Doctor. Thanks. Now, what does this do?

Dr. JACK KEVORKIAN: Well, you've all been executed, but revived.

PHIL DONAHUE: All right.

Dr. JACK KEVORKIAN: It's not so bad.

Dr. STANTON ELIAS, MD, Miller Physician: She came with Dr. Kevorkian and presented him as someone who was going to help her commit suicide and I was taken aback. I said, "Excuse me, but we have an appointment. I'm going to ask him to leave the room," which I did, and he did.

TALK SHOW HOST: Do you want to be here for another Christmas with your children?

SHERRY MILLER: No.

NARRATOR: But Sherry kept pursuing Kevorkian, telling her story repeatedly on television.

SHERRY MILLER: Bad enough I got to live another birthday, another year. Makes me cry.

Dr. STANTON ELIAS: There are many patients that I see whose physical condition is similar, if not more disabled, who also have depression, also mourn their loss, but do get over it. They do focus on other things in their lives. They're not focused on dying.

NARRATOR: In the trial the prosecution called expert medical witnesses who testified that Kevorkian had made a serious mistake, that Sherry Miller's real problem was psychological, a clinical depression for which she never received adequate treatment.

Psychiatrist Jan Fawcett:

JAN FAWCETT, MD,: [in court] If the depression is treated, the pain and the hopelessness lift and so do the suicidal ideations. I've had patients, you know, beg me to let them commit suicide and I've said, "You can commit suicide after your depression's better." And after their depression's better, I'll say, "Well, now, do you want to commit suicide?" And they'll say, "Are you kidding?" You know, "I've got things to do." The suicide ideation goes away. It's a symptom of the depression.

RONALD and JUNE MILLER, Parents: I don't care. We took her to a psychologist for what, 15 weeks or something like that. Cost us what, about $200 a visit or something. And she come out of there feeling the same way every time that she went in. And then he sent her to a psychiatrist because he said she needed some medicine.

SHARON WELSH, Friend: And I remember her saying to me, "The only thing that works is my head and they want to mess with that." And so she wouldn't take them.

JUNE MILLER: Everything they gave her was the same thing. It just put her in a_ I don't know. You wouldn't call it a trance, but just put her out of it, like she was a zombie.

SHARON WELSH: And Sherry wanted more than that. Sherry didn't want to live that way any longer.

NARRATOR: In the trial, Kevorkian's defense team countered with its own psychiatric expert, Dr. Bernard Carroll.

BERNARD CARROLL: [in court] Being emotionally upset, even having crying spells, is by no means the same thing as being in a state of clinical major depression.

GEOFFREY FEIGER: Why not?

Dr. BERNARD CARROLL: Because to be in a state of clinical major depression, the depressed mood, to begin with, needs to be pervasive and constant, and it clearly was not in Sherry Miller's case. She had periods of what I call appropriate grief or adjustment reaction to her physical problem, but she was able to make little jokes. She was able to smile. She was able to appreciate the humor of some situations. She was able to make bright eye contact with other people. She did not have about her the overall appearance of a person in a pervasive, fixed depressive state.

Dr. JACK KEVORKIAN: [home video] What is you want? Put it in plain English.

SHERRY MILLER: Yeah. I want_ I want to die.

Dr. JACK KEVORKIAN: That's as plain as you can put it?

SHERRY MILLER: Yeah. Yeah. And I know there's no turning. I know that. Yeah, and this is not an overnight decision. I've waited too long. I cannot do anything myself. I waited too long.

Dr. STANTON ELIAS: If you think about it, I'd know Sherry Miller, at that point, I think, for three or four years. She said three years earlier that she wanted to commit suicide. She might have been thinking about it for several years before. She never tried. She'd never even made any plan whatsoever to do so.

But now she's with Dr. Kevorkian and somehow her resistance has broken down or becomes broken down. I'm not saying that he coerced her or that he somehow influenced her, but he creates an atmosphere where it's okay.

Dr. JACK KEVORKIAN: [home video] Are you_ are you afraid at all? Do you have any fear?

SHERRY MILLER: No, no. None. I just want to know what_ no fear.

Dr. JACK KEVORKIAN: Okay. We'll get_ we'll get back to you, Sherry, in just a minute.

Marjorie_

NARRATOR: Marjorie Wantz had also pursued Dr. Kevorkian for years, asking for relief from the excruciating pain she had suffered following surgery to remove some benign vaginal tumors.

MARJORIE WANTZ: [home video] I get a half-hour, an hour's sleep a night with all the pills, the sleeping pills I take. I go to bed all day long, most of the time, with sleeping pills just to get out of pain. That's the only time I get out of pain is when I sleep.

BILL WANTZ: I see her in her pain every day.

NARRATOR: Marjorie's husband, Bill Wantz.

GEOFFREY FEIGER: [in court] How would she demonstrate the pain? How would you know she was in pain?

BILL WANTZ: Hollering.

GEOFFREY FEIGER: What do you mean?

BILL WANTZ: Hollering in her sleep, hollering when she's awake_ "Give me more medicine so I can get rid of this pain."

MARJORIE WANTZ: [home video] Every surgery has made me worse, especially the last one.

Dr. JACK KEVORKIAN: How many have you had?

MARJORIE WANTZ: Ten.

Dr. JACK KEVORKIAN: Ten surgeries?

MARJORIE WANTZ: In the one spot. In the one spot. And this time he left a needle up there and he won't take it out. No doctor will take it out. You know, he's left a needle up, way up in the vaginal area.

ATTORNEY: [in court] After the doctors got through working with her, did she have any female organs left?

BILL WANTZ: No offense to anyone in this courtroom, but no, she did not look like a woman anymore.

[home video] I don't say the doctor did it on purpose just to take an experiment. No doubt he thought he was doing a good job or trying to do something for it. It didn't work.

MARJORIE WANTZ: I think I was a challenge and I think he_ I was like a guinea pig.

BILL WANTZ: It was a challenge for him, that's true, and she's the one that's suffering for it. It's not that we didn't tell him to go ahead and do it.

MARJORIE WANTZ: Right.

BILL WANTZ: But every time he said, "We'll do this," it was supposed to make you better. Well, it didn't make you better, it made you worse. And then when it got worse, "Well, we'll do this. This is_ this'll make you better."

MARJORIE WANTZ: And when it didn't_

BILL WANTZ: And nine times later_

MARJORIE WANTZ: And it didn't and he_

BILL WANTZ: _ten times later we're still waiting.

MARJORIE WANTZ: When it didn't, he became colder and colder and more distant and more distant and just that I imagined it was hurting like this and he got real, real hateful. Really bad.

BILL WANTZ: [in court] Every doctor we seen said "There's no way we can take the pain away"_

GEOFFREY FEIGER: But didn't she_

BILL WANTZ: _from the Cleveland Clinic, up to the Mayo Clinic, to the University of Michigan. "We can't help you with your pain. You got it. Live with it." Well, sometimes you don't want to live with it.

MARJORIE WANTZ: [home video] No, I tried it, as you know, with the car. I put the hose on the exhaust and into the window. I stayed in the car. I tried it three times. Nothing happened. And my doctor told me that within 25 minutes, that's all it should take. I was in there three hours. I didn't get sleepy. I didn't get sick. I felt no nausea. Nothing. I took 120 Halcyon two different times. Then I was told, "Well, 120 is nothing. You need 4,000 of_ of Halcyon." So I've tried everything short of a gun. I have tried loading a gun, but I don't know how to load one. If I did, I probably would have_ as Bill says, I probably wouldn't have succeeded and I'd have been in worse shape than I am right now.

NARRATOR: Many of the psychiatrists who examined Marjorie Wantz said she was suicidal not just because of her pain, but because she was depressed. Some felt her pain might even be psychosomatic and one had tried to commit her to a mental hospital for treatment.

Dr. ALEXIS DEROSARYO: [in court] We already noted she was significantly and severely depressed and_

NARRATOR: Pain specialist Dr. Alexis Derosaryo testified for the prosecution.

Dr. ALEXIS DEROSARYO: _treatment of pain that you do need to address and treat the depression oftentimes more urgently, certainly, in this case, more urgently than trying to treat the pain itself.

GEOFFREY FEIGER: You've seen the records. Several of psychiatrists have indicated that Marjorie Wantz was in need of psychiatrist help.

Dr. BERNARD CARROLL, MD, Defense Witness: Well, some did and some didn't and_ there really is no credible evidence from her appearance on the videotapes that she was in a morbid mental illness that distorted her judgment.

ATTORNEY: Was there evidence in the records that you reviewed for Marjorie Wantz that she had exhausted treatment possibilities for clinical depression?

Dr. JAN FAWCETT, MD, Prosecution Witness: Absolutely not.

ATTORNEY: What else was_ was available?

Dr. JAN FAWCETT: Well, she never had any adequate treatment.

TALK SHOW HOST: Please welcome Mrs. Marjorie Wantz.

NARRATOR: Like Sherry Miller, Marjorie Wantz had courted Kevorkian's help in the most public way.

TALK SHOW HOST: The bottom line is you are in a lot of pain.

MARJORIE WANTZ: Yes.

TALK SHOW HOST: All the time.

MARJORIE WANTZ: All the time.

Dr. JACK KEVORKIAN: I've known Marjorie here for going on two and a half years now and I haven't_ you notice I haven't done anything with her because I knew there was more to be done. Her doctors had to do more surgery. They had to have more pain medication.

TALK SHOW HOST: When do you want to do this?

MARJORIE WANTZ: As soon as possible. As soon as possible because the pain has gotten just worse and worse and worse with each surgery.

GEOFFREY FEIGER: [in court] Your wife wrote a diary. Are you familiar with that?

BILL WANTZ: Yes.

GEOFFREY FEIGER: How do you know about that?

BILL WANTZ: She always kept diaries.

GEOFFREY FEIGER: What sort of things would she write in her diary?

BILL WANTZ: In that one you're holding, her pain is worse, getting worse, how she slept the night before.

GEOFFREY FEIGER: On Wednesday, October 16th, it says, "Tylox at 3:40 A.M., two Halcyon at 3:40 A.M., one Xanax at 4:00 A.M., two Tylox at 8:30 A.M., one Haldol at 8:30 A.M., one Xanax at 8:35 A.M., one Tylox at 9:00 A.M." "Feels like I need to urinate all the time. Scars are becoming worse_ awful. Pain_ 1 to 10_ a 25. Hurts to urinate. Hurts all the time. Help me, Jesus. Please help me with my pain."

BILL WANTZ: Geoff, please! Don't! [weeps]

JUDGE: It's almost 5:00 o'clock, so let's break at this point. I'll excuse the jury. Please come back Thursday at 1:45. 1:45.

Dr. JACK KEVORKIAN: [home video] Do you have any fear at all about what you're asking?

MARJORIE WANTZ: I'm a little nervous. I have no fear of it. I'm a little nervous because I've been waiting so long. You know, we were waiting for the medicines and then we_ you know, it wasn't_

NARRATOR: Marjorie and Sherry had scheduled their final appointment with Kevorkian and his suicide machine for early the next morning.

MARJORIE WANTZ: [home video] A week seems like you're waiting a month and three days seems_

ATTORNEY: [in court] In your opinion, Doctor, when a patient comes to a doctor requesting suicide, is it_ is it proper medical care for the patient to offer to assist in that suicide?

Dr. JAN FAWCETT: In almost every case, I would say no. It would depend on the individual case, of course.

ATTORNEY: In the case of Marjorie Wantz_

Dr. JAN FAWCETT: In the case of Marjorie Wantz, it was certainly improper.

ATTORNEY: How about in Sherry Miller's case?

Dr. JAN FAWCETT: In Sherry Miller's case, I would consider it also improper.

Dr. JACK KEVORKIAN: [home video] Now, people are going to wonder_ you know, they're going to think it's bizarre that we're doing two of you together.

NARRATOR: Kevorkian set up this double suicide because he was not sure what the police and prosecutors would do to him afterward. He told the women if he helped only one of them, he might not be around to help the other.

Dr. JACK KEVORKIAN: [home video] Sherry and you, then, will reach up and Sherry will put her finger in a ring and you'll put your finger in a ring. Then you will have to guide Sherry, but she could do it, too. You just pull the ring. That ring turns on the hypnotic, the sedative solution, which will put you to sleep within_ within 20 seconds, 25 seconds, soon as it gets into your veins.

GEOFFREY FEIGER: [in court] If this was desired by Sherry Miller and Marjorie Wantz, in your opinion, is that rational?

Dr. BERNARD CARROLL: It was rational. They were rational on the videotape. They were not in the grip of a morbid melancholy, where their judgment was distorted by a primary psychiatric condition. They were not in the grip of a morbid major depression. This was a rational decision made in full knowledge of the existential circumstance in which they found themselves.

Dr. JACK KEVORKIAN: [home video] Okay. Well, then, we'll bring this to a close. Thank you very much, all of you.

NARRATOR: Early the next morning, they all gathered at a primitive cabin in Bald Mountain State Park near Detroit. The police later recorded the scene.

GEOFFREY FEIGER: [in court] Did Dr. Kevorkian force Marge to go to the cabin?

BILL WANTZ: No.

GEOFFREY FEIGER: Did anybody try to make her do anything she didn't want to do?

BILL WANTZ: No.

NARRATOR: Inside the cabin, the two women lay side by side on cots. Marjorie Wantz went first.

GEOFFREY FEIGER: [in court] Did Marge end her own pain and suffering or did somebody else do it for her?

BILL WANTZ: She did.

GEOFFREY FEIGER: How did she do it?

BILL WANTZ: By lowering her hand and allowing the fluid to flow.

NARRATOR: But Kevorkian was unable to insert the I.V. in Sherry Miller's veins and had to improvise with an alternate method, carbon monoxide gas.

SHARON WELSH: [in court] And he said to Sherry, you know, "You've just witnessed what happened to Marjorie and this has been a really long day. Maybe we should just put this off and come back another day." And at one point, Dr. Kevorkian and I were still talking and I was standing right there, beside her cot, and she raised her little arm up and she said, "Next."

It was almost like, "Come on, you guys. I've waited long enough. Let's do this." And I held her head up and Dr. Kevorkian put the mask on her face. And she had already practiced pulling_ the screwdriver was taped to a nozzle. Sherry wasn't able to turn the nozzle herself, but she could pull the screwdriver toward her that would start the gas.

You know, I don't know whether Dr. Kevorkian said to her, "Whenever you're ready" or_ or exactly what, but she never hesitated. She just reached over and pulled it.

GEOFFREY FEIGER: [in court] Did you love Sherry?

SHARON WELSH, Friend: Yes.

GEOFFREY FEIGER: Do you still love her?

SHARON WELSH: Yes.

GEOFFREY FEIGER: Would you do it again for her?

SHARON WELSH: Yes.

GEOFFREY FEIGER: Even knowing everything that you're going through now?

SHARON WELSH: Yes.

GEOFFREY FEIGER: No further questions.

NARRATOR: As Kevorkian fought his noisy crusade in Michigan, there had been dramatic developments around the country. In 1994, Oregon voters were the first to legalize physician-assisted suicide and this spring two separate federal appeals courts ruled that Americans had a Constitutional right to that help. The issue is ultimately headed to the U.S. Supreme Court.

And as Kevorkian's last trial unfolded, a Congressional committee convened hearings.

CONGRESSMAN: Dr. Quill?

TIMOTHY QUILL: I want to thank you for inviting me and I thought I might try to give you a different perspective on this_ on this issue and try to tell you a little bit about where the passion comes from for me on this issue. I'm a primary care doctor_

NARRATOR: Dr. Timothy Quill of the University of Rochester Medical School has emerged as the leading physician advocating the legalization of assisted suicide. Five years earlier, just as Kevorkian was emerging, Dr. Quill had shocked the medical world, writing in the New England Journal of Medicine that he had prescribed an overdose of barbiturates for a patient he called "Diane" suffering from terminal leukemia.

Dr. TIMOTHY QUILL: Diane lived for about three months after I gave her the prescription by which she could take her life and she lived that time free of a fear that she would have the kind of death that she was afraid of, the lingering, dependent death. But at the very end, she was having high fevers, was having a lot of pain, was requiring more and more medicine to control her symptoms, so she met with me and_ and said that this was where she was, and it was where she was. And then she said she was going to take the overdose in the next several days, which in fact she did.

What we do for these people as a last resort also says a lot about us as a culture. If we walk away from them because it's too dangerous, that is abandonment. We have to be much more creative about how we're going to respond to them and I think we would agree that that needs to be done.

Well, this is tapping something very deep. It's tapping all those bad deaths that people have seen, all those times when they've been struggling as a family or as a_ as a person alone and feeling that no one's really hearing what's really happening. That's what's at work, fear about that feeling of abandonment and_ and a desire for some real help in that process. And that's what we have to try to address. We have to really provide that kind of help and provide reassurance that we won't be afraid.

NARRATOR: Dr. Quill, like most doctors, has been a persistent critic of Jack Kevorkian, of his judgment, his methods and the sheer number of his cases. But deep inside many of the stories of Kevorkian's patients, Dr. Quill finds evidence of the struggle he sees at the center of this issue, the moral and ethical chasm that has opened between desperate patients and their cautious doctors over the right way to end a life.

Consider the case of Hugh Gale, Kevorkian suicide number 13.

Dr. JACK KEVORKIAN: [home video] We'll introduce ourselves. On my right is the patient, Mr. Hugh Gale. And I'm Dr. Kevorkian. And on my left is his wife, Cheryl Gale.

Now, Mr. Gale, what is it that you wish?

HUGH GALE: Relief.

Dr. JACK KEVORKIAN: What do you mean by relief?

HUGH GALE: Well, I can't_ I can't breathe, of course, and every day it gets worse now.

NARRATOR: Gale, a former Merchant Marine and a long-time smoker, had suffered from emphysema for almost 20 years.

HUGH GALE: [home video] The way you see me, this is my life, right here.

Dr. JACK KEVORKIAN: Right there in that chair, huh?

HUGH GALE: Yeah. And I've been in this chair for three weeks_ three years.

CHERYL GALE: He's been in that chair for five years. He has not slept in a bed for five years.

Dr. JACK KEVORKIAN: Really? You sleep in that chair?

CHERYL GALE, Wife: Sometimes he would pray. He would pray not to wake up. The wake-ups were very hard for him because while he slept, the mucous would accumulate and he would end up drowning in his own mucous when he woke up.

Dr. KARL EMERICK: He was despondent. He was very outspoken, the fact that he was tired of living. He told me on numerous occasions that he was tired of all this, he was ready to die.

NARRATOR: Karl Emerick was Hugh's doctor.

Dr. KARL EMERICK: That was basically what he wanted.

ATTORNEY: [in court] And for how long had he been saying that?

Dr. KARL EMERICK: At least two, three years.

CHERYL GALE: I don't think his doctor knew how to respond. I don't think he was prepared for the statement and I don't think he knew what to say.

Dr. KARL EMERICK: Hugh was a painter and for years and years he promised to paint me a painting and I remember telling him that, you know, "You can't stop living yet. You've promised me a painting for years and you have to come through." And I_ I_ you use those type of things to try to give people a little bit of a boost and just try to_ try to bring them up a little bit.

Dr. TIMOTHY QUILL, MD, University of Rochester: We're really taught to fix things_ you know, come up with suggestions for people. And what's needed in this circumstance is to listen to Hugh Gale and to tell him what's the worst part and_ and try to explore with him_ you know, the suggestion that he's going to go out to dinner or that, "Why don't you take up a hobby?"_ you know, it's almost ludicrous. I mean, you almost say, "What planet are you on?" suggesting that kind of stuff. "Listen to what's happening to me."

HUGH GALE: [home video] No, I_ I just_ it just isn't there anymore. I can't paint anymore. I_

Dr. JACK KEVORKIAN: Oh, yeah, that's right. I saw your painting right here.

HUGH GALE: Yeah.

Dr. JACK KEVORKIAN: Let's show his painting here. You got some talent there.

HUGH GALE: Yeah. And_

Dr. JACK KEVORKIAN: You don't enjoy that at all anymore?

HUGH GALE: I can't.

Dr. JACK KEVORKIAN: You can't paint at all?

HUGH GALE: No. I put everything away. And_ I can't_ I couldn't_ I can't get out in my garage and work with wood or anything. I can't even get to the garage.

CHERYL GALE: He was hoping to get some type of medication, pills. He had talked about pills. I think he was afraid of ending his own life by himself because if he survived, it would be worse than death.

INTERVIEWER: If Hugh Gale would have said to you, "Could you give me some pills for my pain and could you give me a month's supply and tell me how many I need and how many would be a dangerous dosage," would you have ever done anything like that?

Dr. KARL EMERICK: That is not something that I would do. It's not something that the medical community is allowed to do. And I would have denied such a request.

INTERVIEWER: Has anybody ever asked you for that?

Dr. KARL EMERICK: There_ there have been hints, at times, of people that wanted to use medication such as that for purposes they were really not intended, that might end their life.

INTERVIEWER: You wouldn't do it?

Dr. KARL EMERICK: Wouldn't do it, no. Wouldn't do it and can't do it.

Dr. TIMOTHY QUILL: But if a person ends up in a bad situation, it means you have an obligation to help them through that process. That's the piece that's been missing. People have said, "I can't intentionally help a person to die, even if they're in extremist, because that violates the way I've been taught or the way," you know, "medical ethics tells me I should behave."

CHERYL GALE: It was very difficult for me at Christmastime because I didn't know what to get him. He couldn't go out. I asked my husband what he wanted for Christmas and he said to me, "An appointment with Dr. Kevorkian is what I want."

HUGH GALE: [home video] I know_ I know I'm going to die, but I_ what I'm hoping for is I'll take my own way of going and_ and the easiest way out, I guess.

Dr. JACK KEVORKIAN: You want help in ending your life, is that what you want?

HUGH GALE: Right, yes.

Dr. JACK KEVORKIAN: All right. Okay, then. Understand, now. You enjoy yourself now and you two talk it over and decide_ both of you decide when you think it's time. We'll come and we'll have another quick session, sign the papers.

HUGH GALE: All right.

Dr. JACK KEVORKIAN: Let's hope it's weeks. Let's hope it's a couple months.

HUGH GALE: Hope it's years.

Dr. JACK KEVORKIAN: Let's hope you feel better now. Let's hope_

NARRATOR: Three weeks later, on Valentine's Day, 1993, Hugh Gale told Kevorkian he was ready.

CHERYL GALE: He slept the entire night. I was awake, so I know he slept the entire night. I could not sleep, but he did and he became very peaceful.

NARRATOR: Kevorkian arrived early the next morning.

CHERYL GALE: I felt like I was someone else, watching what was going on, but I don't think I was there emotionally. If I didn't distance myself emotionally, I wouldn't have been able to be there. And he wanted me there and I wanted to be there for him.

1st REPORTER: Seventy-year-old Hugh Gale died in his home_

2nd REPORTER: Kevorkian assisted Hugh Gale to commit suicide_

3rd REPORTER: _taking the possibility of murder very seriously.

4th REPORTER: Attorneys for Dr. Kevorkian say Gale was hooked up to_

INTERVIEWER: Are you unhappy that he did it?

Dr. KARL EMERICK: I respect the man for making his decision.

INTERVIEWER: But as a doctor?

Dr. KARL EMERICK: As a doctor, I feel very strongly in patients' rights and in this country as being able to make one's choice. And I think if that's his choice and that's the one he made, I would respect that.

INTERVIEWER: As a physician, could you ever assist in a suicide?

Dr. KARL EMERICK: I hope I'm not asked.

INTERVIEWER: Why does it seem to be so difficult for so many doctors to deal with helping their patients die?

Dr. TIMOTHY QUILL: Well, we're not supposed to help people to die, you know, if_ in a conscious way. There_ there's such ambivalence about this whole process and how we're trained is in such an uncertain way. My own belief is that's where we need to go. We need to say, "It is your job as a physician to help people die better." We have to be able to say that in an unambiguous way. And that usually means relieving suffering, helping them get into hospice care and then doing the hard work that that involves of addressing symptoms, mobilizing supports and so on. And in that exploration, again, usually you find other avenues to respond that don't involve assisting death, but sometimes you don't. Sometimes people have really reached the end of their rope and then you have a hard situation.

Dr. JACK KEVORKIAN: [home video] This is July 1st, 1993, and we're in Novi, Michigan, at the home of Thomas Hyde and his wife, Heidi.

Can you stretch your fingers out?

NARRATOR: Thirty-year-old Thomas Hyde had ALS, amyotrophic lateral sclerosis, Lou Gehrig's disease.

Dr. JACK KEVORKIAN: [home video] Okay. Don't strain too much, Tom. Don't strain.

HEIDI HYDE: Conserve your energy, now you're getting cramps, right?

Dr. JACK KEVORKIAN: Now, he's getting cramps, right? Okay. We're not going to go any further with the physical right now.

LOUIS RENTZ, MD, Hyde Physician: He had come down to_ in his last visit, he was having to face the concept of a feeding tube because he couldn't swallow as well, and where he had to start dealing with the concept of whether or not he would have a respirator, something to breathe for him.

NARRATOR: Dr. Louis Rentz was Tom's doctor.

INTERVIEWER: So it was getting bad.

Dr. LOUIS RENTZ: Yes.

INTERVIEWER: But he never talked suicide?

Dr. LOUIS RENTZ: Not to anyone that I know of.

NARRATOR: But at home Tom began to talk to Heidi about ending his life with a drug overdose, but he didn't think he could swallow pills any longer. His doctors were offering hospice care, but Tom decided to write to Dr. Kevorkian.

Dr. JACK KEVORKIAN: [home video] Well, Tom, what is it you wish? Tell me your wish in plain English.

THOMAS HYDE: I want_ to_

Dr. JACK KEVORKIAN: Take your time. Take your time.

THOMAS HYDE: _end my_ to die.

HEIDI: He wants to die.

Dr. JACK KEVORKIAN: Die?

Dr. LOUIS RENTZ, MD, Hyde Physician: I guess I have a basic prejudice that a physician should not be involved in taking life. We can allow it to happen, but I_ the Lord giveth and the Lord taketh away. I think it's a dangerous thing when a doctor is willing to take your life for whatever reason.

INTERVIEWER: Could Tom Hyde have killed himself all by himself?

Dr. LOUIS RENTZ: It would have been difficult, I think, for Tom, other than if he had waited and he had not eaten and he had not had any fluids and he were in pain and we sedated him or gave him medications to relieve that discomfort, he_ Tom would have died in a very short period of time.

Dr. TIMOTHY QUILL: But for a lot of people, that doesn't sound particularly humane. I_ I_ I think they would say that a much more explicit act would be much more humane. You would never_ many people would find dying in that kind of sedated, very gradual, dehydrating way would be humiliating, would be an added indignity on top of everything else that was lost.

Dr. JACK KEVORKIAN: [home video] Is there anything else that we_ you want to add to this or have Heidi tell us? Or Heidi, is there anything you want to add before we conclude this discussion?

HEIDI: I want Tom to be free. I want Tom to be free.

Dr. JACK KEVORKIAN: Okay.

HEIDI: I've watched him suffer too long!

Dr. TIMOTHY QUILL: I mean, I think people are genuinely scared about what might happen to them, particularly people who are in the throes of this kind of an illness. And it must be a relief to come in and have somebody who will talk to you about that, who will acknowledge that it exists, that there's a real problem here.

I think these cases are as much an indictment of our current medical system as they are of Dr. Kevorkian. Where are these people's doctors? These conversations_ the conversation that each of these individuals had with Dr. Kevorkian should have been happening with their doctor, the doctor who's going to work with them throughout the end of their life, no matter what path they choose.

GEOFFREY FEIGER: [in court] I call Dr. Jack Kevorkian to the stand.

NARRATOR: Dr. Kevorkian was to be the final witness in his own defense against the charges that he illegally helped Sherry Miller and Marjorie Wantz commit suicide. He would be on the stand for three days, defiantly defending his actions in this case and during his six-year crusade.

GEOFFREY FEIGER: [in court] Did you assist Sherry Miller and Marjorie Wantz to end their suffering?

Dr. JACK KEVORKIAN: Yes.

GEOFFREY FEIGER: Did you provide the means?

Dr. JACK KEVORKIAN: Yes.

GEOFFREY FEIGER: Did you intend, therefore, Dr. Kevorkian, that they commit suicide?

Dr. JACK KEVORKIAN: No.

GEOFFREY FEIGER: How could you possibly say, after providing them with the means to end their suffering, that you didn't intend for them to commit suicide?

Dr. JACK KEVORKIAN: My intent was to carry out my duty as a doctor, to end their suffering. Unfortunately, that entailed, in their cases, ending of the life.

GEOFFREY FEIGER: Don't you have a greater duty to not listen to he desire of the patient, but just to keep the patient alive?

Dr. JACK KEVORKIAN: No. Unfortunately, that has crept into medical practice. It's_ it's too_ penetrated too deeply. The patient's autonomy always, always should be respected, even if it is absolutely contrary_ the decision is contrary to best medical advice and what the physician wants.

Dr. TIMOTHY QUILL: This is not a simple rights issue, in my mind, the right to die. I don't know what that means, exactly_ you know, as if it were a choice or_ you know, dying were a choice or if people could choose it whenever they wanted. I_ if we end up there, I think that's a real problem. These are complicated decisions. People have wishes to die, who are seriously ill, on a fairly regular basis. We need to be able to distinguish between those transient feelings of discouragement and a real, genuine, persisting wish to die for somebody who has no other choices.

GEOFFREY FEIGER: [in court] Why did you make Marjorie Wantz and Sherry Miller wait so long?

Dr. JACK KEVORKIAN: Just to make sure that they knew what they were doing, to satisfy me that_ that their condition was irremediable and_ and waiting a certain period of time, which I thought was enough to prove that it's not going to get better. In Sherry Miller's case, it was easy. The disease is usually_ at best, it may taper off into a remission. Hers didn't. Hers was progressive. And in that case, you knew that she would go on an eventually die.

NARRATOR: The bioethicist Arthur Caplan is a vocal opponent of legalizing physician-assisted suicide.

ARTHUR CAPLAN: Oh, I'm definitely in the, "Are you kidding?" when we come to helping someone like Sherry Miller die_ not terminally ill, probably depressed, got lousy medical care throughout her life. She is an example of exactly why you're playing with fire in America when you're talking about changing the law much beyond the obviously terminally ill and in pain patient to include anybody who says, "My quality of life is too poor."

GEOFFREY FEIGER: [in court] Sherry wasn't really suffering, Dr. Kevorkian, was she?

Dr. JACK KEVORKIAN: Sherry was suffering.

GEOFFREY FEIGER: Wasn't Sherry just pathologically depressed and that there were some pills available to her to make her feel better about what the disease was doing to her?

Dr. JACK KEVORKIAN: No.

GEOFFREY FEIGER: Well, there's been psychiatrists hired by the prosecutor who said that.

Dr. JACK KEVORKIAN: The psychiatrist who said that wasn't physically_ wasn't physically incapacitated.

GEOFFREY FEIGER: What does that have to do with it?

Dr. JACK KEVORKIAN: I would believe a psychiatrist who says that if he also were a quadriplegic in front of me. Then I would believe it.

BUNTING, Prosecuting Attorney: How much longer did she have to live?

Dr. JACK KEVORKIAN: No one knows.

BUNTING: But you made the decision that she was appropriate for her to die.

Dr. JACK KEVORKIAN: She made the decision that her existence had lost its meaning. And you cannot judge that.

BUNTING: That's a subjective determination, correct?

Dr. JACK KEVORKIAN: That's right. Subjective of the patient's.

BUNTING: What about her condition made it medically justified?

Dr. JACK KEVORKIAN: You fail to understand that I said it was justified when she came to me.

BUNTING: So why didn't you do it?

Dr. JACK KEVORKIAN: Because I wanted to be sure, like every doctor should be.

BUNTING: It took you 18 months to be sure?

Dr. JACK KEVORKIAN: That's right.

BUNTING: Why?

Dr. JACK KEVORKIAN: Because I_ because everyone would agree, then, it's incurable_

BUNTING: Who would agree?

Dr. JACK KEVORKIAN: _and hopeless. Anybody with sense.

BUNTING: Okay.

ARTHUR CAPLAN: We've spent very little time in this society thinking about how to deal with disability. We don't like it. We isolate it. We tend to put it off on the periphery. And now, in a society that only wants to talk about rationing health care, to bring forward a disabled woman and say, "Yes, medicine has something for you. We will give you suicide on demand"_ no long-term care health system, no health insurance_ people who would rather spend time in a prison than in a nursing home, as_ given the option_ Sherry Miller is exactly what you don't want to be in this society. If you fear going down slopes, she looks like the absolute ski lift that will take us to a place where I think this country doesn't want to be.

BUNTING: [in court] How do you determine before you'll agree to help, for example, Marjorie Wantz, that she'd suffered enough?

Dr. JACK KEVORKIAN: I don't_ how can one answer that question?

BUNTING: Well_

Dr. JACK KEVORKIAN: Given enough time, you see if there's any retrogression of the process or any progression or any kind of amelioration. It's subjective. All_ many medical diagnoses and interpretations are subjective. That's why this can't be legislated.

BUNTING: You are aware that three psychiatrists in Michigan had determined that Marjorie Wantz was mentally ill and needed psychiatric treatment, is that correct?

Dr. JACK KEVORKIAN: Yes, and I was aware of others who said she wasn't. It was a split opinion. I was aware of a split opinion. Don't make it sound like it's one way.

BUNTING: Oh, if you got three psychiatrists that say she is in need of mental health treatment, but two other ones that say she's not, you're the umpire? You can say, "Touchdown. She can die"?

Dr. JACK KEVORKIAN: I knew she was sane, so if it's a split decision, I rely on my good judgment.

BUNTING: Oh?

Dr. JACK KEVORKIAN: That's right. Even though I'm not a psychiatrist, I can judge an insane person pretty well.

ARTHUR CAPLAN: When we think about assisted suicide, I don't think we have in mind helping people who are depressed or despondent seek death from the doctor. If we're talking about those people, we're again talking about millions of other Americans who go through life on medication, but depressed, and often wake up saying, "I can't take it anymore. I've had it." I don't see any way, if we're over in the Wantz type of situation, to stop us from going down that slope.

BUNTING: [in court] How many doctors that you know of have used potassium chloride in an I.V. drip to treat intractable pelvic pain?

Dr. JACK KEVORKIAN: I don't know.

BUNTING: Isn't it true there is no other doctor who uses carbon monoxide to treat multiple sclerosis?

Dr. JACK KEVORKIAN: I don't know that for a fact.

BUNTING: Have you ever heard of any?

Dr. JACK KEVORKIAN: No.

BUNTING: Have you ever read of any in the literature?

Dr. JACK KEVORKIAN: No.

BUNTING: Okay. So to your knowledge, there's no other doctor.

Dr. JACK KEVORKIAN: To my knowledge, right. All these are irrelevant questions. Also a good indication of your mentality in this matter.

JUDGE: Doctor, I suggest you wait for the question.

Dr. JACK KEVORKIAN: I don't think so, your honor. This is not a trial_

JUDGE: Well, you better talk to your lawyer during the recess.

Dr. JACK KEVORKIAN: This is not a trial. This is a lynching. There is no law. I don't participate_

BUNTING: Let's presume, just for the heck of it_

Dr. JACK KEVORKIAN: _in my lynching.

BUNTING: _that we're all really here, okay? That this judge has got a courtroom, that we're all in here, there's a real jury here, there are real witnesses. Let's just presume that and_

Dr. JACK KEVORKIAN: No.

BUNTING: _that we're in a trial, okay?

Dr. JACK KEVORKIAN: I won't presume it. I will not presume it.

There's no law here! Tell me I'm wrong!

BUNTING: You're wrong.

Dr. JACK KEVORKIAN: Prove it!

BUNTING: Easily.

Dr. JACK KEVORKIAN: Prove it! Cite a case on common law of assisted suicide prosecution. Cite it!

BUNTING: Judge, I'm sorry. You want to instruct him not to ask questions, speak before he's asked a question?

Dr. JACK KEVORKIAN: You can cite me for contempt, your honor. I don't care.

JUDGE: I think it's time to take a break.

BUNTING: Thank you, Judge.

Dr. JACK KEVORKIAN: During the break_ look up your case during the break. Look up your case. Prove it to me, then I'll apologize. You ain't got a case. And no law.

INTERVIEWER: What's your verdict on Kevorkian?

Dr. TIMOTHY QUILL: Oh, I don't know. He's_ I have very, very mixed feelings. To be fair to him, you're going to have to say that he has really raised consciousness of the issue. He has at least got suffering, to some degree, more on the table than it was before. Maybe a simplistic view of it, and it's not simple, but he's got it on the table, which is where it needs to be.

Dr. JACK KEVORKIAN: [in court] Rotten travesty. [crosstalk] Yeah. Send me to jail for contempt. Try that. Go ahead.

NARRATOR: Just hours after he left the stand, Dr. Kevorkian was present at the suicide of 53-year-old Austin Bastable, a tool maker from Canada who suffered from multiple sclerosis. It was Kevorkian's 28th assisted suicide.

Dr. TIMOTHY QUILL: I_ I really think he needs to stop doing what he's doing. I think whatever good he has done, in terms of raising public awareness of this issue, is done. I think what he can do now is simply harm. He's going to add to the polarization. He's going to be an example of what_ the worst case scenario of a maverick doctor acting on his own. And_ and I think that needs to stop.

NARRATOR: But the state of Michigan would not stop Jack Kevorkian. Today the jury acquitted him of all charges in the deaths of Sherry Miller and Marjorie Wantz. Afterwards, Kevorkian told reporters _ quote _ "That's enough criticism of me."

ANNOUNCER: Visit FRONTLINE's website at pbs.org for more on "The Kevorkian Verdict", writings that shed light on his private world, his early career, the so-called death machine, and his paintings. Kevorkian's last interviews with four patients. Read the legal rulings on assisted suicide and lots more at FRONTLINE online at www.pbs.org [http://www.pbs.org].

And now for your letters. The program "Angel on Death Row" prompted a variety of comments about the death penalty.

NORBERT KNAPKE II: [Chicago, Illinois] Dear FRONTLINE: "I am an attorney who represented a man who was executed in 1995. Whether or not the death penalty is ever justified, the interminable appeals process and the hyper-technical legalities associated with an execution deny the victims the right to feel justice has been done; they also work to deny the condemned the right to redemption. Norbert Knapke, Chicago, Illinois."

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The numbers just aren't adding up. You run a leaner operation or you shut down. How many people will you have to let go? Or is there another way? "Does America Still Work?" next time on FRONTLINE.

Dr. JACK KEVORKIAN: [press conference] First of all, do any of you here think it's a crime to help a suffering human end his agony? Any of you think it is? Say so right now. Well, then, what are we doing here?

THE KEVORKIAN VERDICT

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