Today’s luncheon is our last of the summer but we have several luncheons scheduled for September, including U.S. Ambassador to Japan Walter Mondale, Education Secretary Richard Riley, retiring Congresswoman Pat Schroeder, Laura D’Andrea Tyson of the National Economic Council, Secretary of the Army Togo West, and the chief executive officer of Compaq Computers, Eckart Pfeiffer (sp).

If you have questions for our speaker, please put them on the cards at your tables and pass them up to me, and I will ask as many as time permits.

I’d now like to introduce our head table guests and ask them to stand briefly when their names are called. From your right, Hugh Sidey, Washington editor, Time Magazine; Xavier Briand, legal affairs reporter, Education Daily; Ed Silk, anchor, UPI Radio; Lisa Zagaroli, congressional correspondent, Detroit News; Frank Best, chairman, United States Medicine, Inc.; Abigail Trafford, health editor, the Washington Post; Geoffrey Fieger, Dr. Kevorkian’s attorney; Peggy Roberson, freelance journalist and chairman of the National Press Club speakers committee; Dr. George Reding, Physicians for Mercy; Marshall Cohen, freelance journalist and member of the Press Club speakers committee, who arranged today’s luncheon; Patricia McCarthy, executive editor of International Medical News; Jacobo Goldstein, White House correspondent, CNN Radio Noticias; Jonathan Gardner, Modern Health Care; and Joe Nell, Washington bureau chief, Physicians Weekly, and correspondent, National Public Radio. (Applause.)

When Victor Borge, the noted comic, stood at this podium just a few months after Dr. Kevorkian’s visit to the National Press Club in October 1992, he quipped, “When I heard that Jack Kevorkian was recently here, I thought I would be speaking to an empty hall.” This draconian impression may be shared by opponents of physician assisted suicide, most notably the American Medical Association. Yet polls taken among both physicians and the general public show some support for physician assisted suicide under certain circumstances.

The legal system in the United States has also moved in this direction since 1990, when Dr. Kevorkian assisted in the first of 33 suicides over the past six years. Indictments on first degree murder charges against Dr. Kevorkian were dropped in 1991 for his role in assisting two Michigan women to commit suicide. In recent years, juries have voted in Dr. Kevorkian’s favor, acquitting him three times on charges of homicide.

In a Michigan trial in 1994, jurors agreed with an argument by Geoffrey Fieger, Dr. Kevorkian’s attorney, that in absence of a written statute, a guilty verdict could not be supported. This year the Kevorkian Fieger team moi)fied their defense, winning an acquittal by successfully arguing before a court in Pontiac, Michigan that a person may not be found guilty of criminally assisting a suicide if that person had administered medication with the intent to relieve pain and suffering, even if it hastens the risk of dying.

Since graduating from the University of Michigan’s medical school in 1952, Dr. Kevorkian has specialized in pathology. He received his nickname “Dr. Death” not for his physician assisted suicides but from his pioneering experiments in the 1950s, photographing eyes of dying patients to help determine the exact time of death. He served as an associate pathologist in three Michigan hospitals St. Joseph’s, Pontiac General, and Wyandotte General Hospital. He has also served as a pathologist in various Los Angeles hospitals.

Who would use the services of the right-to-die movement’s death assisters? If suicide were “medicalized,” if there were a death dispenser in every neighborhood staffed with a knowledgeable, certified facilitator, what kind of person would partake? What, in psychologists’ jargon, would be his “presenting problem?” And just what kind of assistance would the physician in the physician-assisted suicide really supply?

For a preview of that brave new landscape, there is no better place to look than at the record being so industriously compiled by Dr. Jack Kevorkian, Royal Oak, Michigan’s notorious “Dr. Death.” The enterprising pathologist has been at it for six years and has, at this writing, assisted twenty-eight suicides–though only his ever-present lawyer knows when and where he will surface next, schlepping the bottles and tubes of the Rube Goldbergian death equipment he calls the “Thanatron” or, more recently, the “Mercitron.”

In the absence of competitors, Kevorkian has attracted a broad spectrum of people seeking a physician-assisted way out. They have come from the proverbial all walks of life, from the trailer park and the manicured suburb. In many respects, the doctor’s clients represent a pretty good sample of the general population. Except for the fact that most of them are women.

Like the men, they are younger than you might expect–ranging from age 40 to early 80s–with a surprising number (or perhaps not so surprising, given mid-life crises, menopause, empty nests) in their 50s. The most striking fact about the field, though, is how much what one might call the “objective despair index” differs by sex. Most of Kevorkian’s men were declared terminally ill by their own doctors; they were in constant, severe pain from medically diagnosed causes and were often physically incapacitated. Whatever you think about suicide or physician-assisted suicide, these were easier calls.

Many of the women, on the other hand, had more ambiguous complaints: in a chart like the one compiled by Kalman Kaplan, director of the Suicide Research Center at Columbia-Michael Reese Hospital in Chicago, we see that most of the Kevorkian women were not diagnosed terminal and had not been complaining of severe or constant pain. We see conditions like breast cancer (for which there is now great hope), emphysema, rheumatoid arthritis and Alzheimer’s (a condition that usually burdens relatives more than the people who have it). Reading the case histories it is clear that many of these women’s lives were messy and unattractive. But in all-too-typical female fashion, the patient often seems to have been most worried about the disease’s impact on others. Is it possible that a certain type of woman–depressive, self-effacing, near the end of a life largely spent serving others–is particularly vulnerable to the “rational,” “heroic” solution so forcefully proposed by Dr. Death?

Kevorkian is far too media-savvy to have been sanguine for long about his disproportionate number of female patients. As the deaths of his first eight women clients were registered and charges of misogyny started ringing from the editorial pages, he began, in his fashion, to make his oeuvre look more like America. The number of men grew as the work progressed, finally bringing the total to eleven. But even with the added effort to diversify, one problem remains: Kevorkian seems to like to feint and bobble, to flirt and play coy with his clients. Some of this tendency stems from his problems finding appropriate venues for medicides and from his responsible attempts to make sure patients have explored the range of treatments. But much of it seems to have come out of Dr. K’s pleasure in the process, in playing God. The upshot is that many of Kevorkian’s male prospective clients had already killed themselves by the time Kevorkian got around to “setting the date.”

Kevorkian’s experience with men is mirrored in suicide records from the National Center for Health Statistics. Women attempt suicide three times more often than men, according to the center. The reason we end up with far more completed male suicides–24,000 men to 6,000 women in 1992–is that men generally seem determined to succeed. They blow their heads off and throw themselves off buildings. Women tend to take overdoses of pills. Sexist as it may sound, women’s suicide attempts are more like the classic “cry for help”–a perverse way of reaching out, of bringing people to the bedside and hands to the body.

He has been hailed as the champion of the right-to-die movement and denounced as a ghoulish cheerleader for suicide. Jack Kevorkian has helped 20 people kill themselves, and now that he has been acquitted in the assisted suicide of Patient No. 17, he says he has only just begun. JACK LESSENBERRY enters the strange world of Dr. Death.
I want to be convicted!” Jack Kevorkian howls. After sitting calmly in Detroit Recorder’s Court all day while his lawyer and the prosecution haggled over selecting a jury, he has been ignited by a deputy who ordered him to take his hat off after he left the cavernous basement courtroom.

Now, out of public sight, in a drab little windowless room, he jams his porkpie onto his head. “I should walk up to the bench just like in the movie Ghandi and say, I have violated your law and if you have any respect for your system you will give me the harshest penalty possible,” he says, finger jutting, eyes flashing. Kevorkian’s pipelayer father originally fitted him with the name of an ancient Armenian warrior, Murad, and genetic memory seems to be kicking in.

Four high-priced jury consultants who have donated their time and flown at their own expense to Detroit stare with alarm at the apostle of physician-assisted suicide, who is yelling loudly enough to be heard through the closed oak door, startling a skulking photographer. Dr. Death pitching a fit is not a pretty picture. Paulette Taylor’s jaw actually sags at the sight. Her boss, Howard Varinsky, and Paul Tieger are caught in the headlights. Only Dr. Louis Genevie, who looks like a Weimar finance minister –round glasses, thinning hair, a sober suit–manages a tiny smile.

The first time they met Jack Kevorkian, this very morning, they found him warm and witty. In the courtroom, he has shown genuine tenderness to several of the “survivors” of his suicide patients, as they call themselves. But the consultants have never seen the inventor of the suicide machine, whom most of them revere as a hero of modern medicine, in what his attorney, alter ego, and part-time parent, Geoffrey Nels Fieger, calls his “real asshole” mode.

Taylor says timidly that she thinks they have a good jury, that they have helped stack the jury box with supporters.