SALEM, Ore. – For Oregon and Washington advocates pressing for a physician-assisted suicide law in the 1990s, the attention-seeking behavior of Dr. Jack Kevorkian provided a model for many doctors and activists — of what not to do.
The Michigan-born pathologist, who died Friday, drove around the country in his Volkswagen van helping people end their lives with a carbon-monoxide suicide machine built from spare parts. He became a public figure in 1990 when he used his machine to inject lethal drugs into an Alzheimer's patient.
He continued with his unorthodox methods throughout the decade, earning the nickname "Dr. Death" and often leaving the bodies of his assisted suicide patients at emergency rooms or motels.
"Jack Kevorkian raised the profile of the issue fairly quickly with his antics in Michigan," said Portland attorney Eli Stutsman, who was the lead drafter of assisted suicide laws in Oregon and Washington. "But he also put a very bad face on the issue. And at the time, it was not helpful. ... We'd see his work, his name, his image associated with us, and it was something that we always had to work to explain and put in context."
Meanwhile, ballot measures that would allow physician-assisted lethal injections for terminally ill people failed in Washington in 1991 and in California in 1992.
"Periodically there'd be another body at another hospital, and a reminder that people deserved better," activist Barbara Coombs Lee said, referring to Kevorkian's methods. "That continued to 1994."
That was the year Oregon voters approved the Death with Dignity Act, the first state to enact a law that lets terminally ill people end their lives by taking lethal medication supplied by a doctor. It provided clear restrictions that set a medical process for physician-assisted suicide by mandating multiple doctor consultations to ensure the person is terminally ill and has no more than six months left to live, and to determine the person is mentally sound enough to take their own life.
Unlike the earlier ballot measures that had failed in Washington and California, the doctor couldn't administer the medication, only the patient could. After legal challenges to the law, Oregon voters approved the measure again in 1997.
Kevorkian ended up highlighting, in the eyes of the public, the need to provide people with more official assisted suicide options, said Coombs Lee, who helped draft the law. The alternative seemed to be Kevorkian's "flamboyant practice," she said.
"In the end he was helpful because we used his approach as an example of a problem," Stutsman said.
The multiple legislative and legal efforts on assisted-suicide, as well as a 1991 New York Times bestselling book written by right-to-die activist Derek Humphry that detailed how to end your own life, were part of a major cultural shift on death in the 1990s, said Peg Sandeen, executive director of the Portland-based Death with Dignity National Center.
So many activists were working within the system, trying to persuade lawmakers to write a state-sanctioned policy, Sandeen said. But Kevorkian was on the outside — he didn't even support the Oregon law, believing that a doctor should be part of the entire process including the end.
Through the 1990s, Kevorkian assisted in the deaths of about 130 people.
"He was the renegade out driving around the country in his van," Sandeen said.
But his actions helped physician-assisted suicide advocates fine tune their message in those early years, said Rita Marker, executive director and attorney at Patients Rights Council, a nonprofit group that provides information on euthanasia.
"Jack came along, and Jack was so bizarre," she said. "He was on the other side of the spectrum; he pushed people suggesting legalizing (physician-assisted suicide) into the middle. He made them appear very moderate, mainstream of the road. He did them a favor."
In 1998, Kevorkian broadcast his assisted suicide of Thomas Youk on CBS' "60 Minutes." A year later, Kevorkian was found guilty of second-degree homicide and served eight years in a Michigan prison.
Washington voters joined Oregon in 2008, becoming the second state in the nation to allow physician-assisted suicide when they approved their own Death with Dignity law, largely modeled on their neighbor's. State health records show that in 2010, 65 Oregonians took their lives under the law and at least 51 Washingtonians did the same after requesting and taking a lethal prescription.
Also, a Supreme Court ruling in Montana in 2009 determined that the state doesn't have prohibitions on physician-assisted suicide.
Ultimately, the focus on a more moderate approach paid off for proponents of physician-assisted suicide.
"We never would have been successful or passed the Death with Dignity Act if we let it be something characterized as something similar to Jack Kevorkian's approach," Stutsman said. "We did our work from the political middle, and not the political margins."
Tami Abdollah can be reached at http://www.twitter.com/LATams