Euthanasia

Public Controversy

In 1998, euthanasia and PAS received widespread public attention as a result of the physician and former pathologist Jack Kevorkian's assisted suicide practices. Kevorkian, often referred to in the press as “Dr. Death,” set off an avalanche of public debate about the morality and legality of euthanasia and PAS. Kevorkian allowed the news program 60 Minutes to air a videotape of him administering a lethal injection to Thomas Youk, a terminally ill patient suffering from Lou Gehrig's disease. Kevorkian believed that people had a right to commit suicide and a right to receive assistance in doing so, regardless of whether or not they were terminally ill or suffering from severe and chronic pain. [Page 264]Kevorkian admitted to assisting in 130 suicides before being convicted in 1999 of second-degree murder for euthanizing Youk, and because he had previously lost his license to practice medicine, he was also convicted for the delivery of a controlled substance. He spent 8 years in prison and was only paroled after agreeing to end assisting suicides. Kevorkian died in 2011.

The Biomedical Model and the Death with Dignity Movement

The biomedical model is the predominant approach to illness and disease in industrialized nations. It is characterized by a cure-oriented logic that focuses almost exclusively on biologic factors in understanding disease. However, the absence of concern over social and psychological elements of disease can dehumanize and add to the misery of terminally ill patients. Within this model, if a cure for disease is not within reach, the goal often shifts to the prolonging of life through technology and not on the quality of life for the patient. Moreover, the modern organization of the medical establishment is highly bureaucratized. As the sociologist Max Weber explained, bureaucracies are formal rational systems, meaning that they are organized around the specialization of tasks in the name of efficiency, productivity, and control. Many have argued that the biomedical model produces a medical factory system that treats the human body as an object that is broken and in need of repair, and doctors are the proprietary experts who possess the knowledge and skill to diagnose, treat, and cure diseases. In this model, health is the normative goal, and death itself is viewed as deviating from this goal. As such, the inability to completely control the process of dying challenges the formal logic that underpins the biomedical model. Consequently, terminal patients often remain hospitalized, and disease is aggressively treated until it proves fatal. Doctors, patients, and political and legal experts working from more holistic perspectives of health have helped bring attention to the limits of formally rational modes for dealing with death. For instance, the death with dignity movement, also sometimes referred to as the palliative care or hospice movement, has been hugely successful in its fight for the provision of treatments to maximize quality of life for all terminally ill patients alongside any disease-directed treatment that patients want to continue. In the United States, for example, the American Board of Medical Specialties now provides board certification for palliative care. The death with dignity movement is international and has been successful at challenging the biomedical model's definition of death as failure and its impositions on patients and doctors who champion the rights of the dying to end their lives.

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