After talks with her husband, sons, minister, and
local doctors; Janet Adkins decided she didnt want to undergo the sustained mental deterioration that Alzheimers Disease caused (Uhlman 111). She began to realize she had the disease when she started forgetting songs and failed to recognize notes as she played the piano (Filene 188). She read in Newsweek about Dr. Jack Kevorkian and his Mercitron machine, then saw him on the Donahue Television show(Filene 188). With her husbands consent but objections by sons and doctors, she telephoned him to arrange to kill herself (Filene 188). She still had a life expectancy of at least ten years with the illness, but she wished to die. She wanted to die before the disease robbed her of her competence (Larson 229). Kevorkian later killed Adkins and faced the consequences boldly (Hendin, Suicide in America 247). The background, process, and effects of Dr. Kevorkians questionable first patient, Janet Adkins, have a very detailed story in them.
Janet Adkins led a very productive life up to and even after she had been diagnosed with Alzheimers, but she couldnt handle losing control of her brain (Filene 188). She was 54 years old and lived in a wealthy Oregon suburb with her stock broker husband, Ron. She was also the mother of three sons, taught English and piano, went hang gliding, trekked in Nepal, climbed Mount Hood, and generally behaved with a lot of energy (Gutmann 20). She and her husband were longtime Hemlock society members, which advocates Euthanasia in some cases (Betzold 22). Doctors at a Portland hospital told her that eventually she would be dependent on her husband for feeding and bathing (Gutmann 21). She did not want to take her own life in case she messed it up, and her own doctors wouldnt help her (Hendin , Seduced by Death 132). Though she was still able to carry on clear conversations and demolish her son at tennis; her husband explained that if she was going to go, shed probably want to go to soon rather than to late (Gutmann 21). After hearing about Kevorkian, Ron Adkins contacted him to employ his services (Wolfson 56). Her husband complained to Dr. Kevorkian that he had to remind her of the times of her tennis lessons, and that she kept leaving her purse in the house. After the brief conversation, Kevorkian agreed to meet with her (Gutmann 20). Dr. Kevorkian was a retired pathologist in Michigan with a passionate commitment to promoting assisted suicide and the use of his suicide machine (Hendin, Seduced by Death 130). He had an abiding interest in helping people die painlessly. He was the perfect person to carry out Janets wishes (Larson 229).
Dr. Kevorkian and Janet Adkins then met to discuss their intentions and eventually carry out the suicide (Hendin, Seduced by Death 134). Kevorkian and his two sisters, Margo and Flora, met with Ron, Janet, and Janets closest friend Carroll Rehmke in their motel room on June 2, 1990 (Wolfson 56). He had already prepared authorization forms signifying Janets intent, determination, and freedom of choice, which she readily agreed to sign (Wolfson 56).
While she was resolute in her decision, and absolutely mentally competent, her impaired memory was apparent when she needed her husbands assistance in forming the cursive letter A. She could print the letter but not write it, and the consent forms required that her signature be written. So her husband showed her on another piece of paper how to form the cursive letter A, and Janet complied (Wolfson 56).
He then asked her questions from behind a camera in a pre-death consultation. She frequently had to turn to Ron for help with the answers (Betzold 22).
He asked her, What are you asking for? Can you put it in plain words?
I don’t know, Janet Adkins replied.
Do you want to go on?
No, I dont want to go on.
You dont want to go on living?
Whats the word for that?
No. What is the word for the end of life? What happens when you stop living?
Is that what you wish?
Yes (Betzold 22).
Through this method Kevorkian believed he had established informed consent (Betzold 23). As a former pathologist, he had not been Adkins attending physician and further lacked the special training necessary to evaluate a patients mental state (Larson 229). The week before she died, Janet selected the music and the readings for her memorial service. She arranged for a therapist to mediate final closure sessions with her family (Gutmann 21). The night before her death she stayed up past midnight in a restaurant with friends, and rhapsodized about Bach with Dr. Kevorkian (Gutmann 21).
In her suicide note that she wrote the night before she died; she said, I have decided for the following reasons to take my own life. This decision is taken in a normal state of mind and is fully considered. I have Alzheimers Disease and do not want to let it progress any further. I do not choose to put my family or myself through the agony of this terrible disease (Fessenden 7).
Kevorkian had a knack with machinery that he used to build his suicide machine. For Adkins, he employed a machine that allowed her to self-administer poison intravenously (Larson 229).
A tiny motor from a toy car powered the intravenous lines. Then the patient was connected intravenously to a harmless saline solution. When ready to die, the patient pushed a button that caused a valve to shut off the saline and to open the adjoining line to a bottle of pentothal, which induced sleep within 30 seconds.A timing device connected to the line between the second and third containers triggered after one minute, causing an infusion of potassium chloride and succinylcholine (Hendin, Seduced by Death 130).
In a public park outside Detroit on June 4, 1990; he inserted the intravenous line into her vein as she laid on a cot in a Volkswagen van. He attached EEG electrodes to her wrists and ankles and inserted syringe into her arm (Filene 189). She then pulled the lever on the wooden, three-chambered device (Uhlman 111). Within ten seconds her eyelids flickered and drooped. She said Thank you, thank you. He replied, Have a nice trip (Filene 189). She became unconscious and six minutes later the EEG showed that her heart stopped beating (Filene 189). The only struggle that occurred was that it took Dr. Kevorkian five tries to insert the intravenous line into her arm (Uhlman 111). The machine worked as planned though, and Kevorkian made no attempt to conceal his role in the death (Larson 229).
The public found out about it almost immediately, touching off a national and international controversy (Hendin, Seduced by Death 131). Within a week of her death, the Oakland County prosecutor went to court to ask for a temporary restraining order to stop him from using his suicide machine (Hendin, Seduced by Death 131).
Next month it became time to consider whether to make the order permanent, Kevorkian tried to submit to the court a rambling, twenty-page statement, which included the views of Aristotle, Saint Thomas More, Thomas Jefferson, and Albert Einstein. The court would not accept the document (Hendin, Seduced by Death 131).
His lawyer used the argument that Kevorkian was not actually killing people but relieving suffering (Filene 134). He was not charged with murder, but he did have his Michigan Medical License suspended by the Michigan Board of Medicine in an 8-0 vote (Filene 134). He appealed the decision, but it was rejected. He then took no further notice of the suspension and either did the people who he continued to kill (Filene 134). He would later say, I dont rely on mental problems. I rely on their physical disease, which then affects the mind. Anybody who has a terrible crippling disease and is not depressed is abnormal (Betzold 24). He also declared publicly that the patient decides when its best to go, and that he is for absolute autonomy of the individual (Larson 229).Some opponents of physician-assisted suicide denounced the episode as the grim consequences of the Euthanasia movement (Larson 230). Proponents within the medical community dismissed it as an extreme case that showed the need for regularizing the practice within health-care facilities (Larson 230).
Media reaction was immediate, intense, and totally hostile. Some critics said it was a mockery of medical responsibility for a pathologist to help a woman die who was not terminally ill, who was still in early stages of Alzheimers, and just met two days before (Filene 134).
Another critic said, If anything the clandestine administration of a lethal injection in the back end of a rusty van mocks the very phrase, death with dignity (Filene 134). In 1992, Washington state initiative 119 asked the public to vote on a referendum that would make physician-assisted suicide illegal in Washington for at least a three year period. The initiative failed to pass by a slim margin (Hamel 128). In a poll in 1991, 72 percent of the public approved of Dr. Jack Kevorkian’s actions in assisting suicide (Hamel 127).
There is a very detailed story in the background, process, and effects of Dr. Kevorkians first patient, Janet Adkins.He killed Janet Adkins even though she was not terminally ill by any means. Kevorkian said that any disease that shortens life, no matter how much, is terminal (Larson 229). Clearly his lack of knowledge of her and his investment in promoting assisted suicide disqualified him from determining how ill she was. Also the method of which he carried out the suicide raised questions (Hendin, Seduced by Death 130). Among supporters of Euthanasia he became something of an antiestablishment here (Larson 230).This was the first of over a hundred assisted suicides that he would perform (Uhlman 111).
Betzold, Michael. The Selling of Doctor Death. New Republic 26 May 1997: 22-28.
Fessenden, Ford. Matters of Life and Death. Newsday 10 June 1995: 7.
Filene, Peter. In the Arms of Others. Chicago: Ivan R. Dee, 1998.
Gutmann, Stephanie. Death and the Maiden. New Republic 24 June 1996: 20-22.
Hamel, Robert. Must We Suffer Our Way to Death. Texas: Southern Methodist Press, 1996.
Hendin, Herbert. Seduced by Death. New York: W.W. Norton and Company, 1997.
Hendin, Herbert. Suicide in America. New York: W.W. Norton and Company, 1995.
Larson, Edward. A Different Death. Illinois: Intervarsity Press, 1998.
Uhlman, Michael. Last Rights. Washington D.C.: Ethics and Public Policy Center, 1998.
Wolfson, Adam. Killing of the Dying. The Public Interest Spring 1998: 56.