Physician-assisted suicide and the politics of problem definition

Abstract

In the United States the issue of physician-assisted suicide (PAS) first reached the governmental agenda in the state of Michigan. This occurred because of the personal crusade of Dr Jack Kevorkian, a retired pathologist, to legalize PAS. In June 1990 Kevorkian initiated his crusade by assisting Janet Adkins, who suffered from Alzheimer's disease, to commit suicide. The bizarre nature of the suicide—conducted in the back end of Kevorkian's Volkswagen van, and using a suicide machine to deliver a lethal dose of a drug, created an international media sensation. The efforts of prosecutors to stop Kevorkian were frustrated because Michigan, unlike most other states, did not have a law prohibiting assisted suicide. In response to the controversy, the Michigan state legislature enacted a temporary ban on assisted suicide and created the Michigan Commission on Death and Dying, charging it with developing legislative recommendations on aid-in-dying. The Commission, comprising 22 groups, is of historical interest because it was one of the first public bodies in the United States to debate the issue of PAS. The debate that occurred on the Commission illustrates three different definitions of physician-assisted suicide deriving from beliefs rooted in political ideology, moral intuitions and religious belief. It also illustrates that the politics of PAS for some time is likely to involve conflict over different problem definitions.