PONTIAC, MICH., FEB. 5 -- A state judge today permanently barred retired pathologist Jack Kevorkian from using his "suicide machine," with which he helped an Oregon woman with Alzheimer's disease kill herself last year.
In a strongly worded decision that Kevorkian's lawyer said would be appealed, Oakland County Circuit Court Judge Alice L. Gilbert told Kevorkian that he may not assist a suicide in any way and said his role in aiding the suicide of Janet Adkins, 54, "flagrantly violated" all standards and codes of medical practice.
Occasionally looking directly at Kevorkian as she read from the 34-page opinion, Gilbert also assailed the 62-year-old physician for what she called his flamboyant attempts to attract public recognition through "bizarre behavior."
"His arrogance, coupled with unabashed disregard and disrespect for his profession and its current professional and ethical standards, reveal that his real goal is self service rather than patient service," Gilbert said.
Kevorkian's lawyer, Geoffrey Fieger, called the decision in the civil suit brought by prosecutors "a sham" and accused Gilbert of "taking up the standard of fanatical antiabortionists, people who wish to perpetuate suffering."
He said he would appeal on grounds that Gilbert has no authority to prohibit "a legal activity" by Kevorkian simply because "she thinks it is immoral or unethical."
Kevorkian suggested that he was being hounded for advocating what eventually will be seen as an enlightened approach toward the terminally ill. "Persecution is always a prelude to an advance," he said.
Gilbert's ruling was the latest chapter in an emotionally charged legal and medical drama that began last June 4 in the back of Kevorkian's 1968 van. There, Kevorkian attached Adkins to his crude, homemade device and watched as she pressed a button that injected drugs that rendered her unconscious, then caused her death.
Adkins's suicide attracted national attention, fueling a debate about issues involving the right to die and assisted suicide.
Gilbert's opinion said there is "reason to condone dying with dignity" but only in a tightly controlled environment. Joanne Lynn, director of the division of aging studies and services at George Washington University Medical Center, said that should refocus attention on "the really hard cases" involving the terminally ill while putting an end to Kevorkian's "bizarre endeavor."
Adkins, a former English teacher from Portland, sought out Kevorkian after reading about his device. She flew to Michigan with her husband and met with Kevorkian, who videotaped their discussion of her suicide.
Michigan has no law against assisting a suicide, so Oakland County prosecutors initially charged Kevorkian with murder. However, after a preliminary hearing in December, an Oakland County District Court judge threw out the charge, ruling that Adkins had caused her own death.
At the same time, a preliminary injunction prohibiting Kevorkian from using the device or otherwise assisting in a suicide remained in effect. Gilbert's ruling today made that injunction permanent. Last August, Kevorkian said almost 50 people had asked him for help in ending their lives.
In her ruling, Gilbert faulted Kevorkian on a wide range of medical, legal and ethical grounds. As a pathologist who retired in 1982, he "was not professionally qualified" to evaluate Adkins, Gilbert said.
In the videotape, she said, Adkins clearly is not near death nor in pain, and evidence about her desires is "too sparse" to support a finding that she wanted to commit suicide. But, Gilbert said, Kevorkian did little to explore Adkins's "rather ambiguous expressions" about ending her life or discuss alternative approaches to Alzheimer's, a brain disease that is degenerative and incurable.
"The interview conveys the impression that Dr. Kevorkian was rather anxious to try his invention that he had advertised, and Janet Adkins appeared as a likely candidate," Gilbert said.
Gilbert also dismissed Kevorkian's claim that he was seeking to expand basic human rights to include a right to assisted death.
"The rights of privacy and self-determination do not encompass the right to direct another person to kill or the right of a third person to participate in the killing," she said. "Patients cannot confer a right upon a doctor to assist a suicide. Patients cannot dictate to a physician how to practice medicine."
Kevorkian's device is in court custody, and it was not immediately clear what will be done with it. However, Michael J. Modelski, an assistant county attorney who prosecuted the case, said the key factor is that Kevorkian is permanently prohibited from helping a suicide.
"It's not really the machine that's important," Modelski said. "It's Kevorkian."