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GETTING DEAD ON A NOVEMBER EVENING IN 1998, a national television audience watched Thomas Youk die at his home in Waterford, Michigan. He did not expect millions to witness his death, but his attending physician thought it was a good idea. Youk actually died several months before the broadcast, but what the audience saw that night on the CBS show 60 Minutes was not a studio recreation but raw footage of his last breath. At fifty-two, he suffered from amyotrophic lateral sclerosis (ALS), also called Lou Gehrig’s disease, in which nerve cells slowly die and muscles atrophy until the heart no longer receives signals from the brain and stops. Like many ALS victims, Youk was lucid but had so little muscular control he feared he would die from choking on his saliva. He and his family were desperate and so contacted a Michigan pathologist with a reputation for assisting in cases like his. Dr. Jack Kevorkian agreed to help. With over 130 assisted suicides to his credit, Kevorkian was at the height of his notoriety as “Dr. Death.” Flaunting that, he brought his videotape of Youk’s death to CBS, offering it to Mike Wallace for use on his program . Wallace agreed, and on November 22, Kevorkian narrated the video and explained why he wanted it shown nationally. “Either I go or they go,” he said of the prosecutors who for years tried to get homicide convictions from reluctant juries. But Kevorkian’s challenge to the courts in the Youk case was different. Previously, Kevorkian’s clients activated his “suicide machine” themselves, turning a knob or pulling a handle to start the flow of fatal chemicals. But Youk was paralyzed and could not do that, so Kevorkian personally injected the lethal solution into his client’s right arm, which in 1 1 medicine would be called active euthanasia. Youk died quietly in less than a minute. Weeks later, no arrest had been made, despite the video evidence of what appeared to be a homicide. Kevorkian joked with Wallace about that, asking if the police needed fingerprints. Apparently not. Soon he was arrested, tried for manslaughter, and convicted. A resident of the Lakeland Correctional Facility in southern Michigan, Kevorkian was released in 2007, at age eighty. Youk’s story, and Kevorkian’s part in it, is notable beyond the details of his death. Tom’s wife said she was relieved that his suffering was finally over, satis fied and appreciative of what Kevorkian had done for them both. A brother described a family at the “end of our rope,” with no other options, and fully supportive of Kevorkian’s help. The CBS program also featured a Chicago physician, appearing as a professional counterbalance to Kevorkian, who commented in shocked tones how sad it all was, saying that much more could have been done to help Youk in his desperation. Yet Wallace himself did not seem interested in exploring one of the obvious themes of this story—the gap between the Youk family’s frustrations and the physician’s assurances that help is available for those who ask. Nor did he pursue the question of whether Youk’s death qualified as a “good” one, a controversial idea debated in the medical literature and well known to the lay public through popular media over several decades. And beyond his dismay at Kevorkian’s enthusiasm for his peculiar cause, Wallace seemed uninterested in why this medical gadfly was a hero to some. That is unfortunate because many 60 Minutes viewers may have had questions about how well the health care system works for people like Youk, what qualifies as a “good death” in an ethical or a religious sense, and how others make hard decisions for themselves and family members when the prospect of a painful death seems unavoidable. While death is a natural event, in the sense that cells die off and body systems fail, Youk’s experience was shaped by medical, demographic, and cultural trends that are new. They include the demographics of mortality, with more of us living longer and dying later from chronic rather than acute diseases ; new medical technologies that prolong life but raise questions about its quality, while dying bodies are kept alive with powerful medications and machines; movements within medicine challenging heroic life-prolonging measures and the traditional view that death is the profession’s enemy; an emerging international system of organ “harvesting” and transplantation; the institutionalization of hospice and palliative care as newer medical...

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