ANN ARBOR, Mich.—Jack Kevorkian, known as Dr. Death, may be facing life in prison.

Kevorkian, a suspended medical pathologist, renowned as a media showman and advocate of physician-assisted suicide (PAS), was charged with first-degree murder Nov. 25, in the lethal injection killing of 52-year-old Thomas Youk, a victim of the so-called Lou Gehrig's disease. (See story on page 16.)

The turn of events was no surprise to the 70-year-old Kevorkian, whose actions have long been geared to confrontation. In killing Youk, Kevorkian defied a clear-cut law banning PAS in the state of Michigan, and he allowed the CBS show 60 Minutes to air nearly 15 minutes of a homemade videotape of himself administering a lethal injection to the victim. Now he appears ready for a final showdown with law enforcement and the courts. “The issue's got to be raised to the level where it is finally decided,” Kevorkian stated.

Detroit archdiocesan spokesman Ned McGrath commented: “What I saw on my TV screen is a publicity-hungry unlicensed pathologist kill a visibly troubled, vulnerable man — and make a spectacle of it on national TV.”

The killing of Youk took place shortly after Kevorkian's conviction on charges of assault, following a scuffle with police. This and other factors indicate Kevorkian's apparent determination to bring his campaign for PAS to a spectacular conclusion, even to the point of seeing himself put on trial and convicted of murder.

Kevorkian's modus operandi in the Youk case diverged from his past activities and publicity stunts on behalf of PAS. For one thing, he dispensed with the apparatus he had used until then, which allowed the patient to administer the lethal dose. This time he administered the lethal injection himself. More spectacularly, he offered videotape of the killing to the media; CBS aired significant portions of the tape on the Nov. 22 broadcast of 60 Minutes. Finally, he has waived the right to legal counsel, expressing the preference to defend himself — a decision which significantly increases the likelihood of a conviction.

“It would be lunacy to represent himself and he will get himself convicted, period,” said Geoffrey Fieger, Kevorkian's former lawyer. Fieger, himself an outspoken advocate of euthanasia and a recent Democratic gubenatorial nominee defeated in a run this past November, said that Kevorkian has a “self-destructive” impulse.

“Kevorkian has no sense of loyalty and no sense of honor,” Fieger stated in a separate interview. “He thinks about himself more than he thinks about the issue.”

Fieger's own failure in the governor's race came the same day as the resounding Nov. 3 ballot defeat of Proposal B in Michigan. The proposal, which would have legalized PAS, was trounced by a 71% to 29% margin.

Despite this apparent mandate against PAS, many remain confused about the issue — and many, including Catholics, believe people should have the right to choose assisted death. As Kevorkian still remains unconvicted after more than eight years of assisting in the death of more than 130 victims, is perhaps less than surprising.

“What you have, for instance, in the issue of assisted suicide is where people say, ‘Well, I'm a Catholic and I don't believe that suicide should be legalized, but I am not going to impose my views on the other party,’” said Richard Thompson, former Oakland County prosecutor. “Someone's moral values are going to be imposed on society and the question is not whether they are going to be imposed, but whose values. Is it going to be the values of the ACLU, the moral relativists, or the Christian heritage?”

As Oakland County prosecutor, Thompson tried unsuccessfully to put Kevorkian behind bars from 1990 to 1996 in the Michigan county where he had carried out most of his assisted suicides. Many believe Thompson's persistence in trying to convict Kevorkian ruined his chances for reelection. Thompson entered the Catholic Church earlier this year.

Thompson's successor, David Gorcyca, has chosen to prosecute Kevorkian for this latest offence, stating that Kevorkian's videotaped actions clearly corresponded to the legal definition of premeditated murder. He predicted that the euthanasia advocate's defense would attempt to “rely on the emotions and the sympathy of the jury in an attempt to nullify what is quite clearly the law.” While Gorcyca admitted that a jury might disregard the law and acquit Kevorkian, he stated that “[t]he law is pretty obvious, and the facts are pretty clear.”

The victim, Thomas Youk, suffered from amyotrophic lateral scerlosis (ALS), the progressive and degenerative nerve disorder, widely known as Lou Gehrig's Disease. Physicist Stephen Hawking and onetime Major League baseball star James “Catfish” Hunter are other well-known personages who suffer from the disease, which is characterized by degeneration of motor cells in the spinal cord and brain.

The prognosis for survival is varied, with some patients, such as Hawking, living twenty years or more. As the ALS Association writes in its web site: “The life expectancy of an ALS patient averages about two to five years from the time of diagnosis. But with recent advances in research and improved medical care, many patients are living longer, more productive lives. Half of all affected live at least three years after diagnosis.”

“ALS results in progressive incapacitation,” said Dr. Ljubisa Dragovic, the Oakland County medical examiner involved in most of the autopsies on Kevorkian's victims. “It is a disease with a relentless course but the quality of life is directly proportional to the quality of care that is given.

“If care is delivered (to ALS patients) with the will and desire to make the person comfortable in a very supportive fashion, death can be forestalled for an extended period of time and we are not talking days, we are talking years,” explained Dragovic. “And there are tremendous returns in the way of overall human gratification when you are doing that for your loved one. That is where compassion comes in.”

The web site of the ALS Association concurs: “Present treatment of ALS is aimed at symptomatic relief, prevention of complications and maintenance of maximum optimal function and optimal quality of life.”

Yet as the Association warns, “The financial cost to families of persons with ALS is exceedingly high. In the advanced stages care can cost up to $200,000 a year. Entire savings of relatives of patients are quickly depleted because of the extraordinary cost involved in the care of ALS patients.”

If Kevorkian is convicted and imprisoned, he plans to starve himself to death. Fieger, who had earlier cited Kevorkian's “self-destructive” streak, confirms the likelihood of his carrying out this threat. As Father Robert Sirico, head of the Michigan-based Acton Institute for the Study of Religion and Liberty, wrote in The New York Times, “It would be a pathetic but not a surprising conclusion to this drama for Dr. Kevorkian to display the same disregard for his own life that he has for the lives of others. It would be a sad epitaph for Dr. Kevorkian to become the first martyr to die for the right to kill.”

Register correspondent Diane Hanson provided information for this report, which was compiled by staff with the use of wire and Internet sources.