Death and Dying in the 1990s: Intimations of Reality and Immortality

By Fins, Joseph J. | Generations, Spring 1999 | Go to article overview
Save to active project

Death and Dying in the 1990s: Intimations of Reality and Immortality

Fins, Joseph J., Generations

To me alone there came a thought of grief:

A timely utterance gave that thought relief. . .

-William Wordsworth

How has death

become a

popular issue?

As the decade comes to da close, it is an opportune time to reflect on death and dying in America. As I write, Jack Kevorkian-the figure perhaps most identified with the death with dignity movement-has just been sentenced to ten to twentyfive years in a Michigan jail for second-degree murder. Although Kevorkian will almost certainly appeal his conviction, his sentencing to prison time makes it highly likely that his involvement in our nation's dialogue about death and dying is fast coming to a close. This occurrence is a milestone because Kevorkian's initial physician-assisted suicides sparked our national debate about this contentious issue.

This story could be said to have begun in June 1990, when we read that the retired pathologist had helped a 54-year-old woman with a presumptive diagnosis of Alzheimer's disease to end her life (Belkin, 1990). After playing a game of tennis and writing a note to her family explaining her actions, Janet Adkins was connected to Dr. Kevorkian's suicide machine to receive a lethal injection of medication in his now famous Volkswagen microbus.

The story seems to have ended on April 13, 1999, when Kevorkian was sentenced to ten to twentyfive years for seconddegree murder of Thomas Youk. With overwhelming media coverage, the nation watched as Kevorkian received his first conviction after three acquittals and one mistrial. As the Kevorkian chapter appears to be coming to a conclusion, it is a good time to reflect on where we have been this past decade in order to predict where we might be headed in the next.


It could be argued that we have made remarkable progress since Kevorkian's first assisted suicide. Although his actions are not responsible for these accomplishments, they did help set the stage for greater receptivity to the work of more mainstream investigators and policy makers concerned with the care that people who are dying receive. It is worth cataloguing these activities to fully appreciate the scope of our efforts over the past ten years and to predict future trends.

Medicine and the law. At least within the profession of medicine, it could be argued that the most significant event of the decade was the publication in I995 of the massive Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment (SUPPORT), finded with $28 million from the prestigious Robert Wood Johnson Foundation. The SUPPORT study found that a disproportionate number of critically ill hospitalized patients received inadequate pain relief and that their preferences regarding end-of-life care were either unknown or ignored.

In the wake of SUPPORT, it was not uncommon to read in leading newspapers that advance directives did not work, that physicians ignored pain, and that they were often unaware of their patients' end-of-life care preferences (Gilbert, I995; Colburn, I995; Winslow, I995). SUPPORTS conclusions, which were sometimes accurately described and sometimes misrepresented in the professional and lay press, helped to further a desire for the legalization of physician-assisted suicide that had begun in earnest with Timothy Quill's 1991 New England Jounal of Medicine account of how he helped his patient "Diane" end her life. Quill's mainstream reflections in the nation's leading medical journal-coupled with Kevorkian's libertarian practices-led prominent physicians and medical ethicists to propose guidelines to legally regulate this practice (Quill, Cassel, and Meier, I992; Miller and Fletcher, I993; Miller et al., 1994). Although many advocated improved palliative care as the appropriate response to these deficiencies in care (Sach et al., 1995), others read the SUPPORT results as a justification for the legalization of physicianassisted suicide.

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
Loading One moment ...
Project items
Cite this article

Cited article

Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited article

Death and Dying in the 1990s: Intimations of Reality and Immortality


Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

While we understand printed pages are helpful to our users, this limitation is necessary to help protect our publishers' copyrighted material and prevent its unlawful distribution. We are sorry for any inconvenience.
Full screen

matching results for page

Cited passage

Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.

Are you sure you want to delete this highlight?