Jack Kevorkian: a medical hero? Law has a protective function for both patients and doctors [Correspondence]

EDITOR,—“Show me a hero and I will write you a tragedy”; so wrote F Scott Fitzgerald. Jack Kevorkian is a fanatic, not a hero.1 There are some practical reasons why the killing of a patient, even when problems seem insurmountable, must remain prohibited in law. The law has a protective function. It protects the vulnerable from misinformation due to mistakes by or the ignorance of the informer, from pressure by those with malintent, from economically driven judgments on their future, and from much more. It also protects us, as doctors, from ourselves: our ignorance or arrogance, any temptation to cover up medical mistakes, our difficulty in asking for help from a colleague, overinvolvement with a patient that colours our judgment, our fatigue, or personal prejudice or bias about clinical or social conditions. It protects us from undue pressure by relatives weary of caring or who stand to gain financially. Managers cannot put pressure on us to clear those who are dying from our beds rapidly, and purchasers cannot question why we strive to provide quality care to patients with a poor prognosis. As a pathologist Kevorkian may be desensitised to corpses. We provide long term care and bereavement support and are increasingly aware of the absolute import of death. Currently, prognosis cannot be predicted accurately, there are errors of diagnosis, depression is difficult to diagnose in medically ill people, patients' priorities alter often during the course of a life threatening illness, hope can re-emerge from hopelessness, we find some patients' problems overwhelming at times, and sometimes our judgment is clouded by ignorance or fatigue. Why no cries to enshrine in law the right of all patients to a second opinion if their suffering remains intractable for a week? Why call for legalising carelessness?