The Remarkable Death Of Janet Adkins

HER face is staring at me from the front page of the newspaper. It's not a very good print, but even so she looks like someone I'd like to know - friendly, intelligent. The face matches the words used to describe her: mother, grandmother, busy, gutsy, zest for living.

It's the face of Janet Adkins. The last gutsy thing she did was fly to Michigan so she could end her life rather than face slow death as an Alzheimer's sufferer.

Her death and the circumstances surrounding it have stunned and saddened some, shocked and dismayed others, perhaps inspired yet others.

No longer a matter for private grieving, her death has become an event that cries out to be discussed by more than just her circle of family and friends. But what to say? Was she right or wrong? What about the Michigan doctor whose device she used and who assisted her in the final moments - was he right or wrong?

Are those the right questions? Should we even presume to judge Janet Adkins' decision and Dr. Jack Kevorkian's assistance? Should we instead be asking ourselves what we would do? What we hope our parents would do?

One harsh judgment was made in these pages Friday by a Scripps-Howard columnist who said Kevorkian deserves society's contempt ``for his awful rush to put a frightened woman to death.''

Somehow that assessment doesn't square with Janet Adkins' own words or those of her husband, Ronald, and sons who met with members of the press Wednesday in the family home in Portland's West Hills.

In her own statement, made public by her husband, Janet Adkins said: ``This is a decision taken in a normal state of mind and is fully considered. I have Alzheimer's disease and do not want to let it progress any farther.''

Nowhere in the news accounts of her life and death do Adkins' family or friends describe her as anything like a ``frightened woman.'' Not in the year since she was diagnosed as having Alzheimer's; not even in the final days of her life. To the contrary, this musician and outdoor enthusiast, described by some as a Renaissance woman, seems to have planned and carried out her death in the same independent spirit with which she lived.

She heard about Kevorkian through news accounts and contacted him. He had sought a clinic, church or funeral home in which to allow Janet Adkins to push the button on his so-called suicide machine. None would allow it. So he drove to a park outside of Flint, Mich., where, in the back of a van, the doctor began the intravenous injection of a harmless solution. She pressed a button to switch to the fatal solution, then she died.

Yes, it's a grim scene. But pull back for a moment from that image of a parked van thousands of miles from home. Until that final jarring circumstance, Adkins' decision and conduct seem to be what death with dignity is all about.

Her story adds poignant immediacy to what until now had been a rather obscure moralistic and ethical debate over Initiative 119. Washington voters are being asked now to consider in the abstract the very issues Janet Adkins addressed the last year of her life.

Initiative 119 is sponsored by Washington Citizens for Death with Dignity. If passed, the initiative would change the state's Natural Death Act to allow an adult who is expected to die within six months to sign a directive asking that a physician provide ``aid in dying.''

Clearly, Initiative 119 enacted into law would not have enabled Janet Adkins to simply cross the border to Washington to die. One year after her Alzheimer's diagnosis, she was still probably years - not six months - from death.

Other provisions in the initiative would have required more of Adkins, even in those final months: It requires written statements from at least two physicians that a patient is indeed in an incurable state, and sworn declarations from at least two disinterested witnesses that the patient has voluntarily signed an aid-in-dying request.

Backers of Initiative 119 include the Hemlock Society, of which Adkins was a member, and Humanists of Washington. If they gather 151,000 signatures by the end of this year, the issue will be on the general-election ballot in 1991.

Janet Adkins' remarkable death can be a guidepost for Washington citizens as we confront one of the most difficult dilemmas of the decade. The stark reality is that medical technology to prolong life has advanced well beyond the boundaries of society's moral and ethical traditions.

Adkins' decision to end her life seems premature (after all, she was still able to beat her son at tennis only a week before her death), but not wrong. Moralistic judgments about the rightness and wrongness of her death seem more wrong than the death itself.

What is moral or ethical about the vastly diminished quality of life of dying patients in nursing homes and hospitals? What is immoral about a public policy that carefully defines procedures by which a person confronted with the reality of her own incapacity and death can make the final important decision of her life - the decision to die on her own terms?

It's a choice we all hope we don't have to confront. But once confronted, I'd rather society let me choose than to make me a helpless pawn on the medical-ethical battleground of well-meaning strangers.

Mindy Cameron's column appears Sunday on The Times' editorial page.