DETROIT (AP) - Once known as ``Dr. Death'' in his passionate crusade for physician-assisted suicide, Dr. Jack Kevorkian these days is Inmate No. 284797 in a remote Michigan prison where he serves time for murder.
Kevorkian's sentencing in April ended a saga in which the retired pathologist sometimes left bodies at motels, coroners' offices and hospital emergency rooms; burned state orders against him; showed up at court in costume, and challenged authorities to make his actions legal - or stop him.
But while assisted suicide's most visible advocate has been silenced, activists on both sides say their efforts continue.
Supporters point to legal and legislative efforts in several states to give people the right to choose when and how their lives will end.
Opponents, led by the medical establishment, say they are working to make it easier to treat debilitating pain effectively and make suicide, with or without a physician's involvement, less appealing.
Both sides agree that Kevorkian sparked their efforts.
Kevorkian ``had the very positive effect of galvanizing a lot of people, making them see what horrible straits some people were in,'' said Estelle Rogers, executive director of the Death with Dignity National Center, a right-to-die lobbying group.
``Having Jack Kevorkian finally be convicted was a great success,'' said Cal Montgomery, a policy analyst with Not Dead Yet, a Forest Park, Ill.-based advocacy group for disabled people.
By Kevorkian's count, he assisted in 130 deaths since helping Alzheimer's patient Janet Adkins die in his rusted Volkswagen van in 1990. Four felony trials resulted in three acquittals and a mistrial.
Then in September 1998, Kevorkian videotaped himself injecting a lethal mix of barbiturates into 52-year-old Thomas Youk, immobilized by Lou Gehrig's disease. Kevorkian gave the tape to ``60 Minutes,'' which broadcast parts of it two months later.
``I've got to force them to act,'' Kevorkian said on the CBS program. ``They must charge me. Because if they do not, that means they don't think it was a crime ...''
Authorities did act, charging Kevorkian with first-degree murder and other charges. He insisted on serving as his own attorney.
``Honestly now, do you see a criminal? Do you see a murderer?'' Kevorkian asked jurors. ``... If you do, then you must convict.''
And so they did, finding Kevorkian, 71, guilty of second-degree murder and delivery of a controlled substance. He was sentenced to 10 years to 25 years in prison, time he is serving at the Kinross Correctional Facility in the Upper Peninsula. He will become eligible for parole in May 2007.
He no longer wants to talk to the media. He shares a room with two other inmates and passes his time reading.
Even if Kevorkian were not in prison, said his attorney, Mayer Morganroth, ``he feels that ... he would not assist with suicides any longer, and the courts are now the appropriate place for the issue to be resolved.''
Michigan's ban on assisted suicide is being challenged in court by Robert Sedler, a professor of constitutional law at Wayne State University in Detroit. Sedler's federal lawsuit claims that the 14th Amendment includes the right ``to be relieved from unbearable pain and suffering.''
The suit was filed on behalf of a family practitioner in Pontiac and an internist in Grand Blanc, neither of whom is treating patients with intractable pain, Sedler said.
``They want to be allowed ahead of time to help end their (patients') suffering if they think it's medically appropriate,'' he said. ``They can't do it because if they did, they would end up like Dr. Kevorkian.''
The Michigan State Medical Society formed a Task Force on End of Life Care after the 1998 defeat of Proposal B, a statewide referendum on whether to legalize assisted suicide.
``Rather than say that's the end of the issue, a lot of physicians with the State Medical Society felt that what the public was saying was that they were concerned about end-of-life issues,'' said its chair, Flint pathologist Dr. Cathy Blight.
The task force's mission includes educating doctors about more effective ways to treat pain, and educating the public about hospice care, living wills and other ways of dealing with terminal illness, Blight said.
If Oregon is the experiment for physician-assisted dying, she said, ``let's have Michigan be the experiment in physician-assisted living.''
Assisted suicide has been legal for several years in Oregon. Right-to-die legislation is pending in states including New Hampshire and California. The issue will be on the 2000 ballot in Maine unless lawmakers legalize the practice.
The U.S. House in late October approved the Pain Relief Promotion Act, which would make it a federal crime to use suicide drugs to intentionally end a patient's life. It also would provide a new legal defense for doctors who unintentionally end patients' lives with large doses of pain relievers.
The bill has the American Medical Association's overall support, although the group is lobbying for changes that it says would make doctors, not the government, responsible for pain management.
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