Kevorkian, 83, hospitalized at Beaumont Hospital in Royal Oak with pneumonia and kidney ailments, died of a pulmonary embolism, said his lawyer Mayer Morganroth.
A raucous advocate of assisted suicide who admitted attending 130 deaths, Kevorkian lost his medical license and freedom in the fight that saw him convicted of murder -- even as the changes he championed became law in Oregon and elsewhere.
Relentless and often theatrical in demanding that patients should be sovereign, he helped change the patient-doctor relationship.
Kevorkian "forced the medical profession and government to step forward and say, 'We've got something for you.' That's probably his biggest impact," said Dr. Michael Stellini, a palliative care physician at Detroit Receiving Hospital.
He also was sure that the logic of his position could withstand attacks and indictments from those he considered petty-minded and controlling bigots. After a string of acquittals, he was convicted of second-degree murder in 1999.
In a statement from prison in 2000, Kevorkian defended his position: "My single-minded dedication to the constitutional right of a human being to request and receive medical assistance in ending incurable suffering -- painlessly, quickly and with certainty -- has unjustifiably been branded a crime."
Even though he was stuck in a hospital setting he hated, Kevorkian died as he wished: with his niece Ava Janus, friend Morganroth, and Bach, along with Beethoven's "Moonlight Sonata," playing from a laptop computer.
Kevorkian a lightning rod for debate, controversy
Admired as a compassionate crusader or abhorred as a murderous crank, Jack Kevorkian is widely credited with changing how states deal with assisted suicide and stimulating much-needed discussion about improving end-of-life care in the U.S.
Kevorkian admitted being present at about 130 suicides, and his hectoring defiance of established laws and protocols forced re-examination of personal freedoms in medical treatments and end-of-life decisions.
"He had an impact, but not deliberately," said Dr. Maria Silveira, a University of Michigan end-of-life specialist.
"He was such a lighting rod that there was a huge reaction to what he was doing," Silveira said. "Many people in medicine were quite alarmed at the notion that we could be asked to help assist our patients in death and dying. In response to that, more of us began to realize we had a greater responsibility to recognize our patients' suffering and to find ways to address it, short of what Jack Kevorkian was doing."
Kevorkian "was a historic man," said attorney Geoffrey Fieger, who represented him in numerous legal fights. "It's a rare human being who can single-handedly take on an entire society by the scruff of its neck and force it to focus on the suffering of other human beings."
After years of combative advocacy for assisted suicide, Kevorkian slipped quietly from life early Friday. Known as Dr. Death even before launching his fierce fights against the medical and legal establishments, Kevorkian, 83, died at Beaumont Hospital in Royal Oak, where he had been hospitalized with kidney problems and pneumonia.
"It was peaceful. He didn't feel a thing," said his attorney Mayer Morganroth.
'He wasn't a kook'
Many people who went to Kevorkian called him the best doctor they had ever seen.
"I know my mom and myself were eternally grateful. ... He wasn't a kook or anything. He was a man with an idea whose time had come," said Alan O'Keefe, 52, of Lincoln Township, near Reed City. Kevorkian helped his father, Donald O'Keefe, 73, a retired engineer with bone cancer, die in 1993.
Since his first acknowledged assisted suicide in 1990, authorities tried to rein in Kevorkian as the toll soared. He was charged four times with murder, only to have three juries acquit him and one case collapse in mistrial.
That streak of courtroom triumphs ended with the 1998 death of Thomas Youk, 52, of Waterford, who had Lou Gehrig's disease.
In a self-inflicted triple injury, Kevorkian videotaped himself injecting Youk, had it broadcast on "60 Minutes," and then acted as his own lawyer in the ensuing Oakland County murder trial.
Kevorkian was convicted of second-degree murder and was sentenced to 10-25 years in prison in 1999. He was released in 2007 and discharged from parole in 2009.
His post-prison career included a 2008 congressional bid and a cable TV biopic starring Al Pacino as Kevorkian.
In his failed political career, Kevorkian, as usual, cast himself as the truth-teller in a world of hypocrisy: "We need some honesty and sincerity instead of corrupt government in Washington."
"You Don't Know Jack," the HBO film, earned Pacino an Emmy, Golden Globe and Screen Actors Guild Award. Kevorkian cut a vivid image at premieres, sometimes wearing his iconic blue thrift store sweater with a tuxedo. He almost glowed at receptions as women circled him and powerful men elbowed their way through the adoring crush to shake his hand.
Later, when friend Neal Nicol gave him a picture of Pacino from the film, Kevorkian joked: "Where did they get that picture of me?"
Despite his public persona, Kevorkian will not be openly memorialized, Morganroth said.
"If Jack could look down on us -- and who knows -- he wouldn't want that," Morganroth said.
Kevorkian's death, naturally and in a hospital, was not a rejection of his own beliefs, Morganroth said.
"There was no reason for him to end his own life," he said. "It wasn't terminal until the end with the clot. He followed his own wishes and died the way he wanted to."
His life, career
Kevorkian, the son of Armenian immigrants, was born in 1928 and raised in Pontiac during the Depression and World War II. The son of an excavation contractor, Kevorkian graduated from the University of Michigan School of Medicine in 1952, but his career soon took an idiosyncratic trajectory.
A book about the Greco-Egyptian Ptolemies who ruled Egypt for about 300 years just before the start of the Common Era shaped Kevorkian's life for the next half-century. As he'd recall in interviews and court testimony, the book described a society in which criminals repaid their crimes by undergoing medical and scientific experimentation.
Kevorkian was soon advocating use of convicts and condemned prisoners for experiments and research. He and U-M parted ways, and he moved his residency to Pontiac General Hospital but interrupted it for a year of independent study in Europe.
He returned to the U.S. and completed his residency. He was first called Dr. Death by nurses for his fascination with the transition from life. Volunteering for night shifts, he photographed the eyes of patients as close to the instant of death as possible.
He became a pathologist and worked at several Detroit-area hospitals, including Saratoga and Pontiac General hospitals, as they were called at the time. His interest expanded into the use of blood from cadavers, including direct corpse-to-patient transfusions. He envisioned tremendous battlefield benefits if wounded soldiers were saved through their fallen comrades' blood.
Turned down for a research grant -- an act he would later call an example of establishment corruption -- he moved to the West Coast, where he worked for several southern California hospitals. Stretching frugality to eccentricity, he sometimes lived in his 1968 Volkswagen van.
His last employment ended in 1982 when he left a Long Beach hospital to devote himself to research and authoring articles such as "Marketing of Human Organs and Tissue is Justified and Necessary" and "The Last Fearsome Taboo," a work outlining his theories of suicide clinics and experimenting on patients.
Returning to Michigan, he lived a skinflint's life in a barely furnished apartment above a store in downtown Royal Oak. He lived on cheese sandwiches and shopped for clothes at the Salvation Army.
Kevorkian knew he was often seen as an odd bird: "I've never really fit in."
Ultimately, for Kevorkian, thought and words demanded deeds.
In 1987, he tried placing newspaper ads offering "Special Death Counseling." Instead, he got references in short stories in the Free Press and magazines like Newsweek about a strange pathologist.
One of those reading about Kevorkian -- who'd cobbled together a suicide machine out of $30 worth of spare parts -- was Janet Adkins, a former teacher in Portland, Ore. Adkins, who at 54 had an early diagnosis of Alzheimer's disease, feared the condition's inevitable mind-stealing progression and flew to Detroit.
The jury-rigged device delivered the flow of saline, sedatives and finally the heart-stopping potassium chloride, and Adkins died June 4, 1990, inside Kevorkian's rusty VW van.
Her death -- a murder charge was dismissed before trial -- launched Kevorkian into the national eye and set his course.
Challenges to his methods
Using drugs and later carbon monoxide, Kevorkian, backed with a coterie of supporters, attended more deaths, sometimes dropping the bodies off at hospitals, other times having them collected at the suburban Oakland County home of his associate Nicol.
Gaunt, theatrical and hyperbolic, Kevorkian appeared to demand martyrdom, staging increasingly outlandish provocations, from appearing in court as Thomas Jefferson in a tri-cornered hat, knee britches and powdered wig to offering a client's crudely harvested kidneys for transplant.
Those who opposed him were denounced as superstitious know-nothings, Dark Age hypocrites and philosophical cowards.
Medical experts challenged his methods.
"Kevorkian presented a false choice," said Dr. Michael Paletta, chief medical officer for Hospice of Michigan. "Either have your pain and suffering or have a physician end your life."
Legal authorities also were taking notice and action against Kevorkian.
By then, he had teamed with attorney Fieger, who turned the trials into slashing attacks on then-Oakland County Prosecutor Richard Thompson. In the ensuing cases, Thompson, Oakland County Medical Examiner L.J. Dragovic and the medical establishment were cast as cruel, hidebound fanatics condemning the sufferers to end their lives in agony and helpless humiliation.
"I want to make euthanasia a positive thing" for those too weary and beaten by illness, Kevorkian said.
Kevorkian and Fieger loudly proclaimed that they stood for personal freedom to choose a gentle, dignified release. Along the way, they slapped a red clown's nose on a blow-up of Thompson and cast the Yugoslavian-born Dragovic as a bowtie-wearing incarnation of Dracula.
They won acquittals in three murder trials and a mistrial in another.
It was a fractious courtroom partnership, though, with an agitated Kevorkian often trying to direct the case as Fieger shouted, "Shut up!"
Kevorkian's authority-baiting antics got him on David Letterman's Top 10 lists, but they antagonized potential allies.
Derek Humphry of the Hemlock Society, which advocates for the right to suicide, said Kevorkian was "too obsessed, too fanatical, in his interest in death and suicide to offer direction for the nation."
Nevertheless, he undeniably forced the debate into the limelight.
In 1994, Oregon voters approved a measure making physician-assisted suicide a legal medical option for terminally ill residents. It was delayed through a series of court challenges. In 1997, Oregonians again voted in favor of it.
Growing fame
As his fame grew, Kevorkian, still wearing a $1.50 thrift shop cardigan, exhibited his gruesome paintings of leering skulls, agonized patients or dismembered bodies. He also performed his own musical compositions as he championed the notion of absolute personal freedom in life decisions.
Then-Gov. John Engler and Michigan state legislators tried to curtail or outlaw his practice, which only fed Kevorkian's loud outrage and demands for carefully administered release for terminal or agonized patients.
But growing examination of Kevorkian's works showed he often ignored his own professed standards.
Franz-Johann Long, a 53-year-old Pennsylvania man who died in late 1997, told Kevorkian that he had terminal bladder cancer. But relatives said he had a history of mental illness -- at times he claimed to be a secret agent -- and an autopsy found only a "superficially involved" tumor.
Autopsies of at least five other people who died with Kevorkian in Oakland County found no sign of diseases, and only 17 of 69 closely examined cases had terminal illnesses or conditions such as multiple sclerosis or cancer.
In November 1998, 11/2 months after a state law banning doctor-assisted suicide took effect, CBS's "60 Minutes" aired a tape of Kevorkian fatally injecting Thomas Youk, who had amyotrophic lateral sclerosis. He then dared officials to do something about it.
"Either they go or I go," Kevorkian told CBS interviewer Mike Wallace. "If I'm acquitted, they go because they know they'll never convict me. If I am convicted, I will starve to death in prison. The issue has got to be raised to a level where it is finally decided."
Waterford Police Lt. John Dean was taken by Kevorkian's demeanor on the tape: "He was a very charming man, but then, so was Ted Bundy."
'Dared me to prosecute him'
The murder charge was brought by David Gorcyca, who was elected Oakland County prosecutor on a pledge not to pursue Kevorkian using homicide charges based on common law.
"I was elected and dismissed 17 counts against him," Gorcyca said.
He said he ignored Kevorkian for 18 months, depriving him of an antagonist.
"I ignored him until he went on '60 Minutes' " with the taped death of Youk in 1998, Gorcyca said. "He not only dared me to prosecute him, he begged me. He wanted to be on the national and international stage."
He got his stage and more.
Although the "60 Minutes" broadcast led to Kervorkian's conviction, the segment's producer, Bob Anderson, said he did not see the pathologist as a murderer.
"The Jack Kevorkian I dealt with was well-intentioned and humane," Anderson said.
"It was something Tom Youk so clearly wanted," he said. "I was particularly moved by (Youk's wife) Melody. For Melody Youk, he was a godsend."
He said Kevorkian had set up all the other deaths so the person could trigger the fatal medication by flipping a switch or pulling a string.
"He wanted to take it to the next level -- so a person could ask someone to do it for them," Anderson said.
Kevorkian believed no jury would convict him if he spoke directly to them, Anderson said.
He did speak directly as his own lawyer, but it ended with his conviction.
Trial prosecutor John Skrzynski, who had lost one murder case against Kevorkian, said the doctor's motive didn't matter because it "is not an element of murder. The facts are pretty cut-and-dried in this case. He spelled out all the elements himself."
Outside court, Kevorkian shouted: "The question is, 'Do any of you think I'm a criminal?' "
But inside court on April 13, 1999, an Oakland County jury convicted him of second-degree murder and he was ordered to serve a 10- to 25-year sentence.
Former Oakland County Circuit Judge Jessica Cooper, currently the county prosecutor, oversaw the trial.
At his sentencing, Cooper had strong words for the tiny man in the orange jumpsuit.
"You invited yourself to the wrong forum," she said in a lecture that was broadcast worldwide. "When you purposely inject another human being with what you know to be a lethal dosage of poison, that sir, is murder and the jury found so.
"Then you had the audacity to go on national television, show the world what you did and dare the legal system to stop you. Well, sir, consider yourself stopped."
Life after conviction
Inside the prison walls, his fame endured. He was given the Gleitsman Foundation's Citizen Activist Award in 2000.
Attending and accepting for him was his lawyer, Morganroth, who read a statement from the imprisoned pathologist saying his acts had been wrongly criminalized.
Attempts to overturn his convictions were rejected, as were his efforts to win an early release.
His health started faltering in prison, and he was paroled in 2007.
As a parolee, he faced the usual restrictions and constraints -- seeing a parole officer, getting drug and alcohol testing and shunning felons, weapons and anything that constitutes criminal behavior.
There were special conditions, too. He couldn't provide care for anyone older than 62 or who was disabled. He was barred from being present at any suicide or euthanasia, and he could not counsel people on how to commit suicide.
His failing health
Once free, Kevorkian's health continued to fail.
Kevorkian's assistant Nicol said he and Kevorkian contracted hepatitis C from experiments they did together in the 1960s at the former Pontiac General Hospital, where they both worked -- Kevorkian as a pathologist, Nicol as a medical assistant.
Kevorkian was hospitalized twice in May because of kidney problems and a fall. Additionally, he suffered from an array of ailments including liver and heart disorders. He underwent hernia surgery in February 2005.
Doctors hoped they could strengthen the frail Kevorkian so he could undergo radiation treatments for liver cancer, but he never got to that point. Indeed, Kevorkian's cancer appeared treatable. He had only two tumors on his liver, one benign and the other small, Morganroth said.
Kevorkian spent his 83rd birthday, on May 26, in the hospital, where Nicol; Ava Janus, Kevorkian's niece; longtime Royal Oak friend Brian Russell, and Morganroth visited him.
Nicol brought Kevorkian's favorite dessert -- a homemade pineapple pie -- but Kevorkian could not take food by mouth at that point, Nicol said.
Even at the end, Kevorkian was seeking answers, Morganroth said. He didn't deny the afterlife as much as challenge the notion of an eternal soul, Morganroth said.
"Jack wasn't an atheist. He was an agnostic," Morganroth said. "He wasn't sure -- but now he knows."
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