Can a doctor kill? Is mercy killing the same as giving the patient the freedom to die? Michigan courts acquitted Kevorkian four times for physician-assisted deaths but convicted him for second degree murder last week. The law recognises neither physician-assisted deaths nor mercy killing which is directly done by the physician. But the courts had to bow each time in the past before claims of an individual's right to choose the manner and time of his death.

Even the right-to-die supporters in Michigan have deserted the retired pathologist as they do not see assisted suicide and mercy killing in the same light. In Oregon, the only State in the US which considers physician assisted deaths legal, mercy killing is still banned. However, outside America,Netherlands for instance does not discriminate between the two and considers both legal.

Is it the same for the patient? A prosecutor asked during the trial recently if giving the patient a loaded gun was the same as pumping bullets into him. It could be if the patient asks for it. If he begs to be killed as one begs for water or medicine. As many patients in the US are reported to be demanding as medical advances are keeping them alive longer than they want, totally dependent on tubes and respirators.

As long as the choice is his, the patient can die either way by pulling the string of a suicide apparatus prepared by doctors like Kevorkian or letting the doctor inject a killing dose.Thomas Youk who was suffering from Lou Gehrig's disease was drowning in his own saliva and needed someone to end his life when Kevorkian injected a killer medicine into him.

But assisted death and mercy killing may not mean the same for the doctor who must `kill'. Kevorkian who claims to have assisted the deaths of 130patients since 1990 feels that they do not mean different for him. He told the jury in a Michigan court recently that he sees himself as the executioner who kills because that is his job. He has no vicious intent in committing the deed. And so long as there is no vicious intent a murder cannot be seen as a crime.

Killing here may not be a crime. It may be alright ethically and rationally for the doctor. But there are other limitations that bind a man than his reason and morality. There is the fear of playing omnipotent, of tampering with nature. There is some mysterious fear that makes man flinch from murder. There is a fear of oneself. Or is it a fear for oneself? There is a terrifying quality in life that makes one refrain from tampering with it.But there have been people who have ignored the throbbing substance called life and snuffed it out. Only the conviction of ideology and the quality of mercy can give man such a freedom from fear of `murder'. While ideology can lead to homicides, mercy can lead tosolutions such as suggested by Kevorkian and doctors like him all over the world in situations beyond medical help.

Kevorkian has resolved his spiritual crisis if he had any by looking at mercy killing as a way to help his patient. The absence of self interest absolves the doctor of guilt.

But besides a doctor's spiritual dilemmas, other questions remain. Of patients being cheated by relatives, of a patient's consent not being taken at all, a patient's competence to take a decision. Yet the question remains that if a patient wants to die should he be permitted, assisted? The doctor and the relatives can have no choice here. The choice belongs to the patient.