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When Alzheimer's patient Janet Adkins pressed the button on a suicide machine and chose death over mental degeneration, she stirred debate over the ethics of euthanasia and sent prosecutors to the law books.

The 54-year-old Portland, Ore., woman on Monday became the first person to die using Dr. Jack Kevorkian's suicide device. After her husband of 34 years told her once more that he loved her, Mrs. Adkins had Kevorkian hook her intravenously to the machine inside his van parked in a suburban park.She hit the button, coma-inducing thiopental and a lethal dose of potassium chloride dripped into her veins, and within six minutes she was dead.

She and her husband, Ron, were members of the Hemlock Society, which supports the option of suicide for the terminally ill.

But assisting someone's suicide is explicitly illegal in Oregon; the Adkinses flew to Michigan, where the law is not so clear, after they read about Kevorkian's device and after experimental Alzheimer's cures failed.

"It's unfortunate that Mrs. Adkins had to go so far to get the assistance she desired," Hemlock Society spokeswoman Diana Smith said from the group's office in Eugene, Ore.

"Since Michigan is the only state in the union that doesn't have specific laws against people who assist in suicide, Kevorkian used it as a testing ground," Smith said. "What happened Monday kind of opens the door for seeing these laws are outdated and need to be changed."

Others vehemently disagreed.

"This ghoulish event illustrates the lengths that medicine can go once doctors violate the Hippocratic Oath and tradition which separates the killer from the caregiver," said Mary Senander, director of the International Anti-Euthanasia Task Force of Steubenville, Ohio.

The American Medical Association considers passive euthanasia ethical, said lawyer Reinhard Priester of the Center for Biomedical Ethics at the University of Minnesota.

But Priester said that Kevorkian, by arranging a suicide with the patient's consent, appeared to have participated in active euthanasia - which the AMA has deemed morally inappropriate.

Whether Kevorkian's action is legal in Michigan is what Oakland County Prosecutor Richard Thompson is now trying to decide.

He said Tuesday he believes a 1920 Michigan Supreme Court decision makes abetting a suicide illegal, although he hasn't decided whether to bring charges.

In 1920, the court upheld the murder conviction of a man who placed a bottle of poison within reach of his wife, who wanted to commit suicide, Thompson said.

But a 1983 state Court of Appeals decision said a man who gave a gun to a friend who used it to commit suicide shouldn't have been charged, he said.

Kevorkian, a longtime advocate of euthanasia, said Tuesday he expected to be prosecuted. "What I am doing was ethical even in Hippocrates' day. I guess highly emotional people would call it murder," he said.