The Kevorkian controversy, in short, seems to be reaching an ugly new crescendo. Never mind the fact that what we’re talking about is nothing less than the ethics of human suffering, or that the Netherlands recently legalized euthanasia with virtually no political acrimony. This is America, where the quality of debate on this most sensitive of issues can best be summed up by the fact that one local prosecutor, Richard Thompson of Oakland County, Mich., likened Kevorkian to “Jeffrey Dahmer in a lab coat,” while Kevorkian’s lawyer, Geoffrey Fieger, said Thompson is “a sick motherf–ker, and you can quote me.” Kevorkian himself is no shrinking violet. Doctors who oppose him are “idiots,” the Michigan Legislature is “medically ignorant” and the prosecutors who have tried to jail him are “irrelevant.” His main opponents, Kevorkian says, are “rightwing religious fanatics” who are “making people suffer.” “I don’t care about the law,” he told NEWSWEEK last week. “I have never cared about anything but the welfare of the patient in front of me.”

In 15 cases since 1990-and nine in the past three months-Kevorkian’s view of welfare equaled death. He has been charged with committing three murders, in 1990 and 1991, but each time the cases were thrown out. The reasons are simple: Kevorkian has been careful not to do the deed himself-and Michigan for years had no law against assisting in a suicide. It does now. In December the state legislature passed a bill that made assisting in a suicide a criminal felony, subject to penalties of up to four years in prison and a fine of up to $2,000. Last week, alarmed by the quickening pace of Kevorkian’s activities, the legislature changed the effective date of its new law from March 30 to Feb. 26. “We thought maybe there’d be a handful more, but this has just gone crazy,” said Ed Rivet of Right to Life of Michigan, which strongly backed the bill. “Our greatest fear is the week before the [March 30] deadline. I can imagine him killing people as quickly as he can line them up.”

The religious right has targeted “Dr. Death” for the kind of pressure it once reserved for abortion clinics. This has now led to the discovery of a piece of evidence that may be used to file a fourth murder charge against Kevorkian. A woman named Lynn Mills, who is a member of the anti-abortion group Operation Rescue, told reporters she recently rummaged through the trash outside the home of Neal Nicol, a Kevorkian assistant, and found a copy of something called a Final Action form. This typewritten document, purportedly signed by Kevorkian himself, described a suicide Kevorkian supervised on Feb. 15. Kevorkian, who lost the legal authority to obtain prescription drugs when his medical license was suspended in 1991, no longer uses the “Suicide machine” that made him famous. He now uses carbon monoxide, with patients utilizing a mask fitted with a clip to start the flow of gas. The patient pulls the clip, breathes the carbon monoxide and falls unconscious; death comes within minutes.

The Final Action form describes the death of Hugh Gale, 70, of Roseville, Mich., who suffered from emphysema and congestive heart disease. According to the form found in the garbage, Gale asked that the mask be removed after about 45 seconds, then calmed down and asked that the suicide procedure continue. The mask was put back on his face and, according to the form, “he again pulled the clip off” to resume the flow of gas. “In about 30-35 seconds he again flushed, became agitated … and immediately after saying ‘Take it off’ once again, he fell into unconsciousness,” the form continues. “The mask was then left in place,” the document says, and Gale died.

If the form is authentic, says Macomb County prosecutor Carl J. Marlinga, it “suggests that the death was involuntary and that at the last minute the patient changed his mind.” Investigators searched Kevorkian’s home in Royal Oak, Mich., and found what the doctor’s lawyer claimed was the original Final Action form that omitted any reference to Gale’s second request to have the mask removed. They also seized Kevorkian’s typewriter to match the typing on the forms; Marlinga says handwriting experts will decide whether Kevorkian’s signature is genuine. “The question then becomes what other evidence or testimony there is to corroborate … that the patient made a request right before death of changing his mind,” Marlinga said. That means interviewing those who were there-especially Gale’s widow, Cheryl.

But Cheryl Gale appeared on television last week to deny that her husband had wanted to halt the suicide procedure. Attorney Fieger angrily suggested that the form had been altered by the right-to-life activists who brought it to the authorities, and he said the search through Kevorkian’s apartment smacked of “fascism in the middle of the night.” Another of Kevorkian’s lawyers, Michael Schwartz, said that the account of Gale’s suicide in the “original” form was erroneous and that Kevorkian revised it for accuracy. Prosecutor Marlinga, playing it safe, refused to say whether he would charge Kevorkian with homicide, though he said the decision might be made this week.

None of which will answer the gravely disturbing questions that Kevorkian has raised. Who has the right to choose death, and under what circumstances? What responsibility does a physician have to maintain life in the face of a patient’s overwhelming suffering or, in the alternative, to allow or even help the patient to die? This last distinction is all-important. Though few experts dispute that a physician can ethically halt certain forms of life-sustaining treatment to allow death to take its course, Kevorkian has deliberately chosen to accelerate the process by assisting in suicide. The fact that many of his patients and their surviving relatives seem to be grateful for his help is arguably beside the point. So is the fact that Michigan residents, in several recent surveys, seem willing to support the concept of physician-assisted suicide. (Washington and California voters rejected the idea in two separate referendums in 1991 and 1992.)

There is, says Arthur Caplan of the University of Minnesota’s Center for Bioethics, “tons of confusion” in the public mind about just what should be permitted-and plenty of evidence that “the health-care system has done a terrible job of managing dying.” But Kevorkian “has caused as much harm to the movement for meeting the needs of dying people as he has helped,” says Dr. Tim Quill, author of a forthcoming book titled “Death and Dignity.” “Suicide is the sole basis for the relationship he has with his patients, and that is frightening.” Leading constitutional scholars, meanwhile, say there is little chance the ACLU will be able to overturn Michigan’s law in court. They argue that society has the right to regulate a doctor’s conduct in life-and-death decisions. “This is dirty business,” says Yale Kamisar of the University of Michigan Law School. “Who wants to make these decisions? For a long time we left it to the doctors. But now the legal system is catching up.”

PHOTO: Zealot with an acid tongue: To Kevorkian, his critics are merely idiots and wimps-while the Michigan legislature is ‘medically ignorant’ (LORI GRUNKER–CONTACT)

Dr. Kevorkian has helped 15 people commit suicide in Michigan. Wrote one, Susan Williams, 52, “I’m happy to have his assistance, since I am unable to do this myself.”

Janet Adkins, 54 June 4, 1990, Portland, Ore. Alzhimer’s disease

Kevorkian charged with murder; case dismissed.

Sherry Miller, 43 Oct. 23, 1991, Roseville, Mich. Multiple sclerosis

Miller took a lethal dose of carbon monoxide. Again, murder charges were dismissed.

Marjorie Wantz, 58 Oct. 23, 1991, Sodus, Mich. A pelvic disease

Wantz took a fatal injection, alongside Sherry Miller, in a secluded cabin.

Susan Williams, 52 May 15, 1992, Clawson, Mich. Multiple sclerosis

Williams, who also suffered a skin disease, died in her home. No charges were filed against Kevorkian.

Lois Hawes, 52 Sept. 26, 1992, Warren, Mich. Lung cancer

Hawes took a lethal dose of carbon monoxide.

Catherine Andreyex, 46 Nov. 23, 1992, Moon Twp., Pa. Cancer

Andreyev died in the compnay of four friends, at home in suburban Detroit.

Marcella Lawrence, 67 Dec. 15, 1992, Clinton Twp., Mich. Heart disease, emphysema

“I wish [the lawmakers] could have [my pain] for one night,” Lawrence once said.

Marguerite Tate, 70 Dec. 15, 1992, Auburn Hills, Mich. Lou Gehrig’s disease

Tate died after inhaling carbon monoxide, alongside Lawrence, at Tate’s home.

Jack Miller, 53 Jan. 20, 1993, Huron Twp., Mich. Bone cancer, emphysema

Miller, a former tree trimmer, was the first man to commit suicide with Kevorkian’s aid.

Stanley Ball, 82 Feb. 4, 1993, Leland, Mich. Pancreatic cancer

Kevorkian, who doesn’t like to travel, drove to northern Michigan to aid Ball.

Mary Biernat, 73 Feb. 4, 1993, Crown Point, Ind. Breast cancer

Biernat, whose cancer had spread to her chest, died at Stanley Ball’s home.

Elaine Goldbaum, 47 Feb. 8, 1993, Southfield, Mich. Multiple sclerosis

Goldbaum died in her apartment. Police confiscated the equipment she used but didn’t arrest Kevorkian.

Hugh Gale, 70 Feb. 15, 1993, Roseville, Mich. Emphysema, heart disease

Gale died in his living room, his wife by his side.

Jonathan Grenz, 44 Feb. 18, 1993, Costa Mesa, Calif. Cancer of the neck, lungs and chest

Grenz, a former real-estate agent, inhaled carbon monoxide in the home of a friend of Kevorkian.

Martha Ruwart, 41 Feb. 18, 1993, Cardiff-by-the-Sea, Calif. Ovarian cancer

Ruwart, a former computer software engineer, had moved to Michigan last year to be near family.