I have mixed feelings about the release from prison of Jack Kevorkian, the "Dr. Death" who helped some 130 people commit suicide between 1990 and 1998 before Michigan authorities finally locked him up for the second-degree murder of a man with Lou Gehrig's disease.

The retired pathologist is 79, in failing health and promises not to repeat his crimes, so I don't begrudge him living out his final years in freedom.

But though Kevorkian says physician-assisted suicide won't be his primary mission anymore, I worry that death-with-dignity advocates will continue embracing him as a patron saint, bringing the same discredit to the cause as Kevorkian did the first time around.

I personally favor allowing terminally ill patients to choose to die on their own terms if unbearable pain, disability and loss of control rob their lives of hope and meaning.

But in matters of life and death, we need safeguards to assure that all medical due diligence is done and that the right to die doesn't become an obligation to die for the benefit of overwhelmed caretakers and health insurers who don't want to pay.

These issues are addressed in the assisted suicide law in Oregon, the only state where a patient with six months or less to live can legally ask a doctor for a lethal prescription, and in similar legislation that's been pending before Hawai'i lawmakers since 2002.

But Kevorkian is a ghoul who took matters into his own hands in defiance of the law, and the deaths he was responsible for were anything but dignified.

He'd help people kill themselves in seedy motel rooms with a contraption he invented to dispense deadly medications, then leave their corpses to be found baking in vans in hospital parking lots.

Kevorkian's greatest crime was that he didn't do his medical homework. Many of the patients he helped to die weren't terminally ill, were incapable of giving informed consent because of depression associated with their disease, were driven by guilt about the burden they placed on their families and were victims of poor care that left them feeling unnecessarily miserable.

Kevorkian seriously grabbed my attention in 1995 when he dispensed his potion to a 46-year-old multiple sclerosis patient named Esther Cohan, proclaiming that MS is 100 percent fatal.

I was also 46 at the time and had knowledge about MS I'd obtained the hard way — I had the disease. It was obvious from what they said that Kevorkian and his attorney were ignorant about MS.

Cohan was nearly quadriplegic, but it was doubtful that she was anywhere near death within six months unless she was receiving grossly inadequate care.

Her biggest immediate problems appeared to be severe bedsores and depression. I had to wonder how her thoughts about life and death might have changed if these treatable problems had been addressed and she'd been able to lead a more functional and comfortable life.

You'd think considering these issues would be the least a doctor owes his patient before facilitating drastic measures, which is exactly what is required by the Oregon law and the proposed legislation here.

Most national organizations representing disabled people oppose physician-assisted suicide, fearing that the issue is really about sparing society the cost of keeping the disabled around.

I don't personally subscribe to this view, but I can understand why others do when a criminal such as Kevorkian enjoyed such broad support in his heyday.

The death-with-dignity crowd would be well-advised to keep their distance from Dr. Death and let him move on to other causes if they hope to see responsible laws such Oregon's enacted in Hawai'i and other states.

David Shapiro, a veteran Hawai'i journalist, can be reached by e-mail at dave@volcanicash.net. Read his daily blog at blogs.honoluluadvertiser.com.