When the patient was ready, he or she would press a button that would stop the flow of the harmless solution and begin a new drip of thiopental. This chemical would put the patient into a deep sleep, then a coma. After one minute, the timer in the machine would send a lethal dose of potassium chloride into the patient's arm, stopping the heart in minutes. The patient would die of a heart attack while in a deep sleep. The death, according to Kevorkian, would be quick, painless and easy. For a person suffering from the pain of terminal cancer or some other disease, the machine would provide what Kevorkian called a painless "assisted suicide."

In June 1990, Kevorkian assisted in the first of many physician-assisted suicides. He used his machine to hasten the death of Janet Adkins, a 54-year-old woman from Portland, Oregon, who was suffering from Alzheimer's disease. The State of Michigan immediately charged him with murder, although the case was later dismissed, largely due to the unclear state of Michigan law on assisted suicide. By 1999, Kevorkian had been present at the death of nearly 130 people. In each case he made his assistance known to the public, as part of a determined campaign to change attitudes and laws on physician-assisted suicide.

Many agreed with what Kevorkian was doing. On June 21, 1996, during an interview with a Detroit radio station, famed broadcast journalist Mike Wallace said, "I am an old man. I'd be the first, if necessary, to go to Kevorkian." Wallace said he could imagine seeking Kevorkian's services if he were suffering from a painful and lingering disease.

Others disagreed with this opinion. The National Spinal Cord Injury Association opposed assisted suicide because there were better ways around the problem. "Refusing medical treatment is your choice to die how you wish-in your own home with your family or in your hospital bed. Assisted suicide is you giving somebody the power to take your life away. A person is given the power to kill."

Despite constant legal problems, Kevorkian continued to assist with suicides. In 1994, he faced murder charges in the death of Thomas Hyde, who suffered from a terminal nerve illness known as Lou Gehrig's disease. Jurors agreed with the argument that there was no statute against assisted suicide in the state of Michigan, and thus Kevorkian could not be found guilty.

The Kevorkian team of defense lawyers won yet another acquittal. They successfully argued that a person may not be found guilty of criminally assisting a suicide if that person had administered medication with the "intent to relieve pain and suffering," even it if did hasten the risk of dying. Kevorkian was prosecuted four times in Michigan for assisted suicides, and he was acquitted in three of those cases; a mistrial was declared in the fourth.

In 1998, the Michigan legislature enacted a law making assisted suicide a felony punishable by a maximum five year prison sentence or a $10,000 fine. This law went into effect months before a ballot proposition legalizing assisted suicide was defeated by Michigan voters. It closed the loophole on relief of pain and suffering, which Kevorkian's lawyer's relied upon to obtain acquittals. The statute provides that a person who knows another intends to kill himself and provides the means, participates in the suicide, or helps to plan the suicide, is guilty of a felony.

Kevorkian proceeded with what he thought was right, and challenged authorities to arrest and prosecute him. On September 17, 1998 he took the ultimate step in the assisted suicide of Thomas Youk. Instead of asking the patient to press the button to inject the fatal dose of drugs, Kevorkian, after speaking gently to the man suffering from Lou Gehrig's disease, administered the drug himself. Furthermore, he videotaped the entire event so there would be no doubt of what he had done. He then gave the tape to the television show 60 Minutes. The episode was aired for the whole world to see.

Shortly thereafter, Kevorkian was arrested in Michigan for first-degree murder. In this case, when he injected Thomas Youk with the lethal drugs, he committed euthansia, or mercy killing, not assisted suicide. Kevorkian was also charged under the felony law that bans assisted suicide, which went into effect approximately two weeks before Youk's death. Kevorkian decided to represent himself in the Youk murder trial. On March 26, 1999, he was convicted of the lesser offense of second degree murder by a Michigan jury.