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Jack Kevorkian, the controversial American doctor who claimed to have assisted more than 100 suicides, has died aged 83.

To his critics, he was Dr Death. To other detractors, Jack the Dripper.

Kevorkian was given plenty of nicknames after receiving international attention in the 1990s, throughout which he waged a defiant campaign to help people end their lives.

But to his supporters, he became the poster boy for legislative reform.

Both sides of the debate would agree that he provoked a national discussion, and doctor-assisted suicide is now legal in three American states.

"Kevorkian didn't seek out history, but he made history," was the conclusion of his attorney, Geoffrey Feiger.

Even the judge who put him behind bars, Jessica Cooper of Oakland County in Michigan, acknowledged as much.

"He brought to the forefront end-of-life issues," says Ms Cooper, who now serves as Oakland County's prosecutor.

"Those were not things that were discussed publicly before. That debate continues in medical schools and on Main Street, but I think the debate he stirred resulted in the growth and greater acceptance of hospice care and greater opportunity for death with dignity.

"I don't know if that was his intended effect or a fortunate side effect, but that is what occurred in Michigan."

The son of Armenian immigrants, Jacob Kevorkian was born in Michigan on 26 May 1928.

He studied pathology at the University of Michigan, where he excelled. He taught himself seven languages, including Russian and Japanese, he painted and he played three musical instruments.

Business cards

He worked as a pathologist after medical school. And in 1958, his interest in death was evident when he delivered a paper on the subject to a meeting of the American Association for the Advancement of Science in 1958, according to the New York Times.

In it, he proposed that murderers condemned to die be given the option of execution with anaesthesia so they could donate their organs to study.

His career ignited in 1989 when he demonstrated his "suicide machine" on television and even had business cards printed advertising his services although by his own insistence, payments were never made.

His first client was Janet Adkins, a 53-year-old sufferer from Alzheimer's, who used his machine to die in the back of his Volkswagen camper van in 1990, with him in attendance.

Kevorkian reported the death to police but it never got to trial. The following year, two more people used his machine. He plugged his services on television - likening himself to protest icons including Gandhi and Martin Luther King.

Sufferers from cancer, Alzheimer's, arthritis, heart disease, emphysema and multiple sclerosis were helped to die in the years that followed.

Damage

He continued to generate plenty of publicity as the authorities tried to restrain his practices. Before one court appearance, he met the press in homemade stocks to make a point about the common law under which he was being prosecuted.

Despite his critics, he always insisted he was simply helping patients ease their suffering.

His home state of Michigan introduced laws banning him from assisting in a suicide but by 1993, Kevorkian said he had helped 19 people take their own lives. Unsuccessful prosecutions followed until he was finally imprisoned in 1999.

Wesley J Smith, author and leading campaigner against assisted suicide, says the media fawned over him and failed to see the damage he wrought.

"I think his more important place in contemporary history was as a dark mirror that reflected how powerful the avoidance of suffering has become as a driving force in society, and indeed, how that excuse seems to justify nearly any excess."

Kevorkian was prophetic in calling for the creation of euthanasia clinics, which now exist in Switzerland, says Smith.

"Time will tell whether Kevorkian will be remembered merely as a kook who captured the temporary zeitgeist of the times.

"Or whether he was a harbinger of a society that, in the words of Canadian journalist Andrew Coyne, 'believes in nothing [and] can offer no argument even against death'."

Kevorkian tried for a Congress seat as an independent candidate in 2008, but won few votes, and a year later, Al Pacino starred as him in a film for HBO, You Don't Know Jack.

He was admitted to hospital last month, suffering from pneumonia and kidney problems.

And overnight, listening to classical music, Jack Kevorkian died. Of natural causes.