If you were these doctors, what would you do?

[jAZ]

http://www.msnbc.msn.com/id/13916867/

NEW ORLEANS - A doctor and two nurses who worked through the chaos that followed Hurricane Katrina were arrested overnight, accused of giving four patients stranded at their hospital lethal doses of morphine and a sedative, authorities said Tuesday.

“We’re not calling this euthanasia. We’re not calling this mercy killings. This is second-degree murder,” said Kris Wartelle, a spokeswoman for Attorney General Charles C. Foti.

The arrest warrants say Dr. Anna Pou and the two nurses intentionally killed four patients at Memorial Medical Center “by administering or causing to be administered lethal doses of morphine sulphate (morphine) and midazolam (Versed).”

After the bodies were recovered, Orleans Parish coroner Frank Minyard said they were so decomposed the deaths could only be listed as “Katrina-related.”

He later said samples had been taken from dozens of patients who died at various hospitals and nursing homes to test for potentially lethal doses of drugs such as morphine.

In a December interview, Dr. Pou had told Baton Rouge television station WBRZ: “There were some patients there who were critically ill who, regardless of the storm, had the orders of do not resuscitate. In other words, if they died, to allow them to die naturally, and to not use heroic methods to resuscitate them.”

“We all did everything in our power to give the best treatment that we could to the patients in the hospital to make them comfortable,” Pou said then.

Tammie Holley, an attorney representing about a dozen families whose relatives died at Memorial, says the presence of the sedative in addition to morphine is important in determining whether hospital staff intended to kill a patient. Midazolam is used to induce unconsciousness before surgery, according to a medical Web site.

“If it was only morphine, there would be no way to know if they were administering it to control their pain,” Holley said.

Harry Anderson, a spokesman for Dallas-based Tenet Healthcare Corp., said the allegations against the doctor and nurses, if proven true, were disturbing.

“Euthanasia is repugnant to everything we believe as ethical health care providers, and it violates every precept of ethical behavior and the law. It is never permissible under any circumstances,” Anderson said.

In addition to Pou, nurses Cheri Landry and Lori Budo were arrested and later released on personal recognizance bonds, officials said.

Simmons said Pou was arrested and handcuffed at her house late Monday night.

“I told them that she is not a flight risk. I told them that she would surrender herself. Instead, they chose to arrest her in her scrubs so that they could present her scalp to the media,” he said.

Angela McManus said Tuesday that her 70-year-old mother was among the patients who died at Memorial. Her mother had been recovering from a blood infection but seemed fine and was still able to speak when police demanded relatives of the ill evacuate. She died later that day, McManus said.

“At least now I’ll be able to get some answers,” McManus said. “For months, I haven’t known what happened to my mom. I need some answers just to be able to function.”

In an accompanying affidavit, an agent for the Louisiana Justice Department wrote that Pou told a nurse executive three days after the hurricane hit that “lethal doses” would be administered to those patients who could not be evacuated.

Pou said the patients remaining at the hospital would likely not survive and that a “decision had been made to administer lethal doses” to them, the affidavit says.

“’Lethal doses of what?”’ the nurse executive asked, according to the affidvit says. It says Pou answered: “Morphine and ativan.”

Two months after the hurricane, the attorney general subpoenaed more than 70 people in an investigation into rumors that medical personnel at Memorial Medical Center had euthanized patients who were in pain after the hurricane as they waited in miserable conditions for rescue.

Pou’s lawyer, Rick Simmons, said his client is innocent, and her mother said she was distressed by her daughter’s arrest.

“Medicine was the most important thing in her life and I know she never ever did anything deliberately to hurt anyone,” Jeanette Pou said in a telephone interview.

Memorial Medical Center had been cut off by flooding after the Aug. 29 hurricane swamped New Orleans. Power was out in the 317-bed hospital and the temperatures inside rose over 100 degrees as the staff tried to tend to patients who waited four days to be evacuated.

At least 34 patients died there during that period, 10 of them patients of the hospital’s owner Dallas-based Tenet Healthcare Corp. and 24 patients in a facility run by LifeCare Holdings Inc., a separate company.

[Redrum_69]

"If you were these doctors, what would you do?"


Stay and tend to everyone.

Those doctors choked under the pressure.

I hope they get life in prison

[crazycoffey]

Well, depends.... Are we talking about then or now?

Then? - try my best to do my job

now? - Take a big hit of Morphine and Ativan......

[cdcox]

I just don't see any justification whatsoever, zero, none, of giving fatal dosages of morphine.

Give them a dosage of morphine that would make them as comfortable as possible without endangering their lives.

If they die, they die. You did the best you could under very difficult circumstances. People die every day. Most suffer in the process.

At least they would have a chance of rescue and recovery, however small.

Even when the chance is zero, there is no provision for a medical care giver to give a fatal dose of a medicine.

What makes this situation different than a starving child in Africa? Should we euthanize all of them?

And this seems like a DC topic.

[jAZ]

I hope it's not a DC topic in that this is really a moral, ethical question... and certainly not a political one.

[jAZ]

IMO, (assuming the medical facts were as it seems... they were going to die soon and painfully), I see it as euthanasia, I'm ok with it, I couldn't do it myself I don't think.

I was suprised to see them pressing murder charges. I wondered if there was more to the story than was reported in the article. Based on the few comments so far, it seems I might not be in the majority on this.

[pikesome]

Link (http://www.pbs.org/wgbh/nova/doctors/oath_modern.html)

I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.


Written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University, and used in many medical schools today.

[Planetman]

Hippocratic Oath—Modern Version

I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

[ChiefaRoo]

I just don't see any justification whatsoever, zero, none, of giving fatal dosages of morphine.

Give them a dosage of morphine that would make them as comfortable as possible without endangering their lives.

If they die, they die. You did the best you could under very difficult circumstances. People die every day. Most suffer in the process.

At least they would have a chance of rescue and recovery, however small.

Even when the chance is zero, there is no provision for a medical care giver to give a fatal dose of a medicine.

What makes this situation different than a starving child in Africa? Should we euthanize all of them?

And this seems like a DC topic.

Well said. A Doctors first responsibility is to do no harm to his patients.

[crazycoffey]

I hope it's not a DC topic in that this is really a moral, ethical question... and certainly not a political one.

discussions about two different sides of an ethical/moral quesion, mmmm. How is that not like political debates????


J-K with ya.


The facts seemed pretty loose, and obviously there has to be more to the story that we aren't privy to. But, if I was in horrible pain, stuck under part of a building and I knew there was a great chance I wouldn't make it out, hit me with some dope to kill the pain, if I die then I hope no one in my family compains about my death, I hope they instead celebrate my life.

[el borracho]

It takes way too much to become a doctor. If I were a doctor I certainly would not risk my license by doing anything I knew was illegal so I certainly would not have given a lethal dose of anything to anyone.

Ethically, however, I see it as humane and wish euthanasia were a legal option for people (patient or legal caregiver's choice, obviously). Probably never happen but I think a lot of people on hospice care would choose euthanasia were it legal, maybe even a lot of people serving life-terms in prison.

[ChiefaRoo]

There's not enough info. yet to know exactly what happened.

[crazycoffey]

but what is starting to disturb me in this discussion, is that we are assuming (and so is the article) that the "lethal doses" were given intentionally and purposely with the intent to kill the person, and not to - oh say - help them, ease some pain, and maybe because they were hurt, in horrible pain and shock, their bodies gave up....

[Planetman]

There's not enough info. yet to know exactly what happened.
They overdosed their patients with narcotics and sedatives, leading to their ultimate deaths. What's not to understand about that?

[pikesome]

but what is starting to disturb me in this discussion, is that we are assuming (and so is the article) that the "lethal doses" were given intentionally and purposely with the intent to kill the person, and not to - oh say - help them, ease some pain, and maybe because they were hurt, in horrible pain and shock, their bodies gave up....

Based on what is in the article it was both. They purposely killed them because they were going to suffer. The bit about the affidavit spells out what, at least, the doctor thought the actions were accomplishing.

[cdcox]

but what is starting to disturb me in this discussion, is that we are assuming (and so is the article) that the "lethal doses" were given intentionally and purposely with the intent to kill the person, and not to - oh say - help them, ease some pain, and maybe because they were hurt, in horrible pain and shock, their bodies gave up....


Clearly this is the crux of the matter. The first is murder; the second is best available care.

[Eleazar]

Well, if you're a nihilist then these people were just in the way anyway, so what's the difference?

[Planetman]

Looks like this discussion is irrelevant now.
Jury Refuses To Indict Doctor After Katrina
Two Nurses Escape Prosecution
POSTED: 12:29 pm CDT July 24, 2007

NEW ORLEANS -- A grand jury Tuesday declined to indict Dr. Anna Pou, the surgeon accused of killing four seriously ill patients in the aftermath of Hurricane Katrina.

http://www.thekansascitychannel.com/2007/0724/13745413_240X180.jpg
Dr. Anna Pou

"I feel the grand jury did the right thing," said District Attorney Eddie Jordan, who was not in court when Judge Calvin Johnson read the grand jury's opinion.

Pou and two nurses were arrested last summer after Attorney General Charles Foti's investigation concluded they gave four patients a "lethal cocktail" at Memorial Medical Center amid the chaotic conditions that followed the August 2005 storm.

Foti said the doctor and nurses had determined the patients were too ill to be moved.

Pou has denied murdering anyone, and lawyers for the three have said they acted heroically by staying to treat patients rather than evacuating.

"I did not murder those patients," Pou told CBS' "60 Minutes" last fall. "I've spent my entire life taking care of patients. I have no history of doing anything other than good for my patients."

In a December 2005 interview, she told WBRZ-TV of Baton Rouge: "There were some patients there who were critically ill who, regardless of the storm, had the orders of do not resuscitate. In other words, if they died, to allow them to die naturally, and to not use heroic methods to resuscitate them."

"We all did everything in our power to give the best treatment that we could to the patients in the hospital to make them comfortable," Pou said told the station.

The Orleans Parish grand jury had been investigating the allegations since March.

Charges against the nurses, Lori Budo and Cheri Landry, were dropped after they were compelled to testify last month before the grand jury under legal guidelines that kept their testimony from being used against them.

Assistant District Attorney Michael Morales had asked the grand jurors to return one charge of second-degree murder and nine of murder conspiracy against Pou.

He declined to comment after the judge read their decisions rejecting each charge.

Budo's attorney, Eddie Castaing, called the decision proof that none of the three should ever have been arrested.

Attorney General Charles Foti, who announced the arrests July 11, 2006, released a one-sentence statement Tuesday. "The dedicated employees of the Attorney General's Office have done their duty as required by federal and state law, and I am very proud of our efforts on behalf of the victims and their families."

Families of the four people named earlier as alleged victims -- Emmet E. Everett Sr., Rose Savoie, Hollis Alford and Ireatha Watson - have filed civil lawsuits against Pou.

Four more were identified in the rejected conspiracy charges: Wilda McManus, Alice Hutzler, George Huard and Elaine Nelson.

Savoie's son-in-law, Pat Crabtree of Houma, La., referred questions to lawyer Michael Samanie, who was unavailable for comment.

Assistant Attorney General Julie Cullen, who sat in on the grand jury hearings, said investigators in her office still consider the deaths to be homicides.

When the levees broke in New Orleans after the hurricane's landfall, 80 percent of the city flooded. The lower level Memorial Medical Center was under 10 feet of water, and electricity was out across the city. Inside the hospital, the temperature topped 100 degrees.

At least 34 people died at Memorial, many from dehydration during the four-day wait for rescuers to evacuate them. In the "60 Minutes" interview, Pou acknowledged administering drugs to relieve pain but stressed: "Anytime you provide pain medicine to anybody, there is a risk. But as I said, my role is to help them through the pain."

Other doctors who were there described the situation as resembling a MASH unit during wartime rather than an urban American hospital.

"It was stifling. We were hoisting patients floor to floor on the backs of strong young men. It was as bad as you can imagine," Dr. Gregory Vorhoff, who stayed throughout the storm and eventually hitched a ride on a boat to seek help, told The Associated Press after Pou was arrested.

The four patients Pou was accused of killing ranged in age from 61 to 90. Foti said all four would have survived if they hadn't been given morphine and midazolam hydrochloride.

Pou, whose specialty is eye, ear, nose and throat surgery, gave up her private practice after she was arrested and has been teaching at LSU medical school in Baton Rouge.

Assistant Attorney General Julie Cullen, who sat in on the grand jury hearings, said investigators in her office still consider the deaths to be homicides.

Asked what the grand jury's decision does for Pou's reputation, she said, "I guess that depends on who's considering her reputation."
Copyright 2007 by The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

[chagrin]

Well, if you're a nihilist then these people were just in the way anyway, so what's the difference?


"I am Darth Nihilus"

[Sully]

"I am Darth Nihilus"
ROFL

[Sully]

There's not enough info. yet to know exactly what happened.
I agree. Tough to say what I'd do without knowing everything, though I'd lean toward not ever doing something so severe.
I have a buddy who is a doctor in NO, and he had to stay at his hospital through the whole thing helping patients until the NG evacuated them.

[HemiEd]

I am pretty sure there was a TV show based on this exact case. They did a good job of portraying the situation the doctor was faced with.
No oath or law could have possibly taken this situation in to account IMO.

[Simplex3]

“At least now I’ll be able to get some answers,” McManus said. “For months, I haven’t known what happened to my mom. I need some answers just to be able to function.”
:deevee:

Your mom called from the other side, she said "man up and move the f**k on."

[ChiefaRoo]

They overdosed their patients with narcotics and sedatives, leading to their ultimate deaths. What's not to understand about that?

Well, to start I'd like to ask them why they did it in a court of law.

[Miles]

I am pretty sure there was a TV show based on this exact case. They did a good job of portraying the situation the doctor was faced with.
No oath or law could have possibly taken this situation in to account IMO.

I think it was in a Boston Legal episode and I agree it did a good job illustrating what I would imagine was total despair.

[WilliamTheIrish]

If I was a patient in that condition, in that situation, I'd be thankful they put me out of my misery.

[HemiEd]

I think it was in a Boston Legal episode and I agree it did a good job illustrating what I would imagine was total despair.

I think you are right, good job! I know, the way they illustrated the situation, I was on the Doctor's side.
The patients were begging and pleading to be put out of their misery. The situation looked hopeless to the point of total futility. The doctor did what appeared to be the most humane thing to do.

[Mecca]

:deevee:

Your mom called from the other side, she said "man up and move the f**k on."

He'd have rather his mom died a painful and suffering death apparently.