Retrospectacle: A Neuroscience Blog

Imagine this:
You are a doctor at a hospital in New Orleans, and you’ve just heard that the worst hurricane to hit New Orleans in centuries is headed your way. Your hospital is completely unprepared for this event, and nurses, doctors, and staff are leaving in droves. The wind and rain whip the hospital, tree branches are breaking through the windows. The power goes out; those on life supporting machines are now supported by a generator. Then, the generator goes out. You watch patients suffocate and die, as the hospital halls are filled with panicked, frantic patients, family, and staff. As the water levels rise outside, you are left with only the most loyal of caregivers—the nurses and doctors who have stayed behind despite concerns for their own safety—and their families and property. This bare-bones, frazzled group stands with you in an empty hospital, scared outta their minds, and looks to you—-what do we do? Are we going to die? And over the screaming wind, the crashing, the glass shattering, and terrified yells, you tell them what you are going to do. (More under the fold……)

This scenario (while the product of my imagination) was probably not unlike the real situation that the doctors, now being prosecuted for 2nd degree murder, faced during Katrina.

In the hours before the last of the hospital’s patients were evacuated, one of Hurricane Katrina’s most uncomfortable decisions had to be made: What would happen to those too sick to be moved?

Should they be left, in terror, to drown or be crushed by debris?

Should we go down with the ship, sacrifice our own lives to tend to the hopeless?

Or, should they be given a painless, quick death—–but face the possibility that we would be murderers?

What is the humane thing to do?

According to a months long investigation by the state’s attorney general that was made public Tuesday, a doctor and two nurses “pretended that maybe they were God” and put to death four patients using a lethal injection of drugs, after deciding that the four were either too ill or too incapacitated to be transported.

The deceased, who ranged in age from 61 to 90 years old, would have survived Katrina had they not been administered the lethal doses, Louisiana Attorney General Charles C. Foti said.

In a situation such as this, there are no easy choices. But this prosecution now makes that decision all the more difficult. In a city where real murders are happening every day, the time of the Attorney General could be better spent. When I am 90 years old and Katrina is at my doorstep, I can only hope that some doctors such as these will give me a peaceful way out.

Comments

  1. #1 outeast
    July 20, 2006

    It’s a truly difficult ethical dilemma. However, while I agree that it sounds like the AG’s report sounds deeply inappropriate (‘pretended that maybe they were God’? Is it the AG’s place to pass such judgements?) how else but in the courts should the rightness or wrongness of any killing be tested?

    These people made a decision to kill their patients; my feeling is that this was probably a justified decision, and in the circumstances the case for a humantarian killing seems pretty strong. However, in the absence of clear legislation dealing with euthanasia and in the absence of appropriate controls (such as prior reviews by ethics boards, for example, obviously an impossibility in this case), surely cases need to be judged on a case-by-case basis. Plus, the judgement of the rightness or wrongness of a killing is too important to be left to one person: what better alternative is there to the courts is there?

    Ending a life is a drastic step, especially if done without the considered and informed choice of the patient. No one should be given the power to kill without being tested lest that power be abused: I would hope that these individuals are aquitted, but I am at a loss to see an alternative to a court trial.

    That having been said, the AG’s report sounds deeply irresponsible and if I were representing those charged I would move to have the charges dismissed on the grounds that the report would likely prejudice the outcome of the trial.

  2. #2 Jayson
    July 20, 2006

    What I want to know; what does the DA know that he’s not letting us know?

    I mean there’s definately the possibility that he’s just an asshole right wing nut trying to make a zero tolerance example out of these doctors, but I can’t see what kind of case he has here given the current evidence. I’ve heard him talk about how “those people would have been alive today,” if it wasn’t for these doctors, but is that a medical opinion handed down to him or is that based off the sole fact that the toxicology reports show that they died of drug cocktails?

    the latter just seems far too subjective.

  3. #3 impatientpatient
    July 20, 2006

    Those people Might have survived Katrina if they had been transported out. I know people who work on ICU and if there is a fire THEY are instructed to leave, without patients. Their patients often cannot even be MOVED without a possibility of death.

    This is so screwed up. I am so tired of keeping people alive no matter what…… sometimes people do die, and sometimes in EXCEPTIONAL circumstances there are complications that make it so people cannot get the necessary care that they need- like what happened here. Is this not more human than letting them starve, in pain, waiting for someone to help- who never comes. If it was my grandma I would HOPE that I had enough sense to figure out that there were a hell of a lot of things going on in this situation that were beyond the ken of even the most experienced medical professionals. ‘

  4. #4 MJ Memphis
    July 20, 2006

    “if they had been transported out” is a really big “if”. I haven’t seen detailed info on all of the patients, but the two I remember were an elderly woman with gangrene in both legs plus dementia, who had been scheduled for a double leg amputation the day the storm hit, and a 380 lb paralyzed man. Getting those two out of a partially flooded building with no power would be reallllly fun. Given the choice between a quick death by lethal injection, versus leaving them to a likely painful and prolonged death, I would have to say euthenasia was the much more humane decision. Foti is just being an ass.

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