A Dark Mercy

There have been growing numbers of stories about the heroism of rescuers and medical personnel, such as this one, who risked their lives and personal safety and comfort to rescue, comfort and evacuate often critically-ill patients in New Orleans. But not all the medical care was directed at saving and healing the sick, as this troubling report indicates (HT: Orbusmax):

Doctors working in hurricane-ravaged New Orleans killed critically ill patients rather than leaving them to die in agony as they evacuated hospitals…

With gangs of rapists and looters rampaging through wards in the flooded city, senior doctors took the harrowing decision to give massive overdoses of morphine to those they believed could not make it out alive.

In an extraordinary interview with The Mail on Sunday, one New Orleans doctor told how she ‘prayed for God to have mercy on her soul’ after she ignored every tenet of medical ethics and ended the lives of patients she had earlier fought to save.

Her heart-rending account has been corroborated by a hospital orderly and by local government officials. One emergency official, William ‘Forest’ McQueen, said: “Those who had no chance of making it were given a lot of morphine and lain down in a dark place to die.”

Euthanasia is illegal in Louisiana, and The Mail on Sunday is protecting the identities of the medical staff concerned to prevent them being made scapegoats for the events of last week.

Their families believe their confessions are an indictment of the appalling failure of American authorities to help those in desperate need after Hurricane Katrina flooded the city, claiming thousands of lives and making 500,000 homeless.

‘These people were going to die anyway’

The doctor said: “I didn’t know if I was doing the right thing. But I did not have time. I had to make snap decisions, under the most appalling circumstances, and I did what I thought was right.

“I injected morphine into those patients who were dying and in agony. If the first dose was not enough, I gave a double dose. And at night I prayed to God to have mercy on my soul.”

The doctor, who finally fled her hospital late last week in fear of being murdered by the armed looters, said: “This was not murder, this was compassion. They would have been dead within hours, if not days. We did not put people down. What we did was give comfort to the end.

“I had cancer patients who were in agony. In some cases the drugs may have speeded up the death process.

“We divided patients into three categories: those who were traumatised but medically fit enough to survive, those who needed urgent care, and the dying.

“People would find it impossible to understand the situation. I had to make life-or-death decisions in a split second.

“It came down to giving people the basic human right to die with dignity.

“There were patients with Do Not Resuscitate signs. Under normal circumstances, some could have lasted several days. But when the power went out, we had nothing.

“Some of the very sick became distressed. We tried to make them as comfortable as possible.

“The pharmacy was under lockdown because gangs of armed looters were roaming around looking for their fix. You have to understand these people were going to die anyway.”

Mr McQueen, a utility manager for the town of Abita Springs, half an hour north of New Orleans, told relatives that patients had been ‘put down’, saying: “They injected them, but nurses stayed with them until they died.”

I find this story deeply troubling at any number of levels. I have written before on my concerns about the practice of active euthanasia (here and here), which arise not merely because of my Christian convictions about its morality, but perhaps equally so because of the great potential danger I see in breeching the moral and social levies which protect us from hubris and the creeping progressive tolerance of evil inherent when crossing them. The weariness of great tragedy saps the spirit, making it all to easy to rationalize the repulsive, to move on to the next horrid scene without reflecting on the last. But sometimes we must stop and focus amid the deadening blur of death and suffering. This story demands such a pause.

I am assuming, first of all, that this story is true–although I have seen no independent confirmation elsewhere. The name of the hospital where this occurred is not given, but it makes one wonder if it is the same facility where 45 dead patients were found abandoned. If it proves true, one must wonder whether there will be less outrage over patients euthanized than abandoned to die–somehow I suspect there might be. After all, they were terminated mercifully, rather than just abandoned–which would be oh, so terribly, terribly heartless.

But of course, if they were euthanized they were abandoned–abandoned by their providers and sworn protectors, those whom they trusted to comfort, heal, and protect them. Granted, the circumstances were horrendous: deprived of power, light, medications, and security, threatened by a mob of barbarians bent on drugs, theft, and destruction–one can hardly begin to imagine the terror, the helplessness, the frustration shared by doctors, patients, and nurses alike. It is easy to judge those who were there, sitting as I am dry, safe and secure, far from this hell on earth. It would be foolish to say that–were I there–my behavior would have been different, more noble, more self-sacrificing, more righteous. I would hope so–but I have been known to underestimate my frailties and potential for moral lapses far too often to be smug or self-righteous: I simply do not know how I would have handled this situation, were I there.

But still I must ask: you killed them? Actively, deliberately, methodically? What has occurred here, it seems, steps over a line clearly blurred by the panic, fear, and hopelessness of a terrible storm and its even more horrible aftermath–the opportunism of human evil in the face of Nature’s wrath–into the realm of a darkness far deeper than wind and water and chaos could wreak. Have you not countered evil with evil? “And if Satan cast out Satan, he is divided against himself; how shall then his kingdom stand?”

Could not the morphine you used to end their lives be instead used to ease their pain, their fear, as you stood by their bedside doing what little you could to comfort them? It takes far more morphine to kill than to comfort. Could you not stand and defend them against the looters, the rapists, the thugs–though ill-equipped you might well lose your safety, your well-being, even your life. There is a word for those who act thusly, defending the weak against the strong at the cost of their lives: heroes. Did you not, by actively terminating their lives, avoid the shameful option of abandoning suffering and dying patients to save yourselves? They were condemned to die by their disease, by the untimely fate of a hospital in harm’s way, by social chaos and raging mobs. You are alive today because you expedited their inevitable death. But your life, so secured, is not enobled by this act: you may indeed find forgiveness, but the act remains: a dark mercy, an act of weakness, heinous forever.

The interview in The Mail is redolent with the special pleading and specious arguments so common among those who have compromised principles for expediency, and by those who justify any and all such moral relativism. The paper protects the anonymity of those who so acted “to prevent them being made scapegoats for the events of last week.” Scapegoats? Whose sins are you carrying into the desert, if not your own? What was the proximate cause of their death, if not your syringe?

The doctor informs us: “This was not murder, this was compassion. They would have been dead within hours, if not days. We did not put people down. What we did was give comfort to the end.” Aahh, compassion–I’ll have a double dose, please. Com-passion: “to suffer with”–this is its root, its meaning. To suffer with a patient, to experience their pain while strengthening their spirit–that is compassion. To stand in the breach, between the looter and the lost, to suffer that they may be spared–that is compassion. To stay with a dying patient, when the lights are out and you have no treatment to offer–that is compassion. To stop their breathing with an overdose so that you can escape without abandoning them to die alone may be rational, understandable, defensible, even arguably reasonable–but it is not compassion. Words have meanings: I know what murder means, what compassion involves, what comfort entails–and they are not the same.

The doctor informs us: “It came down to giving people the basic human right to die with dignity.” Death with dignity–is that indeed our right? Who ordains such a right? Who enforces it? What about the bloated bodies floating face down in sewage-laced water, drifting down streets in the company of dead rats and fire ants–is that dignity? Who stole their right to die with dignity? Would you have injected them also to save such an indignity? And how is it we now define “dignity” as the right to die when and where we want–or when our doctor thinks it’s best? Is not dignity instead dying with inner grace, strengthened by those around you, comfortable that your life has been lived with meaning and purpose–though your body be racked by pain–in the presence of others who care? Many died just this way in Katrina–under circumstances just as horrid and terrifying and degrading as the good doctor experienced. They died with dignity–brutally, but with nobility, grace, and courage, saving and protecting family members, pets, friends, strangers.

The doctor informs us: “You have to understand these people were going to die anyway.” Yes, I do understand–and that is true of every living breathing human on this planet. But your patients died early–in your time, not theirs, under your hand, not that of a looter, nor the ravage of a disease, nor the savagery of storm. Your hand, doctor. Who granted you this right, this power?

But someone in this story sees through the hollow rhetoric, the noble talk, the faux compassion: “Mr McQueen … told relatives that patients had been ‘put down’, saying: ‘They injected them, but nurses stayed with them until they died.'” America, meet your new compassion, your new dignity: the nurse will stay by your side after your doctor puts you down.

Now, perhaps this story is a tabloid fabrication. Perhaps–so often the case–the truth of the situation was mangled beyond recognition by truncated quotes, Dowdian ellipses, or the pure fabrication that passes for journalism in our oh-so-enlightened 21st century. And I was not there–would my behavior have been that much different? I don’t know. Tragedy rips the scab–covered by layers of makeup and cheap jewelry–from the deep wounds of the humans spirit. It may reveal bleeding, and pain, and health, and healing–or the putrid aroma of rotting flesh and festering maggots. A white coat does not bestow deity, but bespeaks instead service and sacrifice–and the dark horrors of a dying hospital do not change this simple truth.

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13 thoughts on “A Dark Mercy

  1. Thank you for this thoughtful response to that situation. I was horrified and wondered how it would be viewed within the medical profession. Great post.

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  3. Maria,

    Thanks for commenting–of course, the point of that paragraph–and the last–is exactly that: the story is unverified, may be a fabrication. The named witness has been mentioned by another tabloid rag–the BBC–as a Brit, a utility working living in Abita Springs LA: Family’s hope for hurricane dad.

    As for the “stupid” and “idiot” part, no disagreement there–I’ve been called far worse by those whose opinion I value far more. Sure sounds like I touched a raw nerve, though: may I assume you think it would be a good thing to do, to kill patients rather than protect them, if indeed the story is true?

  4. Oh, for heaven’s sake, Maria.

    Clearly, in this posting, the author analyzes motive and repurcussions of underlying themes of an article. Because the focus is on themes, discussion is the underlying assumptions, social context, and implications of like actions. Near the close, there is a disclaimer to re-emphasize that the posting explores the ideas, not the instance. (If the focus was on the instance, the author, plainly at odds with the actions in the article, would address what should be done to right the wrong.)

    Yes, if true, actions described in this article would be an example of terrifying rationalization and justification where people may have been killed without their consent. Too many people behave poorly in desperate situations simply because they haven’t mentally prepared themselves to think and not to panic. God help them when they realize what they’ve done.

    The quote from the doctor–“You have to understand…”–is very telling, isn’t it? First, in imposing _her_ will on the patients, then attempting to coerce others who may voice the nagging doubts in her own head.

  5. Valentin has it exactly right: the story is a segue into a discussion of physician-assisted euthanasia. If the story is indeed a fabrication, the issue is not: A study in the New England Journal indicated that nearly 5% of physicians surveyed had personally administered a lethal injection, and 7% would do so if asked.

    The rationalizations of the physician in the story–real or fictitious–are those heard repeatedly from proponents of euthanasia: “compassion”, “death with dignity”, “they are going to die anyway.”

    And while I am relieved to know that you oppose euthanasia, Maria, your immediate resort to ad hominem attacks bespeaks something beyond mere concern about whether this story is true or urban legend.

  6. I am aware that it is a British tabloid, which are not known for their veracity or reliability–but then, I am skeptical of what appears in most newspapers. The individual quoted has been independently sourced by the BBC as being a real person whose job and activities match that of this story (see earlier comment). And patients have been found abandoned in a NO hospital, cause of death not definitively determined at this time (i.e., no autopsy).

    I am neither naive nor stupid (although others have a different opinion): this story may well be an urban legend, red meat for the tabloid crowd. If it turns out to be so, I will acknowledge that here. Humble pie is one of my favorite desserts, based on how often I’ve eaten it…

    But anyone who thinks such a scenario could never happen here in the U.S. is, in my opinion, much more naive than I am.

    Thanks for the heads up, though.

  7. Hmmm! Probably not true. But, from the patient’s point of view, likely the best solution.

    Were it I, terminal and in those circumstances, I would be praying for someone with sufficient fortitude to make such a decision. Only those there will ever understand ~ true or no.

  8. I think the story’s accuracy is suspect, but I’m not prepared to disbelieve it entirely. And treating it as a hypothetical, there are more than I’d like to think who would admire the morphine-administering angel of death.

    That said, aside from Dr. Bob’s customary wise comments, it strikes me as an example of how, if we adhere seriously to our moral principles, we may suddently be called upon to apply them in a heroic fashion. Something I hope I never have to face.

  9. Doc, as others have said, your commentary on the issue was beautifully and thoughtfully explored and written. That is true, whether the story is factual, or not. I cannot say the same for Maria, who would have had an F from me, had she submitted any of her comments, here, as pieces of a persuasive essay, when I was teaching.

    Maria, knee-jerk reactions are often filled with ad hominems (look that up, if you aren’t familiar with its meaning), and they do not often have the desired effect on the intended audience; they tend, instead, to put people off. Doctor Bob (yes, he is) responded to you with far more grace that I would likely have found, and more than you deserved . . . although, I think he would agree, that is the meaning of “grace.”

    The commentary on this story was provoked, I suspect (note: no assumption, here!), by a need to think through the possibilities in this type of situation. Maria is probably too young to be familiar with the news story of long ago, of a plane that crashed in the mountains somewhere in South America. After a period of days with no rescue in sight, the living began to eat the bodies of those who had died. The horror of it shocked many of us and provoked thought: What would I have done? Surely, I wouldn’t have done that! But as Doctor Bob says, there is no way to know, for sure, without being there. Still, it does not hurt to weigh the possibilities and the implications.

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