For those who may have read my earlier posts (here, here, and here) about the possibility of euthanasia at a hospital in New Orleans in the aftermath of Hurricae Katrina, you may be interested in the following report on the conclusion of an investigation by the Louisiana Attorney General, just reported by CNN:
NEW ORLEANS, Louisiana (CNN) — In the desperate days after hurricane Katrina struck, a doctor and two nurses at a flooded New Orleans hospital allegedly killed four patients by giving them a lethal drug cocktail, Louisiana’s top law enforcement official said Tuesday.
“We’re talking about people that pretended that maybe they were God,” Attorney General Charles C. Foti Jr. said, announcing second-degree murder charges against Dr. Anna Pou, Lori L. Budo and Cheri Landry.
“This is not euthanasia. It’s homicide,” Foti said.
The charges stem from the post-Katrina deaths of some patients at New Orleans Memorial Medical Center.
An affidavit said tests determined that a lethal amount of morphine was administered on September 1 to four patients ages 62, 66, 89 and 90. Hurricane Katrina swamped the city on August 29.
According to the court document, the morphine was paired with midazolam hydrochloride, known by its brand name Versed. Both drugs are central nervous system depressants. Taken together, Foti said, they become “a lethal cocktail that guarantees that you die.”
The doctor and nurses were taken into custody late Monday, following a 10-month investigation that continues. Each was charged with four counts of being a principal to second-degree murder and released on $100,000 bond.
The original reports showed up in a British tabloid not known for its reliability, and this sourcing, as well as some of the details therein, led to widespread scepticism about their reliability. However, interviews with physicians and health care workers at Memorial Hospital raised troubling questions as well, and a formal investigation was launched. The investigation was delayed by the reluctance of the involved hospital personal to testify, as well as the difficulty of obtaining autopsy evidence on the badly decomposed bodies after the fact.
What struck me the most, at the time I first posted it, was the vehemence of some commenters about how ridiculous this report was. One suspects there will be no humble pie eaten by those who sarcastically castigated me for posting on such obviously fictitious urban legends.
But sometimes the truth can be more frightening than fiction.
UPDATE: Here’s some earlier media links filling in some detals of the investigation as it unfolded (I’ll keep this updated as more becomes available):
- CNN: Katrina Investigation Focuses on more than one person
- CNN: New Orleans doctor recalls dire scene
- CNN: New Orleans hospital operator has checkered past
- CNN: Staff at hospital debated euthanizing patients
- LifeSite: Court documents show hospital gave lethal injections
- AP: Bodies of Katrina patients to be tested for euthanasia drugs
- NPR: Euthanasia probe continuing in NO
- NOLA: Doctor, 2 Nurses charged in killing patients
- NOLA: Ethicists: Any deliberate killing crosses the line
- Disability group statement on NPR report
- AP: Doctor, 2 nurses charged
- Post-Courier: Charges over mercy killing
- Scholars say case won’t be easy
- Doctor, nurses used lethal injections to kill patients
- Arrest warrants and details of accusations from Louisiana DA
- Ethics discussion of Memorial Hospital events
- NOLA: Accused doctors calls get scrutiny
- Ethicists: No way to justify mercy deaths
17 comments so far ↓
Moof // Jul 18, 2006 at 8:34 pm
Dr. Bob, I recall both the posts, and the comments, and I believe you’re probably right.
What happened during Katrina, and since, is going to remain a dark blot on our history.
Not sure how much we’ve learned though …
Grumpy Old Man // Jul 19, 2006 at 3:59 am
A sad kind of vindication. I wish you had been wrong.
Hans G. Engel, M.D. // Jul 19, 2006 at 4:44 pm
It is sad to hear when physicians or nurses assume judgment based on their own opinion in this complex decision. It mahy well be that the doctors had the best inh mind; they might have had patients who requested suicide, vegetative patients or others they though were suffering too much.
As a supporter of assisted suicide I feel sorry for these doctors, nurses and patients. However the seriousness of such a decision cannot be ignored.
When assisted suicide is approved legally, as in Oregon, Holland and other countries, no pysician can make the decision on the basis of his own opinion.
Assisted suicide should, in my opinion, be approved in America, but under highly specific conditions decided by not one physician, but by at least a second who has no prior knowledge of the patient and no social or professional contact with the primary physician, an ethicist or person well acquainted with ethics and, most important the clear demand by the patient himself, following all the detailed laws of the state.
Vicki Small // Jul 21, 2006 at 7:00 am
Dr. Bob, I’m joining the discussion after it’s over, because I’ve been out of town.
I understand that this same “cocktail” is given to anyone undergoing a colonoscopy, to relieve anxiety. Wouldn’t the state need to prove not only that the drugs were administered, but that they were given in amounts that would be expected to bring certain death, especially considering both weather and patients’ conditions?
I do not favor assisted suicide or euthanasia, although we certainly utilize the latter with pets when they are suffering, with no reasonable hope of renewed health. But I also don’t favor D.A.’s who grandstand about their cases, a la the guy prosecuting the Duke la crosse players. My sense (for what that’s worth) is that the guy in NO may be doing the same sort of thing.
Dr Bob // Jul 21, 2006 at 1:15 pm
Yes, the drug combination is a common one–but one suspects they weren’t doing too many colonoscopies in the aftermath of the hurricane.
Of course, the DA may be fishing for publicity, and have a very shaky case; from the accounts I’ve read of some health workers at Memorial, it sounds like there’s a good chance there’s quite a bit of substance to it. The trial will be interesting, of course, and it all may prove to be a nothing.
As to the subject of euthanasia, I may post again soon on this, addressing these points as well as some of Dr Engel’s.
Vicki Small // Jul 22, 2006 at 8:40 am
:~) I could also believe not many colonoscopies are done in nursing homes, but what do I know?
If the charges are well-founded, I could be persuaded that the doctor(s) and nurses involved felt overwhelmed, helpless to do anything else for their patients, and didn’t want to see them suffer anymore. That wouldn’t make their actions legal or necessarily moral, but given the persistent and pervasive humanity of humans, they might be more understandable.
Chieftain of Seir // Jul 23, 2006 at 3:31 pm
I work in a health care setting, so I have a rather cynical view of what health care professionals are willing to do to make their jobs easier. But you never no what really happened, so it does not pay to judge. However, (there is always a however) I could not help but think of Dr. Bob’s post when I read this article.
Hootsbuddy // Jul 24, 2006 at 3:57 am
Thank you, Dr. Bob, for keeping with this very important issue. The vitriol you got from your original post was totally uncalled-for. You like to cook. Maybe you could modify that turkey technique to make crow a little more tasty for some of those commenters.
Dr Bob // Jul 24, 2006 at 5:42 am
A wise sage once told me that crow is a dish best served warm…
Thanks for your encouragement.
I’ll be posting some additional thoughts in the next few days (on this case & euthanasia, not turkey or crow).
Rouxdsla // Jul 25, 2006 at 1:48 pm
The Attorney General is grandstanding. He cannot prosecute the case and must refer it to the already overwhelmed local Orleans Parish District Attorney. The one who can’t even prosecute the drug dealers and murderers he’s got in custody.
Prior to becoming AG he was the Sheriff of Orleans for 30 years and many prison inmates died during his tenure under accusations of lack of medical care. IMO Charles Foti could give a wit about this case except for his 15 minutes of fame. If Foti cared so much he would go after some of the administrators who left the staff and patients stranded for days without power, water, food, etc… He may start with himself.
I certainly don’t condone euthanasia and I don’t think that’s what happened. I’m also very conserned that no sane medical staffer will volunteer for the next storm.
Mary Wehmeier // Jul 27, 2006 at 3:54 am
Dr. Bob,
This story in the UK paper that started all this, never passed the smell test from the beginning. Now the rumormill is trying to hang the Tenet Administrators out to dry as well. I know personally that the VP of Ops for Tenet in Dallas and the CEO were personally working their fanny’s off trying to get help and helios in for rescue. Trever Fetter, CEO of Tenet himself as said they called in Blackwater to evac patients and staff with the help of the Ross Perot and his son. So why would the doctor and nurses in question do this? Makes absolutely no sense. Didn’t then– doesn’t now.
I am writing up my opinion over on my blog, and honestly I’m just warming up…
Thanks for the opinion and letting me vent with peers.
Mary Wehmeier
Hello Mary Lu - The New Home of the Original Blog du Jour of Mary Wehmeier // Jul 27, 2006 at 7:17 am
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Dr Bob // Jul 27, 2006 at 7:20 am
Yes, the UK paper was a rag, and its initial story had lots of holes — facts of which I was unaware when I first posted on the story, and subsequently acknowledged. What really caught my eye about this case — and what almost certainly initiated the investigation — was first-person statements from physicians and other health-care workers at Memorial who reported that active euthanasia had in fact occurred. Since seeing these first-hand reports, I have followed the case very closely, and if any of these first-hand reports held up under scrutiny and oath, it would be derelict not to pursue them.
The activities and motivations of Tenet administrators seem to me to be largely irrelevant to whether the physician and nurses in question actually carried out euthanasia. I have worked at a Tenet hospital, and I found their administration to be absolutely horrid: money first, patients last, hired marginal docs on a regular basis. Is this relevant to the Memorial Hospital investigation? Of course not–it just demonstrates that most people ranting on this incident, whichever side they are on, have strong opinions not based on much, if any, fact. I’ve seen comments made by physicians who support Dr. Pao because they knew her in high school, for goodness sake! (”I went to nursery school with Dr. Pao, and she was the cutest baby! She could never have done such a thing!”)
I am actually agnostic on the merits of the Memorial case — there are simply are not enough hard facts available to know exactly what happened. Should this case come to trial, far more information will be in the public domain, and it may be possible to make a reasoned judgment, but it is not so now.
And, yes, the Attorney General may well be grandstanding: DA’s and Attorneys General do this all the time for political purposes. But this strikes me as an odd case to use for political gain: most people, rightly so, consider the physicians and nurses who endured hurricane Katrina to be heroes. Prosecuting heroes is a no-win situation for a politician: imagine a prosecutor going after a 9/11 fireman, for example.
The intensity of feeling about this case comes not from the mere prosecution of a physician in Katrina, but because it has lanced the boil of the euthanasia controversy. There is lots of heat, and very little light, on both sides of this debate right now. I am currently working on a rather extended post on euthanasia which hopefully will shed more light without needless heat, which I hope to have up fairly soon, time permitting.
Thanks for reading and commenting.
Hello Mary Lu - The New Home of the Original Blog du Jour of Mary Wehmeier » Other Medical News of Interest: // Jul 27, 2006 at 8:01 am
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WI Catholic // Aug 1, 2006 at 9:38 pm
I heard about this shortly after Katrina on a UK newspaper ‘gossipy’ sort of website, and searched, but could not find a single solitary word online about it anyplace else, especially not here in the US. So I said… nah, can’t be true, can it? Sadly, it was, and sadly, those involved seem to not think that they did anything wrong…
Jon Ray // Aug 13, 2006 at 11:23 am
Unwittingly the debate for euthanasia has turned our sympathies away from the patient to those in charge of decision making. This is a trend which can be seen elsewhere than in the New Orleans Memorial Hospital debate. It is also seen in obortion rights and day care for newborns as well as other places where a call for compassionate guardianship is called for. When citizens in the “home of the brave” will awaken to their responsibilty for those they are supposed to care for, these issues will evaporate. I, for one, cringe at the outcome of our increasingly selfish society.
Katrina Euthanasia Update | The Doctor Is In // Jun 20, 2007 at 5:40 am
[…] prior discussion of this event may be found here, along with a substantial list of links for more […]