Euthanasia

On ‘Death Panels’, Compassion & Choice

Dr Bob

I must confess to having had some misgivings about the uproar over Section 1233 of the proposed health care reform bill HR 3200. This section pertains to government payment for counseling on end-of-life options under Obamacare. From Sarah Palin’s ‘death panels” to an endless host of hyperbolic rhetoric about how this counseling is “mandatory” (it’s not) and will inevitably lead to euthanasia, I have felt that much of the discourse is over the top and poorly supported by the text of the bill, and may well prove counterproductive in the long run.

This is not to say that there is no reason for concern: the enormous financial strains which the proposed legislation will place on the health care system, combined with a government panel to decide the “appropriateness” of medical care, certainly introduces significant moral hazards in creating pressures to restrict expensive care at the end of life. Given the growing legality of physician assisted suicide (PAS) — first legalized in Oregon and most recently in Washington, with many other states considering it legislatively or by fiat from judges — it is likely that PAS will become one of the options which must be discussed as part of such end of life counseling, and that there will be pressure to use such “cost-effective” options. Oregon is now offering coverage for PAS while denying expensive palliative chemotherapy. It is not hard to imagine such a trend developing at the federal level as well.

But despite my reservations about the current political firestorm on this issue, there may well be more cause for concern than I have previously believed: via the invaluable Second Hand Smoke, Wesley Smith picks up an interesting trail: the organization Compassion and Choices was deeply involved in helping to craft this section of HR 3200.

So who exactly are these folks? Does the name “Hemlock Society” ring a bell, per chance?

The Hemlock Society was founded by Derek Humphry in 1980, a rabid proponent of assisted suicide and euthanasia, as he himself makes clear:

Born in 1980 in my garage in Santa Monica, California, Hemlock went on to be the largest and oldest right-to-die organization in America fighting for voluntary euthanasia and physician-assisted suicide to be made legal for terminally and hopelessly ill adults.

But the name ultimately proved a little too close to the truth for comfort, and so eventually needed to be changed to something more anodyne: “We [also] need access to the halls of government in the states and in Washington DC – access that the name ‘Hemlock’ is currently denying us. The name Hemlock … is also baggage, baggage that we can no longer afford to have weighing us down or interfering with our being able to partner with such important and powerful organizations as AARP.” And so Hemlock joined other pro-death organizations in 2003 to become reincarnated as “Compassion and Choices.”

And now, clearly, they have the congressional access they sought. Ahh, the power of euphemism — what would a death cultist do without the words “choice” and “compassion”?

Compassion and Choices has become the shepherd and sole spokesmen of Oregon’s assisted suicide law — and were intimately involved in writing the Oregon legislation. They have been involved in over 75% of PAS cases in Oregon, and tightly control the media disclosures surrounding these suicides:

The group promoting assisted suicide, so-called “Compassion and Choices (C&C)”, are like the fox in the proverbial chicken coop; in this case the fox is reporting its version to the farmer regarding what is happening in the coop. Members of C&C authored and proclaim they are the stewards of Oregon’s assisted suicide law. They call it “their law”. They have arranged and participated in 3/4ths of Oregon’s assisted suicide cases. Their medical director reported she’d participated in more than 100 doctor-assisted suicides as of March 2005. A physician board-member reported in 2006 that he’d been involved with over forty such patients. Their executive director reported in September 2007 that he has attended more than 36 assisted suicide deaths. He has been involved in preparing the lethal solution. Yet, he is not a doctor.

Furthermore, there is no outside audit of PAS cases in Oregon; Neither Oregon’s Department of Health Services nor independent outside auditors may review them — and complications of the procedure are reported only by the prescribing physician, an obvious conflict of interest.

They have been involved in like manner in the PAS cases in Washington as well.

Hyperbole aside, there is plenty of reason for concern when government gets in the business of managing end of life decision making; assisted suicide will be a very tempting option when government desperately tries to reign in runaway costs for care of the elderly and dying.

And you can be sure if they implement these controls that groups like Compassion & Care will have a seat at the table.

The Children Whom Reason Scorns

Dr Bob

Several weeks ago, Washington State logged a solitary but grim statistic: the first assisted suicide under a new law enacted by initiative last November. It seems fitting, therefore, to re-post the following essay, written some five years ago, occasioned by the decision in the Netherlands to legalize euthanasia for children. It is, I fear, a harbinger of things to come, far closer to home.

 
You Also Bear the BurdenIn the years following the Great War, a sense of doom and panic settled over Germany. Long concerned about a declining birth rate, the country faced the loss of 2 million of its fine young men in the war, the crushing burden of an economy devastated by war and the Great Depression, further compounded by the economic body blow of reparations and the loss of the German colonies imposed by the Treaty of Versailles. Many worried that the Nordic race itself was threatened with extinction.

The burgeoning new sciences of psychology, genetics, and medicine provided a glimmer of hope in this darkness. An intense fascination developed with strengthening and improving the nation through Volksgesundheit–public health. Many physicians and scientists promoted “racial hygiene” – better known today as eugenics. The Germans were hardly alone in this interest – 26 states in the U.S. had forced sterilization laws for criminals and the mentally ill during this period; Ohio debated legalized euthanasia in the 20’s; and even Oliver Wendall Holmes, in Buck v. Bell, famously upheld forced sterilization with the quote: “Three generations of imbeciles are enough!” But Germany’s dire circumstances and its robust scientific and university resources proved a most fertile ground for this philosophy.

These novel ideas percolated rapidly through the social and educational systems steeped in Hegelian deterministic philosophy and social Darwinism. Long lines formed to view exhibits on heredity and genetics, and scientific research, conferences, and publication on topics of race and eugenics were legion. The emphasis was often on the great burden which the chronically ill and mentally and physically deformed placed on a struggling society striving to achieve its historical destiny. In a high school biology textbook – pictured above – a muscular German youth bears two such societal misfits on a barbell, with the exhortation, “You Are Sharing the Load!–a hereditarily-ill person costs 50,000 Reichsmarks by the time they reach 60.” Math textbooks tested students on how many new housing units could be built with the money saved by elimination of long-term care needs. Parents often chose euthanasia for their disabled offspring, rather than face the societal scorn and ostracization of raising a mentally or physically impaired child. This widespread public endorsement and pseudo-scientific support for eugenics set the stage for its wholesale adoption — with horrific consequences — when the Nazi party took power.
Continue reading “The Children Whom Reason Scorns” →

On Assisted Suicide

Dr Bob


In a previous post on physician-assisted suicide, I had the following exchange with a commenter named Van:

Van:

I take it you are are against assisted-suicide?

Let me ask you this – how can we say we live in a free nation if we cannot do what we wish to our own bodies, as long as we do not impact the life, liberty and safety of others?

I have mixed feelings on the subject, but I really have a hard time with others telling me what to do with my body.

Dr. Bob:

Yes, very much against it.

You are, of course, perfectly free to end your own life, with or without such legislation. A handgun and a single bullet will do the job very nicely — along with a hundred other ways.

The problem with this public policy is that you are asking your physician to kill you — and therefore it is no longer just about “what you do with your body”, but very much involves other people — the doctor, the families, and society as a whole.

The problem with this sort of “it \'s my body” radical self-autonomy is that it focuses solely on the self, while conveniently ignoring the enormous consequences of such legalization on others and society as a whole.

Van:

So your key issue is the doctor assisting in the suicide, thereby involving others?

Let \'s say you have a 90 year old individual with no family, suffering from cancer, who has no meaningful impact on others… If they take their own life, you are OK with it?

Just trying to understand where you are coming from.

Van’s question is a valid one, to be addressed shortly, but in digression one should note what often passes for arguing from principles in our current culture: the argument from the exceptional. When promoting or defending some contentious social or moral issue, we seem always to find the most extreme example imaginable and argue from this specific, then applying our conclusions to the general. Hence, for example, when arguing for government prescription health coverage, we must first find some old woman who has to eat cat food in order to pay for her prescriptions; when discussing gay adoption, we must find the idyllic gay couple, lifelong partners (or so we are told), ecstatically happy with nary a relational dispute, as parents; when arguing for assisted suicide, we must find the patient in unbearable pain with a loving husband passionate about ending her life “in dignity” by slipping her a deadly cocktail — or one who is dying utterly alone, with nary a friend or family member to share their suffering. That such argumentation almost invariably presents a false dichotomy is never considered; that far better alternatives might exist to solve the problem never pondered; that applying the suggestive solution based on emotion without consideration for its broad implications or ramifications might prove disastrous, is never seen as a possibility. We press for great social and policy changes with profound effects on culture and society using pop emotionalism and pulp fiction.

But I digress. So, to answer the question: I would not find suicide of such a sadly-abandoned individual justified, simply because no physician was involved. Suicide is the ultimate repudiation of life, of relationships, of hope, the product of the deep hopelessness and self-absorbed insanity of depression. My point was simply this: we all have free will. Each of us may choose, if we decide to do so, to end our own lives. There is a pernicious distortion of the idea of freedom which is a product of our radical individualism, to wit: I live in a free society, therefore by necessity I must be free to do whatsoever I please, and others must not only allow me to do so, but must bear the consequences of my actions, and must be actively engaged in enabling my behavior, because it is my right. Hence, I must be free to say anything I wish, without consequence, including criticism of my speech; I must be free to terminate my pregnancy, without guilt or restriction, though my unborn child pays the ultimate price; I must be free to end my life when I wish, and my physician must be required to deliver the lethal potion — or at least must be coerced into finding another doctor who will, if his “values” (defined as mere subjective opinions) don’t agree with mine.

Many of the “rights” which are being promulgated and promoted by today’s secular culture are in reality straw men, fine-sounding proxies for demands and desires far less salutary than they sound. Thus, gay marriage is not about gays getting married (hence the lack of enthusiasm among gay rights advocates for civil unions which provide all the legal benefits of marriage), but is instead an effort to destroy traditional heterosexual marriage as normative in culture, thereby removing not merely legal but cultural restraints on all forms of sexual and relational deviancy. The high standard — heterosexual marriage, with its enormous advantages in the raising of children and establishment of societal self-restraint, morality, and relational stability — must be brought down to the lowest common denominator of any two (or more) people getting “married” — with the sole purpose of muting societal condemnation for self-gratifying, dysfunctional and heterodox partnerships. Unrestricted abortion, a.k.a. “freedom of choice”, is about the uncompromising (albeit delusional) demand for unconstrained sexual license without consequences — especially for women, but also for their sperm donors who want no responsibility for their casual hookups: dispose of the unplanned pregnancy, move on to your next “partner”, and you have achieved the perfect “zipless fuck.”

Likewise, physician-assisted suicide is not at all about “death with dignity”, but rather about actively enlisting the culture in support of radical individual autonomy. Not only must we exert full control over the time and manner of our death — which we have always been able to do, by simply killing ourselves — but we demand that society support, honor, and praise this decision, without the faintest whiff of criticism or condemnation. It is not sufficient that we be able to kill ourselves. Rather, it is necessary that we actively kill those societal sensibilities and strictures which condemn such a choice as morally misguided and potentially destructive to our human dignity and our social fabric.

Were some silver-suited alien from Alpha Centuri to visit our noble globe, he would find our passion for self-extinction puzzling, to say the least. What manner of sentient being seeks to facilitate its own demise, only to perpetuate the illusion that they control their own lives? Has their existence no purpose but to be ended at their own direction? Are their relationships so shallow that they choose death over life, has their suffering no meaning, will their precious time with life partners, friends, and offspring be traded for the dark comfort of a deadly cocktail? Who are these intelligent fools who hand over the power of death to their doctors, oblivious to the evil which dwells in the hearts of men, waiting to be empowered by cold rationalism, scientific professionalism, self-justification, and sterile repetition?

Yet were our starship sojourner to study the society which breeds such nihilism, he would, by turns, find his answer: we are, for all our technological advances and unbounded prosperity, a culture without meaning, a people without purpose. We have embraced unquestioningly the mantra of materialism: we have come from nothing, and to nothing shall return. Our relationships mean naught but what we may gain from them; our suffering gains us nothing but rage and resentment; our deaths are like our lives — without hope, without a future, joyless and empty. We desperately push the buttons and mix the potions which promise to make us happy and whole, yet find they only echo forlornly through our hollow souls, singing that siren song:

“I am my own master.”

Assisted Suicide: Coming to a State Near You

Dr Bob

I hope to have more to say on the issue of euthanasia and assisted suicide in the near future. In the meantime, I highly recommend this article by Herbert Hendin, M.D. Dr. Hendin’s book, Seduced by Death: Doctors, Patients, and Assisted Suicide, is an excellent resource on the topic, the result of extensive research and multiple interviews taken while studying euthanasia practices in the Netherlands. This article provides a nice summary of his research and experience, which builds a solid case against euthanasia and physician-assisted suicide.

Washington has recently become the second state to pass an assisted suicide initiative, and, legislating from the bench, a Montana judge has ruled that man has right to assisted suicide.

This movement is on a roll, and you will want to be informed about why this is such a ghastly public policy trend.

A few highlights from the article:

Concern over charges of abuse led the Dutch government to undertake studies of the practice in 1990, 1995 and in 2001 in which physicians’ anonymity was protected and they were given immunity for anything they revealed. Violations of the guidelines then became evident. Half of Dutch doctors feel free to suggest euthanasia to their patients, which compromises the voluntariness of the process. Fifty percent of cases were not reported, which made regulation impossible. The most alarming concern has been the documentation of several thousand cases a year in which patients who have not given their consent have their lives ended by physicians. A quarter of physicians stated that they “terminated the lives of patients without an explicit request” from the patient. Another third of the physicians could conceive of doing so.

An illustration of a case presented to me as requiring euthanasia without consent involved a Dutch nun who was dying painfully of cancer. Her physician felt her religion prevented her from agreeing to euthanasia so he felt both justified and compassionate in ending her life without telling her he was doing so. Practicing assisted suicide and euthanasia appears to encourage physicians to think they know best who should live and who should die, an attitude that leads them to make such decisions without consulting patients–a practice that has no legal sanction in the Netherlands or anywhere else.

Assisted-suicide laws are always framed as being “compassionate” — appealing to the universal fear of dying a prolonged and painful death. Yet the unintended consequences of giving physicians the unrestricted power of life and death are often anything but:

Compassion is not always involved. In one documented case, a patient with disseminated breast cancer who had rejected the possibility of euthanasia had her life ended because, in the physician’s words: “It could have taken another week before she died. I just needed this bed.”

He also extensively studied Oregon’s experience with assisted suicide — the legislation which served as the model for Washington’s law — and found plenty of problems here as well:

Oregon physicians have been given authority without being in a position to exercise it responsibly. They are expected to inform patients that alternatives are possible without being required to be knowledgeable enough to present those alternatives in a meaningful way, or to consult with someone who is. They are expected to evaluate patient decision-making capacity and judgment without a requirement for psychiatric expertise or consultation. They are expected to make decisions about voluntariness without having to see those close to the patient who may be exerting a variety of pressures, from subtle to coercive. They are expected to do all of this without necessarily knowing the patient for longer than 15 days. Since physicians cannot be held responsible for wrongful deaths if they have acted in good faith, substandard medical practice is encouraged, physicians are protected from the con-sequences, and patients are left unprotected while believing they have acquired a new right.

The idea of assisted suicide has enormous allure in a culture of self-gratification and increasingly-shallow moral and ethical principles. Don’t be surprised when it comes your way — be prepared.

Crossing That Dark River

Dr Bob

Often in the sturm und drang of a world gone mad, there comes, through the chaos and insanity, some brief moment of clarity. Such times pass by quickly, and are quickly forgotten — as this brief instance might have been, courtesy of my neighboring bellweather state of Oregon: (HT: Hot Air)

Last month her lung cancer, in remission for about two years, was back. After her oncologist prescribed a cancer drug that could slow the cancer growth and extend her life, [Barbara] Wagner was notified that the Oregon Health Plan wouldn \'t cover it.
 
It would cover comfort and care, including, if she chose, doctor-assisted suicide.
 
… Treatment of advanced cancer meant to prolong life, or change the course of this disease, is not covered by the Oregon Health Plan, said the unsigned letter Wagner received from LIPA, the Eugene company that administers the plan in Lane County.

Officials of LIPA and the state policy-making Health Services Commission say they \'ve not changed how they cover treatment of recurrent cancer.

But local oncologists say they \'ve seen a change and that their Oregon Health Plan patients with advanced cancer no longer get coverage for chemotherapy if it is considered comfort care.

It doesn \'t adhere to the standards of care set out in the oncology community, said Dr. John Caton, an oncologist at Willamette Valley Cancer Center.

Studies have found that chemotherapy can decrease pain and time spent in the hospital and increases quality of life, Caton said.

The Oregon Health Plan started out rationing health care in 1994.

We have, at last, arrived. The destination was never much in doubt — once the threshold of medical manslaughter had been breached, wrapped as always in comforting words of compassion and dignity, it was only a matter of time before our pragmatism trumped our principles. Once the absolute that physicians should be healers not hangmen was heaved overboard, it was inevitable that the relentless march of relativism would reach its logical port of call.

Death, after all, is expensive — the most expensive thing in life. It was not always so. In remote pasts, it was the very currency of life, short and brutal, with man’s primitive intellect sufficient solely to deal out death, not to defer it. There followed upon this time some glimmer of light and hope, wherein death’s timetable remained unfettered, but its stranglehold and certainty were tempered by a new hope and vision of humanity. We became in that time something more than mortal creatures, something extraordinary, an unspeakable treasure entombed within a fragile and decomposing frame. We became, something more than our mortal bodies; we became, something greater than our pain; we became, something whose beauty shown through even the ghastly horrors of the hour of our demise. Our prophets — then heeded — triumphantly thrust their swords through the dark heart of death: “Death, where is your victory? Death, where is your sting?” We became, in that moment, something more than the physical, something greater than our short and brutish mortality. We became, indeed, truly human, for the very first time.

That humanity transcended and transformed all that we were and were to become, making us unique among creation not only in the foreknowledge of our death, but our transcendence of death itself. Life had meaning beyond the grave — and therefore had far more weight at the threshold of the tomb. Suffering became more than mere fate, but rather sacrifice and purification, preparation and salvation. The wholeness of the soul trumped the health of the body; death was transformed from hopeless certainty to triumphant transition.

But we knew better. We pursued the good, only to destroy the best. We set our minds to conquer death, to destroy disease, to end all pain, to become pure and perfect and permanent. We succeeded beyond our wildest dreams. The diseases which slaughtered us were themselves slayed; the illnesses which tortured and tormented us fell before us. Our lives grew long, and healthier, more comfortable, and more productive. Our newfound longevity and greater health gave rise to ever more miracles, allowing us to pour out our intemperate and precipitous riches with drunken abandon upon dreams of death defeated.

Yet on the flanks of our salient there lay waiting the forces which would strangle and surround our triumphant advance. Our supply lines grew thin; the very lifeblood of our armies of science and medicine, that which made our soldiers not machines but men, grew emaciated and hoary, flaccid and frail. We neglected the soul which sustained our science; the spirit which brought healing to medicine grew cachectic and cold.

So here we stand. We have squandered great wealth to defeat death — only to find ourselves impoverished, and turning to death itself for our answers. The succubus we sought to defeat now dominates us, for she is a lusty and insatiable whore. We have sacrificed our humanity, our compassion, our empathy, our humility in the face of a force far greater than ourselves, while forgetting the power and grace and the vision which first led us and empowered us on this grand crusade. Our weapons are now turned upon us; let the slaughter begin.

We will, no doubt, congratulate ourselves on the wealth we save. We will no doubt develop ever more ingenious and efficient means to facilitate our self-immolation while comforting ourselves with our vast knowledge and perceived compassion. Those who treasure life at its end, who find in and through its suffering and debilitation the joy of relationships, and meaning, and mercy, and grace, will become our enemies, for they will siphon off mammon much needed to mitigate the consequences of our madness.

It has been said, once, that where our treasure is, there will our heart be also. We have poured our treasure in untold measure into conquering death — finding succor in our victories, while forgetting how to die. The boatman now awaits us to carry us across that dark river — and we have insufficient moral currency to ignore his call.

Memorial Hospital Euthanasia Update

Dr Bob

As many have heard, the grand jury in New Orleans declined to bring charges against the physician, Anna Pou, and two nurses, arrested and charged with euthanizing patients at Memorial Hospital in the days following Katrina.

In New Orleans and elsewhere, many — including numerous physicians and the AMA — sighed in relief, hoping to put the nightmare — which many regarded as a gross injustice against heroic health care workers in unimaginably difficult circumstances — behind them.

But CNN is reporting that the issue may not be put to bed quite so easily:

A New Orleans grand jury that declined to indict a doctor on charges that she murdered patients in the chaotic days after Hurricane Katrina never heard testimony from five medical experts brought in by the state to analyze the deaths.

All five concluded that as many as nine patients were victims of homicide.

In detailed, written statements, the five specialists — whose expertise includes forensic medicine, medical ethics and palliative care — determined that patients at Memorial Medical Center had been deliberately killed with overdoses of drugs after Katrina struck New Orleans in 2005.

The grand jury had been asked to consider second-degree murder charges against a doctor and two nurses in four deaths. But in July, the grand jury decided that no one should be indicted…

In a decision that puzzled the five experts hired by the state, New Orleans District Attorney Eddie Jordan never called them to testify before the grand jury.

The experts themselves were puzzled and frustrated to have their evidence ignored:

“They weren’t interested in presenting those facts to the grand jury,” said Dr. Cyril Wecht, the former coroner of Allegheny County, Pennsylvania, and a past president of the American Academy of Forensic Scientists.

“The hard scientific facts are those from five leading experts, [the patients died] from massive lethal doses of morphine and Versed. As far as I know the toxicological findings were not presented to the grand jury and certainly not with quantitative analysis.” …

“I was never called to the grand jury,” said Caplan. “As far as I know, the grand jury never saw my reports. As far as I know, none of the reports prepared by these experts, who looked at all the cases, who were independent, and came to the conclusion that massive amounts of drugs were used as the cause of death and that they couldn’t have been requested [by the patients], they had to be given involuntarily. That’s evidence that I think a grand jury would want to be familiar with before it made its decision as to whether or not to proceed with an indictment.

“Now you can still get into a dispute about the evidence,” Caplan added. “You can get into a dispute about the circumstances and all the rest of it, but at face value there is no other conclusion I think that’s possible, other than these people — or someone — killed them.”

Dr. Pou testified that she had sedated patients to keep them comfortable in the intolerable conditions; the forensics experts found this an implausible explanation:

“The primary and immediate cause of death for each of these patients was acute combined drug toxicity, specifically morphine and Versed,” wrote Wecht. “The manner of death would be classified as homicide.”

“Large doses of these drugs were present in patients and the administration of the drug was not documented,” wrote James Young, the former chief coroner of the province of Ontario, Canada, who, like Wecht, once served as president of the American Academy of Forensic Sciences.

“Accidental overdoses would need to have occurred nine times between 12 noon and 3:30 p.m., all on one floor, to every patient who was left on the floor,” Young wrote. ” Again, it is noted that morphine was not ordered for seven of the patients and Versed was not ordered for any. Therefore it seems highly unlikely that nine patients died on the same floor on the same afternoon of accidental overdose.”

Caplan wrote that there was no evidence any patient asked to be given assistance in dying, and no evidence that any consented to be given an overdose of medication to end their lives.

“In reviewing the facts and opinions, my conclusion is that the deaths of the nine persons at Memorial Medical Center in New Orleans are all cases of active euthanasia,” Caplan wrote. “Each person died with massive doses of narcotic drugs in their bodies.”

The grand jury’s findings remain secret, although there are legal challenges to disclose them. The experts’ summary, however, also includes some chilling testimony, although the witnesses are not identified:

In its executive summary report included with the forensic experts’ findings, the attorney general’s office paints a chilling picture of what its investigators say happened four days after the hurricane hit New Orleans.

The summary cites a number of people — whose names are blacked out in the report — as having offered statements through their attorneys and having sought immunity from prosecution.

The summary states that Pou told the nurse executive of Lifecare, the acute care facility on the seventh floor of the hospital that housed the nine patients, that “a decision had been made to administer lethal doses of morphine to Lifecare patients.”

According to the report, none of the nine was a patient of Pou’s and there was no indication she had talked to their doctors before seeing them on the day they died.

The attorney general’s report also said that other medical personnel told Pou that one of the patients, Emmett Everett Sr., was conscious and alert. Everett was 61 years old, weighed almost 400 pounds and was confined to a wheelchair.

“Dr. Pou decided (patient name blacked out) could not be evacuated. He could not be taken out by boat because he was not ambulatory and Dr. Pou felt he was too heavy to be evacuated by helicopter,” according to the report.”

While we may never know the exact details of what happened at Memorial Hospital, the ghosts of that tragedy may continue to haunt us for years to come.

Grading on a Curve

Dr Bob


My previous post, an update on the investigation into deaths at Memorial Hospital during hurricane Katrina, elicited this comment from a reader, Carla:

It was not the district attorney who had these people arrested. It was attorney general of the State, Charles Foti, who had them arrested despite that they were not charged. He made a big grandstand about it saying they were murderers, much like Mike Nifong said the Duke lacrosses players were rapists. The atty. general can investigate pursuant to his powers under the Medicaid Fraud Act. Then he has to turn things over to the local district attorney. Now the district attorney has convened a grand jury to see if he can charge the nurses and doc. that the atty. general arrested. The local coroner says he cannot determine cause of death. May I suggest heat, lack of medical equipment, stress and failure of government. But not lack of care from those who chose to stay behind to help patients and did not leave until all patients were evacuated.

I stand corrected on referring to Charles Foti as district attorney, rather than Louisiana Attorney General. And I wholeheartedly agree that he may well have used the Memorial death case opportunistically for personal political gain: the shadow of Mike Nifong looms long, and politically ambitious prosecutors can destroy lives by abusing the power of their office.

In fact, almost everything about this case begs for dismissal — it is fraught with extraordinary circumstances which solicit quick judgment and counsel hasty condemnation. A raging storm roars through a fragile city long known for its vulnerability, frail aging levies its sole defense against certain disaster. A city flooded, its weakest citizens trapped in a hospital-turned-hellhole. Heroic doctors and desperate nurses battling impossible circumstances, tending to the sick and dying, utterly abandoned by corrupt, inept civil servants and emergency services overwhelmed and overtaxed. An Attorney General exploiting public horror at the trapped and hopeless, sacrificing valiant healers to the gods of political ambition and self-aggrandizement. We desperately want to avert our eyes in disgust, having witnessed yet another example of corrupt politicians and cynical civil servants. The news is old; heap scorn and hurry along; judge harshly and hastily dismiss; feel that self-righteous contempt which comforts the mind while killing the spirit.

Yet pause we must. This perfect storm of pathos and perfidy masks a simple question which we ignore at our peril:
Continue reading “Grading on a Curve” →

Katrina Euthanasia Update

Dr Bob

Lost in the dustbin of inconvenient memories, left behind in the light-speed pace of internet information mania is the story of the deaths of patients at Memorial Hospital in New Orleans in the wake of Hurricane Katrina. A physician and two nurses were arrested after the Louisiana District Attorney charged them with murder, accusing them of having injected a lethal cocktail to terminate frail patients who had no hope of rescue from the hell-hole the hospital had become.

The arrests were widely decried in the medical community — most of whom clearly had read none of the rather compelling and chilling testimony of other physicians and nurses who were present at the hospital. The case quickly became mired in charges of political grandstanding by the DA, who was considering running for governor and using the publicity around the case to raise money for his campaign. It subsequently went to a grand jury, which has used deliberate — some would say glacial — speed in investigating the case.

CNN today reports an update on the grand jury proceedings, where two of the involved nurses have been offered immunity to testify against the physician accused, Dr. Anna Pou.

The CNN update mentions this previously-unknown side story:

Craig Nelson, a New Orleans lawyer who is convinced his mother was killed by a lethal dose of morphine, has taken steps to file a civil lawsuit.

Nelson had an autopsy performed on the body of his mother, Elaine Nelson. The 90-year-old Jefferson Parish resident died inside Memorial Medical Center during the aftermath of the hurricane. Nelson said her death is not part of the murder investigation because his mother was elderly, frail and sick.

She was a patient of LifeCare, a long-term care facility run inside Memorial Medical Center’s seventh floor. Nelson said his sister was helping to care for his mother during Katrina, but was asked to leave. It was after his sister was evacuated that he was told his mother had died.

Test results conducted by a private lab hired by the lawyer indicate high levels of morphine in Elaine Nelson’s liver, muscle tissue and brain, Nelson said. He said his mother should have had no morphine in her system, since none had been prescribed to her in the week and a half before she died.

My prior discussion of this event may be found here, along with a substantial list of links for more information.