Wednesday, July 19, 2006
Well it's happened. A physician and 2 nurses have been charged with the murder of 4 people at Memorial Hospital in New Orleans during the Hurricane Katrina catastrophe. Probably more indictments will be forthcoming. I cannot of course pass judgment on what happened--either to defend it or outright condemn it--the legal process has to play out, and all I can hope for is justice for all involved. Euthanasia (if that is what this is, which it probably actually isn't...) is morally objectionable to most of us practicing medicine in the US, including palliative medicine, but at this point it's too early to get any clear sense of what actually happened, let alone judge or defend what happened one way or the other, particularly given the extreme circumstances these individuals were acting in.
That said, I'm quite concerned the media coverage of the charges and the public discussion of what happened is going to spill over onto 'regular' end of life care and be full of misrepresentations, half-truths, and gloriously inaccurate and damaging portrayals of end of life symptom management, comfort care, etc. being life- shortening care, and somehow dangerous and ethically suspect.
Example one, from the breaking story yesterday on cnn.com:
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."
(Mr. Foti is the district attorney bringing the murder charges.) One had better inform (the majority?) of ICU survivors in the US that were intubated that they received at some point during their hospital stay a 'lethal cocktail' which should have guaranteed their death.
This same CNN piece at one point seems to differentiate between euthanasia (usually conceived of as a physician deliberately ending a patient's life early at the request of the patient in order to end suffering in the setting of a life-limiting disease) and run-of-the-mill homicide and then later conflates the two. It's going to be a mess.
I invite submissions of aggregious misrepresentations of end-of-life medical care, medical ethics, etc. that come up during this case--email me or leave a comment here.