Monday, January 8, 2007

Updates on Past Posts: NOLA MD, Teen with Hodgkins, Italian Right to Die

Dateline: New Orleans, LA
Old Pallimed Post #1 Post #2 post #3

The Times-Picayune reports that Dr. Anna Pou, and nurses Cheri Landry and Lori Budo have still not been formally charged with a crime. The story revolves around Hurricane Katrina and the actions at Memorial Hospital in NOLA. The three (sometimes referred to as the Memorial Three) were arrested by the Attorney General because of suspicion of committing euthanasia on 4 patients under their care during the few days after Katrina. CNN was denied access to some of the court documents in another event. Not much is actually happening in this case, and some are trying to get the case to move along so the nurses and doctors can have their day in court to clear their name or be prosecuted. But some newspaper editorials in NOLA have insinuated the AG is dragging his feet. Nothing much new since mid December.

Dateline: Chincoteague, VA
Old Pallimed Post

Abraham Cherrix is back in the news, and sadly his health and family are not doing as well as they had expected. He was given court approval to seek alternative treatments, including the Hoxsey method in Tijuana, Mexico. He is followed by a Mississippi physician who is a specialist in alternative medicine (particularly immunotherapy although the ACS states this is now the 4th modality of cancer treatment so I am not sure how alternative this is...) and radiation medicine. He has swollen lymph nodes in his axilla and is likely going to receive more radiation. And also very sadly the parents have split, which news outlets attribute to the stress of Abraham's illness. This is a grim reality of how much illness, goals of care, hopes, fears, emotions, etc. can infect family dynamics. And then you throw on top of that the magnifying glass of the media and the courts. That is incredible pressure. There is also a bill being introduced called "Abraham's Law," which basically states a terminally ill mature child (under 18) can make a joint decision with the parents to pursue non-standard treatments and not be accused of medical neglect. Some are protesting saying that this will weaken child protection laws and clog the courts with cases trying to define 'terminally-ill' or 'life-threatening' (Ask any palliative medicine consult team if they have ever had a controversy with other medical staff/patients/family in defining someone as terminally is very common!)

One nice silver lining for a often-maligned discipline, social workers. The same social services that first reported the case for suspicion of neglect (a good thing to at least look into) were also the same social services that came to the mother's aid when she was separated and was having difficulty with her bills and emotional support. Social workers are really great people. They are not baby stealers. (A social worker once told me that and it has stuck with me.)

Dateline: Rome, Italy
Old Pallimed Post
Piergiorgio Welby died on December 20th after a doctor removed him from his ventilator. The The physician, Dr. Mario Riccio, had a long conversation with the patient, during which time he found him to be competent and able to make this decision. Dr. Riccio also rightly clarified:

"This must not be mistaken for euthanasia. It is a suspension of therapies;
refusing treatment is a right. Quite frankly, in Italian hospitals
therapies are suspended all the time, and this does not lead to any intervention
from magistrates or to problems of conscience."
But despite his clarification, the Associated Press still managed to muddy the issue, by contrasting his statements with how long you could be prosecuted for assisted suicide and about how law makers felt about euthanasia. Again, three different issues with very important differences that are often confused for one another.

When the people took his coffin through the streets, apparently the Roman Catholic Church kept the doors closed denying him a religious ceremony, because he 'sought to end his own life.' there is some explanation of possible investigation and prosecution of the physician involved. Apparently most of the Italian public supported the patients right to withdraw his ventilator.

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