Thursday, August 27, 2009
A Detailed Look at Euthanasia Accusations During Hurricane Katrina
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"Thiele practiced palliative-care medicine and was certified to teach it. He told me that he knew that what they were about to do, though it seemed right to him, was technically ‘‘a crime.’’ He said that ‘‘the goal was death; our goal was to let these people die.’’"Topics covered in the article particularly relevant to palliative care include:
- the role and varied meaning of DNR orders
- the administration of morphine and/or versed as a potential cause of death
- the role of medical professionals in civil emergency and potential liability
- patient centered care and the difficulty of informed consent in emergencies
- the ethics of rationing medical resources (medicines, personnel, technology) in emergency
- the role of the chaplain and others for staff support
- the meaning of dying with measurable opioids in your blood
- the selection of a triage protocol when mortality risk is high
- the difficulty of prognostication and it's role in every medical decision
- the role of double effect
"Doctors, nurses and clinical researchers who specialize in treating patients near the ends of their lives say that this ‘‘double effect’’ poses little danger when drugs are administered properly. Cook says it’s not so simple. ‘‘If you don’t think that by giving a person a lot of morphine you’re not prematurely sending them to their grave, then you’re a very naïve doctor,’’ Cook told me when we spoke for the first time, in December 2007. ‘‘We kill ’em.’’"See I told you that you should read it. Read the whole article before casting any judgments on the above quotes please.
We have covered the case of Dr. Anna Pou at Pallimed in the past here and here.
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7 Responses to “A Detailed Look at Euthanasia Accusations During Hurricane Katrina”
August 28, 2009
This article was really well-written. I hope readers will realize how extraordinary the circumstances were and won't generalize about palliative medicine from some of the statements in the article, like those you quoted. Unfortunately, this is exactly what a lot of people are afraid of right now, given the misinformation about health reform and end-of-life care.
August 28, 2009
The best description of this article is "gripping," as Christian said. That is exactly how I described it to my family after reading it with great interest yesterday. It took me 45 minutes to read it, but once I started I was unable to focus on anything else. I will only recommend it to others with caution, however, because of the risk of generalizing this situation and statements contained in the article to palliative care as a whole.
After reading it, I have drawn different conclusions about the physicians' actions than I had previously (after reading earlier coverage and watching the 60 Minutes interview with Dr. Pou). The hardest part is that, while the conclusion that this was likely euthanasia is a horrible one to come to, it's impossible to know how to view this morally and ethically given the disasterous conditions which were the grim reality for these clinicians at the time.
August 28, 2009
Thanks for the comments Mike and Lynn.
I very much agree and maybe I should bold my statement in my original post, that the whole article needs to be read before making any final judgments. I think this is a thought provoking piece that palliative care departments should share and debate.
September 01, 2009
Hey Lynn. I agree that one could conclude from this that euthanasia did occur (I am still agnostic about this); but even for a relatively confirmed anti-euthanasia person like myself it challenges one's assumptions that such actions are never appropriate. Gripping, challenging, and a tough read for me.
September 04, 2009
Christian (or others), what do you know, if anything, about the credibility of the author of this rather scathing account of "what happened" and what various persons reportedly told her about it? I am hesitant to accept Fink's (real name or pseudonym??) account at face value, despite the publisher. Especially given that this case was considered in the courts, sorting through (one assumes) reams of testimony and evidence, and yielded exoneration--a judgment considerably different than the one clearly implied by Fink. I have not yet spent the full 45 mins that it will take me, also, to finish this expose'; but the author's perspective is not hard to discern even from the chosen title and opening paragraphs. I.e., this is not a journalist's report. In a summer-fall season of misinformation, disinformation and demogoguery on all things "end of life" related, I am especially cautious and skeptical of what I read online. Any assurances out there that this is not yet another cog in the right-hand wheel of discrediting legitimacy? -- Tarris Rosell
September 04, 2009
I see now Sheri Fink's bio on ProPublica. Sure has the look of credibility... -- Tarris
March 27, 2011
Hey Lynn. I agree that one could conclude from this that euthanasia did occur (I am still agnostic about this); but even for a relatively confirmed anti-euthanasia person like myself it challenges one's assumptions that such actions are never appropriate. Gripping, challenging, and a tough read for me.
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