By ALAN FREEMAN
Toronto Globe and Mail
December 27, 2005
The disturbing story of what may have happened at Memorial Medical Center, where 45 bodies were found two weeks after the hurricane hit, is unclear, but enough information has emerged to raise serious questions about whether hospital staff may have stepped over ethical boundaries and hastened the death of their patients.
"We can confirm that euthanasia is what we are investigating," said Kris Wartelle, a spokeswoman for Attorney General Charles Foti, who added that there is no proof yet that doctors actually put any patients to death prematurely.
She said that many of the 45 patients died of natural causes or were already in their final days when the levees broke, leaving the hospital without power, short-staffed and suffocatingly hot in the days following Katrina's Aug. 29 landfall. However, she added that "we are looking into something that might have happened to some of the patients."
Bryant King, a contract doctor at the 347-bed, privately owned hospital, has told CNN that on Sept. 1, three days after the hurricane hit, a hospital administrator suggested to him that some patients be put "out of their misery."
"Most people know that something, something happened that shouldn't have happened," he said.
King said that later that day he saw a fellow physician, Anna Pou, go through the hospital with a handful of syringes filled with an unknown substance. "And the words that I heard her say were, 'I'm going to give you something to make you feel better.' This was strange on a lot of levels," King told CNN.
"Number one, we don't give medications; nurses give medications. We almost never give medications ourselves unless it's something critical. Nobody walks around with a handful of syringes and goes and gives the same thing to each patient. It's not how we do it."
In a local TV interview after the hospital was evacuated on Sept. 2, Pou explained, "There were some patients who were critically ill, who, regardless of the storm, had the orders of 'do not resuscitate.' In other words ... to allow them to die naturally, and to not use heroic methods to resuscitate them. We all did everything in our power to give the best treatment that we could to the patients in the hospital to make them comfortable."
In a statement to CNN, Pou's lawyer said that his client "worked tirelessly for five days to save and evacuate patients, none of whom were abandoned." The statement did not address the issue of euthanasia.
King later abandoned the hospital and admits he never saw any specific acts of euthanasia, but Angela McManus, who was at the hospital taking care of her elderly mother, said hospital officials decided on that Thursday that patients who had signed "do not resuscitate" forms would not be evacuated.
Wartelle, the attorney general's spokeswoman, said that 73 subpoenas have been issued in connection with the investigation and that there are "multiple persons of interest" involved in the case.
As part of the inquiries, toxicology reports have been ordered of tissue samples from the dead. It's believed that the tests will look for evidence of high levels of morphine.
Aine Donovan, executive director of the Ethics Institute at Dartmouth College in New Hampshire, said that the situation may have been chaotic but it provided no excuse for doctors to forget their professional obligations. "We all saw the news reports. It did look like absolute, utter chaos. But you don't simply say, 'We have chaos, therefore this is what we're going to do to elderly patients.'
"If it's true, it's really an indictment of the (medical) profession that people said, 'These are old, sick people who aren't going to live much longer anyway.' It doesn't make it OK. You can't be cavalier with your patients," said Donovan, who teaches ethics to medical students. "You have to be held to a higher standard."
But Stuart Finder, senior medical ethicist at Vanderbilt University's Medical Center in Nashville, sympathized with the difficult decisions facing the medical staff dealing with dying patients in extreme pain.
"The law isn't designed for crises. It's designed for the norm. People may have made choices to ease the suffering of the dying and as a result expedite their death."
The attorney general's office said an announcement on the results of the investigation is expected next month.
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