In the email last night (I wrote this person back, and got permission to post this):
I am a home health worker in Washington State.
We fight every day for the well being of our clients.
We deal with docs all the time that think it’s the “time” for the patient, or that they just have “the dwindles”.
With care and intervention they’ve done very well.
Healthcare providers need to be honest.
Real grunt docs fight for the vulnerable not kill them.
You are not God. You are not invincible. If you can’t take the heat get out of the way of those of us who can.
These people had a right to life, not execution.
When more of the truth comes out, we won’t be suprised at the “uppitty” attitude these killers will spout.
Dr. Pou was weak, should not of been in charge.
Ai
Where to begin. I’ll start with a presumption of innocence, and that the facts presented in the indictment aren’t terribly damning.
I’m glad I wasn’t in Dr. Pou’s shoes, and doubt there’s any actual wrongdoing there in NOLA. This email, however, shows some disagreement.
Perhaps you would like to retort?
I think it’s near impossible to guess what we’d do unless we were actually there, in their shoes. Ya know? I can read about what it was like, but I have no idea what I would consider to be the “right thing” to do in the situation. There were extenuating circumstances – it’s just not all that black and white.
Dr. Hebert had an interesting dialog running in the comment section of his post r/t this same topic. As a student, this situation raises so many questions for me. I am anxiuosly awaiting the discovery of more FACTS. But for now, I must admit my take on the affidavit was that it was pretty incriminating.
Maybe you can answer this question, GruntDoc: in a disaster such as Katrina, what is a docs (or nurses for that matter) legal responsibilities in relation to patient abandonement and finding another doc to “cover your hospital inpatients?” An answer here will really help me sort some of this out in my own mind.
I don’t know. That’s a good question, and one that doesn’t have a good answer, I’m guessing.
Disaster, by implication, means the normal situations, and therefore abilities, have been exceeded. That doesn’t mean there are no rules, but that laws that govern disasters, and behavior during disasters, cannot anticipate every circumstance; on the other hand, this doesn’t mean an absence of laws, and you can’t kill your patients (the hypothetical here). I think the reasonable thing to do is to act as any reasonable person would do, do the best you can, and hope there isn’t some state AG who doesn’t have the guts to go after the politicians who contributed directly to the magnitude of the disaster but wants to punish the victims.
From the beginning I’ve wondered if this can of worms was worth opening. I’m not for murder, if that is what happened, and from what I’ve read that’s not a slam-dunk. I don’t know what I’d have done, or not done, and try hard not to imagine myself in that situation.
My initial read of the story wasn’t real positive, either, but I, too am willing to wait for all of the facts to come out. The story I read said that the two patients in particular “would not survive the evacuation attempt”, and that led to the decisions made. I think I personally would have tried to evacuate them anyway. If they died while I was trying my best, that’s one thing. To put them out of their misery to save them the anguish of the evacuation attempt is a completely different thing…
The only thing I am certain of, though, is, I’m glad I wasn’t in that situation, to have to find out what I indeed would have done.
This is definitely a grey area indeed! Were the pateints DNR? Were they suffering? Did any of them ask for euthanization? What is the definition of murder vs mercy in such a situation? In past wars, often those who could not be saved/evaced, were given a gun or put out of their misery. These days, with all the air/ground support, this is a thing of the past. I have seen this potrayed in old films, but never viewed it as murder. To let a terminal, suffering patient pass with comfort a crime? If this did occur, the motives were not profit or hate, they were caring and compassion. When i joined the ER at my small hospital and was told if several traumas came in on nights, the ones we could definitely save would receive our focused care. With 2 nurses and a doctor, at the time, this was the plan. I was horrified by this, yet time and experience has taught me the necessity of such. I luckily never had to work a shift, where that decision had to me made. Is that murder? Well, those who can truely judge, are those who lived and survived the crisis.
Let’s take a look at that letter, Al.
We have a home health worker – an aide, in all probability – who is pronouncing sentence on respected physicians and nurses, based on the accusations of a politician.
Did *anyone* learn *anything* from the Schiavo case? Bill Frist could probably give a few pointers here re: don’t leak opinions on topics you don’t know about until the facts are in.
Ai seems to be mounted on an awfully high horse there, and my experience is that you have to wait until they dismount before you can have any sort of conversation with them.
S/he also seems to be in possesion of “facts” that haven’t been established in a court of law. And as for “uppity attitudes,” I think we have a prima facie case of the pot calling the kettle black.
I think I’ll sit this one out until there’s a trial. Until that time, it hasn’t been established that anybody killed anyone, and public defamation through ignorant accusations is no way to determine guilt.
I think that we live in a society full of people who damand everything be black and white. Thats a great thing when it can happen but it’s not always reality. People are passing judgements based on their personal beliefs and allowing nothing for the reality of the tragedy.
They see only a physician and two nurses who may or may not have done something wrong. So immediately they want to crucify them because they don’t believe in murder. Well, who among us really does believe in murder? Obviously, if this doc. went to work on a “normal” day and decided she would give a few patients some injections to end their life I think we would all look at it in a completely different light.
That wasn’t the case though. I don’t know all the facts and neither does anyone else. So I’m in no hurry to send anyone to a life in prison or a death sentence. I think there were things that happened in New Orleans that most of us, “who wern’t there” can’t even imagine.
I bet the people in Washington State were a lot more comfortable during that time than what those in the effected area’s were. So it becomes easy to block out facts and only focus on one event. Particularly, if that happens to be the only event you chose to focus on.
If this is murder then what do we call the demiss of all those people that died in that dome one after another? Or the dead bodies, I saw on a video, (from Dr. Heberts blog, floating with the muck down the streets of New Orleans? Was that murder? If so, then why aren’t the “people’ who were responsible for those deaths being locked up? I imagine it’s because they have found a scape goat to take the heat. Who better to persecute than a physician who tried to stay behind when everyone else was running away?
How many docs are going to be leery of “disaster duty” after this sure-to-be-nasty trial?
I’ve done it a couple of times (living in a hurricane-prone area makes it a requirement)… but I think more than a few docs will think twice about it, particularly if this doc ends up being crucified for nothing. Law of unintended consequences, folks.
We’ll have to wait and see what this trial brings, and I can only hope that this DA isn’t doing this for political reasons, and/or he has some compelling evidence/testimony. If this thing turns into a no-evidence fiasco, he should be run out of office for wasting taxpayer time and money.
I disagree with the home health woker’s statements. And yes, that person is probably an aide who needs to gain some training & experience as a professional before condemming others – even though she/he is entitled to her opinion.
I’ve been a nurse for over 30 years and am now a forensics nurse. I’ve seen a lot in my time and am proud to have been a part of this profession.I do not condone murder. However, I do not see this as murder, even if they did inject those people.
For a crime to have been committed, you have to have Mens Rea (intent). According to our laws, without intent, there is no crime. On the surface, it may appear to have been an act of murder, but they need to look at the actual “intent” here. Was it really murder or a last act of compassion because they could not save their patients and they didn’t want to see them suffer?
Would I have done the same thing? I don’t know. Thankfully, I’ve never been in that position. But could I just stand by & watch frail patients suffer with no chance of rescue or survival? I’d have to say I doubt it.
I’d like to add something if I may:
I’ve never once, in all my years, have spoken to a physician who simply felt that it was the patient’s “time” or had the “dwindles” – never heard those words spoken. Usually it’s been just the opposite.
And the remark about getting out of the heat to make way for”those who can” is pretty arrogant in my view. I worked home health care for 10 years. I don’t know what “fighting” she’s talking about (it sounds like a she)and aides don’t do any “fighting” for the patients anyway. The nurses do that.
The fog of disaster medicine seems to bring out the best in many medical personnel, and it reveals all of us to be less than perfect. It’s interesting to see who eagerly volunteers for extra duty, and who disappears into the shadows, returning only when all is back to normal.
I personally enjoy the challenge of practicing under less than ideal conditions. I’ve driven through floodwaters to make quite a few “essential personnel” shifts, usually to enjoy the peace of a practically unaccessible facility with plenty of snacks and loads of free time to watch the weather and spend some quality time with my favorite colleagues. I worked the entire weekend in an ER in the Texas Medical Center without power (after the Allison flood), using a headlamp as my only light source. The lack of A/C was a bit stifling, but we could ignore some of the usual formalities like those pesky transfer forms and computerized records. We just did the best we could with what we had. We carried patients up and down the stairs, bagged them as long as necessary, and fanned them. In the Astrodome after Katrina, I was amazed at some of the nurses I worked with who had stayed there for 4 days straight, catching a catnap on a cot when they had the chance. We didn’t document every single patient care intervention, but I guarantee you we did the best we could for each patient we saw.
Even though I don’t know any of them personally, I would wager the staff in New Orleans did the same.
I think many people are forgetting that the doctors and nurses who were left for days, trying to care for dying patients in horrible conditions were victims also. At the time this supposedly happened, they had already endured more than most of us ever will–and they did it in order to provide aid to others. I think that prosecuting these individuals is leading us down a slippery slope that can only have negative consequences.