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What in the heck were these rocket scientists thinking


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It sounds like media mongering and I think there is alot more info which would be clinically relevant than is available here. Thanks for posting this "Ruff,"

ACE844

DITTO ACE I AGREE

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I think the circumstances of Katrina and the extreme explosivity of any issue involving Katrina should give all of us pause.

But whatever the legal outcome of this and whatever the reality of what transpired, I want to ask:

Are medical ethics absolutely constant? At what point do circumstances reach such an extreme that normal ethical standards become blurred?

Euthanasia or physician-assisted suicide in the context of a normally functioning hospital is one issue, but should the hellish conditions of a hurricane ravaged hospital beg forgiveness for what would otherwise be inexcusable?

Just questions I wonder about. Though again, we don't really know that anything criminal happened at all.

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I think the circumstances of Katrina and the extreme explosivity of any issue involving Katrina should give all of us pause.

But whatever the legal outcome of this and whatever the reality of what transpired, I want to ask:

Are medical ethics absolutely constant? At what point do circumstances reach such an extreme that normal ethical standards become blurred?

Euthanasia or physician-assisted suicide in the context of a normally functioning hospital is one issue, but should the hellish conditions of a hurricane ravaged hospital beg forgiveness for what would otherwise be inexcusable?

Just questions I wonder about. Though again, we don't really know that anything criminal happened at all.

This happens in different hospitals and ICU's DAILY.. in the US in all different forms. The difference is the situation and most probably family pt wishes and acceptance. The DA is looking for a scapegoat and to re-direct attention form soemthing else hence the media involvement... :roll:

ACE844

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This happens in different hospitals and ICU's DAILY.. in the US in all different forms. The difference is the situation and most probably family pt wishes and acceptance. The DA is looking for a scapegoat and to re-direct attention form soemthing else hence the media involvement... :roll:

ACE844

Ace, I'm as suspicious as you are of the whole allegation. But I'm just trying to get at a bigger picture here. Most everyone agrees, for instance, that stealing is wrong and unethical in normal life. But I think few blame those who stole from empty stores to get the things that they needed to survive. (Not the liquor and television thieves, they can go to jail for all I care.)

So I'm questioning if there's a parallel in medical care, where what is normally unethical becomes forgivable.

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If this truly is what happened then shame on them but let's take a step back from the article and think about what was happening

1. you have 3 patients who obviously could not be moved

2. You have a major storm coming and after it hit the hospital if I remember correctly was nearly destroyed. By the time that the three of them realized that this was a hopeless situation there were no ambulances to transport the patients cause I believe the hospital was also under water.

3. No utilities which if the patients were on drips or pumps or ventillator then what the heck was powering the equipment

4. Without utilities running how can they get the patient with all the ancillary stuff on them down or up to a level that they could evac them out. it's impossible to move these types of people down stairs or upstairs.

5. What was the survivability of these patients in the end run?

6. Was it more humane to "put them to sleep" or let them suffocate because their vent didn't work or the pumps that were keeping the lifesaving drugs going in had run out of batteries.

Before we chastise these providers we need the whole story. They are still SCREWED BIG TIME IN MY OPINION, BUT we need to step back and find out the entire story.

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Wow!

Here's a little more info I managed to find that might shed some light on this.

First some pictures...

top.jpgfema050917.jpg1126702967_5277.jpg

Not exactly dream conditions to work in.

Excerpts from a more detailed story from NPR...

All Things Considered, February 16, 2006 · Soon after Hurricane Katrina struck, the first unconfirmed reports surfaced of "mercy killings" -- euthanasia of patients -- at New Orleans hospitals.

After Katrina struck the city, conditions at New Orleans' Memorial hospital were horrendous. The hospital was surrounded by water, power was out and back-up generators failed. Temperatures inside the hospital quickly soared past 100 degrees and patients were in distress.

But it was on the seventh floor of the hospital were the situation was most dire. Memorial Medical Center leased the floor to LifeCare Hospitals, a separate long-term patient care facility. Lifecare Hospitals is based in Plano, Texas. LifeCare has facilities in nine states and considers itself an acute specialty hospital capable of treating the most complex of cases.

There, on the seventh floor of Memorial Medical Center, doctors and nurses were faced with few options. Conditions were deteriorating rapidly, evacuations were sporadic and security was compromised. Staff agonized whether to attempt to transport critically ill patients who might not survive the arduous evacuation. It appears another choice was considered: whether to end the lives of those who could not be moved. In the court documents reviewed by NPR, none of four key witnesses say they knew who made the decision to administer lethal doses of painkillers to the patients. But all four heard discussions that a decision had been made to end patients' lives. According to the documents, attorneys for LifeCare self-reported all of this to the Louisiana attorney general's office on Sept. 14, 2005.

Angela McManus' mother had been on the LifeCare floor for two weeks before Katrina hit. Wilda Faye McManus, 78, was battling a persistent infection due to complications from rectal cancer. Angela McManus says she was given a bed next to her mother and never left her side until Tuesday, the day after the hurricane. She says nurses told her that helicopters were coming for the seventh-floor patients and that McManus needed to get to the first floor and wait for evacuation boats.

Once on the first floor, McManus said, she could hear gunshots outside the hospital. She saw looters sacking a corner drug store. Many sources confirm that at this point, there were 2,000 people -- employees, patients and relatives -- trapped in the hospital. According to McManus, "The sewer lines had all backed up, and we were down there in all that stifling heat and this odor was horrendous. People were trying to get into the hospital just to get to higher ground, and they weren't allowing that... so they boarded the doors up, and we were just in there smothering all night long."

By Wednesday morning, Angela McManus learned her mother had not been evacuated as promised. She rushed back to the seventh floor and said her mother's condition had changed. "She was real lethargic," said McManus. "She would talk to me, then just doze back off. I was like, 'What's going on with her?' I was just sitting there talking to her and stroking her, and she was just sleeping and I'm like, 'Something is wrong'."

McManus says nurses told her that her mother had been sedated. She grew concerned because she says her mother's pain had been manageable with Tylenol and an occasional painkiller. She stayed with her mom for hours and sang gospel hymns to comfort her. According to McManus, attempts were made to evacuate other patients from the seventh floor. She recalls seeing workers desperately trying to get one woman out of the hospital, only to see that the woman died in the process.

Angela McManus became seriously frightened for her mother when she overheard nurses saying a decision was made not to evacuate LifeCare's DNR patients. "DNR means "do not resuscitate." It does not mean do not rescue, do not take care of," McManus said. She tried to rescind her mother's DNR order to no avail. On Wednesday evening, two full days after Katrina hit, Angela McManus says three New Orleans police officers approached her with guns drawn and told her she would have to leave. New Orleans police confirm that armed officers did evacuate non-essential staff from the hospital.

Confronted by police, McManus raced to her mother's bed. "I woke her up and I told her that I had to leave, and I told her that it was OK, to go on and be with Jesus, and she understood me because she cried," McManus recalled. "First she screamed, then she cried. And I said, 'Momma, do you understand?' And she said, 'Yes.' And she asked me, she asked me to sing to her one more time. And I did it, and everyone was crying, and then I left. I had to leave her there. The police escorted me seven floors down."

McManus says that when she left, only eight patients, including her mother, remained alive in LifeCare.

According to court documents reviewed by NPR, a key discussion took place on Thursday, Sept. 1, during an incident-command meeting held on the hospital's emergency ramp. A nurse told LifeCare's pharmacy director that the hospital's seventh-floor LifeCare patients were critical and not expected to be evacuated with the rest of the hospital. According to statements given to an investigator in the attorney general's office, LifeCare's pharmacy director, the director of physical medicine and an assistant administrator say they were told that the evacuation plan for the seventh floor was to "not leave any living patients behind," and that "a lethal dose would be administered," according to their statements in court documents.

According to eye-witness accounts, LifeCare's pharmacy director said that later that Thursday morning, he found Dr. Anna Pou in the seventh-floor medical-charting room. According to his statement, Pou and two unnamed nurses informed him that it had been decided to administer lethal doses to LifeCare patients. From the court documents, it is not clear where the instruction came from. When asked what medication was to be given, the pharmacy director told the investigator from the AG's office that Pou showed him a big pack of morphine vials. The LifeCare pharmacy director stated that, before evacuating, he saw Pou and the two nurses enter the rooms of remaining LifeCare patients.

No one has been charged in the investigation. And nowhere in the documents or in independent interviews conducted by NPR does anyone confirm seeing doctors or nurses administering lethal drugs.

Excerpts from Boston.com News...

The trouble began when the generators started fading Tuesday afternoon as the diesel fuel began running out, Kokemor said, just as levees ruptured in New Orleans, flooding the city and the streets around Memorial.

Diesel trucks came to resupply the hospital, but the rising waters prevented them from delivering the fuel, so the hospital lost all power by the early hours of Wednesday morning, Kokemor recalled.

Electricity is critical in a hospital. In addition to keeping lights and air conditioning running, it powers breathing machines and other equipment necessary to sustain critically ill patients.

Soon, the hospital was surrounded by 6 feet of water, which flooded the first floor, including the kitchens, Kokemor said. After Tuesday evening, the hospital had only cold food such as sandwiches, crackers, bagels, and fruit juice.

Doctors, nurses, and volunteers fanned patients to keep them cool and, in some cases, used manually operated devices to keep patients breathing.

''If you have fragile patients, they're going to have a very difficult time surviving that," said John Matessino, president of the Louisiana Hospital Association, an industry organization. ''Unfortunately, some didn't make it."

Of that number, Anderson said 15 to 20 were recovered from the long-term care facility on Memorial's seventh floor. Such facilities typically treat patients near the end of life.

The remaining bodies, many of which had been placed in the hospital chapel, were those who died in the four days between Katrina's arrival and the evacuation of the last patients.

So many patients died that the hospital ran out of body bags, instead having to cover bodies in sheets. Officials converted the chapel into a makeshift morgue, and when it was full, the deceased were left with identification in patient rooms, Kokemor said.

This is not an easy case to judge. I have asked myself this question numerous times while reading this story, "would I want my mom to suffer in those conditions or would it be better for someone to help her to pass on?"

No simple answers in this case, it's a no win situation.

Peace,

Marty

:joker:

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