By Thaddeus M. Baklinski
A doctor has admitted that he gave orders for a lethal dose of medication to be administered to a patient under his care during the hurricane Katrina disaster in 2005 - a decision that he says he does not regret having made.
Dr. Ewing Cook said that as staff at Memorial Medical Center in New Orleans were struggling to evacuate patients from the flooded building, he gave the order to give Jannie Burgess, 79, who was dying of uterine cancer and kidney failure, a dose of morphine that he knew would kill her.
"Do you mind just increasing the morphine and giving her enough until she goes?" Cook said he asked the patient's nurse, and then wrote "Pronounced dead at" on the patient's chart and left it blank to be filled in later.
Cook described the "double effect" of morphine, which is frequently used to control severe pain or discomfort but can also slow breathing and, if suddenly introduced in much higher doses, lead to death.
"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 said.
"To me, it was a no-brainer, and to this day I don't feel bad about what I did," Cook told ProPublica, an independent nonprofit investigative organization.
"There's no question I hastened her demise," he said. "I gave her medicine so I could get rid of her faster, get the nurses off the floor."
Cook also described another area of the hospital that was crowded with patients on cots and stretchers where he considered euthanizing the ones that had "do not resuscitate (DNR)" on their charts. "We didn't do it because we had too many witnesses," he told ProPublica. "That's the honest-to-God truth."
Louisiana Attorney General Buddy Caldwell told AP he would not reopen an investigation launched by his predecessor, Charles Foti, because of the disclosures by Dr. Cook.
In that investigation another doctor and two nurses were arrested on charges of second-degree homicide, but a Grand Jury declined to indict them.
Dr. Anna Pou, a surgeon who specializes in working with cancer patients, and nurses Cheri Landry and Lori Budo, who had admitted to administering lethal doses of medication to patients during the aftermath of hurricane Katrina, were offered immunity from prosecution by Attorney General Foti, before testifying to a Grand Jury that four patients died after being administered what Foti called a "lethal cocktail" of drugs.
Dr. Pou denied the charges, insisting that she did not support euthanasia and claimed to have given only comfort care for the patients.
However, court documents asserted that witnesses had testified that Dr. Pou and the two nurses took syringes full of drugs to a ward for the chronically-ill and injected four patients. Thirty-four patients died in Memorial Medical Center following the Katrina disaster, more than in any comparable-sized hospital in the drowned city.
A coroner's report stated that more than half of the bodies taken from Memorial tested positive for morphine or midazolam, or both. Robert Middleberg, the director of the toxicology laboratory where the autopsy samples were tested, said the high drug concentrations found in many of the patients stuck out "like a sore thumb."
The ProPublica report cites University of Pennsylvania bioethicist Arthur Caplan, who, after reviewing the records of the patients who died and the coroner's report, concluded that nine patients were euthanized, and that the way the drugs were given was "not consistent with the ethical standards of palliative care that prevail in the United States." Those standards are clear, Caplan wrote, in that the death of a patient cannot be the goal of a doctor's treatment.
The complete investigative article from ProPublica is available here.
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