Dr. Anna Pou, Hurricane Katrina, and euthanasia

I’m an oncology nurse who has particiapted in numerous cases of “terminal sedation”. No one in health care takes these situations lightly. It is an incredible burden to dial up the morphine and ativan in patients when all treatment options have been exhausted, but we accept the task and willingly do our best to mitigate suffering. The time has come for our profession to stop hiding from the right to life contingency and open a dialogue on end of life care. These health care professionals deserve the full support of the medical and nursing communities, we must not let them stand alone.

I would like to know where AG Foti was during Katrina? He must have high tailed it out of town in his European SUV prior to land fall. Ironic, isn’t it? NO & the state of LA should be absolutely ashamed of itself. Where was the AG’s office to help all of the care givers who stayed behind, leaving their own families, to care for others, with complete selflessness. Even if Dr. Pou and the two nurses did assist, their actions were completely humane. The inhumanity can be found in AG Foti.

To the brilliant philosopher *insert sarcasm* above who equates the situation of these health care providers to the callousness of the Mt. Everest climbers (negligence by those on an ego trip in the first place), your logic is fascinatingly weird.

Pallative administration of painkillers can and do suppress respirations to the point of death. Maybe instead of “rationalizing”, these caregivers (who were by the way, actually there …did stop, risked their lives, weren’t on a dick trip mountain climb) were acutally treating pain??? In 100+ degree weather with no clean water for days, non-functioning equipment, useless refrigerated meds …maybe, just maybe, these four patients actually were in pain? If so, to treat it was/is not only legal, it’s required by JCAHO.

I attended high school and college with Dr. Anna Pou (she was known as Anna Maria at that time). Dr. Pou was an outstanding student and a kind and compassionate person to everyone. Over the years, I’ve read of Dr. Pou’s outstanding accomplishments in the field of medicine. She is continuing to provide incredible care and is a wonderful humanitarian. Foti will be proven wrong in his assertions.

Mt Everest…it is unimaginable that hikers could pass the dying British climber for two days without stopping to help him get off the mountain. Can you imagine doctors hiking past an injured person on the trailside for two days and not stopping to help and making no effort to relieve his pain or get him off the trail? Are doctors on an ego trip when they help others? Should Dr Pou have left the hospital with sick patients lying in beds and unable to help themselves?? Should she have left the patients to die in a hospital with no refrigerated meds, no ac, and in a building that was now no longer a hospital with lifegiving equipment? This was now a brick building with sick people that were going to die except for heroic efforts of caregivers who stayed to help. The hospital had become a no man’s zone, with inhumane conditions similiar to Mt. Everest. Should she have left them to die alone in these conditions????

As a care-giver for dementia patients and the terminally ill, I have thought about what I would want for one of my cases if they were in the hospital during such a tragic situation. Death with Dignity is NOT murder, and it does seems from what I’ve read that this was an act of compassion, not neglect or abuse of power. I hope the system can view the situation with as much objectivity as possible, and not condemn doctors to the same fate as armed robbers or random killers.

I have not taken the time to read these 70 comments so if I am repeating then I’am sorry.

I don’t understand how anyone can condemn this woman or thos enurses when we don’t have anything close to the full story. But, we do know that it was a terrible mess there during Katrina.

If they are going to arrest and accuse these 3 women fo murder then I want to know whay someone isn’t arrested for all the people who died in that dome. I don’t care if it is local govt. or FEMA. Someone needs to take responsibility for those deaths. This is someones sick way of taking attention off the many healthy people who were forced to die. “Lets arrest a doctor who was working her ass off, I bet that will get alot of publicity.”

It’s really unnerving to see how many healthcare professionals have granted themselves the right to kill when they are upset.

Anon at 2:28. When listing different groups of posters and how they react you are forgetting non-providers like me who support this doctor and nurses for providing what they would’ve wanted for themselves had they been patients.

Would you have preferred the doctor and nurses leaving them alone without food or water or any relief? What was the right thing to do in your opinion? What you would’ve done in a similar situation? Left them to die? Stayed and died with them even though there was nothing you could do to help?

I also noticed that people who have been in extreme situations – like a Vietnam veteran above – are a little more understanding of these doctor and nurses then those who’ve never been in an extreme situation and haven’t even experienced hunger.

You mention ‘incompetency’ – what incompetency? Would you care to show an incompetent decision in this case given that they had no power, limited supplies and not enough food or water?

Diora:

This is anon 2:28

“Anon at 2:28. When listing different groups of posters and how they react you are forgetting non-providers like me who support this doctor and nurses for providing what they would’ve wanted for themselves had they been patients.”

It is irrelevent what you would have wanted for yourself when it comes to the context of evaluating the legality and/or competency of the providers in this specific case. Empathy and sympathy are not replacements for the rule of law.

“Would you have preferred the doctor and nurses leaving them alone without food or water or any relief? What was the right thing to do in your opinion? What you would’ve done in a similar situation? Left them to die? Stayed and died with them even though there was nothing you could do to help?”

What I would prefer is that the allopathic medical system be treated and reorganized to follow the police and fire protection model. That would put an end to the “give us special privileges or else we will abandon our patients” nonsense that we have been hearing (not just this case but also the case with special legal protections governing professional liability). Relying on the “charity” of those who are “being killed” or “forced out of practice” for only making 100K per year is kind of like letting Enron set the national energy policy. The right thing to do in this case, given the existing system, was to provide competent care within the course and scope of the situation present. If the deaths of these patients were unavoidable, then clear the names of the people involved and let them return to their positions. If, however, the deaths were due to involuntary euthenasia in order to take the patients out of the providers’ misery, then they should be charged and prosecuted to the fullest extent of the law. Gallant egalitarianism is no excuse for murder, manslaughter or incompetence.

“I also noticed that people who have been in extreme situations – like a Vietnam veteran above – are a little more understanding of these doctor and nurses then those who’ve never been in an extreme situation and haven’t even experienced hunger.”

Show me the legal statute that provides for involuntary euthenasia (assuming it happened) under the conditions at the time and I would agree that the providers should not be charged.

“You mention ‘incompetency’ – what incompetency? Would you care to show an incompetent decision in this case given that they had no power, limited supplies and not enough food or water?”

We have a number of options here. The patients died from something that was outside of what the providers did or could do under the conditions present. If such turns out to be the case – great. The patients died because the providers volitionally euthanized them – not great. The patients died because the providers used excessive opiate based medication – not great. The providers are purportedly the paragons of knowledge regarding the care of their charges. Unless the desired action was the death of these patients (with the other option perhaps being easing their suffering) than the results achieved are indicative of an incompetent conduction of action.

Any doc who goes out of their way to alleviate the pain and suffering of these litigious assholes deserves to be raped by the media and medical boards and lawyers…I ain’t going to lose any sleep over that stupid wench…

My regrets. That should have read “stand up and shut up”.

What is the proper way to submit some kind of petition in support of Dr. Pou and these nurses?

I am a patient of Doc Pou and I have surgery scheduled for tommoro. I wish she were with the ENT Team and resident Dr. Tenney whom I also think highly of.

Dr. Pou, Nurses Budo and Landry should be vindicated of these charges, as Louisian will suffer much into the future from this. LB

anon 2:28 you appear to be a doctor hater. you seem to think that all doctors think they are godlike. do you feel inferior? are you educated? i notice that you use big words. i am not in the medical world. yet, i cannot condemm dr. pou for euthanizing the people who were left behind.

I am a practicing Hospice RN in LA who only last year battled Foti during a Grand Jury investigating my practices in administering standard practice dosages of Morphine to an actively dying Hospice patient who was in severe pain. I was fortunate enough to be able to tell my story to the Grand Jury who found “no true bill”. It was a devastating experience both physically and mentally. My heart and prayers go out to Dr. Pou, Lori Budo, and Cheri Landry. I am currently telling my story to The New York Times in hopes of exposing a trend of half-truths, omissions, and the resulting injustice being practiced by Charles Foti’s office.

Thank you Hospice RN for sharing your experience. Please let us know when the NYT article is published.

To anon 2:28

Physicians aren’t saying “give us special priveleges or we will abandon our patients”.

It is simply a statement of fact that if you get punished for making a sacrifice and for making the best decisions possible in extenuating circumstances…then you will not put yourself in that situation again.

So, no physician will voluntarily put themselves in that position should it ever arise again.

“As a nurse, in that position, I only hope I would have done the same thing.”

If you were to make the decision that you had to actively take action to kill one of my family members without their consent because you were stressed, I would not only make sure that you were charged criminally, I would file a civil suit against you too, and push that fully to a jury.

Unless you are the Messiah and this is the 2nd Coming, but I doubt he’ll post anonymously on blogs.

Dr. Pou has absolutley sterling credentials. You cannot achieve the position that she has achieved without your ethics and your demeanor and your behavior conforming to the generally accepted standards of the medical establishment. Since the medical community in the United States generally does not condone euthenasia let alone murder, it is hard to believe that Dr. Pou believed that what she was doing was either euthenasia or murder. It is also hard to believe that after a lifetime of indoctrination into and compliance with generally accepted medical practice, Dr. Pou would suddenly deviate from common eithical practice.

The motivation for the alleged murder in some of the public commentary has been that the medical staff was not being allowed to evacuate the hospital until after all the patients were either dead or evacuated. Who would have forced the staff to stay against their will caring for patients under such perilous conditions other than their own conscience? I just does not make sense that the medical staff at Memorial who chose to stay during and for four days after the hurricaine under arduous conditions where it was impossible to offer even basic medical care to critically ill patients would choose to kill patients so they could evacuate.

Morphine and Versed were alleged to be the drugs that were improperly administered to these critically ill patients in order to murder them. As many medical people have pointed out in news articles and in the public debate, if your intention is to cause a peaceful death, high doses of barbituates are a much more certain way to do it, perhaps followed by a lethal dose of IV potassium chloride. Barbituates and potassium chloride would have been as readily available in the hospital as morphine and versed.

Generally accepted medical practice in end of life care routinely allows doses of medication that may hasten the death of terminally ill individuals in order to treat their pain and suffering. If Dr. Pou ordered or administered medications in order to alleviate extreme suffering of terminally ill patients and their deaths were consequently hastened because of the medications, she did nothing unethical and certainly nothing illegal under current standards of medical ethics. If possible, a doctor would discuss these types of treatment decisions with the sick person before they were in insufferable pain. If the patient could not make these decisions for themselves, the doctor would discuss them with the guardian or next of kin. If their is no guardian or family, the courts would decide by appointing a guardian. If there is a question about what the right thing to do is, the doctor can present the case to the hospital medical ethics committee (generally made up of medical personel, lawyers, clergy, administraters, and interested members of the community). Dr. Pou did not have these options available to her.

Friends, patients, and collegues of Dr. Pou have written about their personal impressions of her competance and character. This type of evidence is allowed in court, so why not present it also in the court of public opinion.

One of the most distressing parts of the public discussion of this case is that when medical people try to explain medical ethics, standards of care, and what it is like to practice critical care medicine without electricity to run ventilatiors, IV pumps, dialysis machines, without a lab, without the equipment to do continuous monitoring of EKG, pulse ox, and central venous pressure, without total parenteral nutrition, without sterile supplies, the medical people are often accused of closing ranks to protect one of their own, or being vain and arrogant, or playing god.

In fact, the medical profession often holds its own to much higher standard than the public or the law does. The medical profession does not look mercifully on mitigating circumstances such as the lack of resources or the lack of accepted guidelines for dealing with the issues that faced the staff at Memorial. If Dr. Pou administered morphine and versed to patients who were not terminally ill with the sole intention of causing their deaths to make things easier on the medical staff and to allow them to evacuate as has been alleged, then she will be condemned by the medical establishment as well as the law.

I am a physician. Rather than feeling vain or arrogant about my position, I am humbled daily by my lack of knowledge, the limitations of medical treatment, and my impotence in treating patients with uncurable diseases. Rather than feeling like god, and always knowing the right thing to do, I struggle with how to appropriately explain to patients the uncertainties of treatment outcome and prognosis. Knowing what I know about medicine and the culture of the medical profession, it is very difficult to believe the charges against Dr. Pou will be substantiated. It just doesn’t make sense.

I feel sorry for everybody who were there, patients and providers. As George Bush said,
“You never know what your history is going to be like until long after you’re gone.”—Washington, D.C., May 5, 2006.

“The reason physicians are defensive, have rallied for legal reform, etc. is that most all have been wrongly accused, sued, or slandered at some point in their careers.”

Odd, is it not? How physicians who have been “wrongly accused, sued or slandered” have no problems with prostituting themselves when it comes to PI cases and/or criminal defense cases in which they stand to profit. It matters not that these streetwalker physicians, with no ability or training to actually analyze events such as motor vehicle accidents (the event itself) are more than happy to “wrongly accuse” and assist in the “sueing” of some poor shmuck that tapped their dirtbag patient’s car at one or two miles per hour. Brain injury in a one mile an hour impact? Disc herniations in a one mile a hour impact? Post-traumatic fibromyalgia? Sure. We won’t even discuss how many murders, rapists and child killers have been let off the hook because of the “mental illness” testimony of the slick psyhciatrists – the same ones that deem these criminals as being cured only to have these scourges loosed to find fresh victims. If physicians want to whine about junk lawsuits, the first people to blame are their colleagues that more than happily bed the same trial lawyers when it comes time to propose post hoc ergo propter hoc junk science causation testimony.

Perhaps you can make yourself of use by contemplating the flip side of the coin: what options will Dr. Pou have to compensate her for all her losses, economic and noneconomic, if/when she is found innocent?

The same recourse that the rest of us have when it comes to this issue? You aren’t argueing for special treatment for her just because she is a MDiety?

ANNA POU IS NOT A MURDERER.

And how do you know this? If you have some information that the rest of us are not privy to then you should pass it on to her defense attorneys (those horrible lawyer types that only live to suck the blood of the physicians).

She saved the life of my dearest friend in the world.

This isn’t your basis for the contention that she did not intentionally kill those patients? Is it? This country is doomed if this line of thinking is what constitutes logic on the part of the masses.

The same recourse that the rest of us have when it comes to this issue? You aren’t argueing for special treatment for her just because she is a MDiety?

No, I’m not, Your Legal Highness. The point is that existing remedies are inadequate. We need extensive legal reform in this country, starting with abolition of the Lousiana Napoleonic guilt until proven innocent you proffer, followed by loser pays in lawsuits, including damages for pain and suffering, loss of consortium, etc. suffered by the accussed when proven innocent. Your professional organization, the American Trial Lawyers Association, is so poorly perceived that it voted to enact a deceitful and patently fraudulent name change to American Association for Justice. A cesspool by any other name would smell so foul.

“Your professional organization, the American Trial Lawyers Association, is so poorly perceived that it voted to enact a deceitful and patently fraudulent name change to American Association for Justice.”

You’re right – they should have been smarter lobbyists and started with something that masks their sinister intentions. Like “Common Good” for example.

“Odd, is it not? How physicians who have been “wrongly accused, sued or slandered” have no problems with prostituting themselves when it comes to PI cases and/or criminal defense cases in which they stand to profit. It matters not that these streetwalker physicians, with no ability or training to actually analyze events such as motor vehicle accidents (the event itself) are more than happy to “wrongly accuse” and assist in the “sueing” of some poor shmuck that tapped their dirtbag patient’s car at one or two miles per hour. Brain injury in a one mile an hour impact? Disc herniations in a one mile a hour impact? Post-traumatic fibromyalgia? Sure. We won’t even discuss how many murders, rapists and child killers have been let off the hook because of the “mental illness” testimony of the slick psyhciatrists – the same ones that deem these criminals as being cured only to have these scourges loosed to find fresh victims.”

Ths “poor schmuck” you refer to has been my spouse in this regard. Although the fender-bender did not warrant as much as a citation from the responding officer, the NON-M.D. backquacker cum ambulance chaser’s footboy who irradiated various bones and organs of the plaintiff managed to ring up a large bill and spurious diagnoses ad nauseum. This is how a large population of pseudo-health professionals and legal hyenas thrive. The buck is passed from the insurance company, which is hence recompensed from our collective pockets. Regarding sentence #2, physicians who prostitute themselves, a despicable minority, may do so due to the ability of the attorney to better remunerate than the health care system. They have no trouble turning on other physicians. One or more will surely be hired in any civil actions filed. Many of these hired guns are, in fact, no longer practicing the area of acknowledged expertise. They are primarily hired by the plantiff’s attorney due to the perception that gray hair and years of experience will play well to a jury naive of the subject at hand. The truth is that many a legal proceding is little more than theater of the absurd. Jury trials are not about seeking truth and justice, but persuading a group of people largely naive of whatever subject is at hand to vote a certain way within a framework of rules interpreted by a judge who may not be impartial. Far more murderers are on the street as a result of highly compensated, egotistical defense attorneys who do the wrong thing “because they can” and are well paid to do so. They are the ones who pay for the hired guns. The flip side of the murderers on the street are the innocents locked up or worse for lack of adequate legal representation.