I agree with the last poster…this seems like a case of non-consensual euthanasia. Pou may have thought she was doing the right thing, but there is no evidence that the patients involved gave consent, no evidence that their condition was terminal, no evidence that there was no other choice. That could only be proved when the grand jury was given all the pertinent facts in front of them, and that apparently did not happen. The sad thing is that I’m sure Dr. Pou is a very good doctor and tries to be a good person, but this cloud will hang over her forever — and she’s not out of the woods as far as civil charges.

And as for you exceptionally nasty people casting blame on the patients’ families for abandoning them, in at least two cases – Elaine Nelson, and Wilda Faye Sims-McManus – their daughters remained at their side throughout Katrina until the police came in and forcibly removed “non essential personnel” and all others. You should be ashamed of your vile accusations against these people who have already suffered such a loss.

This absolutely should have gone to trial. If these people had asked for assisted suicide, if their condition had gone down, if the situation was so dire that there was no chance of evacuation, then a trial could bring exoneration. That’s why we have courts, laws, the Hippocratic Oath. You don’t get to decide that because you had one horrendous emergency, because you were there and I was not, that your choices are above my scrutiny and that of the law! Talk about a God complex.

Otherwise, the question remains: how do we KNOW that there was no way these people could have been evacuated? how do we KNOW they would have died anyways? how do we KNOW these people were not murdered without knowledge of what was about to happen to them? how was this decision made and who takes responsibility? Ask yourself: are we absolutely sure there was no way to get them out? Since I also lived through Rita, claiming that you were there and others who weren’t there can’t judge you – sorry, again – that doesn’t mean you escape legal and moral scrutiny.

As someone who has been a patient and in health care and emergency management, I am shocked by the cavalier assumption that there was no other choice. If it were me, my Aunt Ida or any other person, it would ALWAYS be more moral to pick the CHANCE of a person possibly dying during evacuation than the CERTAINTY of deciding to end their life for them — particularly without the patient’s permission or knowledge.

The men and women of the Grand Jury deserve the respect of the citizens of Orleans Parish, State of Louisiana Attorney Charles Foti.

I confess. I am not a native of Louisiana. However, I am both a retired member of both the medical profession and the Criminal Justice system (another state, not Louisiana). I have therefore looked objectively at both sides of the argument. I do not personally know the doctor, either of the nurses, the prosecutor, nor any of the other principals in the case. I read many comments as to the doctor’s credentials A copy of Dr. Pou’s medical biography is available on-line and the following is a synopsis from the source: LSU Health Sciences Center

Dr. Pou, a native of New Orleans, received her medical degree from Louisiana State University School of Medicine. She subsequently completed 2 years of General Surgery training at the University of Tennessee, a residency in Otolaryngology at the University of Pittsburgh Medical Center and a Fellowship in Head and Neck Surgery and Microvascular Reconstruction at Methodist Hospital of Indiana.

Dr. Pou served on the faculty in the Department of Otolaryngology at the University of Texas Medical Branch in Galveston for 7 where she was the Director, Division of Head and Neck Surgery from 1999 to 2004 and the Co-Director of the Fellowship in Advanced Head and Neck Oncologic Surgery from 1998 to 1999. She joined our faculty in September, 2004 and has recently become the Director, Resident Education.

Dr. Pou is a diplomat of the American Board of Otolaryngology, a Fellow of the American College of Surgeons and a member of the American Head and Neck Society and the Society of University Otolaryngologists. She has served on multiple committees of the American Academy of Otolaryngology and has presented at national and international meetings on the topics of laryngology, head and neck oncology and microvascular reconstruction. Dr Pou has authored more than 40 publications and has served on editorial boards including the Laryngoscope. In addition she is co-editor of the Head and Neck Section of the widely read textbook, Head and Neck Surgery-Otolaryngology.

Dr. Pou’s areas of clinical interests include head and neck oncology, microvascular reconstruction, thyroid surgery and rehabilitation of the head and neck cancer patient. Dr. Pou’s research interests also include quality of life issues following treatment for head and neck cancer, the role of viruses in head and neck cancer and the clinical expression of Human Papilloma Virus in recurrent respiratory papillomatosis.

As a resident of Louisiana by necessity, and not by choice, I would like to just make the following observations.

First, as a retired medical professional who faced the daunting task of triage-(defined as a process for sorting sick and injured people into groups based on their need for, or likely benefit from, immediate medical treatment. Triage is used in hospital emergency rooms, on battlefields, and in disaster situations when limited medical resources must be allocated.)I can assure those who might feel that the doctors and nurses who make the triage decisions easily and without thought towards the patients, this is not the case. You never want to be the person who decides which sick or injured person must fall into the expendable category, but must because your obligation mandates you to make that decision. I challenge every person who has made uninformed accusations towards the medical professionals who had to make those challenging decisions in the days surrounding Hurricane Katrina to place yourself in the shoes of the person who did. Consider the psychological impact this would have on anyone who has dedicated his or herself to caring for the sick and injured. Secondly, understand that when this patient is placed into your care, even though they have been designated as those who will be left behind and as those who have the least chance of survival in the given situation, each person must be treated with respect, dignity and compassion. They must not be allowed to endure suffering when there is a means to diminish pain and discomfort. This means that the medication available cannot be withheld although that very same medication may increase the patient’s chances of death. To withhold a medication that will reduce pain and suffering in order to prolong life is in direct violation of the very oaths we take and would, in fact, be a punishable offense as a crime of negligence. It is truly a catch twenty-two for any medical professional placed in the situation–face being accused of murder, mercy killing, or euthanasia or face the charge of negligence, or nonfeasance (the failure or omission to do something that should be done or something that one is under a duty or obligation to do.)

As a former member of the Criminal Justice system, I feel it is imperative that any alleged crime must be investigated. In this case the Attorney General of Louisiana, Charles Foti, a former Orleans Parish Sheriff,New Orleans physician and two nurses were charged with homicide (specifically second degree murder). It should be brought to the attention of everyone what the definition of the charge is, as defined by the State of Louisiana Criminal Code:

Louisiana Code> Title 14 – Criminal law> RS 14:29 — Homicide

§29. Homicide

Homicide is the killing of a human being by the act, procurement, or culpable omission of another. Criminal homicide is of five grades:

(1) First degree murder.

(2) Second degree murder.

(3) Manslaughter.

(4) Negligent homicide.

(5) Vehicular homicide.

Amended by Acts 1973, No. 110, §1; Acts 1978, No. 393, §1; Acts 1983, No. 635, §1.

Second degree murder is further defined in the code as:

§30.1.A. Second degree murder is the killing of a human being:

(1) When the offender has a specific intent to kill or to inflict great bodily harm; or

(2)(a) When the offender is engaged in the perpetration or attempted perpetration of aggravated rape, forcible rape, aggravated arson, aggravated burglary, aggravated kidnapping, second degree kidnapping, aggravated escape, assault by drive-by shooting, armed robbery, first degree robbery, second degree robbery, simple robbery, cruelty to juveniles, second degree cruelty to juveniles, or terrorism, even though he has no intent to kill or to inflict great bodily harm.

(b) When the offender is engaged in the perpetration of cruelty to juveniles, even though he has no intent to kill or to inflict great bodily harm.

(3) When the offender unlawfully distributes or dispenses a controlled dangerous substance listed in Schedules I or II of the Uniform Controlled Dangerous Substances Law* which is the direct cause of the death of the recipient who ingested or consumed the controlled dangerous substance.

(4) When the offender unlawfully distributes or dispenses a controlled dangerous substance listed in Schedules I or II of the Uniform Controlled Dangerous Substances Law* to another who subsequently distributes or dispenses such controlled dangerous substance which is the direct cause of the death of the person who ingested or consumed the controlled dangerous substance.

B. Whoever commits the crime of second degree murder shall be punished by life imprisonment at hard labor without benefit of parole, probation, or suspension of sentence.

Added by Acts 1973, No. 111, §1. Amended by Acts 1975, No. 380, §1; Acts 1976, No. 657, §2; Acts 1977, No. 121, §1; Acts 1978, No. 796, §1; Acts 1979, No. 74, §1, eff. June 29, 1979; Acts 1987, No. 465, §1; Acts 1987, No. 653, §1; Acts 1993, No. 496, §1; Acts 1997, No. 563, §1; Acts 1997, No. 899, §1; Acts 2006, No. 53, §1.
*NOTE: R.S. 40:961 et seq.

From the information that has been made available through the media it is impossible to say these women committed murder. I have noted several articles which “quote” persons who are “quoting” what they overheard in conversations about what medications would be given patients as Morphine and Ativan, when in fact the AG charges it was Morphine and Versed. So it goes to show that unless you were a juror listening to the testimonies and evidence supplied by the DA and AG’s offices, none of us have any basis on which to pass judgement. I would hope each one of us would stop and consider this the next time we discuss this subject.

“The medical screening of patients to determine their relative priority for treatment”

Medical personnel must look at resources in any situation, and make essential decisions as to whom to treat and whom NOT to treat. The NOT TREATABLE patients are not likely to survive and would consume all of the resources needed for those who COULD survive.

Dr. Pou’s ICU patients were ventilator dependent, unable to survive without machinery, medications, IV fluids, and constant attention. Dr. Pou and her team were in the middle of what must have seemed like Armageddon. The streets were flooded from a hurricane and broken levees, electricity was down, there was complete chaos outside, and it was deathly hot. She probably had very limited staff, too limited to run an ICU, which requires a lot of staff to run properly, including nurses, MDs, respiratory and xray techs, and assistants. She had to make decisions based on what resources she did have, and this meant that the patients consuming scarce resources had to be given up on to save others.

The average person, sitting in his or her armchair with CNN on TV anywhere else in America, had the simple luxury of information; Dr. Pou did not have even this. She did not know if or when this would end, when help would arrive, or how long her staff and supplies would hold out. She was in the middle of a major disaster, and the principles of TRIAGE certainly applied there, as it would for any front-line military offensive. Some patients were not save-able in order that others could be save-able, or that even the staff could be saved. Period.

This probably scares the daylights out of most grain-fed, peace-spoiled, armchair-watching American individuals, but there are situations in which any life, from the homeless to the President, should be expended for the good of others. You cannot simultaneously state that physicians should not play God, and that physicians should do every single thing to save every single patient. If physicians are not God, which we are not, then we acknowledge the fact that we cannot save every life, there are limitations put upon us by our existence in this world.

During disasters, the flow of patients into a hospital can temporarily exceed its carrying capacity. Doctors will treat patients who will likely live if treated but die if untreated, setting aside those without life-threatening injuries and those who will likely die despite treatment. This last group — “expectant” patients, commonly identified with black tags — will not be abandoned. They may receive ongoing comfort care and, later on, reassessment, especially if they unexpectedly survive the period of scarcity.

But during, for example, forced military retreats (and, perhaps, massive civilian disasters) health care professionals and their patients can be compelled to evacuate. Should it prove impossible to relocate black-tagged patients, physicians will have only three choices. (1) They can, at personal risk, stay behind with these doomed individuals. There may be little or nothing that can be medically done for them and, by abandoning other treatable patients, health care professionals may be violating obligations toward them. Or (2), they can abandon the black-tagged patients, leaving them to die unmedicated and unattended or, during forced military retreats, in the hands of the enemy. This would violate legal and ethical obligations toward those patients. Or (3), they can beneficently kill expectant patients who cannot be evacuated. Competent patients could opt for abandonment, but those incapable of giving and withholding consent would receive nonvoluntary euthanasia.

There are two weighty medical norms at issue here: the prohibition against killing patients and the prohibition against abandoning them Where it is impossible to evacuate patients and dangerous and medically futile to remain with them, one of the two norms must give way.

Even though the problem is common enough to have been noted in military medicine, I am unaware of any authoritative ethical or legal norms that directly address this issue. While, for example, the AMA Code prohibits both abandonment and euthanasia, it is silent on which norm gives way when the two conflict.

Given this tragic uncertainty, it would seem both compassionate and reasonable to refrain from condemning those who have tried to render honorable assistance under these rare but appalling circumstances, even though they deliberately end the lives of patients.

Again, I am neither asserting nor conjecturing anything about what was done in New Orleans. As I said, I don’t know.

Has anyone set up a responsible escrow to defend these poor people from the attack of the politicians out for political blood? if not their attorneys should see to it.

Niteowl