Louisiana physician-blogger Michael Hebert with his thoughts on the Anna Pou story:
One final question the reader may ask: Do I think Dr. Pou did it?I don’t know Dr. Pou personally, but I do find it difficult to believe that a doctor educated in the United States, knowing the law as all doctors do, would have tried to do something like this. It would have been much easier for her to simply sedate the patients with the aim to relieve pain. She had no obligation to kill them, and, in fact, with sufficient morphine on hand to keep pain at bay, no need to kill them either. She could have managed them to to the point of natural death without having to make such a terrible decision. So on balance, I would have to say probably not.
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{ 12 comments }
There is the well-recognized principle of “double effect”. You provide comfort care to a dying patient, including opiates (morphine) for pain and benzodiazepines (Versed) for anxiety.
Those drugs will provide comfort, but may well hasten death as well.
You give the drugs to the level needed to provide the pain relief and anxiety relief. If death comes a little earlier, it is not considered unethical.
Otherwise, you would not be able to provide any of these drugs to the dying.
The major religions agree on this. Actually, I have not heard of any religion that does NOT agree. Medical ethicists agree.
Absent a video showing her giving massive overdoses, I can’t believe
she was doing anything other than comfort care.
Circling the wagons.
“Circling the wagons.”
More likely the would-be witch-burner igniting himself with his own gas fumes.
Why do doctors find it amazing that other doctors might do bad things? I don’t know if she did or did not, but in general, do physicians believe that merely by being physicians they become fundamentally better people?
I know Dr. Pou professionally, having met her 20 years ago. She is a good person who stay behind when many others left.
As physicians, we all must wonder what we would have done in the same circumstances.
There are no winners here.
“Circling the wagons”
CJD, she was exonerated, remember?
CJD: “circling the wagons”. Really beneath contempt. Besides, the “Indians” have been driven off. The jury found Doctor Pou less indictable than a ham sandwich.
CJD then moves to complete sentences: “Why do doctors find it amazing that other doctors might do bad things? I don’t know if she did or did not, but in general, do physicians believe that merely by being physicians they become fundamentally better people?”
Harold Shipman, Mengele, Herman Mudgett, aka H.H. Holmes (supposedly a Michigan grad, though records lost in a fire as I recall). Che Guevara studied medicine, though he didn’t finish, his degree was sort of a “medic” level so they say. The recent Muslim docs who tried to bomb the UK airport.
No, I think doctors are capable of doing bad things. Sheesh.
No, what you have is a widely-respected doctor. Much like Bruce, EVERYONE who knows her says wonderful things about her.
You’re the one trying to imply that she would do something totally out of character. No motive. She could have simply left the hospital.
I have fellowship training in palliative care and pain management. I built a University pain service from scratch. I think I know something about palliative care in terminal patients.
Given the description of events, the reasonable thing to believe is she provided palliative care to the dying. Whether you care to believe it or not, “double effect” is a well-recognized principle in medical ethics. If you don’t accept the concept, you have to leave dying in pain.
So all the medical issues and personality issues are straightforward. The only thing that would make me change my mind is someone witnessing massive overdoses.
So Dr. Pou and the medical issues are all in character and straightforward, given the conditions she faced.
Let me tell you what else is straightforward. This is not the first time overzealous prosecutors have gone after physicians providing good-faith palliative care to the dying.
Ann Alpers, “Criminal Act or Palliative Care? Prosecutions Involving the Care of the Dying”
Journal of Law, Medicine & Ethics, 26, no. 4 (1998): 308-31.
Oh, and this one: http://www.weitzelcharts.com/
I know a couple of those cases. I know the accused parties. I have interceded in one of the cases, trying to get attention paid to the injustice.
The outcome of some of these tragic prosecutions is to get state law changed, to require the prosecutors to check with the medical board before charging ahead with the prosecution. So the prosecutor would at least have a clue about the medical issues involved.
And, speaking of being in character, New Orleans elected officials would not exactly be spoken of in the glowing terms Dr. Pou gets.
So you have a physician of sterling reputation doing something medically acceptable, and not a shred of witness documentation otherwise. For her to have done otherwise would have been out of character and senseless. She could simply have left the hospital.
You have a New Orleans elected official (Foti) of dodgy reputation, to put it mildly, in a town known for corrupt politicians.
I have seen cases of physicians prosecuted for murder when what was done was good-faith palliative care.
So no, I don’t have any reason to believe what Dr. Pou did was reasonable under the circumstances, and that Foti was in the wrong, and maliciously so. Just like Nifong.
What amazes me is you can’t, or won’t understand it.
“CJD: “circling the wagons”. Really beneath contempt. Besides, the “Indians” have been driven off. The jury found Doctor Pou less indictable than a ham sandwich.”
Not my post, genius.
But I thought you believed all juries were just unthinking morons led around by the nose by one lawyer while the other sat helplessly? Or is that just when they decide against the doctor on evidence you’ve never seen?
CJD
“This is not the first time overzealous prosecutors have gone after physicians providing good-faith palliative care to the dying.”
And what of the healthcare workers who were the basis for taking it to the grand jury? What’s your take on them?
CJD
They were wrong.
- Grand Juror
They (the witnesses) were less believable than a ham sandwich. Genius.
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