If you read one article health care-related this week, make it this extraordinary Sheri Fink/NY Times Magazine article on the impossible choices that the heroic doctors — including Dr. Anna Pou — faced at the former Memorial Medical Center in New Orleans in rationing limited medical and evacuation services for their patients during the chaotic aftermath of Hurricane Katrina.
Ms. Fink summarizes the issues raised by the issues that Dr. Pou and her colleagues well:
The story of Memorial Medical Center raises other questions:
Which patients should get a share of limited resources, and who decides?
What does it mean to do the greatest good for the greatest number, and does that end justify all means?
Where is the line between appropriate comfort care and mercy killing?
How, if at all, should doctors and nurses be held accountable for their actions in the most desperate of circumstances, especially when their government fails them?
Interestingly, after the federal, state and local governments largely failed the doctors, other workers and patients at Memorial in the aftermath of Katrina, get a load of how the government forces acted once the decision was made to arrest Dr. Pou:
AT ABOUT 9 P.M. on July 17, 2006 — nearly a year after floodwaters from Katrina swamped Memorial hospital — Pou opened the door of her home to find state and federal agents, clad in body armor and carrying weapons. They told her they had a warrant for her arrest on four counts of principal to second-degree murder.
Pou was wearing rumpled surgical scrubs from several hours of surgery she performed earlier in the day. She knew she was a target of the investigation, but her lawyer thought he had assurance that she could surrender voluntarily. “What about my patients?” she asked reflexively. An agent suggested that Pou call a colleague to take over their care. She was allowed to freshen up and then was read her rights, handcuffed and ultimately driven to the Orleans Parish jail. . . .
Read the entire article. Whose judgment do you trust more? Dr. Pou and her colleagues? Or that of those governmental officials who decided to arrest her?
I read this article on the plane yesterday coming home from NYC and was thinking of your previous postings on the matter. While Dr. Pou claims she was acting in the best interests of the patients, I have great reservations that the law allows individuals to euthanize humans during natural disasters. Emmett Everett was selected for euthanasia simply because his substantial size made him difficult to transport.
As we face the inevitability of nationalized health care, the thought of empowering individuals to “eliminate” those who might consume more than their fair share of valuable resources terrifies me. Once the State decides certain individuals are empowered, with no consideration of due process, to eliminate those deemed to be a “burden” on society, our founding documents are left without meaning.
Charles, excellent point. It’s one thing to have doctors abandoned in war-like conditions attempting to make such difficult decisions. It’s entirely another to have the state granted the authority to make such decisions simply as a matter of “health care policy.”
What I find interesting in this particular matter is that the people spoke and decided not to indict Dr. Pou. I think the members of the grand jury fully understood the facts, were well informed of the relevant statute and fully understood the motivation of Dr. Pou. Personally, I believe she did intentionally cause the deaths of one or more individuals. However, the community spoke and decided not to hold her criminally liable. The civil juries will probably not be as understanding.
The main problem here is that neither Tenet Healthcare nor the state failed to provide necessary resources to evacuate the affected patients. I have often said that New Orleans was the most politically corrupt city in the most politically corrupt state in the nation. The people of New Orleans tolerated the corruption for years. When they needed government in a time of crisis, their government failed them miserably. The people of New Orleans got the state and local government they deserved and wrongly blamed the problems on the federal government.
While Dr. Pou was not held criminally liable, it is wrong to be discussing whether the state may empower individuals to eliminate those who present the greatest burden during a time of crisis. Even more so when the burden was imposed because the state failed in its obligations to the people. Consider the fact that that the reason the state failed was due to institutionalized political corruption and the deaths of the patients at Memorial Medical Center should be an embarrassment to the people of New Orleans and Louisiana for generations.