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Tuesday, September 01, 2009

A very sobering but thought-provoking article on medical ethics and disasters

Strained by Katrina, a Hospital Faced Deadly Choices

The smell of death was overpowering the moment a relief worker cracked open one of the hospital chapel’s wooden doors. Inside, more than a dozen bodies lay motionless on low cots and on the ground, shrouded in white sheets. Here, a wisp of gray hair peeked out. There, a knee was flung akimbo. A pallid hand reached across a blue gown.

Within days, the grisly tableau became the focus of an investigation into what happened when the floodwaters of Hurricane Katrina marooned Memorial Medical Center in Uptown New Orleans. The hurricane knocked out power and running water and sent the temperatures inside above 100 degrees. Still, investigators were surprised at the number of bodies in the makeshift morgue and were stunned when health care workers charged that a well-regarded doctor and two respected nurses had hastened the deaths of some patients by injecting them with lethal doses of drugs. Mortuary workers eventually carried 45 corpses from Memorial, more than from any comparable-size hospital in the drowned city.


At some point in the aftermath of Katrina, a decision was made at Memorial to put the patients with 'do not resuscitate' orders dead last in the evacuation. Contrary to most triage schemes, the healthiest were evacuated first, leaving the sickest to linger. Others were thought too big to move (a sobering thought for me, I might add, given my weight, that being fat could doom you). And quite a few patients were 'made comfortable' with injections of medicines whose combined effects made them calmly die. A doctor and two nurses were charged, but the case never got beyond a grand jury. The writer, however, has access to interviews and records that were not made public to those juries, and the story of Memorial, its conditions, the mentality of desperation, and the chilling decisions made is really quite compelling. It's a long article, but well worth a read.

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