Perspective -

[kyburg]

A doctor and two nurses who worked through the chaos that followed Hurricane Katrina were arrested overnight, accused of giving four patients stranded at their hospital lethal doses of morphine and sedatives, authorities said Tuesday.

Talk about loaded.

You stayed and did not abandon your patients. Your patients can't be moved, and with resources dwindling, can't be cared for.

They can:

- starve or die of dehydration
- die in septic shock
- suffocate when the vent's shut off when the power finally gives it up
- die of lethal injection

Only one of those is illegal. Which one is kindest?

I plan to write something in my Advanced Directive for this kind of issue. There is no other way - if it is found to be true that this was done. It. Is. Illegal. It was then, it is now - and anyone who does this kind of work knows it.

For the sake of brevity (I've gotten less than eight hours sleep in the last 72) - I'll just point out that the accused are all female; the people making the accusations - and selling the hospital this happened at to another large healthcare conglomerate - are all male.

The pity of all this is that it's likely Ann Coulter will make a joke about this and someone will find it funny. (GAH. Do me a favor - if you're going to make your argument, don't cite Coulter, cite her sources instead...if you can find them viable when you do verify them yourself....)

OH - and if you give a damn about this, follow the story and demand updates until it is resolved one way or the other. I strongly suspect this is one of those that will likely fall by the wayside in favor of other stories. You haven't heard dick about that one convalescent home that left ALL of its patients to drown, haven't you? Why is this important?

This guy says it better than I can.

This tendency leads us to judge victims unworthy of our assistance, and it is fed, not surprisingly, by the media’s presentation of the disaster and its victims. The myopic focus on the sensational – helpless old folks drowning in a rest home, children torn from their mothers’ arms by the flood, the inevitable comparison to third world nations, and the same haunted black faces in desperate need that we have seen in Darfur, while it may initially spur compassion, can, in the long run numb and distance viewers from the victims. The reality of their humanity and suffering is obscured and they are doubly victimized, becoming “refugees”, though they are as American as we, the dry-footed people.

The barrage of pictures and stories about violence, looting, rapists and snipers further erodes emotional ties to victims, raising doubts about their worthiness to receive help, and feeding the stereotype of the poor black as uneducated, ungrateful and unregenerate. Add shots of white officials and response teams, squads of soldiers and law officers holding back the criminals and trying to reason with the unreasonable, and the chasm between we, the givers and they, the takers, yawns ever wider.

Those deemed unworthy are less likely to receive either short or long-term assistance. It is hard to miss the implicit criticism in the questions we have been asking: “Why didn’t they leave when they were told? Why weren’t they insured? Why do they have to be so uncivilized?”

Really. Your only sure thing is to question. And do it from a loving perspective - protect yourself, sure. But don't go in expecting the worst. Go in expecting to find the truth.

Which, incidentally, has the nice benefit of setting you free.

Keep the perspective small and manageable - and as close to one-to-one, what you know yourself - as possible.

Comments

[eyelid.livejournal.com]

It. Is. Illegal. It was then, it is now - and anyone who does this kind of work knows it.

Not necessarily. In fact, giving aggressive pain relief care is widely practiced and is not the same as "lethal injection." As the Supreme Court said:

"The same is true when a doctor provides aggressive palliative care; in some cases, painkilling drugs may hasten a patient's death, but the physician's purpose and intent is, or maybe, only to ease his patient's pain."

[kyburg.livejournal.com]

You give Versed and morphine in high enough concentration - that intentional and so forth.

*shivers* Some medications reduce a patient to a one-to-one ratio in any hospital situation. If they find that kind of medication in play, it's very clear. As short-handed as they were, that kind of drug use was clearly being used off label, so to speak.

What really chaps my hide is that all of the deaths due to the other causes? Eh. *waves hands languidly*

The only one that was illegal was the kindest one. Something VERY wrong with that.

[eyelid.livejournal.com]

I'm wondering how they're going to prove who administered whatever medication. I don't see how they could possibly get sufficient evidence to convict anyone.

[kyburg.livejournal.com]

Hon, you've never worked in a hospital. Everyone is accountable from clock-in, it's a known quantity.

You're on duty, your role is known and charted. Everywhere and then some. Your name is on everything you do, everyone you touch, every thing you give -

[eyelid.livejournal.com]

Everyone is accountable from clock-in, it's a known quantity.


In a NORMAL situation, yes. But this wasn't a normal situation.

[turandot.livejournal.com]

There's affidavits from employees of a hospice care company that was allegedly primarily responsible for care. They claim that the doctors kept them in the dark about the medications used, but told them not to administer any other care.

I smell the culpability game ball being swatted around.

[foogod.livejournal.com]

The only one that was illegal happened to be the kindest one in this case. The fact of the matter is there are very good reasons why that sort of practice is illegal.

The only method of death that was illegal was the one that involved a deliberate choice of one person to end another human being's life. Was it merciful? Yes, in this case, it probably was. But it was still a choice to kill somebody. To be honest, the only reason it was the right choice was because of luck. If they'd administered these injections and then a couple of hours later somebody had managed to get the assistance needed to save these people? Then it wouldn't have been merciful, it would have been arrogant and tragic.

This is the sort of deliberate choice that can't be undone, and contrary to various propaganda, it's always a gamble as to whether it's the right choice or not. The odds may be stacked in your favor, but it's never a sure thing. That's something lots of people don't pay attention to because all we ever hear about are the merciful ones, where it turned out in the end that it was the right choice. We don't hear about the mistakes. Of course, there aren't as many mistakes to hear about, not now, but that's at least partly because it is illegal. Anybody who does this knows they're going to have to take responsibility for it, and makes sure if they decide to do it it's for a case they're willing to put their own wellbeing and future on the line for.

And of course this doesn't even get into the many darker motivations that the laws are also designed to protect against..

I'm not arguing that it should necessarily be kept illegal. I'm not arguing that these people should be convicted and locked up. I'm not arguing that the choice they made wasn't the right one. I'm not saying any of that. I do, however, think it's critical in this discussion to acknowledge that there are good reasons why it is illegal, that the people who made it illegal weren't stupid, or callous, and that the issue isn't nearly as simple as those in favor of euthanasia tend to make it out to be.

[kyburg.livejournal.com]

The guys who do this stuff intentionally? Usually get away with it more than a few times over - they think it over that well. But get caught, they do.

Oh, talk to me about the whole matter of Schedule drugs, and how they're controlled. The whole brainspace involved with it is fascinating.

[n6vfp.livejournal.com]

This is going to be a tragic case of some compassionate individuals being tried for a crime (2nd degree murder) when the real crime was the hospital not having an evacuation plan in place to handle all cases. There were numerous cases of injustice and neglect in Katrina and singling these people out for punishment is not fair. How about charging the executives at Tenet, add to that FEMA, and ultimately George W. himself for not taking responsibility for the actions of his subordinates. Katrina was a crime against humanity, not the storm but the response by agencies that should have been prepared.

[secanth.livejournal.com]

To be honest, I am much more outraged by those patients left to drown in a nursing home than I am what these caregivers *might* have done. Judging from the news reports, one of the patients was 83. At least they gave this patients an easy out, instead of leaving them to suffer. I would wish someone would be as compassionate about MY loved ones.

[moropus.livejournal.com]

I agree with you. My only experience with lingering terminal patients is with my dad who had cancer for many years. Towards the end I would have gladly given him the shot myself and damn the consequences.

[secanth.livejournal.com]

Mom had Alzheimer's, and passed away last year at 93, so I know exactly what you mean. I watched her linger on, and the thought of her in anything like the situation those people found themselves in is enough to give me nightmares.

Okay, I'm done here....

[tomlemos.livejournal.com]

q>I plan to write something in my Advanced Directive for this kind of issue. There is no other way - if it is found to be true that this was done. It. Is. Illegal. It was then, it is now - and anyone who does this kind of work knows it.

Me, if I come down with a terminal illness, I always take heart in the fact that I could move to Oregon and make the decision myself. Heck, if I get old and don't want to carry on, I'm Oregon bound.

[foogod.livejournal.com]

On a side note, I'm personally getting really sick and tired of this stupid harping on the whole "refugees" thing, like it somehow implies they're not Americans, and therefore must be part of some big conspiracy.

Buy a dictionary, people. The people leaving their homes and lives behind from the hurricane are refugees. That's what the word means. That's a perfectly valid way to describe them. What should be being condemned isn't the use of the word, but instead all these stupid people who seem to think that for some reason "refugee" means they must be foreigners, or that whether or not people think they're Americans is more important than what's actually happening to them.

It just shows how self-centered and privileged the speaker is to think that somehow Americans can't be refugees, and that calling somebody a refugee is an insult. Moreover, to hold up the use of this term as an example that people are being treated unfairly is the height of propagandist hypocrisy.

[kyburg.livejournal.com]

I think it has more to do with the re-defining of the terms - consider how heinous being a "liberal" is in some circles these days, and how hard you have to tap dance to get people out of that mindset.

Words matter. We don't teach people how to measure words anymore. Just pass standardized tests that show they know how to spell them and such. Barf.