15/09/2005

Triage and Culpability in the wake of Katrina

Imagine being a doctor who works hard to assist her patients as they lay dying from cancer. She is someone who has tried to always do what is right and understands that before God she will be held accountable for her actions. This is how one doctor from New Orleans has presented herself to the world as she told the harrowing story of having to make triage decisions that put many of her patients to death in the aftermath of hurricane Katrina. The doctor's story has been verified by some other witnesses who saw what happened. The patients had to be evacuated and the medical staff claimed that they were concerned about whether or not the patients would survive the evacuation. As a result, on the spot decisions were made concerning the level of morphine given to these patients so that they ended up dead.

This story throws a shadow on the ethics of the medical profession in the USA, and especially New Orleans. The doctor who has spoken under anonymity, appears to have been very upset over being forced to make such life and death decisions. Her statement concerning the fact that she has prayed to God for mercy and understanding is an indication that she had strong feelings about those decisions and especially the ethics of such decision-making.

It is difficult to form an opinion regarding the kind of ethics that were applied in this situation. Hurricane Katrina was a category 4 and that meant that the severity of the storm was extreme. It is doubtful that these particular patients would have survived the storm, and it is probable that their particular suffering would have been heightened if they had to go through the stress of Katrina. The doctor did in fact flee the hospital when the armed looters arrived on the scene.  Even if there was no breach of medical ethics in this situation, one cannot come to the same conclusion on the matter of ethics of the owners of St. Rita's nursing home.

The staff at the hospitals and nursing homes were given adequate warning and time to evacuate their patients. The majority of patients were evacuated without incident. However, when the rescuers arrived at St. Rita's Nursing Home they discovered 34 bodies - patients who had died as a result of Hurricane Katrina. What went wrong? Why did this happen? The patients should have been removed to safety. Well, the answer is quite simple. The owners of the Nursing Home refused to evacuate the patients and they refused the offers of help for their patients. They have been charged with the negligent manslaughter of their patients.

Another 40 bodies have been discovered at one of the New Orleans hospitals. This raises the question as to whether these bodies belong to the people who were put to death by the hospital staff or whether there has been another act of negligence over which the staff at the hospital are culpable. Then there is the case of the obese man who was put to death because the staff considered him to be too fat to evacuate. The doctor in charge of the evacuation used that rather trite phrase of "let him go home to Jesus". Has this doctor acted ethically by making that decision?

There are many questions that need to be raised about how the state of Louisana, and in particular the officials of New Orleans, handled the pre-hurricane scenario. From everything that I have read so far, including the histrionics of the left-wing moonbats, and the more conservative within politics, the person most responsible for what went wrong is the mayor of New Orleans. He made a series of bad decisions, including the refusal of an offer to move people out of New Orleans prior to Katrina touching down. That offer was made by Amtrak and there would have been no cost to the citizens of New Orleans since the train had come to move heavy equipment out of the area and there were plenty of free carriages available for the use of the evacuees. The officials of New Orleans have a lot of explaining to do about why they had not used the school buses to pick up those poor people who were left trapped as the flood waters were rising, and taken them to the Amtrak terminal where they could have been placed upon that train and taken to safety.

Why did the officials in New Orleans turn back the supplies that were being brought in by the Red Cross? Why did FEMA and the officials of New Orleans underestimate the amount of food and water that was required by those who were trapped in the Superdome? What happened to the medical supplies? Why is it that new mothers were not taken to somewhere that was a lot safer than the Superdome prior to Katrina hitting? How many of these new mothers ended up with infections as a result of the situation they were forced to endure?

As I find out more about what has happened in the wake of Katrina I will blog on the issue, hopefully with a focus on the ethics or lack of ethics that prevailed in the two weeks since Katrina touched down and caused so much havoc.

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