mercy killings at La. hospital

Officials investigate reports of mercy killings at La. hospital
By Jennifer Latson and Mark Washburn, Knight Ridder Newspapers Thu Oct 13, 7:25 PM ET
NEW ORLEANS - Louisiana's attorney general is probing allegations that patients at the city's Memorial Hospital were put out of their misery by mercy killings in the desperate days after Hurricane Katrina.

"There have been reports that doctors have been going around injecting people," Frank Minyard, Orleans Parish coroner, said Thursday.
Minyard said that as part of the investigation, his office has autopsied at least 45 bodies taken from the hospital.
It's part of a broader inquiry into the practices of 13 nursing homes and six hospitals where patients died during and after Katrina - some because of mistreatment or neglect, family members have alleged.
New Orleans internist Dr. John Kokemor was treating patients in Memorial when floodwaters rose around the hospital the day after the hurricane, the power cut out and the temperature inside soared above 100 degrees.
Patients were suffering and doctors were panicking, but Kokemor saw no sign of euthanasia.
"There was a lot of suffering going on. It was obviously hard on the caregivers," said Kokemor, 53, a physician with a private practice in New Orleans. "But I didn't see any syringes passed around. If people received anything, it was comfort measures."
Some patients were already near death, and some had "do not resuscitate" orders. They may have been the ones who died, Kokemor said.
The investigation at Memorial, first reported by CNN, stemmed from complaints from relatives and others who had heard rumors of mercy killings, authorities said.
Among the dead taken from Memorial were 11 bodies that had been in the morgue before the storm, three people who died in the storm and were brought to the hospital, one body sent by another hospital for safekeeping and 24 bodies of frail patients in a Lifecare unit operated independently from the hospital, according to a hospital official.
Two days after the storm, rising floodwaters shorted out the hospital's generators and batteries, shutting down critical support equipment such as ventilators and dialysis machines, said Steven Campanini, a spokesman for Dallas-based Tenet, which owns Memorial and four other New Orleans hospitals.
"There is only so much a health care provider could do under such extraordinary circumstances," Campanini said.
The company hasn't been able to substantiate any reports that euthanasia was discussed among the staff of the sprawling medical center in the two hectic days after Katrina.
"I don't know how widespread these kinds of discussions could be going on with 2,000 people focused on evacuation," Campanini said.
Ethically, even in an extreme crisis like the one facing the hospital staff, resorting to mercy killings would be out of bounds morally and legally, said Robert Veatch, a professor of medical ethics at the Kennedy Institute of Ethics at Georgetown University.
"There is no formal justification for euthanasia in the technical sense of active intervention to hasten death," he said. "It's illegal and no mainstream medical ethical source would endorse it."
Memorial Hospital is the only medical center under scrutiny for potentially euthanizing patients in the storm's aftermath, authorities say.
Patients from the other hospitals and nursing homes will be autopsied to find out if they "died from neglect or being left behind, from lack of food and water or medication," said Kris Wartelle, spokeswoman for Louisiana Attorney General Charles Foti Jr.
"We'd heard rumors all along," said Wartelle. "We got enough calls from victims' families asking us to look into it that we did."
One of the nursing homes under investigation is St. Rita's, the St. Bernard Parish facility where 34 residents died. The attorney general charged the home's owners with negligent homicide after autopsies showed patients had drowned.
The attorney general's office has received preliminary results of the Memorial Hospital autopsies but wouldn't release the results Thursday.
The investigation will take weeks, Wartelle said.
"It's a pretty monumental case, but we're not ready to say whether it happened or not," she said.
Kokemor believes autopsies will reveal narcotics and sedatives in many of the patients who died at Memorial Hospital, because that's what doctors give people in pain, but not to kill them.
The doctor said he didn't hear any patients ask to be put out of their misery.
Patients can ask that no extraordinary measures be taken to prolong their lives, but doctors can't make that decision for them, even if they'll likely live only a short time longer in extreme pain, Kokemor said.
One patient, a 92-year-old New Orleans man, was bleeding internally during the hurricane's aftermath when physicians were hampered in diagnosing and operating on patients. The man was given six pints of blood in transfusions but wasn't improving.
"He probably had some kind of malignancy or some ulcer in his stomach that was oozing and bleeding," said Kokemor. "All you can do is buy them some time by replacing their blood."
The elderly man had no relatives, lived alone, and had lost his home in the flood.
"Do you want the blood or not?" Kokemor recalled asking the patient.
He did.
"I wrote the order for him to get the blood," Kokemor said. "Whether he got it or not, I don't know."
Lee Hill Kavanaugh of The Kansas City Star contributed to this report. Latson reports for the Olympian in Olympia, Wash., and Washburn for The Charlotte Observer.

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