News Roundup

New Orleans doctor is charged with giving lethal injections during floods

BMJ 2006; 333 doi: (Published 27 July 2006) Cite this as: BMJ 2006;333:218

Florida Fred Charatan

A doctor and two nurses were arrested on 18 July and charged with giving four patients, aged 62 to 91, lethal injections of sedatives during the flooding of New Orleans last year.

The patients were in the long term care facility on the seventh floor of Memorial Medical Center, which had been cut off by flooding and was surrounded by nearly two metres of water, after hurricane Katrina hit New Orleans on 29 August 2005. The hospital was left without electric power, supplies, or functioning lifts. The temperature inside the hospital had risen to more than 38°C.

The doctor, an otorhinolaryngologist who volunteered her services at the hospital, told the Baton Rouge television station WBRZ in December 2005 that some patients had “do not resuscitate” (DNR) orders. The staff had to decide whether critically ill patients would survive the arduous evacuation through the environment of looting and anarchy that prevailed in New Orleans at the time.

A state affidavit said that the doctor made up a list of the sickest patients remaining in the hospital three days after the storm. The affidavit, which was released by the office of Louisiana's state attorney general, Charles Foti, said that a decision had been made to administer lethal doses to those patients whose cases were deemed to be terminal.

Although the doctor and two nurses were not formally charged with a crime, their arrest warrant says that the three committed second degree murder, a crime that could result in a life sentence.

Court papers say that tissue samples taken from the dead patients at the hospital tested positive for morphine and midazolam, a benzodiazepine derivative, and that the amount of midazolam present was found to be higher than the usual treatment dose of less than 2.5 mg intravenously in a normal healthy adult. Medical records reviewed by investigators also showed that none of the four patients was taking either of the two drugs as part of their routine care.

Mr Foti plans to turn the information collected by his office over to the New Orleans district attorney, who will decide whether to ask a grand jury for a formal indictment.

Steven Miles, a professor of medicine at the University of Minnesota's Center for Bioethics, said that instead of trying to kill it was more likely that the people charged were trying to relieve the patients' pain “in a resource poor environment and were doing the best they could.”

Arthur Caplan, professor of bioethics and director of the Center for Bioethics at the University of Pennsylvania, said, “You've got, at best, mercy and panic, but that doesn't add up to an excusable homicide.”

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