[Carrie Anne Weeks]

Five Days at Memorial – Chapter 9 Part 2 Module 13

1. Read an excerpt from the 60 Minutes show referenced in the book. Square this narrative with the book you are reading. Was it fair? Why or why not? http://www.cbsnews.com/news/was-it-murder/

I enjoyed reading what Pou had to say for herself in her own words on the CBS 60 minutes broadcast interview article. Her attorney did a great job setting her up and now I understand how it all came to be and it is a good influence on her case. 60 Minutes displayed Pou as a doctor who was concerned for the well-being of patients. These patients were put into her care at the very last minute when the Life Care doctors never showed up before, during and after the hurricane. She was concerned for the suffering of her patients, and she did not believe in mercy killing or euthanasia. She felt she had done all she could do. During the interview, Morley Safer put Foti in his place by mentioning that there was no help from the governments (federal and state) and the authorities abandoned the staff and patients at Memorial at a horrific time. Foti went to the interview expecting to come out of it as a hero and it was not the case at all. He was seen as this authority figure who did not care about Memorial staff, their suffering, and what they truly went through for those five days trying to keep patients alive, hoping to evacuate the patients and be rescued and being let down when no one came until it was too late. It’s not fair at all that this is happening to Pou, but she is able to show that she is still a doctor who cares about her patients.

2. Why is it important that Fink includes information about high-profile murders and the murder rate in New Orleans?

High profile murders were included in the book because it was to compare to Pou, Landry and Budo’s case of mercy killing and comfort care to racially motivated police brutality murders that occurred right after Hurricane Katrina in New Orleans. It showed that there were worse incidents (murders) that happened in New Orleans at that time aside from what happened at Memorial. Another part of why Fink included the information of these murders is, Memorial staff were called to testify in court by subpoena. The attorneys of Memorial staff seek immunity (for their clients) from further prosecution by the District Attorney or ADA. This was like those other murder cases at the time because those who were called to testify also seek immunity from being prosecuted for the crimes.

3. View the episode of Boston Legal and its possible impact on Dr. Pou and her case. Series 3 Episode 55 on Hulu (Please note: I saw the episode on Hulu as the link provided did not work.)

It was a great episode and something else that helped Pou and her case. The main character attorney (played by James Spader) who was defending the character doctor (loosely based off Dr Pou ) used the forensic evidence found by prosecution to sway the grand jury that she was innocent of the five murders -five end of life care patients (the DA seek first degree murder charges unlike the second degree murder charges that DA and ADA seek for Pou) and her intentions were to be a doctor for the Life Care patients (since the Life Care doctors abandoned their patients before the Hurricane). The doctor (loosely based on Pou) testified for her own defense on the stand, stating, she took care of the Life Care patients and providing comfort for the patients suffering regardless of the drugs being used and euthanasia or mercy killing never came to her mind. She was doing what a doctor would do to end suffering in patients at a horrible time.

4. How do the historical perspectives offered on pages 396-405 impact your view on mercy killing? What factors seem to sway thinkers from one side to the other? Are any perspectives missing from this short historical lesson?

Dating back to the biblical times, when King Saul killed himself on his sword after being injured in battle to Ancient Greece and Rome, when Hippocrates created the speech that was used for medical doctors saying the Hippocratic oath – “That I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan…” (on page 386), to the societies of today who have questioned how ethical it is to allow a patient to die on their own or with the help of physician assisted suicide or the use of terminal sedation in terminally ill patients. The doctors of today are meant to prolong and preserve life at all costs. In 1980’s, Belgium and Netherlands allowed assisted suicide and euthanasia if the patients wanted to do so – those who seek to kill themselves can do so by either going to a drug store with a physician prescription for the euthanizing drugs or having the physician who ordered the drugs assist in the suicide. In comparison, the US does not legalize euthanasia or assisted suicide and it is not OK to end a life through medical intervention to end a patient’s suffering.

As for my view of mercy killing history in the book, the historical perspective presented is interesting to read and it made me think when terminal illness in patient occurs that the use of assisted suicide or terminal sedation is acceptable to do. I also noticed that the Holocaust was mentioned and the WWII euthanizing the Jews by the Nazis, but the book left out the genocides of the century too – especially the ethnic cleansing that happened in Rwanda (1994) and Iraq (2003). There are many factors that make thinkers go back and forth on the debate of legalizing assisted suicide and euthanasia – the quality of life, how to end the suffering in patients with or without medical assistance, and consent of families who help make the decision of when their loved one should be allowed to die.

5. Why did Dr. Pou’s attorney have such a difficult time finding useful guidelines from the AMA on comfort in care during disasters? What is Arthur Caplan’s opinion of what happened at Memorial? What did the AMA decide following Hurricane Katrina?

Simmons kept searching for a way to help Pou’s defense and looked to the AMA guidelines – only to find there were no guidelines according to the AMA on what a doctor should do to provide comfort care to patients during a natural disaster. And according to the AMA, Pou had breached guidelines set for what doctors should do when providing end of life care for patients by not talking to the family members prior to administering treatments for comfort care.

Arthur Caplan is an ethicist who knew the ins and outs of the history of active, in active, voluntary, and involuntary euthanasia. He criticized Pou’s use of palliative care that ended the lives of the Life Care patients. He was disturbed by the fact some of the patients were not seen as terminally ill. He was more troubled to find there was a lack of documentation of the medicines being given gradually with care and “there was no effort made to consult with the family members who were present at Memorial” on page 395.

After Katrina, AMA passed guidelines to protect physicians from criminal or civil liability (in the event of natural and unforeseen events) when doing any treatment for palliative care which could result in patient deaths unless the treatments were used with malice – meaning physicians could then be prosecuted.

• This topic was modified 12 months ago by Carrie Anne Weeks.
• This topic was modified 12 months ago by Carrie Anne Weeks.

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