When the Daily Telegraph ran their piece, Patients put down on September 12, 2005, reporting that a female physician had chosen to euthanize patients who were critically ill and could not be evacuated prior to Katrina, it went unnoticed in the mainstream media. Then on September 22, 2005, another piece ran on the MichNews.com site, Patients killed in New Orleans and the blogs took notice. But still no reporting has come from any of the popular press outlets. Does this mean this incident never occurred and was falsely reported? That is still unclear. Nevertheless, the story is a good scenario for a thought exercise.
What would you do if you were faced with a similar decision? How would you respond knowing you did not have the adequate resources to care for someone entrusted to you? What choice would you make? I have to confess that when I first read this story, I wept. I wept for the physician who was faced with a horrific ethical dilemma, not having the resources to care for her patients. I wept for the patients who had to be left behind, abandoned, in their most desperate hour of need. I wept because of the suffering caused by Hurricane Katrina which has been so devastating to our country. And then I started to think and wonder, what would be the right thing to do if I had ever been faced with such a decision? What would I do if I was faced with a Sophie’s Choice?
So I called my colleagues and picked their brains. I contacted one of our CBC directors, C. Christopher Hook M.D. who is the director of ethics education at the Mayo Graduate School of Medicine who said, “The closest thing that one might compare this to is the concept of battlefield euthanasia where soldiers and army physicians euthanize injured soldiers rather than let them be captured and tortured by the enemy. This is highly controversial within the military and among military medical ethicists, and is considered justified, by those who do, in only the most extreme of circumstances. But this was not an analogous situation.” And that lead me to call another colleague, retired Colonel, Dr. Tom Beam who authored a chapter in Military Medical Ethics on Medical Ethics on the Battlefield.
Dr. Beam, incidentally, was in Louisiana when I reached him, volunteering for the relief efforts. His comments were very affirming to me, as I could not accept euthanizing patients as a solution, even under the most extreme of conditions. He stated that many of our emergency triage decisions are made in a split second and are decisions we must live with for the rest of our life. Therefore, those involved with emergency, disaster and wartime activities must prepare and consider these decisions before they are faced with them. And he countered with the fact that there are many reasons why killing soldiers (or patients) is extremely bad policy. Something I had not considered, which he reminded me of, was how would soldiers’ attitudes be affected if they knew this is how they would be treated if the situation arose, vs. knowing there was a plan in place for their care and safety.
I translated this attitude to the hundreds of patients I had cared for in my career. How would they feel if they knew I had been trained to abandon them and even end their life if such a situation occurred? If this physician’s story is in fact true, she will undoubtedly think about this choice she made all the days of her life. The story goes that she asked God to have mercy on her soul for her acts. We would do well to root ourselves now in the belief that all of human life is worthy of protection and that we should do all that is humanly possible to not leave the weakest and most vulnerable in their hour of need. How would you respond?
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