I read this article in the New York Times Magazine a few weeks ago, and found it really interesting. The article tells the story of a for-profit hospital in New Orleans during Hurricane Katrina and the difficult decisions its physicians faced in deciding how to evacuate its patients during the storm. Some of the physicians have been accused of hastening the deaths of some terminally ill patients by delivering lethal injections of medications to those they deemed not able to survive the storm. I am looking forward to hearing everyone's perspectives on the article:
Doug
2 comments:
Wow, I'm glad I've never been faced with a problem like that of Dr. Anna Pou and her team, but I agree with her that there should be standards of medical care in emergency situations.
What do the Med students have to say? What do they teach you in Med School or Emergency training in regards to emergency situations, and who to try to save first?
On another note, reading about the LifeCare group reminds me of our discussion last week about American values and our fear of death. It seems that LifeCare really plays upon this fear and helps to keep people around for as long as possible.
A main question in the article seems to be one that is still unanswered in the medical community of what achieving the "greatest good" means; how should limited medical staff divide up work and care as well as they can for as many patients as they can?
Even though I understand that these doctors and nurses had to deal with a situation I myself could not even imagine, one quote still sticks out in my mind, from Dr. Ewing Cook, one of the most senior physicians at Memorial Hospital. "It was a desperate situation and he saw only two choices: quicken their deaths or abandon them. 'It was actually to the point where you were considering that you couldn't just leave them; the humane thing would be to put 'em out.'"
Thanks for the article, Doug - quite a different insight into Katrina relief.
Wow Doug thanks for posting this. This article strikes me in terms of how much it comes down to a question of ethics. On one hand it could be deemed unethical that patients are being injected and 'put out,' but on the other hand, given the extreme rarity of the circumstances and limited resources as well as the critical condition of patients, it could be deemed unethical to abandon the patients (especially in category 3) and to leave them high and dry to suffer till death. I personally see the doctors going into management mode as a positive move. The fact that they immediately began to categorize the patients and perform what seems to me, cost-benefit analysis, I see as positive. Of course it is easy as an outsider to say that what the doctors did was logical, however, I may have felt differently if I were a category 3 patient's relative.
I feel that some parts of this article cast a shadow on doctors as being insensitive and careless about human lives, but I think people underestimate the demands of being a doctor and how this a part of their job--making difficult decisions in difficult times and when dealing with patient lives. The fact that Dr. Cook and Pou approached the problem with a cost control mental cap rather than strictly looking at their own risks of being liable is definitely a move away from the norm. However, without a doubt the government needs to be accountable for their lack of resources--providing federal disaster management teams that were understaffed and undersupplied.
The move towards cost-containment will be made very difficult if doctors, as demonstrated in this article, are going to be held liable even in situations of extremity and rare circumstance when they were essentially helpless and acting in what they believe to be the best of intentions. Pou however did not make these last final moves due to cost-containment, she did it because she genuinely felt it was the right thing to do for her patients, which I personally do not believe deserves punishment.
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