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Notebook Medicine

Disaster medicine


Disaster medicine

Medical establishment circles its wagons around New Orleans physician who administered lethal drugs

Legally speaking, Anna Pou, the doctor accused of performing "mercy killings" during Hurricane Katrina, is off the hook. A New Orleans grand jury chose last month not to indict her for murder in the deaths of nine elderly hospital patients. Now Pou faces the public trial of her reputation, pitting the medical establishment against Louisiana's attorney general.

Until Sept. 1, 2005, Pou was a hero. She stayed behind in storm-wracked New Orleans to care for patients at Memorial Medical Center with no electricity, ventilation, or running water. Four days into holing up, Pou took some nurses up to the hospital's LifeCare unit for terminally ill patients who, doctors believed, would not survive an evacuation. Louisiana attorney general Charles Foti alleges that Pou ordered lethal doses of morphine and another sedative for four patients who died in the same three-hour period that day.

Because grand jury proceedings are not public, it is not clear who saw what on the seventh floor of Memorial Hospital, but Pou was arrested last summer along with two nurses. The nurses avoided prosecution by agreeing to testify against Pou. Foti built his case on witnesses' testimonies and the opinions of five nationally known experts who said the four patients' deaths were homicides.

The case had one major weakness: The Orleans Parish coroner said he could not determine the causes of death. During grand jury proceedings Orleans Parish prosecutor Eddie Jordan did not call any of the five experts to testify.

Among the experts was Art Caplan, a bioethicist who provides commentary for MSNBC and is pro-abortion, pro--embryonic stem-cell research, and sided with Michael Schiavo in the Teri Schiavo case. Here he did not give Pou the benefit of the doubt.

"Each person died with massive doses of narcotic drugs in their bodies," Caplan told The Advocate newspaper of Baton Rouge. "There is no evidence of consent. There is no documentation or record of any request on the part of any patient for assistance in dying." Caplan said he believed there was more than enough evidence to justify a criminal trial.

Pou lawyer Rick Simmons mounted an emotional defense that capitalized on the public support of New Orleans doctors, nurses, and hurricane survivors. The American Medical Association (AMA) also sided with Pou. After the grand jury decision, it released a statement saying, "The AMA continues to be very concerned about criminalizing decisions about patient care, especially those made during the chaotic aftermath of a disaster."

But Foti does not buy the argument, or the grand jury's decision. A day after the decision, Foti filed a petition to unseal records that his office filed with the grand jury. He also released his experts' reports to the press, along with a narrative of what his investigators thought happened on Sept. 1, 2005. Foti told reporters, "While I have a deep respect for the grand jury, I think they erred."

Stem-cell payback

Pro-life Missouri politicians have retaliated against last year's passage of a pro-cloning, anti-embryo amendment to the state constitution. The amendment prevented state legislators from passing any law that limits embryonic stem-cell research or the cloning of embryos for experimentation. Since they could not burst the research bubble, pro-life legislators let the air out of a $425 million plan to bolster life-science research around the state. The move stripped funding for the projects and let down not only researchers but also Republican Gov. Matt Blunt, who made the science and business of bio-research an essential part of his economic plans for the state.

In June, one of the state's most prominent private research firms announced it is postponing a $300 million expansion project. Stowers Institute blamed the continuing opposition to embryonic stem-cell research in Missouri for its inability to recruit more researchers to fill new labs.