In Case of Emergency, Kill Patient

Hurricane Katrina and the subsequent flooding caused innumerable problems in New Orleans and the surrounding areas. Homelessness, destruction of businesses, lack of potable water and food, lawlessness. Even lack of proper care for pets. What doesn't immediately come to mind as a problem but created an even more complex dilemma than a lack of availability of basic needs was how to deal with very sick patients in hospitals, even terminal ones. Airlifting every single patient from area hospitals was not exactly pragmatic, and they couldn't just be pushed out into the watery street. So some hospital staff decided to take matters into their own hands, and euthanized four patients who didn't have much hope of recovery. They're currently being processed until charges can be filed against them.

"This case has much bigger significance than just becoming a battle about euthanasia," says Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania. "It's about what we're going to expect doctors to do in [a pandemic of] avian flu. It's about what we're going to expect nurses to do in the face of bioterror .... It has to do with professional duty, professional responsibility, and what we expect healthcare workers to do in the toughest of circumstances."
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While many ethicists condemn mercy killing without permission, some say disaster conditions create an environment in which physicians may deliver a lethal dose with patient consent. Military ethicist David Perry, for instance, says the conditions at Memorial Medical may have resembled those in which a field medic "recognizes there's no way this person is going to survive, and so it's just a matter of how soon and with what sort of suffering or lack of suffering."

Although the military prohibits mercy killing under all circumstances, Mr. Perry notes that in cases where death seems imminent, "it might be worse to let this person die of starvation or suffocation or drowning if the person didn't want that ... than to do something more actively."
It's an interesting twist on the more standard debate concerning euthanasia that tends to involve the consent of the patient or the patient's family when a terminal illness has been recognized from which there is no recovery. The hippocratic oath binds doctors to "do no harm" to their patients. And if a patient cannot consent, or there is no way to immediately contact the patient's family to obtain consent, the prospect of a "mercy killing" becomes even more dubious. But what about an extreme case like what was encountered during hurricane Katrina? Is it doing less harm to the patient to quietly and painlessly allow them to die than to leave them to possible death to starvation or dehydration?

Louisiana state law explicitly forbids assisted suicide, but makes an exception for a physician who " Prescribes, dispenses, or administers any medication, treatment, or procedure if the intent is to relieve the patient's pain or suffering and not to cause death." What if the only way to relieve pain or suffering (and in the case of a dehydration or starvation induced death to an ill patient, it's considerable suffering) is death itself? It's a complicated ethical question, and not one with any readily available solution. Pay close attention to this case, it's sure to be appealed repeatedly, and will hopefully garner the consideration of some of the country's more prominent legal minds.

web address: http://suicidegirls.com/news/all/17305/In-Case-of-Emergency-Kill-Patient/