Five Days at Memorial

Sheri Fink

4 ideas

1. Memorial Hospital's Fifth-Day Lethal Injections

   After Hurricane Katrina flooded New Orleans in August 2005, Memorial Medical Center lost power, and staff and patients were trapped for days. On Thursday, September 1, as evacuation was finally underway, Dr. Anna Pou and nurses allegedly injected morphine and midazolam into patients deemed unlikely to be rescued. One of them was Emmett Everett, a conscious 61-year-old paralyzed man whose weight made him hard to carry. Of the 45 bodies recovered, 23 tested positive for those drugs, yet in 2007 a grand jury declined to indict Pou.

2. Do-Not-Resuscitate Becomes Do-Not-Rescue

   Memorial's doctors placed patients with DNR orders last in line for evacuation. That turned a narrow instruction, not to perform CPR if the heart stops, into a ranking of whose life was worth saving. A document meant to honor a patient's wishes about one procedure was repurposed under pressure as a triage label. It sent people who were stable and wanted to live to the back of the queue.

3. Irreversible Choices Rest on Unverified Assumptions

   The decision to end lives rested on beliefs made under exhaustion and poor communication. Staff believed no rescue was coming, that remaining patients could not be moved, and that they would suffer if left behind. Several of those premises proved false, since helicopters and boats emptied the hospital that same day. Judge a disaster decision by how reversible it is relative to how uncertain its premises are, not only by the decision-maker's intent.

4. Preparedness Failures Manufacture the Ethical Dilemmas

   The agonizing bedside choices at Memorial were set up years earlier. Planners put electrical switching equipment and backup power where floodwater could disable it, and the hospital had no workable evacuation or triage plan. Blame focused on individual doctors obscures that institutions created the conditions for the dilemma.

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