Re: Mercy Followup


That's, as it was at the time, appalling. The fact that we, either in the capacity of the State or the Federales, were unable to respond rapidly and effectively to the disaster says more to me about our abilities than does the fact that we still haven't fully re-built the area.

Posted by: Roamsedge | Link to this comment | 08-30-07 6:06 AM
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Yeah, but all human life is sacred, even when it has been abandoned in the wake of a major disaster by its racist, incompetent and uncaring government. So obviously prosecution is in order.

Posted by: Gonerill | Link to this comment | 08-30-07 7:14 AM
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I read that over the weekend. So incredibly sad. The whole situation is just incomprehensible to me.

Posted by: Robust McManlyPants | Link to this comment | 08-30-07 7:26 AM
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I was on the train this morning reading today's Metro and came across the "Today's Debate" column that asked "How has the country changed since Hurricane Katrina?" How much does this response make you wonder if people are living in an alternate universe?

I think that Hurricane Katrina brought people together, and taught us how to work together like one big family.

Click the link. The dude looks just like you'd expect.

Posted by: Becks | Link to this comment | 08-30-07 7:56 AM
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"So obviously prosecution is in order."

Really? So why no indictment?

Posted by: terpbball | Link to this comment | 08-30-07 8:08 AM
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taught us how to work together like one big family

Yeah, this family.

Posted by: apostropher | Link to this comment | 08-30-07 8:10 AM
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Somebody needs to recalibrate terpbball's sarcasmeter.

Posted by: apostropher | Link to this comment | 08-30-07 8:12 AM
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"Reverse triage." Jesus. This episode really shows the contrast between professionals on the scene acting coolly in an extreme situation and performing well in real-time, and nitwits like Foti who, in their leisure, ponder from a comfortable distance and make ludicrous ideological decisions.

It's a metaphor for the Bush administration and modern Republicanism (although I know Foti is a Democrat).

Posted by: politicalfootball | Link to this comment | 08-30-07 8:50 AM
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7: Perhaps Len Bias' untimely death permanently damaged it.

Posted by: NCProsecutor | Link to this comment | 08-30-07 8:56 AM
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Yeah, she comes off pretty well in the interview. "Terminal sedation" is pretty common with end-stage patients and given the context I'm not sure why the doctor's actions were controversial but I'd like to hear the prosecutor's version before committing to anything.

Posted by: FL | Link to this comment | 08-30-07 9:05 AM
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Generally, listening to both sides is a good thing. Here, given that the prosecutor's case failed the 'ham sandwich' test -- he couldn't sell it to a grand jury even in the absence of any defense case -- while maybe he had something, I doubt it.

Posted by: LizardBreath | Link to this comment | 08-30-07 9:08 AM
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Foti built his investigation on interviews with people in the hospital during the awful days after the storm. As the generators failed, Memorial lost electricity, heat exceeded 100 degrees and floors were blanketed in darkness. According to news reports, the environment was chaotic and rife with rumors.

Now, 14 months after the storm and three months after the arrests, many are wondering why the attorney general made such high-profile arrests without the most basic evidence needed -- lab reports and a coroner's classification of the deaths -- to ensure an immediate indictment.

I thought I'd heard Foti say something about levels of morphine, which is why I wanted to avoid the bandwagon, but even if he did, that couldn't have been his reason for indictment. What a doofus.

Posted by: FL | Link to this comment | 08-30-07 9:46 AM
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At this point I'm the only one interested (partly for professional reasons) but one thing that bothers me in the interview--and this is prompted by a comment at Majikthise-- is that there's no overt mention of the competence of patients in "category 3." The decision to sedate was not made by the patients, which would be problematic if the patients were competent to give consent, and that level of competence is compatible with what's said explicitly about their condition. This is *not* to say that they were competent, or that the decision to sedate was a bad one.

Posted by: FL | Link to this comment | 08-30-07 9:58 AM
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1.) Labs, sometimes the levels of morphine that are required to make people comfortable are the amounts that are likely to kill them. I'm sure that you know that, but, for some reason--now inexplicable to me, I thought that it was worth repeating.

2.) Reading that excerpt made me sob.

Posted by: Bostoniangirl | Link to this comment | 08-30-07 10:00 AM
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Yes, I do know that. That's what "terminal sedation" is, more or less. Did I say something to suggest that I'd made an error about this?

The point about that half-remembered remark of Foti's was that I believed that he had alleged that the toxicology reports were inconsistent with the doctor's story, which would be grounds for suspicion. Further poking around reveals that he couldn't have said this before the arrests, if he ever said it, because he didn't have the lab results at the time of the arrests.

Posted by: FL | Link to this comment | 08-30-07 10:03 AM
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partly for professional reasons

However much you enjoy it, Labs, it's probably best if playing the Angel of Death remains a hobby.

Posted by: SomeCallMeTim | Link to this comment | 08-30-07 10:04 AM
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13: That strikes me as a possible, but not an actual, worry. A doctor giving possibly life-shortening palliative care to a patient over their objections, or without explaining it to a competent patient, seems like really deviant behavior that I simply wouldn't expect. And under the circumstances, I can't picture someone making it into category 3 for reasons of dehydration/heat exhaustion/general debility of whatever pre-existing kind, and still being competent.

Posted by: LizardBreath | Link to this comment | 08-30-07 10:06 AM
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Kevorkian is getting old, Tim, and I'm goddamned tired of waiting in the wings.

Posted by: FL | Link to this comment | 08-30-07 10:06 AM
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17: right, I don't think there's an actual problem here, but that comment at Majikthise about the nurse refusing to give an injection (which I know is most likely bogus) prompted me to look again at some indications of the state of the patients in category three. I endorse the general point that it's really hard to imagine this particular doctor in this particular case committing homicide, as if she's been waiting all this time to commit some involuntary active euthanasia. (At absolute worst, I think, it might have been a reasonable-doctors-differ sort of decision made in horrible conditions.)

Posted by: FL | Link to this comment | 08-30-07 10:11 AM
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Huh. I hadn't seen that comment. Yeah, that would totally be a problem if true, I just don't believe it.

I wonder if it's true at the commenter level -- that there is such an affidavit -- or total fantasy.

Posted by: LizardBreath | Link to this comment | 08-30-07 10:15 AM
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Affidavit was real, but not an affidavit from an eyewitness; rather, an affidavit from a lawyer relating what he says eyewitnesses told him.

Posted by: LizardBreath | Link to this comment | 08-30-07 10:20 AM
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Foti made number four on this list of bad prosecutors.

Posted by: joel hanes | Link to this comment | 08-30-07 10:46 AM
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From the affidavit:

"Dr. Pou informed S.H. and D.R. that a decision had been made to administer lethal doses to the Lifecare patients remaining on the seventh floor. D.R. brought up the fact that patient E.E. was alert and oriented. Dr. Pou asked if someone from Lifecare could talk with E.E. or sedate him. Initially someone mentioned that A.G., a Lifecare RN, had a close relationship with E.E., but A.G. refused to participate in sedating E.E. At that point, D.R. decided that no Lifecare staff should be involved.

This was a patient, by the way, who wasn't terminal. Just paralyzed. And, again, according to the affidavit, Dr. Pou was going to tell him she was giving him something for his dizziness.

Yes, it's possible that the witnesses in the affidavit are wrong. But if their testimony was accurate, I don't see how Foti could have *not* prosecuted.

Posted by: kate | Link to this comment | 08-30-07 1:28 PM
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22: Suck it, Foti! My (former) local prosecutor is #3.

Posted by: apostropher | Link to this comment | 08-30-07 1:32 PM
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23: The thing is, that's not evidence, it's hearsay, and it's pretty incredible on its face. If the witnesses referred to were willing to say the same things under oath, I'd be very surprised if the grand jury hadn't indicted; from the fact that it didn't, my guess is that the affiant misrepresented or misunderstood the stories the witnesses gave, and so the prosecutor couldn't get them to testify to that effect to the grand jury.

Posted by: LizardBreath | Link to this comment | 08-30-07 1:37 PM
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Sure Lizard, it's true that what's in the prosecutor's affidavit are just the allegations. It's not the sum total of the evidence and it's not direct testimony. But *if* it's an accurate representation of witness statements and the evidence he had before him, then it was his responsibility to prosecute, regardless of political pressure otherwise. As you yourself said, *if* it's true - that's really deviant behavior.

I don't have a problem with people who don't buy the allegations as a matter of pure fact. I mean I have no idea. But I do worry a lot about people who say the prosecutor should have turned a blind eye because the allegations weren't that bad or reflected a "terrible choice." The allegations were that bad. And if people are seriously arguing that killing a patient - particularly a conscious, alert patient - without their knowledge or consent is some kind of "mercy" or within the doctor's rights, I think we have real a problem.

Posted by: Kate | Link to this comment | 08-30-07 2:29 PM
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Yeah, but I haven't seen anyone at all, anywhere, arguing that. It may be unstated in some comments, but everyone I've seen supporting Pou appears to have been doing so under the assumption that the prosecutor's allegations are false.

Posted by: LizardBreath | Link to this comment | 08-30-07 2:35 PM
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I don't think my opinion has changed on this much. I don't think the doctor did anything wrong. I think the prosecutor is an asshole. But I don't think the prosecutor was wrong to press charges, either, in light of the crazy atmosphere post-Katrina.

We have a media narrative that's saying "the government doesn't care about the black Katrina victims." We have interviews with black families saying "We left Grandma at the hospital and she was fine. We came back, she was dead, and some cancer doctor who wasn't even her doctor gave her a shot that killed her."

And while it sounds now, after the evidence has come out, that Pou did everything right, I'm not at all confident that just assuming that would have led to anyone getting the answers (like how conditions deteriorated), or that it would have not exacerbated a bad racial situation. You know: no one even cares that they killed anyone, because the victims were black and the doctor's an educated white woman.

How do you get the answers without having the investigation? The prosecutor is an asshole for being an asshole, but I'm not so sure he's wrong for going forward with the charges.

Posted by: Cala | Link to this comment | 08-30-07 2:47 PM
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The thing is, there's an investigation, and then there are arrests and bringing someone before a grand jury. My assumption, given the failure of the grand jury to indict, is that the affidavit linked was bullshit -- that there were not, in fact, witnesses willing to swear to those stories. If there had been, I would expect a grand jury to have indicted. Given the circumstances (lack of lab tests and autopsies done before the arrests, general fuckedupness of the whole situation) I'd call it grandstanding and bad behavior to go forward with arrests and publicity before having enough evidence to make it past the grand jury.

Posted by: LizardBreath | Link to this comment | 08-30-07 2:51 PM
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"Yeah, but I haven't seen anyone at all, anywhere, arguing that."

OK, maybe I'm just zeroing in on the ones that do. But my impression is that a lot of people - at least on Majikthise, where this started - were arguing more or less "she was a hero to stay regardless" or "this must have been a really tough decision" or "the circumstances make it impossible to judge." If I had seen people sticking to "no she definitely didn't euthanize these patients without their consent" I'd have felt a lot less disconcerted.

Posted by: kate | Link to this comment | 08-30-07 5:29 PM
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What Kate said in 23 (and in followup posts). I'm especially troubled by the case of Emmett Everett, who was not terminally ill and who was by all accounts alert and oriented. Apparently he weighed about 350 pounds and was in a wheelchair. He would have been difficult to evacuate.

According to CNN, the grand jury "never heard testimony from five medical experts brought in by the state to analyze the deaths." All five of these witnesses arrived at the same conclusion: i.e., that at least some, and as many as nine, of these deaths looked like homicide.

So why did the grand jury never hear this testimony? Were these five witnesses untrustworthy? This is an honest question, btw, and I'm open to the idea that they're all five a bit kooky or something. Or was there some other reason, having to do with local conditions in NOLA or something? The difficulty of attracting doctors, e.g., to what is hardly the destination of first choice for urban professionals?

I dunno. On the internets, it looks like this is shaping up into another of those epic, if short-lived, battles between the right-to-life crazies and everybody else who is sane and reasonable. But I can't help suspecting it's a bit more complex than that, and I think it's possible to be troubled by this case without being a compleat lunatic.

I do find it difficult to believe that nine patients on the same floor of the same hospital were, within the same narrow time frame (two or three hours on the very same day), just accidentally given fatal overdoses. I'm troubled by the death of Emmett Everett.

Posted by: Invisible Adjunct | Link to this comment | 08-30-07 8:10 PM
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So why did the grand jury never hear this testimony? Were these five witnesses untrustworthy? This is an honest question, btw, and I'm open to the idea that they're all five a bit kooky or something.

This is one of those things where you can't tell what looks weird unless you know what normal procedure is, and to be clear, while I am a lawyer, I don't have a criminal practice and so I don't know what's normal. But the ball you have to keep your eye on is that the prosecutor controls the case brought before the grand jury -- if they didn't want to prosecute, they could have just not prosecuted. It doesn't make sense to think that that there was better evidence of crime than the grand jury saw, and for some reason the prosecutor, while going forward with the prosecution, withheld the good evidence. (It's possible -- things that don't make sense do happen sometimes -- but it's the sort of thing that would need a serious explanation.)

One thing that I will pull out my "I am a lawyer" for is that I don't put a whole lot of weight on expert evidence unless I've seen it on both sides. Experts will say pretty much anything.

Posted by: LizardBreath | Link to this comment | 08-31-07 7:54 AM
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One other note. This:

I'm especially troubled by the case of Emmett Everett, who was not terminally ill and who was by all accounts alert and oriented.

This is based on just a couple of google searches, but I think what you mean by 'all accounts' is 'one account'. I don't see any news articles that go back to anything other than that prosecutor's affidavit, which is hearsay.

Posted by: LizardBreath | Link to this comment | 08-31-07 8:24 AM
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I also meant by his wife's account. Admittedly, she did not speak to him the day he died, but she did speak with him by telephone just a few days earlier. She claims that she was later informed her husband died of heat and lack of water. Apparently his death certificate lists cause of death as Katrina. But I think there is little to no question that the immediate cause of EE's death was an overdose of morphine (or morphine plus another drug?)? This sounds very odd to me.

Posted by: Invisible Adjunct | Link to this comment | 08-31-07 8:47 AM
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His wife's account speaks to his medical condition immediately after the storm, not after several days without access to water, while he had a urinary tract infection requiring hospitalization.

On the overdose of morphine claim, part of the reason I'm not taking the expert testimony all that seriously is that I understand that reconstructing dosages from postmortem samples is difficult and inaccurate, particularly considering that this data can't have been collected until days after death, time in which the bodies were decomposing in high heat. Under the circumstances, I don't think the one-sided expert evidence says much.

Posted by: LizardBreath | Link to this comment | 08-31-07 9:02 AM
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