NHS Blog Doctor: Dr Anna Pou - hero or murderer?

Imagine this.

Your grandmother is frail, elderly, bed bound and hospitalised. She may well not have long to live. The hospital is hit by a hurricane and, in the aftermath, is flooded. There is no way of evacuating her. The flood waters are rising. Drowning is a certainty. To protect your grandmother from the horrors of a cruel and unpleasant death one of the doctors gives her a painless lethal injection of morphine.

An unlikely scenario.

But it happened in New Orleans after Hurricane Katrina. Or, at least, it might have happened.

Dr Anna Pou is a highly respected Ears Nose and Throat (ENT) doctor.

Dr Anna Pou

Read her full c.v. here. Along with two nursing colleagues, she is accused of just such an action. Of administering lethal doses of morphine and midazolam to patients in exactly that situation.

Dr Pou and her colleagues, Cheri Landry and Lori Budo, have been indicted for second degree murder.

It is beyond dispute that Dr Pou, Cheri Landry and Lori Budo stayed on at their hospital after others had been evacuated to care for patients who could not be moved.

Thereafter the facts are in dispute. It is possible that nothing untoward happened. It was apparently the British Tabloid press that started the ball rolling:

The original reports showed up in a British tabloid not known for its reliability, and this sourcing, as well as some of the details therein, led to widespread scepticism about their reliability. (The Doctor is in…)

The case against Dr Pou, Cheri Landry and Lori Budo is put succinctly by David Bowles in "When Drowning is not good enough":

“According to eye-witness accounts, LifeCare’s pharmacy director said that later that Thursday morning, he found Dr. Anna Pou in the seventh-floor medical-charting room. According to his statement, Pou and two unnamed nurses informed him that it had been decided to administer lethal doses to LifeCare patients. From the court documents, it is not clear where the instruction came from.

When asked what medication was to be given, the pharmacy director told the investigator from the AG’s office that Pou showed him a big pack of morphine vials. The LifeCare pharmacy director stated that, before evacuating, he saw Pou and the two nurses enter the rooms of remaining LifeCare patients.”

In the USA, both the main stream media and the bloggers are up in arms.

Many physicians in the USA rule out the possibility that it could have happened at all.

And then there is the characteristically robust view of the American moral right wing. Don't you just love them!

If the facts are, as they were represented in the media, the Defendant Pou is murderess--and should be punished to the full extent of the law.

Mercy killing is illegal. No one has a right to morphine or even a painless death, and those who administer fatal doses are murderers.

That such practices are common or humane is simply beside the point. We simply don't trust people to make decision for other people about when to end life. I know this rule hard for doctors to accept because their vanity convinces them that they are always acting in the patients' best interest. But, society's refusal to condone mercy killings suggest that it doesn't trust doctors.

The Defendant Pou should be executed. (source)

Matthew Holt takes a different, but supportive, view:

But where the hell was the Louisiana or New Orleans AG (or for that matter any other level of government) when desperate physicians, nurses and patients needed help? Absolutely effing nowhere. A humane person wouldn’t leave a dog to slowly die or drown in the 105 degree heat, let alone another human. And it seems to me that in absolutely desperate circumstances, Dr Anna Pou did what she felt was best for those patients.Yet six months later a grandstanding DA gets his jollies off by sending physicians and nurses on trial for homicide. (source)

Balls and Waluts, another ENT, specialist concludes:

I do think this case demands us to remember that Dr. Pou is innocent until proven guilty; but for me she’ll be a hero, too, until someone convinces me otherwise.

There is not much in the way of legal aid in the USA. Even if they are proved innocent, the two nurses in particular may be bankrupted by legal fees. Take a look at the Memorial Nurses Support Campaign

Details of the legal defence fund for Dr Anna Pou can be found here.

Regular updates and follow on references can be found on the ever reliable KevinMD