NEW ORLEANS (BP)–An ethicist with the Christian Medical and Dental Associations says claims that doctors expedited the death of some patients rather than evacuating them as the waters rose in New Orleans should raise important questions about what individuals should be expected to do in such dire situations.
“Discussion by ‘Monday morning quarterbacks’ regarding decisions made and actions taken during the horror of Katrina will attempt to pass judgment,” Robert Orr, M.D., said in the CMDA’s Sept. 22 “News & Views” bulletin. “I am unwilling to do that, especially based on second- or third-hand reports. I am also unwilling to predict what I would do if faced with a similarly impossible dilemma. Monday morning is a good time, however, to review the principles that provide guidance in such unimaginable circumstances.”
The reports surfaced when The Daily Mail newspaper in London ran an article Sept. 11 claiming doctors killed critically ill patients they believed would not survive an evacuation.
“Those who had no chance of making it were given a lot of morphine and lain down in a dark place to die,” William “Forest” McQueen, an emergency official, told The Mail.
One New Orleans doctor told of how she ignored her oath of medical ethics and ended the lives of the patients she earlier had fought to save.
“I didn’t know if I was doing the right thing,” she said. “But I did not have time. I had to make snap decisions under the most appalling circumstances, and I did what I thought was right. I injected morphine into those patients who were dying and in agony. If the first dose was not enough, I gave a double dose. And at night I prayed to God to have mercy on my soul.”
Orr, a trustee for the CMDA, examined the morality of such decisions and acknowledged the line is sometimes a thin one to draw.
“It is morally impermissible to perform an action which intentionally causes death,” he said. “Compassion remains a moral obligation, but we must be wary of the politically charged term ‘death with dignity.’ It is morally permissible to perform an action to relieve human suffering, even if such action unintentionally hastens death. Giving morphine and/or sedation to ameliorate or prevent agony in an imminently dying person, even to the point of rendering that person unconscious, is not only morally defensible, but most would say is part of the noble calling of medicine.”
The triage conditions encountered during a time of war or natural disaster increase the demands on correct judgment, Orr said.
“Which patients are most likely to die? How imminent is death? How fast is the water going to rise? Is it possible to transport this dying person to a safer place? Does providing care for this person place others in jeopardy? And many, many more questions,” he said.
“This may be one situation where the ethicist is justified in providing more questions than answers. Perhaps this is a good time to recall the words of Jesus: ‘Do not judge, and you will not be judged. Do not condemn, and you will not be condemned. Forgive, and you will be forgiven’ (Luke 6:37),” Orr concluded.
C. Ben Mitchell, a Southern Baptist bioethicist, told Baptist Press he largely agrees with Orr but had this to add:
“EMTs and trauma doctors make triage decisions every day. The question comes down to: Who should we save when we cannot save them all?” Mitchell, associate professor at Trinity Evangelical Divinity School in suburban Chicago and a consultant with the Southern Baptist Ethics & Religion Liberty Commission, said. “These doctors had heart-wrenching obligations to both the patients they could not move to another location and the patients they were evacuating. One thing we should be clear about: We must not countenance the intentional killing of a hospital patient.”