Item Three
Catching up on some reading matter I came across this little gem in an article mainly addressing the issue of an American relief doctor who assisted dying people to die easier and more quickly during the recent New Orleans disaster, dispensing morphine to them.
And I quote!
“Queensland doctor and navy reservist Paul Lukin, who was in the first Australian medical team to fly into Banda Aceh after the Asian tsunami, said standard medical and navy policy when confronted with overwhelming disasters was to first treat seriously ill patients who could be saved with available resources.
“We would not give an extra or double dose of morphine,” he said.”
What Mr Lukin is saying in effect “don’t waste valuable resources relieving severe pain more quickly”. Perhaps he could have ensured a thick pillow was available to suffocate them instead!. Or hit them over the head with a brick!. Or stab them to death!
No valuable resources for hopeless cases, used up then!.
Why not just call for more morphine and look after all their needs, both for the dying and the living? I’m sure we’d had found it for Iraq! by the plane load!……It would be on hand as needed, I’m sure.
The quick death would have been preferable regardless of the method, in the absence of medication. They have no future, except pain and the reality of the trauma of surviving a natural disaster. For heaven’s sake how many really difficult decisions would have had to be made to justify who got sufficient drugs for their individual relief.
“No extra or double doses” of morphine, just sounds so rigid a policy, perhaps the policy makers need to experience the pain that would make them consider things differently.
Compassion makes us relieve an animal’s pain by euthanasia (killing it) rather than let it suffer on, after being hit by a car.
We only have to read the daily newspaper to see how people cope with hastening death when there are no alternative like a proper “peaceful pill”. A plastic bag over the head is a grim attempt to get the message across. Any sane person would prefer medication, but when its relief is so very restricted, other less acceptable methods will be adopted.
The agony of untreated pain has to be experienced to be understood.
Item Two
2005-09-26 From: Baptist Press News, Nashville, TN, US
Ethicists respond to claims of euthanasia in New Orleans
http://www.bpnews.net/bpnews.asp?ID=21728
Sep 26, 2005
By Staff
Baptist Press
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.
Item One
This article comes under the heading of “I’m all right Jack!” and would also take into account, vets as well as doctors. At least the good doctor tried to assist his friend! I vaguely remember reading that Dr Irwin has since been “struck off” for believing his patient’s wellbeing is more important than a law which cannot always be respected.
Doctors often help sick colleagues to die, GMC hearing is told By Nicole Martin, The News Telegraph
Filed: 27/09/2005
Doctors regularly agree to help fellow medics to die in the event of them falling terminally ill, one of Britain’s most outspoken pro-euthanasia campaigners told the General Medical Council yesterday.
Accusing the medical profession of double standards, Dr Michael Irwin, 74, said it was hypocritical for doctors to help dying colleagues to commit suicide, but not to “extend this privilege to their terminally ill patients or friends”.
The former chairman of the Voluntary Euthanasia Society, who admitted being “twinned” with a doctor in Glasgow in this way, exposed the practice as he stood accused of agreeing to help a friend with prostate cancer to commit suicide in 2003.
Dr Irwin, a retired doctor from Surrey, admitted travelling from his home to the Isle of Man with about 60 Temazepam sleeping pills he had prescribed for himself with the intention of helping Patrick Kneen to die.
In the event, his plan did not go ahead because Mr Kneen’s condition deteriorated so rapidly that he was unable to take the tablets and he died a few days later. However, Dr Irwin was cautioned by Surrey Police, and his case subsequently referred to the GMC, because the pills he had planned to supply to Mr Kneen were a Class C drug.
He appeared before the GMC yesterday accused of serious professional misconduct over his intentions to break the 1961 Suicide Act which outlaws assisted suicide.
He is also accused of exploiting the “prescribing privilege” of a doctor to stockpile the drug Temazepam over a period of time.
Dr Irwin, who represented himself, accepted that helping someone to die was “unlawful and a crime”, but he said there were times when a doctor’s “duty to a friend” was greater than his “duty to the state”.
He said that doctors commonly helped terminally ill patients to die, whether it was by terminal sedation – administering increasing doses of sedatives – or by providing lethal drugs.
He also said he knew several physicians who had “personal agreements” with other doctors to help each other to die if they became terminally ill.
“Physicians rarely have a very difficult or painful death,” he said.
“Doctors are often generous with providing appropriate drugs to dying colleagues and their close relatives, especially using the procedure of ‘terminal sedation’, which, widely performed in hospices, nursing and private homes today, is really slow euthanasia,” said Dr Irwin.
“And seriously ill physicians usually know how to obtain lethal medications for themselves, either in this country or abroad, allowing them to hasten their own deaths if they wish to do so.”
He added: “If physicians are willing to help each other at the end of life, surely they are guilty of applying double standards if they do not extend that privilege to their terminally ill patients or close friends?”
But Alison Foster, for the GMC, told the Fitness to Practise panel that Dr Irwin had displayed a “blatant disregard” for the law and that his actions “brought the good name of his profession in disrepute”.
She described his actions as unprofessional, inappropriate and irresponsible, and said they discredited the good name of his profession.
If found guilty, Dr Irwin could be struck off the medical register.
The hearing continues.
Article at
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2005/09/27/ngmc27.xml&sSheet=/news/2 005/09/27/ixhome.html