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Biosecurity Briefing
Prosecution of Hurricane Katrina Healthcare Workers Has Consequences for Future Disasters By Crystal Franco, January 11, 2008 On January 3, 2008, The New England Journal of Medicine published an article by Dr. Susan Okie which describes the conditions at Memorial Medical Center in New Orleans following Hurricane Katrina in August/September 2005, including the limits, challenges, and decisions that healthcare providers faced during this time, and future “implications for patient care during disasters.” The article focuses specifically on Dr. Anna Pau, a cancer surgeon on the faculty of Louisiana State University School of Medicine who was “supervising residents at Memorial when Katrina hit on Monday, August 29.” Dr. Pau remained at the hospital following the hurricane to care for patients and help with evacuation. However, when “34 patients died at Memorial during and after the storm…media reports began to suggest that some had been euthanized.” Dr. Pau and two nurses were eventually arrested in July 2006 and accused of killing four elderly patients.1 The New England Journal article presents differing reports from hospital workers, some of whom claim to have witnessed acts of euthanasia, and others that say that it didn’t happen. Dr. Pau herself denies the charges and maintains that she and others only offered “comfort care” to “ensure that [patients] do not suffer pain.” A grand jury “considered possible murder charges” against Pau, but in the end “refused to indict [her].”1 According to James Aiken, medical director for emergency preparedness at LSU University Hospital, the example of Memorial Medical Center and Dr. Pau’s prosecution “…will have a chilling effect on the willingness of medical professionals to volunteer during [future] disasters.” However, this experience has also triggered discussions about “what care should be provided during a disaster that strains medical resources,” as well as the need for “expanded training and public debate about triage, communication and decision making when resources are limited.” According to Marianne Matzo, a professor of nursing at the University of Oklahoma, “[a]s a community we have to say, what are we going to do if we don’t have the resources,” to care for everyone?1 Few discussions have occurred about alterations in standards of care during emergencies because it involves “not only liability but political risks,” said Craig Llewellyn, professor emeritus of military and emergency medicine at the Uniformed Services University of the Health Sciences. Currently, a state of emergency can be declared by a governor or the President, which would suspend some of the normal standards. However, healthcare professionals are still not protected “from lawsuits or criminal prosecution by such declarations.” New laws are being contemplated which would more fully protect healthcare volunteers during disaster situations.1 References
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