Saturday, August 05, 2006

Another physician punished for her good work

Dr. Anna Pou and 2 nurses who stayed to help care for patients during Hurricane Katrina have been charged with homicide for the deaths of some patients under their care.

The charges against Dr. Pou and the nurses caring for patients during Katrina appear little more than grandstanding and scapegoating, as has been done with Dr. Thomas Butler and Michael/Terry Schiavo.

I applaud these health care workers for their dedication to their patients and their tough decision to stay with the patients. The drugs found are commonly used to help patients be more comfortable. It is unfortunate if occasionally patients die—perhaps in larger part due to the appalling and stressful conditions they were under, including the extreme heat.

In a related, timely article, Dr. Daniel Sokol discusses the ethics of healthcare workers “duty of care” in responding to virulent epidemics. While no clear conclusion can be made, I appreciate Dr. Sokol’s discussing the multiple roles that physicians have that may be in conflict. For while a doctor has an obligation to patients, they also have

“a duty to care for their own children by protecting them (and hence themselves) from infection. So a further problem with the duty to care, aside from its vagueness, is that it fails to consider the holder of the duty as a multiple agent belonging to a broader community. Doctors, in such situations, play several incompatible roles—doctor, spouse, parent, for example—and they must deal with them as best they can. The limits of the duty of care are thus also defined by the strengths of competing "rights and duties.”

The irresponsible charges brought against Dr. Pou and her colleagues will have a chilling effect on other health care workers in the future, who will be loathe to respond to disasters. First, there is the risk of malpractice for caring for patients outside our specialties or beyond our experience. Now there is the risk of prison and reputation/career destroying attacks from Monday morning quarterbacks.

Dr. Pou and her nurse colleagues should be hailed for their heroism and devotion to their patients.

Who will care for you during the next disaster or epidemic?

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