Friday, February 7, 2014

the last book I ever read (Sheri Fink's Five Days at Memorial, excerpt eighteen)

from Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital by Sheri Fink:

After the grand jury refused to indict Pou, she made good on her promise to fight to protect medical workers who serve in disasters, capitalizing on the statewide support she enjoyed. In 2008, I watched her as we both sat in a gallery at the Baton Rouge Capitol at a hearing. Ever the committed doctor, she worked on patient charts balanced on her knees as she awaited a chance to rise in support of one of three disaster immunity bills she helped write. “Unless you were there it would be difficult for you to forge a bill,” she said after the hearing. “The fact I experienced it first-hand puts me in a good position,” she added. “I mean you have to understand the circumstances that are created by any disaster when the medical supplies and the medical community is overwhelmed; these are horrific, extraordinary circumstances.” Pou said that providers who use “alternate standards of care [need] a comfort level that we are not going to be second guessed and prosecuted for decisions we make during times of crisis.” The legislators did not ask Pou whether the decisions she was referring to should extend beyond triage to include intentionally hastening patient deaths.

The answer to that question is no, according to reports released by the Institute of Medicine, a highly regarded, independent advisory organization that is part of the National Academy of Sciences. A year after Pou’s campaign, and again three years later after consulting with emergency responders across the country, a group of disaster experts convened by the Institute came down unequivocally on the question of euthanasia in guidance to policymakers and the public on medical care during disasters: “Neither the law nor ethics,” they wrote, “support the intentional hastening of death, even in a crisis.”

A bioethicist uninvolved with the group shared a similar view. “Rather than thinking about exceptional moral rules for exceptional moral situations,” Harvard’s Dr. Lachlan Forrow, who is also a palliative care specialist, wrote, “we should almost always see exceptional moral situations as opportunities for us to show exceptionally deep commitment to our deepest moral values.”

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