Active euthanasia in New Orleans: An urban legend in the making?

Via Kevin, M.D., I've learned of a news report in which it is claimed that doctors made the morally harrowing decision to kill patients in flood-ravaged hospitals with overdoses of morphine rather than letting them die in pain. The story Kevin cites seems to have originated from this article published in the British tabloid The Mail on Sunday and then to have spread thoughout the British, Canadian, and Australian media. It tells a harrowing tale, which has been commented on by Majikthise and Pandagon, among others:

With gangs of rapists and looters rampaging through wards in the flooded city, senior doctors took the harrowing decision to give massive overdoses of morphine to those they believed could not make it out alive.

In an extraordinary interview with The Mail on Sunday, one New Orleans doctor told how she 'prayed for God to have mercy on her soul' after she ignored every tenet of medical ethics and ended the lives of patients she had earlier fought to save.

Her heart-rending account has been corroborated by a hospital orderly and by local government officials. One emergency official, William 'Forest' McQueen, said: "Those who had no chance of making it were given a lot of morphine and lain down in a dark place to die."

Given the horrific conditions in some New Orleans hospitals three days after the hurricane, the story certainly sounds plausible on the surface. Conditions were harsh in New Orleans hospitals for a few days before relief came. There was no power, no running water, and flooding of the lower floors of all but one hospital. And, yes, there were armed gangs of looters threatening to break into some hospitals. But something--I'm not sure what--set my skeptical antennae twitching. Something about this story definitely seemed fishy to me.

As I thought about it more, my misgivings multiplied. Yes, it is very likely that doctors probably were forced to do some form of disaster area triage, deciding which patients had a decent chance of making it and which didn't, and then making decisions accordingly about who would be treated and/or transported first. However, as a physician myself, it didn't ring true to me that these doctors would be quite so cavalier about devoting so much of their precious stocks of morphine to euthanize "hopeless" cases when there were undoubtedly many salvageable patients who needed pain medicine and no new supplies of drugs could be anticipated any time soon. In addition, as The Well-Timed Period points out, if all the narcotics were in a state of "lockdown" because of fear of armed looters and drug addicts breaking into the hospital (as claimed in the story), then how did one doctor get so many doses of morphine to use without attracting a lot of attention from nurses and her colleagues? And if it weren't just one doctor doing this, then why were there apparently no discussions or arguments about this, which would have been hard to keep secret? Killing our patients is not the sort of things that we doctors would all agree on, no matter how extreme the circumstances or how morally justified some might consider it under the circumstances. Individual practitioners would likely have strong and varied opinions about this issue. Finally, even if such passive euthanasia did occur, it seems unlikely that a doctor would talk about this to the press, particularly so soon afterward, with the disaster recovery still very much under way. This unnamed doctor would, under Louisiana law, be admitting to murder. It seems unlikely that any doctor who had actually committed such an act would want to take the chance of drawing attention to what she had done by blabbing to the press, with the attendant risk of the police identifying her. She would also be increasing the pain of the surviving relatives.

I decided to look into the story a bit more last night. Most interestingly, I Googled this William "Forest" McQueen described in this story. (I only wish I had clicked on the link in the piece in The Well-Timed Period before; ema had already done the Googling for me.) I could find nothing on the web about him other than this article from the BBC News Service:

Mother-of-two Suzanne McQueen, of Maidstone, Kent, is waiting for news of her American husband (William) Forest McQueen.

He has been working in his home country since 1997, and lives and works with his brother in the Abita Springs area, north of Lake Pontchartrain, which is north of New Orleans.

The couple married in the UK in 1991, and Suzanne said she and her daughters - aged 11 and 13 - were planning to move to the US to join her husband as soon as was possible.

Mr McQueen's wife has had no news from his friends and family. Part of his job there is to maintain the grounds of an old plantation house, she said.

"I phoned the morning the hurricane hit, and his brother said Forest hadn't been home for the last 24 hours because he'd been on shift clearing up trees and lines from all the wind damage that came before the hurricane. I haven't heard anything since.

This only named source cited in the article was a utility manager whose job it was to maintain the grounds of an old plantation house? He and an unnamed intern were the corroboration for this doctor's story?

But that wasn't the most dubious part. This part of the story sounds even fishier:

Mr McQueen, a utility manager for the town of Abita Springs, half an hour north of New Orleans, told relatives that patients had been 'put down', saying: "They injected them, but nurses stayed with them until they died."

This McQueen guy told relatives that their loved ones had been "put down"? What a compassionate, diplomatic guy! And, if nurses stayed with these patients, why was it that the only sources they could find to corroborate this unnamed doctor's story were an unnamed orderly, unnamed "government officials," and this guy, whose responsibility (if any) in the chain of command is not reported? How would he be in a position to know? Had he gone into New Orleans itself, or had he just been working in Abita Springs? After all, the worst conditions reported were within the city of New Orleans itself. Or were there armed gangs of thugs threatening hospitals the Abita Springs area? Why is Mr. McQueen the only named source?

I don't discount the possibility that this story may turn out to be true, given the brutal conditions in some New Orleans hospitals in the aftermath of the hurricane. Indeed, it could be true or an exaggerated account of what really happened. However, I have not been able to find any independent account to verify that this did happen that doesn't appear to be a variation of the original Mail story, and the three accounts there are as of this writing are riddled with claims that sound dubious to me. In the absence of independent corroboration, I must withhold judgment and consider the account unlikely to be true. What is unfortunate to me is the very credulous response that this story has received in the blogosphere, with lots of outraged or sad posts referencing the story but not one that I've been able to find (other than the one at the Well-Timed Period) expressing skepticism stronger than the "I'm not sure how reliable this source is" variety. Even the Bioethics Weblog commented on it without a whiff of skepticism, even though some of my concerns should have set off their skeptical antennae as well.

There's nothing about this yet on Snopes.com, but, if this story does turn out, as I think likely, to be an urban legend, it still brings up some difficult moral and bioethical questions, as J Train at Majikthise pointed out. Yet one has to ask, what chord did this story strike that caused it to resonate so? I think one possible answer is, oddly enough, contained right in the original story itself:

Their families believe their confessions are an indictment of the appalling failure of American authorities to help those in desperate need after Hurricane Katrina flooded the city, claiming thousands of lives and making 500,000 homeless.

The response to the Katrina disaster was so ineffectual initially that it is very easy to believe that doctors would become desperate enough to consider such an act. In such an environment, a story like this can gain a traction that it might not have gotten otherwise, had the government response been more swift.