Murder, Malpractice or Compassionate Care?

A 46 year old critical care specialist is on trial in Ohio.  He is accused of deliberately overdosing critically ill patients with fatal amounts of the potent painkiller, Fentanyl.  He was originally charged with 25 deaths but the court threw out 11 of those deaths.  The trial has been going on for almost two months.

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In each of the 14 cases left, the patient was brought to the hospital in critical condition and was not expected to live.  The prosecution alleges that the doctor deliberately overdosed the patients in order to cause their deaths.  The doctor’s attorney claims the doctor was acting out of compassion and trying to relieve the terrible pain of his patients so they might pass away peacefully.  According to the prosecutor, even shortening a life by one day is enough to justify conviction.

The case raises thorny questions about ethical responsibilities of doctors dealing with end of life issues.  There is no protocol for determining the amount of Fentanyl to administer to a patient in extreme pain.  It is the responsibility of the treating physician to decide how much to order.  When making the decision, the doctor must walk a fine line.  She does not want to order too much but at the same time needs to order enough to reduce the patient’s pain to a comfortable level.  What is more important in the case of a terminally ill patient?  To be pain free for the last few days of life or to extend that life as long as possible, even if it means those last days are full of pain?  From whose point of view should these questions be answered?  From the point of view of the patient who just wants to be pain free or from the point of view of the patient’s family which may want the loved one to live as long as possible, regardless of how painful that may be for the family member?

Of course, the answers to these questions are complicated by the fact that the family members either are suing the hospital for the deaths of their loved ones or already have sued and collected.

End of life issues are never easy.  They are not easy for the patient leaving this life or for the family members being left behind, who often are concerned more with their own needs than with those of their dying loved one.  Don’t force your family to make these decisions without guidance.  Make a living will to let them know how you want to end your life or at least how you do not want to end it.

P.S.  After nearly a week of deliberations, the jury acquitted the defendant on all charges.

Posted in Doctors, Hospitals, Informed Consent, medical errors, medical ethics, Medical Malpractice, medical mistakes, Medical Negligence, Medication Errors, Secrecy |