"doctor accused of killing 300 patients to free up beds"

[sprinkles]

This is such a crazy story I thought I should share. This doctor is accused of killing off ICU patients...even those who werent even unconscious "Some of the patients were conscious moments before they died"

 

http://www.reuters.com/article/2013/03/27/us-brazil-hospital-murders-idUSBRE92Q1D120130327

 

thoughts?

[Robin Hood]

This is such a crazy story I thought I should share. This doctor is accused of killing off ICU patients...even those who werent even unconscious "Some of the patients were conscious moments before they died"

 

http://www.reuters.com/article/2013/03/27/us-brazil-hospital-murders-idUSBRE92Q1D120130327

 

thoughts?

 

I already lost my faith in humanity.

[future_doc]

It is not just the doctor who is accused but rather her entire team. Incompetence is bad enough, this is homicide on a large scale if proven true.

There must be others like her around the world who have not yet come to the attention of the authorities. How sad.

[taboo]

Might be unconventional, but if you need the bed you need the beds.

[medigeek]

what in the world....

[rmorelan]

what in the world....

 

If this is in some way actually organized it is quite scary. The entire team involved?

[sprinkles]

If this is in some way actually organized it is quite scary. The entire team involved?

 

yah! Like the doctor seems to be the one in charge but he would 'call staff and tell them who is next'. I mean its one thing if, say, a nurse wasnt sure what was happening and may have unknowingly assisted....but when the doc calls and tells you to kill the guy.....

[Skylerate2]

Since the article didn't make it clear, what if she was only killing hopeless cases? People who are languishing and pitiably clinging to life when there is 0 chance for recovery, and taking up beds for people who have some semblance of a chance at living? Then could we really call her a murderer? I'd argue that she is a humanist, a saint who relieves the needless suffering of others. She's willing to do what needs be done, and can be held in a higher regard than some hospital beaurocrat who is more than happy to keep someone's life support running so that they can line thier pockets.

[Mourning Cloak]

Since the article didn't make it clear, what if she was only killing hopeless cases? People who are languishing and pitiably clinging to life when there is 0 chance for recovery, and taking up beds for people who have some semblance of a chance at living? Then could we really call her a murderer? I'd argue that she is a humanist, a saint who relieves the needless suffering of others. She's willing to do what needs be done, and can be held in a higher regard than some hospital beaurocrat who is more than happy to keep someone's life support running so that they can line thier pockets.

 

Even if she were only "killing hopeless cases" the problem is that she was doing it unilaterally (or nearly so) without any transparency or oversight.

 

Certainly in medicine there is a place for restricting heroic measures in futile circumstances, but this needs to be realistic and humane decision discussed out in the open so that everyone, including the patients family, is involved in it and can understand what's going on.

 

You don't just knock people off under cover of darkness cause you've decided enough is enough.

 

Agree? Disagree?

[future_doc]

You don't just knock people off under cover of darkness cause you've decided enough is enough.

 

Agree? Disagree?

 

Of course, you don't. Dr. Shipman in the UK was a loner killer whereas this doctor allegedly involved her entire team who willingly participated in this deviant, homicidal culture.

[Skylerate2]

Even if she were only "killing hopeless cases" the problem is that she was doing it unilaterally (or nearly so) without any transparency or oversight.

 

Certainly in medicine there is a place for restricting heroic measures in futile circumstances, but this needs to be realistic and humane decision discussed out in the open so that everyone, including the patients family, is involved in it and can understand what's going on.

 

You don't just knock people off under cover of darkness cause you've decided enough is enough.

 

Agree? Disagree?

 

If she made what she was doing transparent, all that would happen is that the patient's family would get angry with her for even suggesting it, and her colleagues would report her to the police. There's a reason why these doctors who practice euthanasia do so without anyone else's input.

[Mourning Cloak]

If she made what she was doing transparent, all that would happen is that the patient's family would get angry with her for even suggesting it, and her colleagues would report her to the police. There's a reason why these doctors who practice euthanasia do so without anyone else's input.

 

Interesting our opinions should be so opposed. Could it be our backgrounds?

 

I'm an anesthesia resident, but I just finished an ICU rotation recently. What specialty do you hail from?

[rmorelan]

Even if she were only "killing hopeless cases" the problem is that she was doing it unilaterally (or nearly so) without any transparency or oversight.

 

Certainly in medicine there is a place for restricting heroic measures in futile circumstances, but this needs to be realistic and humane decision discussed out in the open so that everyone, including the patients family, is involved in it and can understand what's going on.

 

You don't just knock people off under cover of darkness cause you've decided enough is enough.

 

Agree? Disagree?

 

You don't knock anyone off regardless under our system - actually there ISN'T any way of doing that except under the cover of darkness, because it isn't supposed to be done at all.

[Skylerate2]

Interesting our opinions should be so opposed. Could it be our backgrounds?

 

I'm an anesthesia resident, but I just finished an ICU rotation recently. What specialty do you hail from?

 

I guess I have to spell it out for you. If your grandfather was in the advanced stages of Alzheimers and was essentially a meat sack that generated waste and took in nutrients and oxygen, would you ever tell the physician in charge of your grandpa "yeah its okay, I understand he's suffering just end his misery already"? The answer is no, because people hold lives they value in such a high regard that they fail to see when someone is essentially dead because emotion and other things cloud their judgement. In situations like these it falls to someone else, who is detached from the situation and is able to make rational decisions to make end of life decisions for your grandfather, like what the doctor in this article may have done.

[rmorelan]

I guess I have to spell it out for you. If your grandfather was in the advanced stages of Alzheimers and was essentially a meat sack that generated waste and took in nutrients and oxygen, would you ever tell the physician in charge of your grandpa "yeah its okay, I understand he's suffering just end his misery already"? The answer is no, because people hold lives they value in such a high regard that they fail to see when someone is essentially dead because emotion and other things cloud their judgement. In situations like these it falls to someone else, who is detached from the situation and able to make rational judgements to make end of life decisions for your grandfather

 

Does it? I mean should a physician be making that choice at all? We as a society have to have a much broader and opener discussion about these sorts of things. It isn't a doctor's job to create policy.

 

This is all of course assuming the doctor and team's approach was strictly speaking for a "nobel cause". We certainly have seen other cases where that wasn't true at all.

[Skylerate2]

Does it? I mean should a physician be making that choice at all? We as a society have to have a much broader and opener discussion about these sorts of things. It isn't a doctor's job to create policy.

 

This is all of course assuming the doctor and team's approach was strictly speaking for a "nobel cause". We certainly have seen other cases where that wasn't true at all.

 

Well if not the physician who else? They are the ones who are aware of the likelihood someone will recover, and they are the ones with direct control over the patients' treatment. They are also the ones detached enough from the patient to be able to do what is necessary, The people lying on the beds in abject misery can't wait for society to make its decision, someone needs to make it now.

 

Of course, if the doctor is just a blatant murderer then that is just unacceptable

[A-Stark]

I guess I have to spell it out for you. If your grandfather was in the advanced stages of Alzheimers and was essentially a meat sack that generated waste and took in nutrients and oxygen, would you ever tell the physician in charge of your grandpa "yeah its okay, I understand he's suffering just end his misery already"? The answer is no, because people hold lives they value in such a high regard that they fail to see when someone is essentially dead because emotion and other things cloud their judgement. In situations like these it falls to someone else, who is detached from the situation and is able to make rational decisions to make end of life decisions for your grandfather, like what the doctor in this article may have done.

 

No, it doesn't fall to anyone else other than the patient's substitute decision maker. A physician that unilaterally takes action to euthanize a patient (understood not as withdrawing life sustaining care but as the active purposeful act of ending life, as with injecting a large dose of KCl) commits an unlawful criminal offence, and even the unilateral withdrawal of life sustaining care may be illegal as well.

 

That doesn't mean you'd take a patient with advanced Alzheimer's to the ICU or the OR though.

[rmorelan]

No, it doesn't fall to anyone else other than the patient's substitute decision maker. A physician that unilaterally takes action to euthanize a patient (understood not as withdrawing life sustaining care but as the active purposeful act of ending life, as with injecting a large dose of KCl) commits an unlawful criminal offence, and even the unilateral withdrawal of life sustaining care may be illegal as well.

 

That doesn't mean you'd take a patient with advanced Alzheimer's to the ICU or the OR though.

 

also fails to consider what the wishes of the patient actually were, and assumes the doctor has absolutely knowledge of the eventual outcome, which he/she won't.

[Mourning Cloak]

This would make a good MMI question.

[aaronjw]

I guess I have to spell it out for you. If your grandfather was in the advanced stages of Alzheimers and was essentially a meat sack that generated waste and took in nutrients and oxygen, would you ever tell the physician in charge of your grandpa "yeah its okay, I understand he's suffering just end his misery already"? The answer is no, because people hold lives they value in such a high regard that they fail to see when someone is essentially dead because emotion and other things cloud their judgement. In situations like these it falls to someone else, who is detached from the situation and is able to make rational decisions to make end of life decisions for your grandfather, like what the doctor in this article may have done.

 

It would be nice if people discussing these subjects actually had some real life experience with them and it's clear you dont.

 

2 times with friends who had terminal cancer and now with my father in law who is pretty much at the end. In all cases I've experienced we would have preferred to be in a position to make a decision to end suffering. When you love someone, the only thing worse than having them die is having to watch them suffer agony and indignity for however long before they finally die.

 

The many people I've talked to about this generally have the same feeling. Some didn't because of religious or other personal views but the majority I've talked to wish there was an option. As I said, worse than having someone you love die is watching them suffer while dying and most people are able to come to grips with that reality when the person is basically terminal with no hope of recovery.

[schmitty]

I guess I have to spell it out for you. If your grandfather was in the advanced stages of Alzheimers and was essentially a meat sack that generated waste and took in nutrients and oxygen, would you ever tell the physician in charge of your grandpa "yeah its okay, I understand he's suffering just end his misery already"? The answer is no, because people hold lives they value in such a high regard that they fail to see when someone is essentially dead because emotion and other things cloud their judgement. In situations like these it falls to someone else, who is detached from the situation and is able to make rational decisions to make end of life decisions for your grandfather, like what the doctor in this article may have done.

 

Actually both of my grandparents were suffering after several strokes over many years and told me several times they would like to end their suffering by dying already. The best we could do was give a DNR for them, which was honoured and they died peacefully but only after much suffering. If we had the option, we would have chosen to end it sooner.

[rmorelan]

Actually both of my grandparents were suffering after several strokes over many years and told me several times they would like to end their suffering by dying already. The best we could do was give a DNR for them, which was honoured and they died peacefully but only after much suffering. If we had the option, we would have chosen to end it sooner.

 

Almost two different issues - a) whether people have the right to end their lives, and by extension those they extend that authority to other care takers and should doctors independently be making those sorts of decisions based in no small part resource limitations, medical futility, and of course the relievement of suffering. Assuming doctors can what safeguards are we going to put in place to protect patients and the doctors as well.

 

With respect to personally doctors having that sort of direct power makes me nervous, in particular in shady dealings, because it weakens our ability to always come across as someone trying to their absolute best to care for the sick. Patients and their families will wonder about our motives. We already have people wondering about that with organ donation and the critically ill - and that is based on no evidence really at all. Add this to the mix there really is a reason to quest things. It also puts a downward pressure on the usefulness and delivery of palliative care.

 

That all being said with respect to a) that is different. If we are going to do something like that we same sorts of safeguards every other country that has it adopted.

[schmitty]

Almost two different issues - a) whether people have the right to end their lives, and by extension those they extend that authority to other care takers and should doctors independently be making those sorts of decisions based in no small part resource limitations, medical futility, and of course the relievement of suffering. Assuming doctors can what safeguards are we going to put in place to protect patients and the doctors as well.

 

With respect to personally doctors having that sort of direct power makes me nervous, in particular in shady dealings, because it weakens our ability to always come across as someone trying to their absolute best to care for the sick. Patients and their families will wonder about our motives. We already have people wondering about that with organ donation and the critically ill - and that is based on no evidence really at all. Add this to the mix there really is a reason to quest things. It also puts a downward pressure on the usefulness and delivery of palliative care.

 

That all being said with respect to a) that is different. If we are going to do something like that we same sorts of safeguards every other country that has it adopted.

 

 

Of course I agree it is different, but I was responding to Skylerate's comment that nobody would give permission for a doctor to end the life of a loved-one, which is patently false.

[aaronjw]

Of course I agree it is different, but I was responding to Skylerate's comment that nobody would give permission for a doctor to end the life of a loved-one, which is patently false.

 

Yup, it's the type of ignorance that comes from having no life exerpejxne in such matters yet telling others how it 'really' is

[aaronjw]

I somehow think that the investigation was birthed by some hopeless patient's family who refused to acknowledge that the end was near.

 

Some of those comments quoted in the article would be reprehensible if taken literally, but sometimes one needs a cynical sense of humor when working in the ICU, where being peripheral and ineffective are de rigeur.

 

Withdrawing futile care is not murder. Withdrawing non-futile care may be. Administering deadly medications with the intent to end one's life, and without their consent, is a felony. I have no idea from the article what actually happened.

 

Muscle relaxers were administered and oxygen reduced.

.