In Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital, Sheri Fink, a journalist with an M.D., expanded on her Pulitzer Prize–winning coverage of the devastating aftermath of Hurricane Katrina at Memorial Medical Center in New Orleans, where one doctor and two nurses were put on trial for ostensibly hastening the deaths of patients.
You reported that one juror felt certain that a crime had been committed. So why didn’t the grand jury return an indictment?
It is hard to know—grand juries are secret. But there are a few good possibilities. One is what the juror describes: she felt like everyone on the jury sensed that a crime had occurred, but that there wasn’t enough evidence. Second, the attorney general has objected to that decision [to not return an indictment] all along. He had a monitor in that grand jury who strongly felt they weren’t being shown all the evidence. The third possibility is that—like some in the health-care profession, who felt that because this was a difficult situation and there were extenuating circumstances—they would excuse them and not punish them.
You wrote of the lessons learned at Memorial for future disaster preparedness. What have we learned about preparedness for clinical decisions regarding critically ill or DNR patients?
The Institute of Medicine came out with a big project over the past few years looking at these questions of how we prioritize people. Two things they said came very clearly out of Katrina: “Neither the law nor ethics support the intentional hastening of death, even in a crisis.” They also came out on how DNR orders should be used. Ever since Katrina there has been a proliferation of efforts at the state level and among hospital administrators to come up with guidelines that would help professionals stuck in a situation like this to prioritize patients. These are questions of values much more than they are of medicine or nursing. They’re the province of everybody.
In the years since Katrina, have the feelings of medical professionals or the public changed with regards to what occurred at Memorial?
The reaction of many people down there was that these were extraordinary circumstances, and normal rules didn’t apply. We saw this with doctors and police. Other people feel that during a time of crisis is when the deepest moral values have to be called upon. When these allegations surfaced that medical professionals had intentionally hastened the death of their patients, a lot of people didn’t believe it, especially because of the reputations of the people who still haven’t been willing to talk about what actually happened. I am so grateful to those who were willing to say that they injected patients and why they did it and why they felt it was right. That was so helpful to help us understand that.