NEW ORLEANS — The situation was desperate in New Orleans’ Memorial Medical Center in the days after Hurricane Katrina struck last Aug. 29.

By the morning of Thursday, Sept. 1, the hospital had lost power and sanitation, drastically impairing the quality of care medical personnel could provide. Without air conditioning, temperatures inside had climbed above 100 degrees, while outside the sounds of gunshots bore witness to the flooded city’s collapse into anarchy.

And although some patients had been airlifted to safety, the evacuation had stalled, and Memorial’s overwhelmed doctors and nurses were struggling to deal with the crisis as patients died amid the deteriorating conditions.

But according to the findings of an investigation by the office of Louisiana Attorney General Charles Foti, one doctor and two nurses at the hospital resorted to a criminal means of handling the situation — murdering patients.

In a legal move that is focusing national attention on “end-of-life” medical issues, Foti last month presented evidence to an Orleans Criminal District Court, who issued an arrest warrant for Dr. Anna Maria Pou and nurses Lori Budo and Cheri Landry on suspicion of murdering four acute-care patients with a lethal combination of morphine and the sedative drug Versed.

Pou and the nurses were released without bail after their July 17 arrests. Orleans Parish District Attorney Eddie Jordan, who will decide whether to proceed with the murder charges, will take the case to a grand jury, the New Orleans Times-Picayune reported July 20.

Foti, who is Catholic, told the Register July 27 that the goal of the legal process in this case is defending the sanctity of human life. “That’s what this is all about,” he said.

The Evidence

An affidavit filed in Orleans District Criminal Court detailed the evidence that triggered the second-degree murder allegations. According to the affidavit, “On Sept. 14, 2005, Lifecare Hospitals self-reported, through their attorneys, the possible euthanasia of patients following Hurricane Katrina by personnel working at Memorial Medical Center.”

The four allegedly murdered patients were all occupants of a seventh-floor facility leased from Memorial by Lifecare Hospitals. Pou, a cancer and eye, ear and throat specialist on staff at Memorial, had taken control of Lifecare’s patients by the morning of Sept. 1, the affidavit stated.

Four of Lifecare’s staff said that Pou came to the seventh floor with two nurses, later identified as Budo and Landry. The doctor told Lifecare staff that the nine patients remaining there were probably not going to survive and that a decision had been made to administer lethal doses of medication.

One Lifecare employee said Pou did not appear to be aware of the condition of the Life care patients, who were not terminally ill. 

Another Lifecare staffer said he asked Pou which medication would be administered and was shown a pack of 25 vials of morphine and some loose vials of morphine. The staffer said Pou also requested syringes and saline flushes, which are given after intravenous injections to ensure medication enters the patient’s system.

Subsequent autopsies on four Lifecare patients, identified in the affidavit as H.A., aged 66, R.S., 90, I.W., 89, and E.E., 61, found lethal concentrations of morphine and Versed in their bodies. None of the four was receiving those drugs as part of his regular medications.

No ‘Crusades’

After Pou and the nurses were arrested, many medical personnel suggested the attorney general’s actions were unwarranted. Dr. Isabel Ochsner, a friend of Pou’s, told the Times-Picayune, “I’m so ashamed of what someone has put her through. For someone of her caliber to be wrongfully accused of killing is a sin.”

Foti said that the charges resulted from a painstaking 10-month investigation, involving a number of state and federal agencies, that was triggered after Lifecare’s self-report last September of possible “euthanasia.”

The evidence from that investigation led to the “inescapable conclusion” that probable cause existed that the four patients had been murdered, Foti said, leaving him no option other than to initiate legal action against Pou, Budo and Landry.

Foti stressed that despite the finding of probable cause, Pou and the nurses should be presumed innocent until proven guilty. “This is not a crusade against the medical profession,” he said.

Pou, described in a Times-Picayune article as “a devout, deeply spiritual Catholic,” declined comment when contacted by phone.

Her lawyer, Richard Simmons Jr., said he could not address the factual allegations against his client at this time, when no decision has yet been made whether to bring formal charges.

And although he earlier told The New York Times that the case “may present a lot of end-of-life issues,” Simmons told the Register, “My client is not a doctor who is on some type of crusade for assisted suicide or anything like that.”

Moral Debate

Euthanasia advocates have already depicted the case in that light, however.

“It seems to me that this New Orleans hospital medical team was placed in a terrible situation with the dying people in their care,” Derek Humphry, author of the euthanasia handbook “Final Exit,” said in a comment posted July 18 on the Internet at www.assistedsuicide.org/blog. “Thus the most humane thing to do, rather than abandon them to die in appalling conditions caused by the hurricane, was to quietly hasten their inevitable ends with sedative drugs.”

 Father William Maestri, director of communications for the Archdiocese of New Orleans, said that people should avoid a “rush to judgment” with respect to the guilt or innocence of Pou, Budo and Landry.

But he said the Church’s moral teaching about intentional killing — whatever the circumstances involved — is “quite clear.”

Said Father Maestri, “It is always morally wrong to directly take the life of an innocent person, regardless of the intention or the hoped outcome. So whether that be physician-assisted suicide or euthanasia, it would be gravely morally wrong to take the life of an innocent person.”

And the New Orleans priest rejected the suggestion that acceptance of medically induced killings has increased in the United States since the state of Oregon legalized doctor-assisted suicides in 1997.

“The vast majority of Americans expect their medical caregivers to promote life,” Father Maestri said. “We don’t expect our medical people to harm those entrusted to their care.”

Tom McFeely is based in

Victoria, British Columbia.