Yeah, you gotta be careful with articles like this. Deemed by who? Attorneys filing lawsuits do not count as reliable sources. The same lawyer claiming a dose of morphine was grossly inappropriate isn’t compelling, to me, without context.
“The hospital says they’ve identified a total of five patients who died under Dr. William Husel’s care who might have benefited from more treatment.”
I have to admit that this surprises me…I thought Fox News commenters would be in the firmly in the “pro-life” crowd. Their lack of concern about consent comes as no surprise though.
I would have thought so too, considering the Terri Schiavo case.
Any doctor will do this, as long is it’s done the right way. The way this doctor went about things is not the right way. The right way would be to sign a DNR and start hospice care, all with the informed consent of the patient and / or their power of attorney. Narcotics are started based on need, and dosed based on established protocols, not just whatever the doctor happens to feel like.
I strongly disagree. This wasn’t a mistake like giving vecuronium instead of versed while in a hurry, or writing an order for 50 units of insulin instead of 15 due to mishearing someone, or even amputating the wrong leg. This was intentional, and clearly not done within the standards of medical care. As a hospice medical director, I take care of terminally ill patients every day. One doesn’t order an overdose. One orders enough narcotics to control the pain, and if the initial dose isn’t sufficient, titrate the dose up. There are protocols on initial dosing and choice of narcotics based on things like weight, kidney function, liver function, and whether or not the patient has been previously treated with narcotics. What happened in these cases is clearly not that.
We are aware of five cases in which this possibility is a concern
Is what the hospital actually said, all the rest is lawyer speak. Now, after 5 years, they couldn’t make that case, shrug.
FWIW, I’ve been closely involved with the end-of-life care of a terminally I’ll family member or very good friend four times.
In three of those case, the patient was chronically under medicated for pain and anxiety. In each case, the patient asked repeatedly for more or better drugs. They were refused every time. They then asked me to advocate for them, and the caregiver or facility would lecture me about “chemical restraint”. In the meantime, the patient was living with constant excruciating pain and denied sufficient medication. I also think fears of addiction in the terminally ill are bullshit. I know addiction is a huge problem nationwide, but in the case of extreme pain in someone that’s almost certainly going to die within the next year or two, I think it’s an acceptable risk.
In the fourth case (the patient was my fiancé), the oncologist that handled his medications was also a close personal friend, and he started him on methadone immediately after the diagnosis, with other medications for breakthrough pain and anxiety. I am eternally grateful for this.
The thing is, terminal illnesses really are terminal and almost all of the people that have them are going to die instead of getting better . Some people might outlast six months, which is how “terminal illness” is legally defined, but very few people “get better”.
Most terminal illnesses have some sort of non-zero survival rate, but just because disease X has a 15% three year survival rate, that doesn’t mean that every individual patient has a 15% chance of hanging on that long. Patients whose illnesses have been particularly aggressive or unresponsive to treatment get to a point where they are virtually certain to die. Many of them don’t admit it, and, even when they do, lots of families have extremely unrealistic expectations of survival.
Now, I’m not in favor of patients being medicated without giving informed consent, including any risks that are relative to dosage. Although a lot of the posters in this thread seem to be talking like they know that the doctor gave this high dosage medication without the consent of the patient, I don’t see anything that says that is an undisputed fact.
When my mother was in the last year of her life, she had a blood clot in her arm that was causing her a great deal of pain, and would’ve continued to do so without surgery.
The hospital was hesitant to perform the surgery because there was a substantial risk she might not survive it. My mother was alert enough to give her fully informed consent, and if she hadn’t been I would’ve given it for her. My mother would’ve rather died than lived in constant pain, and I feel the same way.
Again, I’m not in favor of giving anyone any treatment without fully informed consent, but if I’m dying and in pain, you’re getting my fully informed consent to give me an effective dosage of painkillers, even if it might kill me.
The doctors that make me irate are the ones that pursue increasingly toxic and aggressive chemotherapies long after it has become apparent that those therapies are no longer effective. I bet more dying patients are pushed over the edge by the side effects of those therapies than die from painkiller overdoses, and it’s a way worse death.
To my knowledge, uncontrolled pain was not an issue in the cases presented at trial.
You have this turned around. For which of these patients was consent obtained and documented (assuming that informed consent to such massive doses is possible or ethical)?
People have obviously seen this case through the prism of their own fears and experiences. If the lesson here is that physicians alone may make end-of-life decisions, then many of us will feel more uneasy about the prospect of dealing with serious or terminal illness.
I remember when I had to go in for a procedure last year. It was pretty urgent; it was in that situation a life-saving procedure. Not surgery or anything, but I had to go under full anesthesia; I was totally out. They asked me if I had problems during the process if I wanted to be assisted. I asked them to please do it, I was there because I didn’t want to die. They also had to let me know there was risk involved, and survival rate wasn’t 100% guaranteed, but I knew that without it my survival rate was probably 0%.
It actually went very smoothly and they got done quickly. No unexpected problems afterward. just a sore throat and fatigue, and I was released about an hour later. But they clearly take that stuff seriously.