A legal defense fund has been set up to help Anna Pou defend herself against criminal charges. Contributions may be sent to:
201 St. Charles Avenue
Suite 114-363
New Orleans, LA 70170
I'm sure any amount will be appreciated.
Anesthesiology has a nice article which attempt to quantify some of the less common risks of having an epidural during labor: epidural hematoma, infection, and neurologic injury.
Epidural hematoma 1 in 168,000 6 per million Deep epidural infection 1 in 145,000 7 per million Persistent neurologic injury 1 in 240,000 4 per million Transient neurologic injury
[< 1 year]1 in 6,700 180 per million
It contains an interesting tidbit others might find interesting, too. There are 4 million births in the United States each year and 2.4 million involve epidural analgesia. Wow. That's three fifth of all live birth get an epidural! (And some call nights, it seems every single one does...)
From a critical care physicians stranded in a nearby hospital during Katrina:
My thoughts exactly...
[Time]
The number of physicians in Pennsylvania has declined by approximately ten percent between 1999 and 2005. On its own that number may not sound like such a huge drop. Compare that number to the other 20 most populous states and it becomes obvious that the difference is very significant.
Almost all of have seen net increases of between 7% and 35% over the same period. I would find it very interesting to know how long the wait is for a new patient appointment in an internal medicine practice in Pennsylvania vs. these states that have seen an increase. A knee replacement? First visit to a Neurologist. Follow up visits? You get my drift. Pennsylvania has a population that is among the most aged. Medicare just announced plans for more cuts. New physicians are choosing not to practice in Pennsylvania and we've seen a net loss of 10% in our physicians with unique provider numbers over the last six years. Get the picture, Governor Rendel?
Data from State of Medicine in Pennsylvania--2005
There's a very good article in the July 20 New York Times titled "Medical and Ethical Questions Raised on Deaths of Critically Ill Patients" that describes the ethical questions raised in the New Orleans case with some very good quotes:
I just learned that a former colleague and friend has been charged with second degree murder in the death of four patients at a New Orleans hospital after Katrina. I worked with Dr. Anna Pou in the operating room when we were both in Galveston, Texas for three years in the late nineties. She worked as a head and neck surgeon specializing in cancer surgery and I provided anesthesia for many of her cases. After reading the story my only reaction is that this entire case is about an attorney general making a name for himself. Dr. Pou is a wonderful, caring, highly skilled surgeon. Her concern has always been for the comfort and well-being of her patients.
When I spoke to her by telephone several months ago to express my support, we were unfortunately not able to discuss the events leading up to the criminal charges filed Monday. I don't believe any of us can truly imagine the conditions at Memorial Medical Center in the days following the hurricane. The fact that she was there, taking care of patients rather than safely evacuated with her husband, reflects the deep committment she felt to her patients and is consistent with what I know about her.
In my mind, this case is all about whether or not the intent of administering morphine was to alleviate suffering or to cause death. If the purpose of administering morphine was to treat pain or aleviate suffering, then doing so is permissible even if respiratory depression and hastening of death is a forseable consequence. This ethical position is termed the 'Principle of Double Effect.'In normal practice a hospital ethics committee would be asked to help make these evaluations. Dr. Pou had no such resource available to her.
I'll be writing more about his case as information comes out.
