Potential Killing for Organs Case: Trying to Change the Issue
I have written previously of the case of Dr. Hootan Roozrokh in San Luis Obispo, who is accused of attempting to hasten a patient's death in order to be able to harvest his organs. A letter to the editor by a physician named John P. Okerblom, M. D. , objects. He writes:
Case sends 'ominous message'This is a classic misdirection. Dr. Roozrokh was not the patient's attending physician, he was the doctor who was supposed to harvest organs after the patient died. Consequently, he should not have even been in the surgical suite while the patient remained alive! Indeed, it was unethical in the extreme for him to assume any part of the patient's care.
In the compassionate practice of medicine, it is ethical and proper to provide narcotic and sedative medications, often in extraordinary doses, to relieve distress or discomfort. It is understood that such therapy, while preventing suffering, actually hastens death, but, when death is clearly imminent, these measures are widely accepted and practiced. Many families express deep appreciation for this final gift of comfort care to their loved ones.
In choosing to prosecute transplant surgeon Dr. Hootan Roozrokh, Karen Gray is sending an ominous message to all who care for the terminally ill. If one's reputation and freedom can so capriciously be threatened, who will dare lift a finger to provide those last few hours of comfort for the patient and family?
Regardless of whether you believe this dedicated physician had the ultimate motive of trying to follow the family's wish that their son's organs help save a life, or whether he was simply giving compassionate care, this prosecution is a grave mistake. San Luis Obispo County Deputy District Attorney Karen Gray should be directing our tax revenues to making our county a safer place to live, not a more frightening place to die.
I don't know whether Roozrokh committed a crime or not. That is up to the jury, and as I have written, some elements of the criminal case has fallen apart. Moreover, the point of palliative care legitimately provided is never to hasten death. That can sometimes happen as a side effect, but that is not the purpose. Stating otherwise could cause patients to refuse necessary palliation for fear the point is assisted suicide.
But criminal or no criminal, Roozrokh's wrong behavior is what threatened to make the ICU a "more frightening place," not prosecutors seeking to enforce laws against patient abuse.
posted by Wesley J. Smith @ 10:30 AM
6 Comments
6 Comments:
I think this part of a sentence gives away the letter-writer's ultimate agenda:
"Regardless of whether you believe this dedicated physician had the ultimate motive of trying to follow the family's wish that their son's organs help save a life..."
_That_ is his way of characterizing what the doctor would have been doing if he really _did_ deliberately administer overdoses to try to hasten the patient's death "following the family's wish that their son's organs help save a life." So, obviously, the letter writer doesn't _care_ if that was what the doctor was doing. He thinks it would have been a pretty excusable thing, maybe even a good thing, if that was what he was doing. Which lead me to conclude that the whole business about palliative care is more or less a deliberate misdirection, not a simple misunderstanding of the case.
Lydia: By Jove, I think you are onto something.
Absoluetly. Neither option was presented as negative. As such, the comments simply must be considered an attempt at excusing the crime (if it was actually commited).
The DA is asserting that the patient could not feel pain, and therefore the comfort care wasn't necessary. That's a pretty dangerous assumption - for every expert they produce who says as much, I'm sure the defense can find someone to say different. Also, they assert the medications given were, in terms of volume, surely intended to cause death. If that's true - how come the death was ruled "natural causes" and the kid didn't die for like 7 hours? Ironically, the civil suit sues for suffering caused to the decedent - well which is it - could he experience pain and suffering or not? I also have to wonder why it is that the white people in the OR that night got immunity from prosecution - at least one nurse and one doctor that have already testified and probably more to come - what's with that? The physician who was supposed to be incharge testified the other day that she didn't know she was supposed to be in charge and didn't know she was supposed to be managing the case. What should the surgeon have done? I guess he should have walked away - asking a lot from a man trying to save numerous lives.
JCANDACE: The doctor had no business at all treating the patient at any time. It was unethical for him to even be in the room when the man's life support was turned off, much less order drugs administered. He was not the patient's doctor. Period.
He was there to obtain organs after death.
When the patient didn't die--which sometimes happened, he ordered drugs administered. He should have been ignored and the patient's physicians should have made that call. It appeared to some that these drugs were intended to hasten death. If so, it failed.
But whether he was criminally culpable, he was acting unethically in a way that basic training should have told him was wrong.
There is a problem with the facts presented in your blog. The fact is, there was no formal procedure created by the Sierra Vista Regional Medical Center in San Luis Obispo. So how can you argue ethics with no regulations in place?
This is a small excerpt quoted directly from the judges notes explaining why 2 of the 3 charges were dropped.
* Ruben Navarro most likely had developed a considerable tolerance to morphine. Navarro received an intrathecal pump in 2005 to deliver morphine and the antispastic agent baclofen. During Navarro's previous hospitalization, attending physician Eric Schultz had prescribed morphine and Ativan (lorazepam) for the patient at dosages up to 10 mg every 15 minutes prn.
* Accounts from witnesses in the OR at the time of the attempted cardiac-death donation could not be reconciled with respect to the amount or timing of the medications given. No one recorded the administration of medications in the OR, and the vital-sign records for this time period were lost.
* "There was no credible evidence that Dr. Roozrokh ordered the administration of Betadine," according to the ruling. The testifying nurses could not identify whether Roozrokh or transplant surgeon Arturo Martinez delivered the Betadine to Navarro; although, Martinez denied ever touching Navarro "in this manner." The judge adds, however, that Martinez's claims are suspect given his "natural interest in avoiding civil and criminal liability despite his obvious presence and superior experience [to that of Roozrokh]." A footnote adds that detective Crawford found some of Martinez's statements "lacking in credibility." In addition, the amount or concentration of Betadine given to Navarro is unknown, thereby precluding a determination as to whether the Betadine was harmful. Finally the judge relied on the wording of the relevant statute to determine that it did not apply in the context of a medical procedure.
My question to you is, why wasn't Arturo Martinez, Hootan Roozrokh's superior, (who was in the operating room as well) charged with a crime? I have posted on my blog about this case with lots more facts, if interested in reading goto:
http://hootanroozrokh.blogspot.com/
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