Our view on medical ethics: Katrina survivors say doctor wasn't a killer. Enough said.

Fri Jul 27, 12:22 AM ET
In Louisiana this week, Dr. Anna Pou received news that ended two years of anxiety. A grand jury refused to indict her on charges that she murdered nine terminally ill patients with a lethal cocktail of painkillers in a dark, fetid New Orleans hospital three days after Hurricane Katrina struck.
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By all accounts, Pou is a dedicated professional with an excess of compassion. She was working in nightmare conditions on Sept. 1, 2005. The electricity was cut off at the Memorial Medical Center, and temperatures had soared to well over 100 degrees. Hundreds of patients were suffering from dehydration, several had died while others were screaming in pain. The staff believed, erroneously but perhaps justifiably, that no help was on the way.
Outsiders might never know the full story. Pou herself says she did not intend to kill any patients but was merely trying to relieve suffering. Louisiana Attorney General Charles Foti, who sought to indict her for murder, says she's a mercy killer. Nine people who were alive the morning of the day help arrived were dead by evening — too many, he says, to be explained by any other cause.
The deliberations of the grand jury are secret, so the reasons for its decision are unclear, but controversy is nevertheless rising. Foti is under fire for bringing the case, and he's scrambling to push out evidence that justifies his actions, not least because he's facing a re-election.
The argument will linger because Pou still faces civil suits from patients' families. But for now, at least, it seems justice has been done — both by the attorney general and by the grand jury that rejected prosecution.
Pou lived an extreme version of a dilemma faced by millions of others: When is it appropriate to give a terminal patient pain medication at levels that can hasten death?
These painful choices are best made individually by the patients, or their surrogates, and their doctors. But occasionally, cases have cropped up in which medical professionals usurped that choice. Just think of trusted British doctor Harold Shipman, who was found guilty seven years ago of murdering 15 elderly women patients and was suspected of killing many more. Or the cases that have burst into the headlines of nurses in this country found to have murdered patients. If the attorney general had proof Pou acted in that manner, he was right to pursue the case.
That said, the circumstances in the post-Katrina hellhole of the Memorial Medical Center did not allow for the ideal process with its emotional and procedural checks and balances. Even with the most vivid imagination, it is impossible to comprehend what these people faced. Perhaps the best analogy is a war zone, where medical decisions must be made quickly under impossible conditions. In those cases, medics are shielded from prosecution under a broad provision known as the Feres Doctrine. Even its many critics don't challenge the battlefield exception.
Without question, the people best equipped to understand these events are those who lived through Katrina and its aftermath. So who better to judge Pou's case than members of a Louisiana grand jury? That jury heard the evidence — including accounts of two nurses originally indicted with Pou, then given immunity for their testimony. Its judgment deserves respect.
Foti should move on, and so should everyone else. The jury has spoken.