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It's very kind of you to imagine the family members are liars. Unfortunately Husel decided not to take the stand to testify that he never said that. If Husel is lucky the jury will take the same view as you do regarding the truth of these bereaved family members.
I know you were t replying to me, but on this subject:
I’m not sure he’s saying family members are liars per se. But it’s well documented that clinical and consent discussions are extremely poorly remembered by patients and present family members.
I honestly disagree with this based on the experiences I’ve had with multiple laymen friends who’ve run health care situations by me. I can EASILY see someone hearing “your father’s brain has been damaged and he has no chance of recovering meaningful function” as “they said daddy is brain dead!”
I'm not sure lying changes anything. Aren't their millions are assured in the civil arena, where there is a low bar for guilt, regardless of the criminal verdict?
Actually I imagine they are remembering incorrectly OR lying about what they recollect. Sort of like how one family member claimed the patient had care withdrawn without it ever being discussed and then lo and behold admitted yeah it was discussed several times and that is why when th patient was extubated with them present they didn't raise any fuss.
Hardly, but a guilty criminal verdict all but assures an outcome for the plaintiff in civil court.
I’ve never pushed 10 versed IV at once. Max is 5 if I recall. Little old lady would get the absolute minimum like 1 as needed until she sits still long enough for a CT
Upwards of 30 civil suits were filed against Husel and Mt. Carmel. I believe (somebody fact check me on this) all have already settled but one case, with totals in the tens of millions of dollars. You think all the dozens of plaintiffs witnesses are lying to help one holdout who's refusing to settle to bump their guaranteed millions up a bit?
If it turns out the others are caught lying, seems a easy grounds to try and get the previous verdicts overturned.
I didn't say anything about what I think. You asked a question, I answered it.
Civil settlements in this case seem especially egregious. Every single patient was either assured of death or, at the absolute best, total dependent care. What are the economic damages?
There are some very specific things said that don't appear to match reality. Not everything, and not a conspiracy to set him up because it is only like two people who have said those things. Those two may fully believe what they said at the time but that doesn't make those things true (especially since one of those things was that the patient was made comfort care without family approval and the person who claimed that at one point later admitted that there was family approval. Was he lying or was his memory flawed? Only that person knows for sure but either way it was an untrue statement).
ironically you could argue an earlier death = less costs for the family.
I don't recall where I saw/heard it, but, it was that some absurdly high number of dollars, either 1/3 or 1/2 of all Medicare dollars, are spent in the last 6 months of life.
khn.org
So what difference would that make? Being on comfort care is no justification for ending a patient's life with an overdose of fentanyl. THAT is what this case is about.
To be fair, so does Dr. Husel.
What difference would it make if the doctor unilaterally made the patient comfort care without consulting family or against their wishes? Really?
You obviously missed my point, which is simply that their being on comfort care in no way excuses Dr. Husel killing (either on purpose or accidentally) those patients, and that is the main issue to be resolved by the jury. Whether or not he informed the families about the patients being on comfort care is (or at least seems to me) a lesser issue that would certainly not prompt charges of murder or manslaughter. From your numerous posts on this thread I already know you don't believe he was guilty of anything in his care of these patients and have been strongly advocating that position, which is just fine. The jury, and not you or I, will determine whether he's guilty or not.
I don't know what to say if you don't think extubating a vent dependent patient without having discussed it with family (or doing it against their wishes without a court order or the support of ethics committee) is worse ethically and legally than providing any dose of pain medication to a dying patient. I think that would be more reasonable to result in criminal charges than doses of pain meds to an actively dying patient.
Here is where the disconnect is. We ALL AGREE, that this scenario where the 95yo you describe, being keep in a suffering state while providing futile care that prolongs the suffering against their will, should not happen. Where we disagree, is that some of you think a single physician should be '007, licensed to kill' marching around unilaterally 'ending that suffering' with lethal doses of medication, without the consent of the patient, without the consent of their decision maker, without the consent of society and without the consent of the law. The rest of us, don't.
Economic damages--lost SSI checks. Majority for punitive damages for the loss of watching "Meemaw" gasp for an extra 15 minutes.
I have to wonder whether you really don 't get what I've said or if you are willfully misrepresenting and distorting it to make it seem like you have a valid objection. I am not talking about providing any dose of pain medication. And, yes, the other things you mentioned are ethically questionable, but I think (or at least hope) you'd agree that killing someone with an OD of pain meds is worse ethically that those other things. And please don't repeat the mantra that these were all patients who would have died of their diseases, which of course was the claim of the sole defense expert. They might well have eventually died of their diseases, but the question before the jury is did Dr. Husel effectively euthanize them. From reading this thread I get the sense that there are quite a few posters who seem to believe euthanasia is morally or ethically OK. As has been noted several times in this thread euthanasia is illegal homicide.
I think a point I've been struggling to make here is that it doesn't have to be EITHER 1000mcg boluses OR 25mcg q15min. There's a better way, and that's attentive and deliberate titration of opioids, starting with a dose determined by the individual patient's characteristics - preferrably in a PCA pump operated by a trained nurse or doc at the bedside. This is how compassionate extubations are done with palliative care, and the families almost unanimously perceive their loved ones to have "died a good death" when this is done.
Oh of course. I don’t think that’s lost on anyone. Titration to effect is the way it should be. But FAST titration to effect.
He only violated the letter of the law for murder at least if his only reason for selecting the dose he did was to kill the patient. If he selected the dose to ensure comfort then the doctrine of double effect means he was practicing medicine. Some feel he was practicing it poorly regardless of his intent but then the question is whether it was poorly practiced enough to become criminal. I mean think about it. We hasten death every time we terminally extubate and stop pressors. Should we have to worry that every time we do this after ascertaining it is what the patient would have wanted we might still get a criminal charge because someone believes there is no circumstance where hastening death is OK?
No, we shouldn't have to worry about this. Regardless of the outcome of this case, it will only serve to lead to more suffering for our end-of-life patients, because now we know that a colleague will testify against us for using more than 50mcg of fentanyl at once.
If you read what I said you will note I referred to the moral or ethical evaluation of euthanasia. There is a difference between morals and ethics. Both terms relate to "right" or "wrong" behavior, but ethics refers to rules of conduct provided by a source external to the individual, e.g. by "society." That includes religious, professional, and governmental organizations. These rules are generally referred as "codes of conduct," "regulations," or "laws." Civil and criminal laws are therefore a form of "ethics" (as opposed to "morals"), and my point is that euthanasia is "illegal" and therefore unethical. What you are describing should be more accurately called morality. And yes, I know that some folks make a distinction between "law" and "ethics" but in fact they are making a distinction between law and morality. Feel free to disagree, but at least try to understand the point I'm making.
You implied that those who stated euthanasia is morally OK are incorrect because it is illegal. I don't think I misunderstood your point.
That's where the well established principle of double effect comes in. I can defend my FAST titration with that principle, even when my doses aren't "safe" because my intent is to relieve suffering rather than hasten death, and someone who practices end of life care will be able to ascertain that from my actions.
I think you've got this quite wrong, and I don't want others to think that you are accurately describing the relevant ethics here. I also am of the impression, based on your posts in this thread, that if I post an explanation that you will intentionally misunderstand and/or misconstrue my words, so I'll choose not to do so.
What I said was: From reading this thread I get the sense that there are quite a few posters who seem to believe euthanasia is morally or ethically OK. As has been noted several times in this thread euthanasia is illegal homicide. I didn't imply "that those who stated euthanasia is morally OK are incorrect because it is illegal." You inferred that. This is what I mean about people misinterpreting statements to mislead. Some folks here may feel euthanasia is morally ok, and if that's the case I believe they should just come out and say so. To those who think it's ethically OK, I pointed out that euthanasia is illegal. If you are confused about this, see my previous post. Actually, I don't know if you're confused or just being argumentative. I doubt that further discussion on this particular issue will be of any value to folks here, so I won't have anything more to say about it, even you try to bait me to respond, so I'd suggest don't bother.
Yes, and I think it was a logical inference based on what you said.
That sounds fantastic, I'm holding you to that.
The logic people are using is this: They believe euthanasia is morally ok. They also realize it's illegal, and therefore homicide. That creates cognitive dissonance; simultaneously believing something is homicide, yet 'morally okay.' It's very uncomfortable simultaneously being in favor of something 'morally ok' and also technically homicide (euthanasia). They also can't reconcile seeing someone being severely punished for an act that 'morally okay,' no matter how severe the violation in legal terms. Therefore the brain takes the easy way out and does everything it can to delete, minimize, ignore and rationalize the 'illegal' and 'homicide' parts.
He’s gonna owe millions in civil court. He can sue the hospital, probably settle and pay some of his civil cases. But he’s not getting a license back and not working in medicine again.
Take out the 95yo. The sentence is still true.
