Husel Trial -- NOT GUILTY

[thegenius]

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Well, I think that’s how it could be used but I’m not sure it actually says that. How many of us have ever looked up the LD50 for fentanyl? I literally use it daily and I never had.

I was just going to write this.

he gave one dude 1000 fentanyl, 10 versed, and 10 dilaudid. What health problem on this earth, or any other planet, is this an accepted treatment regimen. it's ridiculous.

I don't know this guy at all and if he's convicted of murder I won't have too much sympathy for him. Unless there is evidence that he gives 1000 / 10 to every single ICU patient who is in pain.

He pushed (I think) 2000 fentanyl on someone. WTF is up with that? How does not raise eyebrows on every single MD's face? Most of these patients are so close to dying they are not even suffering to the extent we think they are.

I've put in emergent chest tubes, without local anesthesia, on polytrauma patients with 20 broken bones (and numerous broken ribs) and they don't even flinch at all when I put scalpel all the way into the chest cavity and make a good 3 cm slice.

 

[thegenius]

(I STILL don’t think we can infer intent from Husel despite what I just said about my own thinking)

No will never know the true intent because he will never testify.

Instead it will be left up to a jury of non-medical people to peer into Husel's mind. You think they are all going to think "compassion" when this doc gives 10x the amount of pain meds and sedatives to people who have no response to noxious stimuli?

 

[thegenius]

I'm just trying to keep the discussion honest and appropriately contextualized. If we're going to cite an LD50 in this conversation, we should probably at least mention the LD50 that's most relevant to humans (in this case, primates). Personally, the elephant testimony seems unhelpful and unnecessary to me. Husel isn't on trial for his care of elephants!

I wonder how anyone can even estimate the LD50 for a drug. It's not like we can perform randomized trials on this.

"WilcoWorld: Hi, my name is Dr. Genius. I would like to enroll you in a study to determine the fentanyl dose that will kill 50% of those it is given to. I would like to start at 100 mcg, and I will increase the dose by 100 mcg every 6 hours until 50% of people enrolled in my study die.

Do you have any questions about this? Please read the fine print on the risks / benefits for this trial."

 

[Robotic Wis-Hipple]

No we can't infer the intent because he will never testify.

Instead it will be left up to a jury of non-medical people to peer into Husel's mind. You think they are all going to think "compassion" when this doc gives 10x the amount of pain meds and sedatives to people who have no response to noxious stimuli?

Nope. If other options than murder are on the table he’s getting the second most serious charge. If the only option on the table is murder it’s a veritable coin flip.

 

[thegenius]

Nope. If other options than murder are on the table he’s getting the second most serious charge. If the only option on the table is murder it’s a veritable coin flip.

Yea...I question whether that coin flip has 50/50 odds. I think it's a weighted coin and more likely to have a ratio of 90/10.

 

[Southpaw]

A lot has been said. People are focusing on the doses of the medicines given. The patients were actively dying. All of them. None of them had life left to live. If he is found guilty I think from a ‘practicing medicine’ viewpoint we take a step backwards.

Put another way - many of you seem to be fine, or actually want, just a protocol where every terminally extubated dying patient gets the same dose at the same time interval. Anything above that - murder. I find this unacceptable, as I am 100% sure some people, or many perhaps, will come along and those doses won’t be enough. They’ll still die - but it’ll be agonizing for the patient and their family. I find this an unacceptable solution.

I don’t condone the dosing. But I believe much could’ve been done to help Dr Husel before charging him with murder and taking away his license. Keep in mind - everyone in that hospital went along with his practice for years. Admin had opportunities to step in, as did other physicians, peer review, and the state board. Everyone took a pass.

Practicing medicine isn’t easy and it’s made much harder when it feels like the deck is stacked against you. The entire EM forum echos that sentiment daily. I just think what’s being done to Dr Husel, on a human level, is wrong.

 

[Southpaw]

And before anyone screams ‘well what about the patients - they were wronged!’. All of those families had accepted death as the outcome. All of those families moved on with their life. All of those patients passed comfortably. All of those families had, I am assuming, peaceful quiet moments with their loved ones prior to passing.

What is wrong with any of that?

 

[DrSnips]

I wonder how anyone can even estimate the LD50 for a drug. It's not like we can perform randomized trials on this.

Well, you can't do RCTs on humans, but on lab rats you can. Typically it's animal data that is extrapolated to humans with varying degrees of accuracy depending on the substance being tested.

 

[AlmostAnMD]

And before anyone screams ‘well what about the patients - they were wronged!’. All of those families had accepted death as the outcome. All of those families moved on with their life. All of those patients passed comfortably. All of those families had, I am assuming, had peaceful quiet moments with their loved ones prior to passing.

What is wrong with any of that?

this x1000

none of the families complained since all were expecting death. All grievances from families came after hospital contacted them.

 

[WilcoWorld]

The patients were actively dying. All of them. None of them had life left to live. If he is found guilty I think from a ‘practicing medicine’ viewpoint we take a step backwards.

All of those patients passed comfortably. All of those families had, I am assuming, peaceful quiet moments with their loved ones prior to passing.

What is wrong with any of that?

You appear to be arguing in favor of euthanasia here. I think that could be a very interesting discussion - it's an issue on which I have not yet made up my mind.

 

[WilcoWorld]

Put another way - many of you seem to be fine, or actually want, just a protocol where every terminally extubated dying patient gets the same dose at the same time interval.

I'm not sure if you include me in this group - in case you do I would like to clarify that I would strongly oppose such a policy. This is neither what is taught nor is practiced in Palliative Medicine.

 

[DrSnips]

I don’t condone the dosing. But I believe much could’ve been done to help Dr Husel before charging him with murder and taking away his license. Keep in mind - everyone in that hospital went along with his practice for years. Admin had opportunities to step in, as did other physicians, peer review, and the state board.

That bothers me as well. If the true story here is that Husel was euthanizing these patients then what are the chances that all of the pharmacists and nurses involved would be ok with that? Because the only two options at that point would be that they were co-conspirators or that they were afraid to speak up and went along with it unwillingly. Both seem unlikely. Husel didn't select which nurses or pharmacists cared for his patients, so the chances that all of the randomly assigned staff would just so happen to be like-minded angels of death seems astronomically low. Were they afraid to speak up? I'm not sure what the Mount Carmel hospital culture was like, but most hospitals have anonymous reporting systems if you're truly afraid to speak out about someone. Were these systems used at any point before 25 patients had died?

 

[thegenius]

And before anyone screams ‘well what about the patients - they were wronged!’. All of those families had accepted death as the outcome. All of those families moved on with their life. All of those patients passed comfortably. All of those families had, I am assuming, peaceful quiet moments with their loved ones prior to passing.

What is wrong with any of that?

Well who is suing Husel then? If the families were accepting of the outcome then why would the families sue Husel?

 

[Tigers540]

Well who is suing Husel then? If the families were accepting of the outcome then why would the families sue Husel?

The families sued after the hospital contacted them to "apologize and notify them of the criminal investigation". It would appear that they accepted the death of their family members up until that point.

For the record I dont blame them for suing. I would want things looked into if a hospital contacted me years after my family member's passing saying that mistakes were made. I still believe the hospital system is vilifying Husel to protect their reputation / funding. Like the previous poster said, the admin knew about his dosing. I believe they even had meetings with him about it before any charges were brought about.

 

[neurodoc]

The families sued after the hospital contacted them to "apologize and notify them of the criminal investigation". It would appear that they accepted the death of their family members up until that point.

For the record I dont blame them for suing. I would want things looked into if a hospital contacted me years after my family member's passing saying that mistakes were made. I still believe the hospital system is vilifying Husel to protect their reputation / funding. Like the previous poster said, the admin knew about his dosing. I believe they even had meetings with him about it before any charges were brought about.

I'm sure they met with him as part of Peer Review, which is SOP for directed peer reviews. Your casual statement implies they were fully aware of his practice and had discussed this matter BEFORE he ever came to the attention of Peer Review. You can believe all you want but try to avoid misleading readers on this thread. I find it very unlikely that hospital administration and the medical staff and its officers were somehow well aware of Husel's "end-of-life" dosing. And any criminal "charges" would be brought by the district attorney and not the hospital. The only thing we can say for sure is that Husel was charged AFTER he was peer reviewed by his hospital medical staff and after his Ohio medical board review that 2took disciplinary action against his license.

Note that SOME of his colleagues may have been aware of what he was doing and either didn't disagree or maybe thought euthanasia was just fine.

 

[Tigers540]

I'm sure they met with him as part of Peer Review, which is SOP for directed peer reviews. Your casual statement implies they were fully aware of his practice and had discussed this matter BEFORE he ever came to the attention of Peer Review. You can believe all you want but try to avoid misleading readers on this thread. I find it very unlikely that hospital administration and the medical staff and its officers were somehow well aware of Husel's "end-of-life" dosing. And any criminal "charges" would be brought by the district attorney and not the hospital. The only thing we can say for sure is that Husel was charged AFTER he was peer reviewed by his hospital medical staff and after his Ohio medical board review that 2took disciplinary action against his license.

Note that SOME of his colleagues may have been aware of what he was doing and either didn't disagree or maybe thought euthanasia was just fine.

Not trying to mislead anyone, just relaying what I’ve read. I’m sure the articles don’t have all the exact details. All I know is that he was met with at least twice about the issue and his practice was allowed to continue. If I recall correctly they were going to put him in charge of some sort of committee to fine-tune palliative care (I’m paraphrasing based on memory, will attempt to find the source).

No one has to take my opinions or statements at face value, you should do your own research on the topic. In my opinion if someone is giving lethal or near-lethal doses of a medication to dozens of patients, he/she wouldn’t be allowed to continue such practice after it is discovered.

 

[WilcoWorld]

That bothers me as well. If the true story here is that Husel was euthanizing these patients then what are the chances that all of the pharmacists and nurses involved would be ok with that? Because the only two options at that point would be that they were co-conspirators or that they were afraid to speak up and went along with it unwillingly. Both seem unlikely. Husel didn't select which nurses or pharmacists cared for his patients, so the chances that all of the randomly assigned staff would just so happen to be like-minded angels of death seems astronomically low. Were they afraid to speak up? I'm not sure what the Mount Carmel hospital culture was like, but most hospitals have anonymous reporting systems if you're truly afraid to speak out about someone. Were these systems used at any point before 25 patients had died?

I read that multiple pharmacists raised concerns. According to the pharmacist's testimony I read some had their holds over ridden, others called to express concern and were told that the dose was "for a procedure".

 

[AlmostAnMD]

Yeah I also remember defense talking about MC putting husel on a dosing committee. And again the voice reports were finalized with all three of them agreeing as his dose "appropriate for palliative care." His actions were definitely condoned by the hospital, or at the very least known and tolerated

 

[neurodoc]

Not trying to mislead anyone, just relaying what I’ve read. I’m sure the articles don’t have all the exact details. All I know is that he was met with at least twice about the issue and his practice was allowed to continue. If I recall correctly they were going to put him in charge of some sort of committee to fine-tune palliative care (I’m paraphrasing based on memory, will attempt to find the source).

No one has to take my opinions or statements at face value, you should do your own research on the topic. In my opinion if someone is giving lethal or near-lethal doses of a medication to dozens of patients, he/she wouldn’t be allowed to continue such practice after it is discovered.

Absolutely, and that seems to be exactly what the hospital did. Looks like we agree.

 

[neurodoc]

Yeah I also remember defense talking about MC putting husel on a dosing committee. And again the voice reports were finalized with all three of them agreeing as his dose "appropriate for palliative care." His actions were definitely condoned by the hospital, or at the very least known and tolerated

I remember so-and-so saying this and that and other off-the-cuff assertions that when checked out don't stand up...like Dr. Ely's testimony means anyone who gives more than 50mcg of fentanyl can be charged with murder seem to be staple posts on this thread. It may be true that Husel was put on some hospital committee...most of us who work in hospitals have been on medical staff committees. I really have to doubt than any of these committees "condoned" or in any way endorsed the kind of doses Husel is on trial for. If you have definite proof that what you claim above, please tell those of us from Missouri where we can find it.

 

[DrSnips]

I read that multiple pharmacists raised concerns. According to the pharmacist's testimony I read some had their holds over ridden, others called to express concern and were told that the dose was "for a procedure".

Right, those pyxis overrides. Still, you'd think that wouldn't work more than once, let alone 25 times. The prosecution has charged him with multiple murders, so their narrative necessarily entails a bunch of hospital staff watching murders occur right in front of them and doing very little about it. If you witnessed a murder at work would you send an email about it?

 

[Tigers540]

Absolutely, and that seems to be exactly what the hospital did. Looks like we agree.

Do we? His practice was discussed at 2 separate hospital meetings, one with risk management and one with the head of medicine at MC. Afterward, 3 more patients passed away under Husel's palliative care. Husel was placed on admin leave after the third meeting on 11/21, and on 11/26 they discussed a new palliative care policy that Husel will help develop the guidelines for.

It wasn't until it was escalated by their parent company Trinity Health that Mount Carmel then hired a criminal defense attorney and fired him the next day.

I'm just confused. How are you asserting that the hospital stopped allowing his "lethal-dose palliative care" once they became aware when 3 patients continued to be treated by his usual practice?

I maintain that if a physician is giving lethal doses of a medication and pharmacy, other physicians, the entire nursing staff, risk management, and head of medicine are aware - such practice would be stopped immediately. That is simply not the case here.

 

[WilcoWorld]

Right, those pyxis overrides. Still, you'd think that wouldn't work more than once, let alone 25 times. The prosecution has charged him with multiple murders, so their narrative necessarily entails a bunch of hospital staff watching murders occur right in front of them and doing very little about it. If you witnessed a murder at work would you send an email about it?

I have encountered many senior doctors who are bullies and have enough clout to get away behaving badly until someone finally stands up to them. I have stood up to several bullies in my career, and I have more than once been penalized for it. It's not easy to do in a lot of hospital cultures.

 

[DrSnips]

I have encountered many senior doctors who are bullies and have enough clout to get away behaving badly until someone finally stands up to them. I have stood up to several bullies in my career, and I have more than once been penalized for it. It's not easy to do in a lot of hospital cultures.

That's fair; I acknowledge those people exist. But the nurses in this case testified that Husel wasn't a bully. That he was someone they could approach if there was a problem.

 

[dpmd]

That's fair; I acknowledge those people exist. But the nurses in this case testified that Husel wasn't a bully. That he was someone they could approach if there was a problem.

I also posted about how he was willing to decrease the starting dose if a nurse asked (and lo and behold the lower dose the dose was not effective so repeat and escalating doses were needed)

 

[Tigers540]

You appear to be arguing in favor of euthanasia here. I think that could be a very interesting discussion - it's an issue on which I have not yet made up my mind.

Is he arguing in favor of euthanasia though? Or is he arguing in favor of allowing provider discretion in palliative comfort care, at least in the absence of a hospital policy?

To be arguing in favor euthanasia these would need to be confirmed lethal doses of medication, and they are not.

 

[neurodoc]

I'm just confused. How are you asserting that the hospital stopped allowing his "lethal-dose palliative care" once they became aware when 3 patients continued to be treated by his usual practice?

To quote Ronald Reagan, "Here you go again." Please tell me where I ever said that, or do you just like to make stuff up and post it here as Gospel truth?

 

[neurodoc]

Do we? His practice was discussed at 2 separate hospital meetings, one with risk management and one with the head of medicine at MC. Afterward, 3 more patients passed away under Husel's palliative care. Husel was placed on admin leave after the third meeting on 11/21, and on 11/26 they discussed a new palliative care policy that Husel will help develop the guidelines for.

Do you have any experience at all with hospital directed peer reviews? I do and was involved in quite a few of them when I served as Chief of Staff and chair of my department. I know nothing about how Mount Carmel conducts peer review of its medical staff physicians, and I have not reviewed any documentation of the hospital meetings you allege occurred. It's possible that Husel came up for review for his care in one or more (you mention three) patient deaths. Since a major purpose of peer review is educational and provide physicians with corrective (when necessary) guidance to improve their care, I can easily imagine that the morbidity/mortality +/- peer review committees were concerned about his practice (specifically the dangerous narcotic doses he used to treat those deceased patients). I have no idea what they concluded after their reviews and since most peer review proceedings are confidential, so I wonder what you actually know about that. I can tell you that it's entirely possible the committees found problems with Husel's patient management of those few patients but counseled him not to make the same "mistakes" in the care of other patients. I also have no problem believing that they suggested he work on a committee to develop palliative care guidelines and even provide a CME lecture on the subject to the MC medical staff, all as part of an effort to salvage him as a physician. I was involved in doing exactly that sort of thing when I chaired peer review committees. It's possible that as more cases came to light they had to refer him to the medical board and eventually he was facing criminal charges.

I apologize for the length of the above response, but I wanted to make it absolutely clear why I don't believe what you (and I suppose his defense team) claim in any way excuses Husel for his "end of life" narcotic dosing or even that this was somehow approved with winks and nods by the MC medical staff organization.

I suspect you will object to everything I've just said, and frankly I don't care if you do or don't. My response to you is intended to reach other readers who maintain an open mind on this discussion. Some folks here may view this whole discussion as some sort of sport of argumentative one-upmanship. It is by no means a game.

 

[DrSnips]

Some folks here may view this whole discussion as some sort of sport of argumentative one-upmanship.

I served as Chief of Staff and chair of my department.

Nothing says opposition to one-upmanship like belting out your CV's greatest hits.

 

[Tigers540]

“lots of things objecting to everything I said”

I suspect you will object to everything I've just said, and frankly I don't care if you do or don't.

This is a forum where, by definition, opinions are exchanged. I’m sorry? You have no obligation to continue in the discussion.

At least one hospital admin at mount Carmel was fired over this. Why else would they do that? Because……ding ding ding…..three additional patients died receiving husels palliative care after it was brought to his attention. Neither of us are privy to the details of that meeting, the peer review, or the conversation with risk management. But we do know that they were all aware and people continued to die.

We can go in circles all you want. The admin knew about supposed “lethal doses” and did not act quickly. Just like no one else acted quickly. Probably because no one really thought this was a big deal until the parent company got involved and a criminal investigation began.

 

[WilcoWorld]

Is he arguing in favor of euthanasia though? Or is he arguing in favor of allowing provider discretion in palliative comfort care, at least in the absence of a hospital policy?

To be arguing in favor euthanasia these would need to be confirmed lethal doses of medication, and they are not.

I'd prefer @Southpaw to answer what they are or are not arguing in favor of. I'm just saying that's what it looks like to me, and I'm quite interested in a discussion of the ethics of euthanasia (but preferably in a new thread as this one is a mess already).

Your point here appears to be that in order for an action to be an intentional killing it has to have a known certainty of lethality. I do not agree with that assertion.

Afterward, 3 more patients passed away under Husel's palliative care. Husel was placed on admin leave after the third meeting on 11/21, and on 11/26 they discussed a new palliative care policy that Husel will help develop the guidelines for.

I don't know if you did this intentionally, it could certainly have been unintentional, but I want to point out the linguistic slide happening here: You have begun referring to his practice as "palliative care". This lends it an air of appropriateness in the mind of a casual reader. It's kind of like if someone else started to refer to his care as "Husel's murderous care" in every post - they would be assuming their conclusion. If intentional, this is sophistry. If not, it's an understandable slip. So I want to point out that, IF the prosecutions assertions are correct, THEN what he did is not condoned by current Palliative Care standards and probably shouldn't be labeled as such.

 

[Tigers540]

I'd prefer @Southpaw to answer what they are or are not arguing in favor of. I'm just saying that's what it looks like to me, and I'm quite interested in a discussion of the ethics of euthanasia (but preferably in a new thread as this one is a mess already).

Your point here appears to be that in order for an action to be an intentional killing it has to have a known certainty of lethality. I do not agree with that assertion.

I don't know if you did this intentionally, it could certainly have been unintentional, but I want to point out the linguistic slide happening here: You have begun referring to his practice as "palliative care". This lends it an air of appropriateness in the mind of a casual reader. It's kind of like if someone else started to refer to his care as "Husel's murderous care" in every post - they would be assuming their conclusion. If intentional, this is sophistry. If not, it's an understandable slip. So I want to point out that, IF the prosecutions assertions are correct, THEN what he did is not condoned by current Palliative Care standards and probably shouldn't be labeled as such.

Interestingly enough, I changed the semantics of that a few times simply bc I wasn’t sure even how to word it. According to Husel his dosages were palliative comfort care, so I’m not sure how else to refer to it. He is innocent until found guilty, no?

If they include lesser charges, he could still be found guilty while truly attempting palliative care.

 

[WilcoWorld]

Interestingly enough, I changed the semantics of that a few times simply bc I wasn’t sure even how to word it. According to Husel his dosages were palliative comfort care, so I’m not sure how else to refer to it. He is innocent until found guilty, no?

If they include lesser charges, he could still be found guilty while truly attempting palliative care.

I'd leave out the word "palliative"(just as I leave out the word "murderous") when referring to it. "Afterward, 3 more patients died under Husel's care" seems to convey all necessary information without prematurely labeling it one way of the other.

I realize this sounds perhaps too semantic, but consider the following 3 formulations:

-Afterward, 3 more patients passed away under Husel's palliative care
-Afterward, 3 more patients were killer under Husel's murderous care
-Afterward, 3 more patients died under Husel's care

To my ear, the 3rd is the most fair way to talk about an ongoing case while the first two suggest a conclusion by virtue of their word choice.

 

[Tigers540]

To my ear, the 3rd is the most fair way to talk about an ongoing case while the first two suggest a conclusion by virtue of their word choice.

The only people who can form a conclusion here is the jury. This entire forum is speculative and opinionated. But sure, I can put "palliative care" in quotation marks at least.

 

[neurodoc]

Nothing says opposition to one-upmanship like belting out your CV's greatest hits.

Instead of prefacing the above comment with: I served as Chief of Staff and chair of my department., you might have put that into its context, ie:
Do you have any experience at all with hospital directed peer reviews? I do and was involved in quite a few of them when I served as Chief of Staff and chair of my department.

In responding to what T540 posted I wondered if he knew how directed peer review actually works. I thought it was quite appropriate to preface my comments about directed peer review by referring to (not "belting out" ) my own experience performing it as a medical staff officer in my hospital. It is certainly part of my CV, but hardly its "greatest hits." That was the main reason I mentioned it, but I have to say that I also suspected someone (like you or T540 et al.) might make exactly the kind of snarky comment that you did. Thanks for confirming that suspicion.

BTW, is T540 a physician? Just wondering.

 

[Birdstrike]

Is it possible Husel himself posts here on this thread?

Is it possible his defense team has someone posting here on this thread?

 

[dadaddadaBATMAN]

Is it possible Husel himself posts here on this thread?

Is it possible his defense team has someone posting here on this thread?

Unlikely unless he’s an idiot.

And unlikely they have that kind of time on their hands. Especially now.

But then again, think of hundreds….well dozens….well 8-10…hearts and minds they could change…..in a highly polarized debate where all parties seem to have made up their minds long ago.

 

[DrSnips]

Instead of prefacing the above comment with: I served as Chief of Staff and chair of my department., you might have put that into its context, ie:
Do you have any experience at all with hospital directed peer reviews? I do and was involved in quite a few of them when I served as Chief of Staff and chair of my department.

In responding to what T540 posted I wondered if he knew how directed peer review actually works. I thought it was quite appropriate to preface my comments about directed peer review by referring to (not "belting out" ) my own experience performing it as a medical staff officer in my hospital. It is certainly part of my CV, but hardly its "greatest hits." That was the main reason I mentioned it, but I have to say that I also suspected someone (like you or T540 et al.) might make exactly the kind of snarky comment that you did. Thanks for confirming that suspicion.

BTW, is T540 a physician? Just wondering.

Are you responding to a comment I made? You might be surprised to learn this, but about a week ago you said you weren't going to do that. Might indicate memory issues if you've forgotten this quickly. Would you like a referral to a neurologist? I know of one who has experience with peer reviews and also served as Chief of Staff and chair of his department. Not sure you'd get a fair evaluation from him though. He tends to immediately assume people are confused or argumentative if they don't agree with him.

 

[turkeyjerky]

Are you responding to a comment I made? You might be surprised to learn this, but about a week ago you said you weren't going to do that. Might indicate memory issues if you've forgotten this quickly. Would you like a referral to a neurologist? I know of one who has experience with peer reviews and also served as Chief of Staff and chair of his department. Not sure you'd get a fair evaluation from him though. He tends to immediately assume people are confused or argumentative if they don't agree with him.

Maybe he needs some Aduhelm...

 

[WilcoWorld]

This thread has gotten quite unnecessarily nasty. Including the ad hominem attack above.

 

[turkeyjerky]

I think it's pretty clear that, strictly defined, he committed euthanasia. It's just inexplicable, in my mind, that this label can be applied to an action that has so little in common with the typical meaning of the word. This saga is utterly lacking any semblance of reasonable professional judgement or prosecutorial discretion as to be more appropriate for a Joseph Heller novel than real life.

 

[neurodoc]

Are you responding to a comment I made? You might be surprised to learn this, but about a week ago you said you weren't going to do that. Might indicate memory issues if you've forgotten this quickly. Would you like a referral to a neurologist? I know of one who has experience with peer reviews and also served as Chief of Staff and chair of his department. Not sure you'd get a fair evaluation from him though. He tends to immediately assume people are confused or argumentative if they don't agree with him.

You seem to be the one with a memory problem. I said I wasn't going to respond to any comments you made about the specific topic you were obfuscating about (ethics versus morality as regards euthanasia), which is a completely different topic from the one I just responded to. To refresh your own faulty memory I'll remind you of exactly what I said:

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.

I'm not surprised you misunderstood what I wrote, since you've already demonstrated your penchant for being unable to understand English and/or misrepresenting facts. The rest of your puerile ad hominem comment should already make you look stupid to others reading this thread, so responding in kind is neither appropriate nor necessary. You've just done that yourself.

 

[neurodoc]

I'm just trying to keep the discussion honest and appropriately contextualized. If we're going to cite an LD50 in this conversation, we should probably at least mention the LD50 that's most relevant to humans (in this case, primates). Personally, the elephant testimony seems unhelpful and unnecessary to me. Husel isn't on trial for his care of elephants!

"Enough to kill [or 'take down'] an elephant" is a cliche that widely understood to be an exaggeration and not to be taken literally...eg "His work was so hard it could kill an elephant." I doubt (or at least hope) Dr. Ely didn't mean it literally and in any case agree Dr. Ely shouldn't have used that expression.

 

[DrSnips]

You seem to be the one with a memory problem. I said I wasn't going to respond to any comments you made about the specific topic you were obfuscating about (ethics versus morality as regards euthanasia), which is a completely different topic from the one I just responded to. To refresh your own faulty memory I'll remind you of exactly what I said:

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.

I'm not surprised you misunderstood what I wrote, since you've already demonstrated your penchant for being unable to understand English and/or misrepresenting facts. The rest of your puerile ad hominem comment should already make you look stupid to others reading this thread, so responding in kind is neither appropriate nor necessary. You've just done that yourself.

Calling me stupid and claiming I can't understand English as you chastise me for an ad hominem attack. I'll admit I went too far, but you are such a superlative hypocrite I'm almost impressed.

 

[neurodoc]

Calling me stupid and claiming I can't understand English as you chastise me for an ad hominem attack. I'll admit I went too far, but you are such a superlative hypocrite I'm almost impressed.

I did not call you stupid. What I did say was:

The rest of your puerile ad hominem comment should already make you look stupid to others reading this thread.

In other words you were quite effectively calling yourself stupid. Your comment itself proves the point I was (and have been) making about your penchant to either be unable to understand English or to misrepresent facts. My response to you was not a mere ad hominem attack but rather a reasonable and civilized response to your own ad hominem attack on me. I'll leave it to other readers besides you to determine whether or not I'm a superlative hypocrite. I'm glad you admit you went too far. That shows insight.

 

[dpmd]

I think it's pretty clear that, strictly defined, he committed euthanasia. It's just inexplicable, in my mind, that this label can be applied to an action that has so little in common with the typical meaning of the word. This saga is utterly lacking any semblance of reasonable professional judgement or prosecutorial discretion as to be more appropriate for a Joseph Heller novel than real life.

Defined strictly enough we commit euthanasia every time we stop pressors for a pressor dependent patient and remove the ETT from a vent dependent patient.

 

[Tigers540]

Hopefully everyone else is reporting the inflammatory/baiting stuff as well.

I still cant find one good explanation as to how someone is giving a lethal dose of medication to 24+ patients, and no one made a legitimate peep. I'm not talking about a few comments like "Dr Husel is giving larger than usual doses of opioids to end of life patients" or the one ding by pharmacy that went nowhere. I'm talking about a response appropriate for a murderous dose of medication.
How do 3 people die after risk management and upper level administration know about homicides? I understand that due diligence needs to be done.......but 24+ lethal doses?

Assuming closing arguments are monday, my prediction is that lesser charges are included and he's found guilty of some sort of reckless homicide. To me, this seems to apply way more precisely to the situation even though I still don't think they can prove the fentanyl killed these people and not the removal of various forms of life support

 

[DrSnips]

I did not call you stupid.

You're splitting hairs. "Oh see, I didn't directly call you stupid, I did so indirectly by invoking the thoughts of others -- thoughts I would have no way of knowing."

Frankly I think you are engaging in gaslighting. You make statements knowing how they will be interpreted and then once someone takes the bait you set about telling them they've either misunderstood or misrepresented what you've said. You then follow up, offering strictly textualist interpretations of what you've written to the point it seems unlikely that any reasonable person would read your comment in that fashion even though your version is technically possible given the inherent ambiguities of English.

 

[VA Hopeful Dr]

Just a reminder to stay on topic (Dr. Husel's trial) and be civil to each other.

 

[WilcoWorld]

Defined strictly enough we commit euthanasia every time we stop pressors for a pressor dependent patient and remove the ETT from a vent dependent patient.

No. In cases where life support is withdrawn the patient's disease causes their death. This is a significant and important distinction in medical ethics.