“I will follow that system of regimen which … I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to anyone if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion …”
Well, there’s lots more in the Hippocratic Oath that has fallen into disuse over the years: the part about abstaining from seducing slaves, for example. What’s one more bit of updating? So where it says, “I will give no deadly medicine,” mark now in its place, “I will give deadly medicines, if: (a) my motive is compassion, and (b) there are no TV cameras present.”
That last may be styled the Kevorkian Caveat, after the well-known Michigan doctor and euthanasiast. Acquitted several times on murder charges, Dr. Kevorkian was judged to have crossed the line, in his most recent effort to “ease the suffering” of one of his patients, by arranging for the event to be televised. Murder is one thing, but bad taste is unforgivable.
Dr. Nancy Morrison kept no such ghoulish record. But the Halifax respirologist now admits she acted to “hasten (the) death” of Paul Mills, a terminally ill cancer patient at the city’s Grace Hospital, by injecting him with nitroglycerin and potassium chloride, a practice that would seem to run afoul not only of her oath, but of the Criminal Code.
Yet, two and a half years later, it appears the severest punishment she will ever receive for putting Mr. Mills to sleep is the formal reprimand issued this week by the provincial College of Physicians and Surgeons. Injecting patients with lethal substances, the College ruled, was “inappropriate and outside the bounds of currently acceptable medical practice.” Currently, you understand; things might change.
All the same, it praised Dr. Morrison’s motives, finding that “she believed at the time that she was acting in his best interests.” By accepting the reprimand, further, she had demonstrated her remorse, militating against further harm to her career. A reprimand, after all; wasn’t that pretty strong stuff? The message to the public, the College registrar observed, was that “if you go into an intensive-care unit, or if you’re terminally ill, the professional organization which tries to set standards has told doctors not to try to end your life prematurely.” Oh, good.
As for Dr. Morrison, her lawyer noted that she accepted the reprimand because a formal hearing “would probably last three to four weeks” and might have set her back another $150,000 in legal fees. The most he would concede was that she made a mistake. “She now realizes, after much thought, that there was a mistake made by herself,” he said. “Sometimes when you have a person who’s dying and going through an agonizing death, you have to make a snap call, and she made it and she made the wrong one.”
Besides, everybody does it. Another doctor might have used an overdose of morphine, rather than potassium chloride – ostensibly to alleviate pain, but with similarly fatal results. “Dr. Morrison chose the wrong drug, that’s all.”
But wait a minute. Appearing in court, little more than a year ago, charged with murder, Dr. Morrison did not say that she made a mistake. Nor, for that matter, did she say she did the right thing – that she acted to save a dying man from suffering horribly in his last hours. She said she didn’t do it.
Though the nurse on duty testified she saw Dr. Morrison injecting Mr. Mills’s intravenous line with a clear fluid, and though Dr. Morrison told her it was potassium chloride – commonly used to execute prisoners in the United States – and though Mr. Mills expired seconds later, her lawyers argued at the preliminary hearing that he died of natural causes.
Incredibly enough, the judge accepted their claim, ruling that there was insufficient evidence to send the case to trial. Mr. Mills’s IV drip might not have been connected properly, the judge argued. Or he might have died from the painkillers he had been given earlier. Perhaps the evidence, in the face of these exotic theories, might not have been sufficient to secure a conviction. But not even to send it to trial?
As it happens, a Nova Scotia Supreme Court judge later found that the judge had erred in law. The evidence, she said, was such that “a reasonable jury properly instructed could return a verdict of guilty of manslaughter, or even first-degree murder.” But she, too, squirmed out of sending the case to trial, on the grounds that the judge, while plainly in error, had not exceeded his jurisdiction.
So: We have a case in which the accused admits “hastening death,” in a manner a higher court has found would warrant a trial for manslaughter, at least. Yet the doctor remains at liberty, and continues to practise, albeit under reprimand. What was that message to the public, again?