The power is out, and I’m on the third day of carrying body after body up more than five flights of stairs. My body is aching, and I’ve begun to sway between wakefulness and exhaustion. Food has grown scarce, and supplies are dwindling as the heat and stench of death engulf me. I hear the whispers of my colleagues, who are beginning to doubt whether help will ever come, and my hope wears thin. I can hardly process the war zone that this hospital has become. 

     This was the reality Dr. Anna Pou faced after Hurricane Katrina devastated New Orleans and left Memorial Medical Center in shambles, with no available power and a staff of overworked medical professionals. Temperatures were soaring above 110°F and days were passing without rest. She was placed in a situation that few physicians outside of a battlefield have ever endured. With helicopters coming and going to rescue patients at sporadic times over the course of five days, Dr. Pou, along with a team of nurses, physicians, and other staff, carried over 40 patients to safety, doing what they could in nearly impossible conditions. 

However, the controversy surrounding Dr. Pou revolves around allegations that she administered a cocktail of sedatives to four patients who she believed would not be rescued during the evacuation process. These drugs resulted in their deaths and were administered to ease their pain, as many of these patients were in critical condition. Dr. Pou stated in multiple interviews that she did not believe this would cause death, but rather administered these sedatives with the intention of easing the extreme pain the patients were enduring. Nevertheless, the outcome of her actions was death. The suggestion to administer the sedatives reportedly came from fellow physicians and emergency coordinators who feared evacuation would never come.

     But as a physician, at what point do you ask yourself if you’ve overstepped? Have I begun to play God? And given the circumstances, were the choices made here and in countless other crises valid under the ethical oath we swear to uphold? 

     A core part of medical ethics is respecting the sanctity of life, which demands that life be preserved whenever possible, regardless of circumstances. The process of euthanasia, when requested by a competent, conscious patient and in jurisdictions where it is legally permitted, can be framed as an act of compassion. However, the patients in Memorial’s LifeCare unit were not in a position to consent. This raises a difficult question: does administering drugs that are likely to hasten death violate the principle of respect for human life? How could Dr. Pou have known with certainty who would live or die? To euthanize in such conditions may rob a person of even the smallest chance of survival. Although some patients were nearing the end of life, the question remains: was this truly the best way? 

     To argue in favor of the choices made, we must first recognize the extraordinary and abnormal circumstances Dr. Pou faced. Simply staying through it all was, in itself, an act of mercy to the patients she saved and carried up every step to the roof, where they were eventually rescued. Dr. Pou worked around the clock in a hospital with dwindling supplies and no power, risking her own life to remain and care for others, an act that reflects the highest standard of care a physician can provide under such conditions. Her ultimate sacrifice was the sacrifice of self in choosing to stay behind, a decision that, from a deontological perspective, represents the purest fulfillment of a physician’s duty: putting the patient’s health even above one’s own. It took great courage to stay in a system where seemingly everything was collapsing. Had Dr. Pou not stayed, it can be argued that fewer patients would have survived.

     The situation was unimaginable, but the lasting effects on families were equally profound. As one patient’s family member, Lou Ann Savoie Jacob, later said: “I consider the nurses murderers. They were in a bad situation, but they were murderers.” That statement alone illustrates the weight of the actions of Dr. Pou on the families of these patients: the grief, the questions, and the “what ifs” that haunt loved ones. Families believed their relatives were murdered, and if that is the case, they believe justice should follow. 

From another perspective, however, one could argue it was an act of mercy. Through a utilitarian lens, if suffering was unavoidable and survival unlikely, hastening death may have been seen as the less brutal option. Many physicians and nurses continued to perform CPR and provide lifesaving care until they physically could no longer do so. From that standpoint, the administration of sedatives might be interpreted not as cruelty but as empathy. 

     Looking through a modern lens, the main concern is the lack of patient consent given that those euthanized were unconscious and couldn't advocate for themselves. Respecting the wishes and autonomy of a patient is at the core of ethics, and without the consent of a patient, a physician risks the greatest betrayal. The argument that this act was palliative care is undermined by the fact that no specific consent was given, and thus it becomes non-consensual euthanasia. It is unknown if the patients’ lives were cared for with respect or instead ended by a decision they had no part in making. 

     In today's society, the principle of “do no harm” is taught to always come first. Administering medications without necessity cannot be ethically justified. However, it can be argued given the circumstances whether alternative measures did or did not exist. Patient care decisions must be guided by the individual’s code status and established medical directives, not solely by empathy

or subjective judgment. In the context of the Anna Pou case, the sedatives that were administered by her caused the deaths according to the autopsy conducted on these patients. This conflicts with the fundamental responsibilities and safeguards that define healthcare practice today. 

     That being said, is it that Dr. Pou played God, or was she the product of a collapsing hospital system? In modern times, there are standards for crises such as this, but when Dr. Pou was a working physician, no such framework existed, leaving her responsible for every moral decision made over the course of five days in war-like conditions. The reality is she was bearing the weight of the lack of support and guidelines, and her staying behind in this collapsing system, with only colleagues and an emergency coordinator advising her, ultimately resulted in her hasty decisions.