No Good Deed: A Story of Medicine, Murder Accusations, and the Debate over How We Die

I'm one of those people who, when taking a beloved animal on its last trip to the vet, always says "Why can't doctors do this for us humans when we're at the end of our lives and suffering needlessly?" This book is a case study in why.Two compassionate nurses were caring for a hospitalized dying woman, and made sure she got sufficient morphine to alleviate her pain. A nurses' aide observed it, misunderstood their actions, and reported them to the authorities as having "killed" the patient. Although eventually exonerated, the nurses went through two years of hell after being charged with murder. Their careers were in shambles and the confused assistant is still at her job.Only experienced medical professionals are qualified to know when "enough" pain medication crosses the fine line into "too much", and the difference between a patient with an agonizing terminal condition versus someone whose life could possibly be extended by a few extra weeks or months isn't readily apparent to law enforcement. But an accusation from a non-professional who knew very little about pain treatment in terminal patients was enough to send equally ignorant law enforcement officers on a rampage through the hospital.Incidents like this are part of the reason doctors are often reluctant to provide appropriate opiates to people in agony -- even those who are unquestionably dying. This book provides a frightening look at the power of district attorneys looking for a high-profile case to show off in the next election and minimally trained medical assistants who don't understand what they're observing.Hospice providers and end-of-life caregivers insist that they can "control even the worst pain". But 'can' is a long way from 'will', and chilling stories like this are part of the reason too many Americans die in unrelieved agony. The chance of losing their license to practice medicine AND a jail term when an already terminal patient dies is simply too great for many people to take the risk.

Decisions about end-of-life medical care are painful and complex; they are untimately grounded in the deep beliefs and unique life-experiences of dying patients and their families. They have much in common with the fundamental liberties protected by the First Amendment, especially the clauses that protect the free exercise of religion and that prohibit government aid to any religious belief or institution. There are good medical practices and bad ones; but there are no verifiably correct personal or religious decisions about whether to terminate life-support and request palliative care, or to pursue aggressive, even futile treatment in the face of imminent death. No one wants to make these decisions, but very few of us will escape the need to do so. Dr. Lew Cohen's new book, NO GOOD DEED: A STORY OF MEDICINE, MURDER ACCUSATIONS, AND THE DEABTE OVER HOW WE DIE, places these exquisitely difficult and heart-wrenching individual decisions in the context of the sometimes hysterical American public discourse that has arisen over whose view of death and dying should be adopted in law and imposed by government upon individuals. If the ideologically and politically driven cries of "death panel" and "pulling the plug on granny" that arose during the health care reform meetings last August made most of us cynical and despairing about human reason and American democracy, NO GOOD DEED restores our confidence in our ability to understand, reason, communicate, and respect end-of-life medical care decisions made by families and physicians. Cohen has provided not just a balanced voice of reason about palliative care, but an honest, well-researched and empathic report of the personal realities, medical practices, and the legal/cultural context that has too often made personal tragedies into ammunition in the culture wars. Whatever your personal experiences, religious or personal beliefs, or knowledge about medicine, law and policy in this area, you will be informed and moved by Cohen's book; and you will emerge from reading it better able to resist the demagoguery that has increasingly infected our public discourse on this vital subject.

I just completed Dr. Lew Cohen's book which I read with great interest through every page. Lew is a friend and colleague which made the book especially interesting for me. I am also an employee of the hospital which he writes about. While I have always had opinions of the major news stories we have read and heard about, never have I truly understood the complexities, nor the highly passionate and emotional aspect of this enormous issue which confronts end of life. Thank you to Lew who so compassionately and wisely discusses all the sides of this compelling drama which played out right at our hospital. I have the utmost respect for Amy and Kim but also can understand why Olga felt she had to come forward with her accusations. I only wish she had gone to the administration and not to the DA. Kim and Amy have survived this horrendous experience of being accused of murdering an end of life patient, but will their scars from their hideous nightmare ever really go away? This is a great read for all in the medical field but also for anyone who has faced or may be facing such an ordeal on any side of the issue.

Brilliant book highlighting d exploring the issues faced by professionals aiming to deliver high quality, compassionate care. Definitely worth a read.