Medical schools should take the lead in discussing how health-care workers should respond to crises like those that led to the controversial arrest of a Louisiana State University doctor after Hurricane Katrina, according to an article published today in The New England Journal of Medicine.

The article, “Dr. Pou and the Hurricane — Implications for Patient Care During Disasters,” was written by Susan Okie, a national correspondent for the journal. It recounts the nightmarish experience of Anna Maria Pou, a cancer surgeon on the faculty of LSU’s School of Medicine who was supervising residents at the Memorial Medical Center in New Orleans when Katrina struck, in August 2005.

“Nowhere was the situation more desperate than at Memorial Medical Center, where for four days a small staff struggled to care for critically ill patients in a dark building with no electric power, no fresh water, a flooded first floor, a nonfunctional sanitation system, and an interior temperature above 100°F,” the article states.

At least 34 patients died in the hospital before and after the storm. In July 2006, authorities acting under the orders of Louisiana’s attorney general, Charles Foti, arrested Dr. Pou and two nurses, accusing them of administering fatal doses of painkillers to four elderly and seriously ill patients during the time the doctors and patients were stranded in the hospital.

Dr. Pou has said that she administered the medication not to kill the patients but to alleviate their pain after she was told no one was coming to rescue them. A grand jury declined to indict her, and charges against the nurses were dropped.

But the case continues to raise troubling questions for health-care workers who treat patients in future disasters, the article points out. One lesson is “the need for community discussions about what care should be provided during a disaster that strains medical resources,” the article states.

“With expanded training and public debate about triage, communication, and decision making when resources are limited,” it says, “caregivers may be better equipped for the kind of ordeal that Pou and her colleagues faced after the deluge.” —Katherine Mangan