Dissecting Coverage of Nursing Home Deaths (Part 2)

homicide, media issues, neglect, nursing homes, Our News & Commentary Blog, reality check

Yesterday, I discussed coverage from late 2006 and early 2007 involving an investigation into suspicious deaths at a nursing home in Woodstock, IL.

Last week, two ex-employees of the Woodstock Residence nursing home were indicted on multiple charges. More on those charges later.

The first news I had of this was via an email message from a colleague, containing a link to an NBC5 story titled “Two Nursing Home Workers Charged in Alleged Mercy Killings.” The term was used in other news reports as well.

As Yogi Berra famously said, it was “deja vu all over again.”

At first, I assumed that reporters were just going back to their old stories and picking up the term from stories they wrote during the initial time of the investigation.

I even assumed – at first – that they were pushing this term with no clear evidence for doing so when I read this bit in a story by Liam Ford, Carolyn Starks and Vikki Ortiz in the Chicago Tribune:

Even as they announced indictments against Marty Himebaugh, 57, and her supervisor, Penny Whitlock, 59, prosecutors refused to offer a motive or to say whether six suspicious deaths at the Woodstock Residence between 2004 and 2006 were mercy killings.

Generally, when a reporter says that an official refused to say something it was in response to a specific question that was asked – in this case we can assume the prosecutors were asked if the suspicious deaths were “mercy killings.”

Feeling that I needed a better handle on what was happening here, I contacted attorney Steven Levin, who is representing a family of one of the alleged victims. He will be filing a nursing home abuse and wrongful death law suit on behalf of the family against Woodstock Residence and the two ex-employees who are facing criminal charges.

Levin was very helpful with some key factual information. First, he pointed out that the charges against Himebaugh and Whitlock didn’t involve any murder, homicide or manslaughter charges. He also steered me toward the indictments themselves, for a key phrase that is bound to cause continual confusion.

In this context, the important document is the Bill of Indictment against Penny Whitlock, the ex-director of the nursing home (link to pdf file).

Counts III and IV in the indictment are virtually identical, accusing Whitlock of “criminal neglect of a long term care facility resident.” Here’s the “money quote” in these two counts:

“…Penny Whitlock, while acting in the capacity of Director of Woodstock Residence, a long term care facility, recklessly encouraged Marty Himebaugh, an employee of Woodstock Residence, to continue actions which constituted abuse or neglect of a long term care facility resident by stating that Marty Himebaugh could continue to play the “Angel of Death” in the facility after receiving a report of the alleged abuse or neglect…”

As colleagues and readers of this blog know, I’m not generally all that sympathetic toward reporters who blow it when covering stories involving old, ill or disabled people. But I have at least a little sympathy this time.

Here we have a case that involved the exhumations of several ex-residents of a nursing home. Their deaths are regarded as “suspicious.” The charges against the individuals, however, don’t involve any accusations of actually causing the death of anyone. That’s already confusing.

To top it off, the grand jury plants the “Angel of Death” bombshell in Whitlock’s indictment. That term is loaded with multiple meanings and a lot of mythology – but all the meanings and mythology involve someone killing people.

The Northwest Herald has a video of the press conference in which prosecutors announced the charges here.

At the end of the conference, reporters zero right in on the “Angel of Death” reference, trying to get clarification on just how they should interpret that. Frankly, the answers from the prosecutors are pretty jumbled and don’t make much sense, and in the end fall back on steering people back to the indictments. Going back and rereading the indictments, of course, won’t really be any help at all.

I’ll go even farther with my concerns regarding the “Angel of Death” bomb. Since Whitlock and Himebaugh are entitled to a presumption of innocence until and unless proven guilty, it’s troubling that this term associates them with acts that they’re not charged with. In the public’s mind, an “Angel of Death” is someone who kills.

Aside from the concerns regarding the term’s effect on the defendants, there are also problems that the term – and how it’s used – might make the public feel it’s OK even if they are guilty. Part of the mythology with “Angels of Death” involves treating that term as a version of “Angel of Mercy” – an “Angel of Death” being a medical professional who kills out of mercy – repeatedly, until caught and stopped.

Frank Main and Dan Rozek of the Chicago Sun-Times demonstrate this conflation in a little bit they threw in about a convicted medical serial killer in “Were deaths at nursing home mercy killings?”

In 1992, a mercy-killing case stunned the nation when Brian K. Rosenfeld pleaded guilty to murdering three elderly patients with drug overdoses. Rosenfeld, who allegedly admitted killing 23 patients, was sentenced to life in prison in Florida. A boast by Rosenfeld led to the exhumation of five drugged bodies.

It doesn’t seem to occur to Main or Rozek that someone who admits to killing 23 elderly people might be operating on some motive a little darker that wanting to provide “mercy.”

This case will be an ongoing one and will be a source of countless stories while it plays out in the legal arena. During that time, I’d urge Main, Rozek and any other reporter covering this story or similar ones to do a little research.

I’ll even give them a head start. Doing a little digging of my own, I found this USA Today article from 2003 titled “Angels of mercy: The dark side“:

Some analysts say that nurses who kill patients do so for a variety of reasons. Orville Majors, convicted of six counts of murder in Indiana in 1999, was sick of complaining patients. Genene Jones, a pediatric nurse convicted of murder in Texas in 1984, apparently enjoyed watching babies go into cardiac arrest.

Yorker said some killers are motivated by “Munchausen syndrome by proxy,” a psychological disorder attributed to those who create medical emergencies in those under their care to draw attention to themselves.

But possibly the biggest reason that some nurses kill is that they can.

They have access to patients who are often very sick, very old or very young — and access to drugs powerful enough to kill unobtrusively through an intravenous tube. And they work at institutions with an inherent aversion to litigation and publicity.

This is just the tip of iceberg. I know that at least one of the experts in this article, forensic psychologist Katherine Ramsland (not quoted in excerpt above), has published a book about serial killers in medical settings.

If some of the local media delved into this phenomenon and just what is known and suspected about so-called “Angels of Death,” we might see a sharp drop-off of the use of the term “mercy killing” in future coverage of this particular case, anyway. –Stephen Drake

Addendum: For the record, according to the same Chicago Tribune story linked at the top of this entry, here are the specific charges against Himebaugh and Whitlock:

Himebaugh, a licensed practical nurse, faces four counts of felony neglect of a long-term resident in connection with overdosing patients with morphine, a felony charge of obtaining a substance by fraud and a felony charge of unlawful distribution of morphine.

Whitlock, of Woodstock, was arrested at the nursing home Friday. A registered nurse, she was charged with five counts of felony neglect of a long-term resident and two felony counts of obstruction of justice. She destroyed drugs to impede the investigation, according to her indictment.

Dissecting Disturbing and Distorted Coverage of Investigation of Nursing Home Deaths (Part 1)

homicide, media issues, neglect, nursing homes, Our News & Commentary Blog

I’ve been thinking this story through for the past two days. I finally decided it’s best to handle it in two parts.

It’s an important story to look at, since it shows multiple factors affecting some highly (to say the least) questionable coverage of suspicious deaths in a nursing home in Woodstock, Illinois.

News first emerged in late 2006 announcing the investigation into suspicious deaths at a nursing home in Woodstock. Many of the articles announcing the investigation carried the term “mercy killing” in the title, suggesting that the perpetrator – if any – was performing a “merciful” act.

Here are a few of the links and headlines from back then, still accessible:

Authorities Investigate Possible Mercy Killings in Woodstock (NBC5.com)
Were deaths at nursing home mercy killings? (Chicago Sun-Times)

Often the term was left out of the headline, but was prominently featured in the story itself as in this story from the Northwest Herald reporting the exhumation of bodies as part of the investigation:

One of the nursing home’s owners has said she thought the mercy-killing accusations came from a disgruntled employee.

(Although the articles are inaccessible to me, my memory of the Chicago Tribune coverage is that they played the story “straight” – as one about an investigation into deaths and neglect and didn’t use the term “mercy killing.”)

Initially, I assumed this was just another example of reporters operating on the default assumption that the murders (or suspected murders) of old, ill or disabled people are “mercy killings.” It’s happened before. Chicago Reader columnist Michael Miner wrote about our criticisms of the media treatment of the murder of Shirley Harrison in “No Mercy,” back in 2002. The subject of reporters asking about “mercy killings” in the context of a serial murder investigation came up there, too:

Drake pointed out to me a telling passage from the first Southtown article: “Oak Lawn police released few details of the investigation. They would not say whether Harrison shot his wife out of mercy for her suffering.” Then he showed me an AP story from Texas, where a former nurse had recently been charged with killing four patients using lethal injections and was suspected in 16 other deaths. The district attorney “would not discuss a possible motive or say whether the nurse might have considered the deaths ‘mercy killings.’ Most of the victims were elderly.”

The leading questions of reporters tell Drake what angle they’re working on. Could the nurse have been acting out of mercy? one of them asked the DA. “This was in the context of a serial killer! It’s like, what the hell’s going on there?

“However, in this case, it appears that reporters have been given multiple excuses since this case began to inject the “mercy killing” term.

Chicago Sun-Times reporter Dan Rozek pointed to the source for his use of the term in this article from November 18, 2006 – Deaths spike at facility in mercy-killing probe:

Authorities are probing allegations that a nurse there gave lethal doses of morphine, a pain-killer, to some patients in what law enforcement sources said may have been mercy killings.

This is what I would call a “smoking gun.” Someone in “law enforcement” threw out the term, and severely affecting the coverage of an ongoing investigation by planting that term into press coverage and the public consciousness.

I don’t work in law enforcement, but I would think this kind of loose talk during an investigation is unprofessional. Wouldn’t the professional and appropriate statement be something like “this is an ongoing investigation and it’s much too early to speculate on motives”??

I wish I could say that this kind of unprofessional behavior is unusual, but it doesn’t seem to be when it comes to cops saying stupid things in the cases of old, ill or disabled people who have been murdered. In the case of these particular types of victims, too many law enforcement officials see all too willing to venture an opinion on “motive” at a time when they know absolutely nothing.

For example, in April 2006 Betty Whitten was charged in the stabbing death of her 34-year-old daughter, who reportedly had cerebral palsy and intellectual disabilities. Dan Rozek, of the Sun- Times, was one of the first to write about (sadly, this story isn’t accessible and the quotes are from an archived copy):

Worn out and depressed after years of caring for her severely disabled daughter, Betty C. Whitten fatally stabbed 34-year-old Nyakiambi Whitten, then apparently tried to kill herself by driving off a bridge, law enforcement officials said Tuesday. But Betty Whitten survived what authorities said appeared to be an intentional crash in west suburban St. Charles and was charged Tuesday with murdering her daughter.

“She was depressed, she just snapped,” a law enforcement source said.

Further down is the stupid comment from aforementioned law enforcement professional:

Whitten, who was the primary caretaker for her daughter, was struggling to cope with her daughter’s medical problems, Ramsey said.

“I think the health issues were a big factor in this,” Ramsey said, adding: “The family was struggling.” (“Ramsey” refers to Kane County Sheriff Ken Ramsey)

Why was this “stupid”?

Because in subsequent articles the family itself denied that Betty Whitten was particularly stressed by the support she gave her daughter. Not only that, Whitten was experiencing a mental breakdown so severe that it was several months before she was declared fit for trial. She had to be placed on a regiment of anti-depressants and anti-psychotics. Eventually, she was convicted in her daughter’s death, but earned a rare “guilty but insane” verdict from the jury, meaning she will get treatment while she serves her sentence.

“Caregiver burden” doesn’t appear to have been a factor, but that didn’t stop one thoughtless cop from jumping to that conclusion and then having it become part of the press coverage.

Tomorrow, I’ll continue with the Woodstock nursing home case. Charges have been filed now. And members of the press have new reasons to perpetuate the “mercy killing” label in their coverage. But the “reason” still doesn’t let them off the hook. –Stephen Drake

Hillary Clinton Says Assisted Suicide “Appropriate Right to Have”

assisted suicide, Oregon, Our News & Commentary Blog, politics

(Note: None of the following should be interpreted as an endorsement or rejection of any candidate. NDY does not endorse candidates for public office.)

Hillary Clinton was in Oregon over the weekend. Predictably, she was asked about assisted suicide:

Q: What’s your attitude toward Oregon’s assisted suicide law?

A: I believe it’s within the province of the states to make that decision. I commend Oregon on this count, as well, because whether I agree with it or not or think it’s a good idea or not, the fact that Oregon is breaking new ground and providing valuable information as to what does and doesn’t work when it comes to end-of-life questions, I think, is very beneficial.

Q: Would you have voted for it if you were a resident of the state?

A: I don’t know the answer to that. I have a great deal of sympathy for people who are in difficult end-of-life situations. I’ve gone to friends who have been in great pain and suffering at the end of their lives. I’ve never been personally confronted with it but I know it’s a terribly difficult decision that should never be forced upon anyone. So with appropriate safeguards and informed decision-making, I think it’s an appropriate right to have.

First, we should all probably get used to this. Clinton and Obama are in a heated race for the Democratic nomination and won’t want to do or say anything to piss off Oregon voters. John McCain is a little more unpredictable, but he’s well aware that the national race will be a tight one and he’s pretty solid on that “states’ rights” stuff.

As to Clinton’s answer – or answers – since she’s contradicting herself, it’s obvious she hasn’t had anyone brief her on the Oregon reports since she still seems to be suffering under the illusion that pain and suffering drive people to ask doctors for lethal prescriptions.

Tim Christie reports in the Eugene Register-Guard:

The most frequently cited end-of-life concerns were: loss of autonomy (100 percent); decreasing ability to participate in activities that made life enjoyable (86 percent); and loss of dignity (86 percent).

More patients were concerned in 2007 about inadequate pain control (33 percent) than in previous years (26 percent).

Christie also reports that there were no psychiatric referrals for evaluation of depression, which has raised expressions of concerns from several quarters:

In 2007, for the first time, no patients who requested assisted suicide were referred for a psychiatric evaluation. The law requires doctors to order such an exam if they believe a patient’s judgment is impaired by a psychiatric or psychological disorder. The number of patients referred for psychiatric evaluations has steadily declined each year the law has been in effect.

and…

Dr. Linda Ganzini, a professor of psychiatry and medicine at Oregon Health & Science University who has published numerous studies on assisted suicide, expressed concern about the decline of psychiatric exams, however.

“I think it’s risky how low the rate of mental health evaluations is,” she said, “because people with depressive disorders are more likely to be able to get a (lethal) prescription if you’re not being very careful.”

This raises some questions about some of those highly praised “safeguards.” So does the scandal involving the Oregon State Board of Nursing, which an investigation found did a better job of protecting nurses than it did the safety of patients, including a patient who received an illegal lethal dose of medication, but the nurses involved claim that the patient requested it.

Most troubling and surprising is Clinton’s reference to assisted suicide as “an appropriate right to have.” The reason it’s surprising is that back in 1997, her husband’s administration – in a position definitely not poll-tested, was to oppose the argument that assisted suicide was a “right” when it came up in front of the Supreme Court, as described in this 1997 article by NY Times reporter Linda Greenhouse:

The Clinton Administration entered the cases on behalf of the states. Solicitor General Walter Dellinger argued in both cases today.

In contrast to the states’ lawyers, who urged the Court to find that there was no constitutional right at stake, Mr. Dellinger urged the Justices to recognize that terminally ill people have a ”liberty interest” in not having the state prevent their relief, through doctor-assisted suicide, from ”severe pain and suffering.” However, he said, the states’ interest in ”affirming the value of life” and protecting vulnerable patients should be given even greater weight, and the prohibitions should be upheld.

”The systemic dangers are dramatic” in a society that allows doctor-assisted suicide, Mr. Dellinger said. ”The least costly treatment for any illness is lethal medication,” he added.

Let’s hope this departure from Bill Clinton’s presidency isn’t an example of what Chelsea Clinton meant when she said her mom would be a better president than her father was. Dellinger’s words about the “least costly treatment” still hold true. It’s something that someone who puts such high importance on universal health care coverage should keep in mind. –Stephen Drake

PS – It already feels like a long election season. I suspect that sooner or later, John McCain might end up a subject of discussion here as well.

More on Karen McCarron’s Sentence

bloggers, crime and punishment, McCarron, media coverage, Our News & Commentary Blog

The first accounts of the sentencing hearing were short on details. There are a few more out. I think they bear reading for a fuller picture of the atmosphere in the courtroom that day.

Yesterday, the Peoria Journal-Star featured an article by Kevin Sempier titled “McCarron Shows Remorse“:

PEKIN – Karen McCarron stood trembling in a courtroom Tuesday, apologized for suffocating her autistic daughter and was sentenced to 36 years in prison, saying she doesn’t deserve forgiveness from those she hurt.

Reading a handwritten statement from a sheet of lined notebook paper, McCarron apologized and said she would take back the moment in May 2006 when she killed her 3-year-old daughter, Katherine “Katie” McCarron, if she could.

“I reach out to all of those I hurt the most,” she said, and began to read a long list of names that included her husband, Paul McCarron. “I reach out to them, but not for forgiveness. I understand that I do not deserve it.”

Kevin Johnson, chief assistant state’s attorney for Tazewell County, commented on the sentencing on behalf of the McCarron family:

Speaking on behalf of Paul McCarron’s side of the family, Johnson said they are ready for the next chapter in their lives.

“They’re relieved that this is over,” Johnson said. “They feel justice has been served, and they’re ready to move on.”

Tenth Judicial Circuit Court Judge Stephen Kouri had these words to say, according to Robert Kerns of the Pekin Daily Times:

While speaking to the McCarron family, Kouri told them that he believed that Katie was lucky enough to have been born into a family that loved her.

“I believe that Katie McCarron won the lottery the day she was born into your family. But I know you may think that it was you who had won the lottery.”

I think that judge Kouri’s sentiments reflect the impressions that many of us have gotten of the McCarrons, mostly through the words of Mike McCarron, Katie’s grandfather.

Finally, Billy Dennis at the Peoria Pundit was kind enough to alert this blog that he’s going to be talking about this trial and “Autism Awareness” on his radio show and invites call-ins:

PeoriaPunditRadio: Autism Debate

April is autism month. I thought it appropriate to devote at least one Peoria Pundit Radio segment to debate on the myths and reality surrounding this condition. The next show is scheduled for 6 p.m. Friday — that’s two days from now. Autism certainly has been in the news recently, from Sen. John McCain jumping on the autism is caused by vaccines bandwagon, to Karen McCarron’ sentencing for killing her daughter with autism. So I’m hoping for a lively debate. Please call at (347) 326-9459.

I plan on accepting his invitation to listen and call in. I hope others will as well. –Stephen Drake

Transcript for Fox News Story on Kevorkian

Kevorkian, media coverage, Our News & Commentary Blog

As promised, this is the transcript of the video linked in the last post:

JACK KEVORKIAN, ASSISTED SUICIDE ADVOCATE: The only qualification you need is what I said, you’re a citizen.

JEFF GOLDBLATT, FOX NEWS CORRESPONDENT (voice-over): He has been called Dr. Death. But soon assisted suicide advocate Jack Kevorkian hopes to replace that nickname with the title of congressman.

KEVORKIAN: I want to run for Congress to make a change. I want to fight for our rights.

GOLDBLATT: Specifically a person’s individual rights, as spelled out in the Ninth Amendment to the Constitution. Though vague and far reaching, the Ninth Amendment protects rights not explicitly specified elsewhere in the Constitution. Kevorkian called it the most fundamental and ignored of all rights.

KEVORKIAN: It says that you have every right in the world, because you’re born with them, as long as nobody gets hurt or threatened or their property is not hurt or threatened, you have every right in the world.

GOLDBLATT: Including a run for Congress, which a 79-year-old convicted felon retains despite serving more than eight years in prison for the assisted suicide of a Michigan man. During the 90s Kevorkian claims to have helped 130 people die, a legacy which makes him a poor choice for Congress, according to disability rights advocate Stephen Drake.

STEPHEN DRAKE, DISABILITY RIGHTS ADVOCATE: Kevorkian has never fought for anybody’s rights but his own. He wants to be the center of attention. That’s what this is about.

KEVORKIAN: Do you think I’m making a mockery of it when I’m fighting for my rights? Goethe said, “No one is more enslaved than the one who thinks he is free.” You’re not free! Look at me. I did something that it should have been anybody’s right to do and I end up in prison.

GOLDBLATT: Kevorkian says on reputation alone, he will collect the 3,000 signatures by mid July to be placed on the ballot as an independent in Michigan’s Ninth District. His opponents, the former Michigan lottery commissioner and Democrat Gary Peters and eight term GOP incumbent Joe Knollenberg, tell Fox News they want to focus on the economy and not Kevorkian. One political science professor says Kevorkian could be a factor in this race, but Dave Dulio predicts that Kevorkian won’t win partly because he won’t take campaign contributions.

DAVE DULIO, OAKLAND UNIVERSITY POLI SCI PROF: He has name identification, yes, but you can’t get elected on name identification alone. You need to tell people why they should vote for you rather than the other candidates. That’s
what he can’t do with no money.

GOLDBLATT: Kevorkian stresses it is an independent message that counts, not the money.

KEVORKIAN: Nobody in any party or any religion really has a free mind.

GOLDBLATT (on camera): Kevorkian says he won’t hire a campaign staff. He will meet voters the old-fashioned way, face to face. Most candidates wouldn’t stand a chance with such a low profile strategy then again the high profile Jack Kevorkian is far from your typical politician. In Chicago, Jeff Goldblatt, Fox News.