Doctor Censured In Death Of 3-Day-Old Baby

What should a doctor do with a newborn who is likely profoundly brain-damaged, almost completely unresponsive to intervention, and who many medical experts would say has only a short time to live?

The state's medical disciplinary commission isn't sure, but it is certain about one thing - a doctor must not do what Dr. Eugene Turner did: place his hand over a gasping baby's mouth and nose, even if those breaths are only reflexes preceding death.

Yesterday, a panel of the Medical Quality Assurance Commission censured Turner, a Port Angeles pediatrician, for taking those actions with 3-day-old Conor McInnerney in January 1998. But the panel said Turner, 63, may continue practicing medicine without restrictions.

It is not a decision that will satisfy everyone, nor will it help answer legal, ethical and societal concerns when it comes to dying infants - a situation the panel termed "one of the most challenging situations a physician faces."

Blocking the airway of a baby for any reason, even to hasten an inevitable dying process or to be humane and compassionate, the panel concluded, "was below the standard of care expected of reasonably prudent physicians in the state of Washington . . ."

Turner's actions broke a state law prohibiting unprofessional conduct because they created "actual harm or an unreasonable risk of harm to the baby and the baby's parents," the panel wrote in its final order.

Before that nightmarish, snowy night at Olympic Memorial

Hospital, Turner had an unblemished record. Now it contains a permanent official assessment that his care in this case was incompetent.

But the panel's censure carries no limitations on Turner's practice.

Turner, reached yesterday in Port Angeles, where he continues to care for patients, said, "We are elated!" He called the panel's decision "almost a total victory."

Turner told the panel he had taken steps to stop Conor's reflexive breathing because he thought the baby was already "brain dead," and he wished to spare the nurses and other staff, as well as the parents, more emotional pain.

Matthew Knopp, attorney for Martin and Michelle McInnerney, Conor's parents, said his clients were pleased the commission agreed that what Turner did was not accepted medical practice. "That's what we've been saying all along. He hastened Conor's death, and that is something that cannot be countenanced in our society."

But Knopp said Conor's parents were concerned that the light sanction sends the wrong message.

"Marty and Michelle have been saying from the outset that their goal is to make sure that this doesn't happen to another child," he said. "Their concern is that this censure isn't severe enough to prevent that."

Earlier this year, the McInnerneys offered to drop plans for a civil suit against Turner if he agreed to apologize and acknowledge his actions were wrong. In February, after second-degree-murder charges were dropped, Turner turned down that offer, saying through his attorney he had committed no wrongdoing.

Knopp said the parents are still considering a lawsuit.

Yesterday, Turner was asked if he would reconsider offering an apology in light of the commission's ruling.

"No," Turner said. "I put out four hours of my life to do everything I could for that baby and more. . . . I cannot find it in my heart to find a single justification for an apology."

Turner said that if faced with the same situation again, "I would not do what I did" - not because it's wrong, he said, but because of the uproar his actions caused. He would walk away, he said, a course of action many experts suggested.

During three days of testimony before the panel in May, several medical experts testified that Turner had tried extraordinarily hard for four hours to revive the baby.

Others testified that Turner went beyond standard medical practice when he covered the baby's mouth and nose.

Turner told the six-member panel he had taken the action because he was out of options, and couldn't let his staff suffer any longer.

Conor had suffered heart and respiratory arrest while breast-feeding at the home of his parents on Jan. 12, 1998.

Turner's attempts to resuscitate the baby included repeated injections of heart stimulants, artificial respiration, drugs and even an experimental treatment of cold packs the doctor had read about in a medical journal.

At one point, after resuscitation efforts had been under way for about two hours, the baby was declared dead. A half-hour later, a nurse noticed him intermittently gasping for breath. Turner tried for another hour to revive the baby. But, he said, the baby was unable to breathe regularly, and his eyes were fixed and dilated, a sign of brain death.

It was at this point that Turner put his hand over the baby's nose and mouth.

In Washington state, brain death is defined as the irreversible cessation of all brain activity, including in the brain stem, which controls breathing and heartbeat. According to the state Supreme Court, death requires either brain death or irreversible cessation of heartbeat and breathing.

Because the baby was breathing and had a heartbeat, the baby was "not legally dead" at the time Turner pinched its nose and mouth, the panel said, although it was "in an inevitable and irreversible process of death."

While Turner's actions didn't cause death, his blocking the baby's airway "injured the baby's right to have his death process not interfered with" as well as the parents' right to make decisions about care of their child.

The panel included three physicians, two physician's assistants and an educator. It made its decision based on a "preponderance of the evidence," a lower standard than for a criminal conviction.

Two other charges against Turner - abuse of a vulnerable patient and conduct that lowers the esteem of his profession - were not proven, the panel ruled.