Deseret News, Tuesday, November 19, 2002
Defense experts back Weitzel's care of patients
By Linda Thomson
Deseret News staff writer
FARMINGTON — Psychiatrist Robert
Weitzel appropriately medicated five patients who died, he did not deviate from
a commonly accepted standard of care, and all five died from natural causes and
not morphine overdoses, according to two experts testifying for the defense in
Weitzel's trial. Weitzel is charged with two counts of second-degree felony manslaughter and
three counts of misdemeanor negligent homicide in connection with the deaths of
five patients at Davis Hospital and Medical Center's geropsychiatric unit in
late 1995 and early 1996. Prosecutors allege he overdosed them with morphine, while defense attorneys
claim he was providing "comfort care" to people with physical medical
problems. The first expert to testify in the trial's fourth week was Dr. Lesley Blake,
who is director of geriatric psychiatry at Northwestern University Medical
School, runs the geropsychiatric unit and has published several scholarly
articles about drug treatment of elderly psychiatric patients. Blake testified that her review of the five patients' records shows Weitzel
properly switched some patients from medications that are not good for elderly
patients to other drugs and increased dosages because their agitation was not
abating. Given the symptoms that nurses charted in their records, Blake also found
Weitzel's use of morphine acceptable. Blake rejected prosecutor Charlene Barlow's suggestion that the patients were
overmedicated. One patient, Judith Anderson, received 28 shots in the last 24
hours of her life, Barlow noted. "You try to give the next injection before
the pain breaks through," Blake said. "I do not feel those drugs contributed to these patients' deaths,"
Blake said. "I think it was entirely appropriate for him to treat pain in
those patients." Blake said the goal of treating elderly psychiatric patients is not to sedate
them but to control their behavior, which often requires some trial-and-error
use of medications to see what combination works best. But people who are
seriously ill upon admission to a hospital probably will not survive, and these
five patients were all in bad shape. "A certain portion of patients who come into the hospital are going to
die," Blake said. "They (the five Weitzel treated) were in the
terminal phases of dementia. No matter what anybody did, they were going to
die." Dr. Bader Cassin, a forensic pathologist for two Michigan counties, testified
that all the individuals who died did so from natural causes. Cassin said patient Ellen Anderson, 91, died from a combination of
arteriosclerosis (chronic hardening and thickening of the arteries) that had an
effect on her heart, along with emphysema and bronchopneumonia. Cassin testified that Judith Larsen, 93, died from advanced arteriosclerosis.
He said Mary Crane, 72, died from hypertension, a stroke and advanced
arteriosclerosis. Cassin said Lydia Smith, 90, died from advanced arteriosclerosis. And Cassin
testified that Ennis Alldredge, 83, died from severe arteriosclerosis,
hypertension and acute bronchopneumonia. Cassin said all five patients had other serious physical health problems that
contributed to their deaths. He disagreed with questions posed by prosecutor Steve Major suggesting that
morphine overdoses killed the patients by depressing respiration, producing
problems with swallowing that could lead to fluid in the lungs or other side
effects of morphine use. "I don't think morphine caused their deaths," Cassin said. Instead, Cassin testified that Weitzel's use of morphine for these
individuals probably gave them a more peaceful natural death than they otherwise
would have had.