NEW ORLEANS (AP) – A doctor and two nurses who labored at a sweltering, flooded-out hospital in Hurricane Katrina’s chaotic aftermath were arrested and accused Tuesday of murdering four trapped and desperately ill patients with injections of morphine and sedatives.

“We’re talking about people that pretended that maybe they were God,” Louisiana Attorney General Charles C. Foti said. “And they made that decision.”

The defendants were booked on charges of being “principals to second-degree murder,” which carries a mandatory sentence of life in prison. The three were the first medical professionals charged in a criminal investigation into whether many of New Orleans’ sick and elderly were abandoned or put out of their misery in the days after the storm.

Dr. Anna Pou, a cancer and ear, nose and throat specialist, and the two nurses were accused of deliberately killing four patients, ages 62 to 90, at Memorial Medical Center with a “lethal cocktail” of morphine and Versed.

“There may be more arrests and victims that cannot be mentioned at this time,” Foti said. “This case is not over yet.”

Memorial Medical had been cut off by flooding after the Aug. 29 hurricane swamped New Orleans. Power was knocked out in the 317-bed hospital and the temperature inside rose over 100 degrees as the staff tried to tend to patients who waited four days to be evacuated.

In court papers, state investigators said Pou told a nurse executive three days after the hurricane that the patients still awaiting evacuation would probably not survive and that a “decision had been made to administer lethal doses” to them.

Overdoses of morphine or Versed can stop the heart and lungs.

Foti, however, said he believed the patients would have lived through the storm’s aftermath.

“This is not euthanasia. This is homicide,” the attorney general said.

Attorneys for the three insisted no crime took place; one praised his client’s dedication during the crisis.

Two months after the hurricane, Foti subpoenaed more than 70 people in an investigation into rumors that personnel at the medical center had put patients to death.

Around the same time, the husband-and-wife owners of a nursing home in neighboring St. Bernard Parish were charged with negligent homicide in the deaths of 34 elderly patients. Prosecutors said the owners failed to heed warnings to evacuate.

According to court papers, tissue samples taken from the dead at Memorial Medical tested positive for morphine and Versed, and the amount of Versed present was found to be higher than the usual therapeutic dose. Medical records reviewed by investigators also showed that none of the four patients were taking either of the two drugs as part of their routine care.

Foti said the combination of morphine and Versed “guarantees they are going to die.” He said that authorities could not determine which of the defendants actually administered the fatal drugs in each case but that investigators believe all three participated, hence the “principal to second-degree murder” booking.

Pou’s lawyer, Rick Simmons, said his client is innocent, and her mother said she was distressed by her daughter’s arrest.

“Medicine was the most important thing in her life and I know she never ever did anything deliberately to hurt anyone,” Jeanette Pou said in a telephone interview.

In December, Dr. Pou had told Baton Rouge TV station WBRZ: “There were some patients there who were critically ill who, regardless of the storm, had the orders of do not resuscitate. In other words, if they died, to allow them to die naturally, and to not use heroic methods to resuscitate them.”

“We all did everything in our power to give the best treatment that we could to the patients in the hospital to make them comfortable,” Pou said then.

In addition to Pou, nurses Cheri Landry and Lori Budo were arrested. All three were released without bail.

Landry’s attorney, John DiGiulio, said, “She’s innocent” and had no further comment on the charges. Budo’s attorney, Eddie Castaing, said no crime had been committed and described his client’s efforts during Katrina as heroic.

Pou’s lawyer complained that she was arrested and handcuffed at her house late Monday night.

“I told them that she is not a flight risk. I told them that she would surrender herself. Instead, they chose to arrest her in her scrubs so that they could present her scalp to the media,” Simmons said.

Simmons declined to discuss details when asked if euthanasia had taken place or if Pou had injected anyone with drugs. But he insisted: “There’s no murder here and there’s no homicide.”

Angela McManus said Tuesday that her 70-year-old mother was among the patients who died at Memorial. Her mother had been recovering from a blood infection but seemed fine and was still able to speak when police demanded relatives of the ill evacuate. She died later that day, McManus said.

“At least now I’ll be able to get some answers,” McManus said. “For months, I haven’t known what happened to my mom. I need some answers just to be able to function.”

Harry Anderson, a spokesman for Dallas-based Tenet Healthcare Corp., the owner of Memorial Medical, said the allegations against the doctor and nurses, if true, are disturbing.

“Euthanasia is repugnant to everything we believe as ethical health care providers, and it violates every precept of ethical behavior and the law. It is never permissible under any circumstances,” Anderson said.

Dr. Steven Miles, a professor of medicine at the University of Minnesota’s bioethics center, said that instead of trying to kill, it is more likely that those charged were trying to relieve patients’ pain “in a resource-poor environment and were doing the best they could.”

He said that there are documented cases where patients have required seemingly lethal morphine doses to relieve extreme pain, and that he doubts the charges will be proven.

“I’m inclined to believe this was palliative sedation that’s been misread,” Miles said.

Mercy killings would be “not only highly frowned upon, but also rare,” Miles said. “It’s highly unlikely that’s what happened here.”

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