Kansas v. Naramore

Ruth Leach, age 78, was suffering from advanced terminal cancer and was admitted to the hospital. Leach seemed to be in pain, and her nurse suggested stronger pain medication. Dr. Lloyd Stanley Naramore (defendant) examined Leach and asked her son, Jim, whether Naramore should prescribe stronger pain medication. Naramore warned Jim that additional medication might kill Leach by interfering with her breathing. Jim told Naramore to administer more pain medication. Naramore administered Fentanyl, after which Jim noticed Leach’s breathing slow. Naramore told the family that the effects of the medication could be reversed by giving Leach a dose of Narcan. Instead, however, Naramore prepared a syringe of morphine for Leach. Jim told Naramore that nothing should be done to accelerate Leach’s death. Naramore responded that Leach’s next few days would be “absolutely terrible.” Jim told Naramore he would hold the doctor responsible if anything happened to Leach. Naramore then withdrew from the case. In an unrelated case, Chris Willt, obese and diabetic, was found slumped over and was taken to the hospital. At the hospital, Willt was given Norcuron to allow him to be intubated. Norcuron was a paralyzing agent that, once administered, prevented patients from breathing on their own. Naramore told observers that Willt had suffered a stroke and was brain-dead and that the case was hopeless. Dale White, an administrator/nurse, told Naramore that if a second doctor agreed that Willt was brain-dead, life support could be withdrawn. White and other staff noticed movement in Willt’s limbs and facial muscles. A staff member said, “I think he’s coming around.” When ventilation was stopped, White thought that Willt was trying to breathe. However, Naramore diagnosed the movements as seizure activity. Dr. Ernest Cram was called to give a second opinion. Cram found that Willt had no pulse, respiration, or reflexes and said, “He’s gone.” White told Cram that Willt had moved and that he had been given Norcuron. Cram said he would have to look up Norcuron’s effects. When Cram returned, he said he agreed with Naramore. Mechanical ventilation was stopped. Willt showed no neurological activity, respiratory activity, or cardiac activity and was pronounced dead. The State of Kansas (state) (plaintiff) charged Naramore with the attempted murder of Leach and the murder of Willt. At trial, two doctors involved in the treatments of Leach and Wilt testified that Naramore’s actions were medically appropriate, and three other doctors agreed that his actions were within the bounds of good medical practice. Three doctors testifying for the state disagreed. The jury found Naramore guilty of attempted murder and intentional and malicious second-degree murder. On appeal, the state argued that the court should defer to the jury’s findings.