"We're talking about people that pretended maybe they were God and they made that decision," Louisiana attorney general Charles Foti said at a press conference in the state capitol of Baton Rouge.

"This is not euthanasia. This is a homicide."

The affidavit charged that the three gave lethal doses of morphine and another drug to patients at Memorial Medical Center who were deemed too sick to be evacuated three days after the hurricane devastated New Orleans on August 29.

Two of the victims were in their 90's and two were in their 60s, including a 380-pound man who was described as "alert" but paralyzed.

Doctor Anna Pou, 50, and nurses Cheri Landry, 49, and Lori Budo, 43, were charged with four counts of second-degree murder. They were released on bail to await formal arraignment.

The charges followed an investigation launched after rumors circulated that medical staff had euthanized patients whom they thought would not survive the harsh conditions that followed Katrina, including lack of food, drinking water and air conditioning.

The attorney general's office investigated 13 nursing homes and five hospitals throughout the region but found credible evidence of mercy killings at only one.

Four hospital administrators at Memorial Medical Center heard of plans to give patients lethal doses, although none of the key witnesses said they knew who made the decision, the affidavit said.

During a meeting about the evacuation plan, one hospital administrator who has not been charged told employees they did not expect to evacuate nine critically ill patients.

She also said the plan was they "were not going to leave any living patients behind."

Pou later told a hospital worker that many of the patients on the seventh floor "were probably not going to survive" and that "a decision had been made to administer lethal doses," the affidavit said.

At least one patient was "aware, conscious and alert, but he weighed 380 pounds and was paralyzed. Dr Pou decided that (he) could not be evacuated... and that they didn't have a lot of time and that she needed to clear the floors as soon they could," the affidavit said.

Court documents show that the killings were not done in secret.

Budo was observed giving an injection to a 92-year-old man who said, "That burns," as she administered a lethal dose of morphine.

The attorney general said that more charges could be laid in the case, and that more victims might be found among the 45 bodies recovered from the hospital -- 11 of which were already in the morgue when the storm hit.

He also said he believed the patients "would have lived through it" if Pou and the nurses had not taken "the law into their own hands."

But Pou's lawyer said the attorney general was more interested in staging a "media event" for political gain than in pursing justice.

"It's a year later and the blame game is now shifting to a doctor and two nurses and maybe others," Rick Simmons said at a press conference in New Orleans.

"They're victims of the storm not victims of homicide... There's no criminal misconduct."

Simmons said Pou - who was arrested in her hospital scrubs - would plead not guilty to the charges.

Most of New Orleans was flooded by Hurricane Katrina, which killed as many as 1,500 people across the Gulf Coast. Much of the city was without power, water or transportation.

Emergency generators in the city's hospitals quickly ran out of fuel and hospital staff used flashlights to tend to patients in the sweltering heat and stench of backed-up sewage.

Outside, the city descended into chaos and evacuations were stymied by reports of snipers shooting at medical helicopters.

The decision to impose murder charges does not sufficiently address the issue of motive and the complex ethical questions underlying the situation, University of New Orleans criminologist Peter Scharf told AFP.

"This is a case that involves a clash possibly between moral duty and legal duty," he said.

"The issue that escapes discussion in the action of the attorney general is ... what are your duties in that kind of situation? Were these acts of conscience or acts of crime?"

New Orleans Patient Said That Burns As Lethal Dose Administered

Trapped inside a sweltering hospital as floodwaters and chaos inundated New Orleans, a 92-year-old man told his nurse, "That burns," as she administered a lethal dose of morphine, court papers released Tuesday showed.

Nearly a year later, two nurses and a doctor were arrested and charged with the murder of four patients deemed too sick to be evacuated.

The attorney general refused to speculate on a motive for the crime but accused the three women of playing God.

It is not clear who made the decision to kill the patients. Nor is it clear why none of the people aware of the plan stopped it.

But court documents show it was not done in secret. Three days after Hurricane Katrina ravaged the city and left the hospital without water, lights or electricity, a meeting was held at seven o'clock in the morning on the emergency room ramp on the first floor of Memorial Medical Center.

The hospital's incident commander told employees of LifeCare, which rented three floors of the facility, that nine of their patients were very sick and "we don't expect them to make it."

When asked two hours later about the evacuation plan, Susan Mulderick - who has not been charged - said, "We're not going to leave any living patients behind."

She then told some LifeCare employees to find doctor Anna Pou, who was arrested on murder charges along with two of the facility's nurses.

Pou, 50, and two nurses were on the seventh floor, filling syringes. She told the head nurse of LifeCare that "a decision had been made to administer lethal doses" to these patients.

She asked for a list of all remaining patients and told the LifeCare employees that their patients were in "our care now" and "you've done everything you can." She showed the employee 25 vials of morphine and asked for supplies, which the LifeCare director of pharmacy supplied.

Pou appeared nervous as she walked down the hall to the room of a patient who was "aware, conscious and alert, but he weighed 380 pounds and was paralyzed." She said she was going to tell the 62-year-old man -- whose body was recovered from the hospital days later -- that she was going to give him something to help with his dizziness. Then she closed the door.

Nurse Lori Budo, 43, was also observed giving an injection to the 92-year-old patient who told her, "That burns," the affidavit showed. His body was also recovered, along with those of two other patients who were given lethal doses, the court papers said.

Later, Pou told a LifeCare administrator: "I want ya'll to know I take full responsibility and ya'll did a great job taking care of the patients."

Nurse Cheri Landry, 49, was also charged with murder.

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