The hospital was eventually replaced by an asylum during the 1970's. The history of the institution has been extensively covered on Wikipedia. The history of the asylum also became a major subject of controversy in the 1980's, when the psychiatrist and social worker who managed the asylum, Dr. Henrik Strom, was arrested for the rape of a young female patient.

The only way the jury could have found in Dr. Strom's favor would have been for the court to find there was no evidence or motive to support a criminal charge against Dr. Strom. It consisted of the chief of the public health department, the secretary to the city government, the head of the city health department, two nurses from the city health department, and three doctors. They chose the patients whose death would be the most difficult to stop. All the members of this second committee were selected by the city health department's chief medical officer, Dr. Richard Worthen, who was also in charge of the public health department. The first death committee met regularly, in November, 1877, to examine all the applications for treatment received in the preceding month. In the course of making their decisions, they made recommendations on the type of treatment that each patient should receive. This was done by dividing the patients into four groups: those of moderate severity, severe disease, severe and moderate disease, and extreme disease.

This was not necessarily for practical and medical reasons: those with severe and moderate diseases often needed a different type of treatment, or none at all. The medical officers, in consultation with the two nurses, were allowed three weeks to make their final recommendations. If a hospital was to admit a candidate, the physician who gave the recommendation was required to sign a form acknowledging that he or she had consulted for the doctors. As was the custom, the doctors were paid by the city, although Dr. Worthen had the right to approve his own salary. In some respects, this practice may have saved the public health department money in the short term; in the longer term it may have been quite costly. The physicians recommended the most severely ill, but they did not know whether the death had been hastened in some way.

They were only able to make a decision if some other criteria were met- the patient had been examined, and the physician was sure he could find no abnormality to explain the death. These were the four categories: severe disease, severe disease, extreme disease and severe and moderate disease. The diuertic potency amiloride vs aldactone serious diseases, while the last two were considered less serious: acute disease, for example, or acute poisoning. The recommendations they made would not have been possible without the help of the ordinary citizen who decided to participate in the process of determining whether to save a patient in his or her last hours. The first decision was made on November 30th. Dr. Richard Worthen was notified by a letter from the chief of the city health department. The city did not specify who these poor souls were- and the decision was not made until four days later, on December 7th.

The two nurses received the same letter. The doctors decided that the patient should be put on a diuertic potency amiloride vs aldactone days, and then sent for the third committee meeting. The first meeting in the afternoon of December 10th was in the city house. Worthen, attended for that purpose. Worthen took to drinking coffee and reading the newspaper. It is reported that he took an interest in the medical aspects of the case, and in particular the treatment and recommendations. Worthen was the first to present his recommendations to the council.


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