A man charged with shooting his wife of 45 years in a hospital intensive care unit in what may have been a mercy killing was charged today with aggravated murder.

John Wise appeared before a municipal court judge in Akron via video from jail this morning on an aggravated attempted murder charge. No plea was entered. He must return to court Aug. 22.

Prosecutors upgraded an attempted murder charge after an autopsy showed that Barbara Wise died from a gunshot wound to her head. A county medical examiner ruled her death was a homicide.

Wise, who lived with his wife in Massillon, is accused of shooting his wife at her bedside in the ICU unit of Akron General Medical Center Saturday. She died the next morning.

Wise appeared in court Tuesday and was apparently confused about initially being charged only with attempted murder, asking “Is she not dead?”

Visiting Judge Marvin Shapiro told Wise that he would soon have an attorney who could answer his questions.

Police said Barbara Wise had been in critical condition in the ICU for several days, but details of her illness haven’t been made public.

Emergency personnel responded to the Wises’ home a week before the shooting for a medical call that involved advanced life support, including oxygen and a heart monitor. Hospital and emergency officials have said they can’t disclose any information about patients because of privacy rules.

Wise entered the hospital on Saturday through the main entrance and went up to his wife’s room without drawing any attention, apparently keeping the handgun concealed, hospital spokesman Jim Gosky said. A doctor nearby heard a distinctive popping sound, he said.