Just read an article on Fox News that Michael Jackson’s physician, Conrad Murray, is going to be charged with manslaughter. The DA’s office is allegedly building a case against Michael Jackson’s dermatologist as well.
According to the article, the LA District Attorney’s office denies the story, but Fox News is standing firm with its allegations.
I’m putting my money with Fox News on this one. There is too much of a public outcry regarding Jackson’s death for the DA’s office not to do something – even though I don’t think it’s right. As Kevin MD highlighted in a post, such are the risks of treating celebrities.
If Dr. Murray administered propofol to help Michael Jackson sleep, he was obviously using the medication in an unapproved manner. Doctors use medications in unapproved manners all the time. Many of you are probably being prescribed medications right now that are not FDA approved for the purpose for which your doctor has prescribed them to you.
So if we’re going to criminalize some activity, exactly what activity are we going to criminalize? How do we define when a doctor has committed a criminal act? Highly dangerous? Giving tPA for stroke is highly dangerous. People die from receiving that medication. We going to throw all the doctors in jail that use tPA?
I’m not condoning what Dr. Murray did, but I also think society has to think very carefully before crossing the line between charges of professional negligence and charges of criminal behavior. It’s one thing to be sued for millions of dollars or even lose your license because you gave a medication that resulted in someone’s death. It’s another thing to be thrown in jail for doing so.
Start threatening any health care providers with incarceration for using professional judgment and very quickly you will see how few people will be willing to provide those services.
Do we really want to start down this slippery slope?
UPDATE AUGUST 24, 2009
See additional discussion about the criminalization of medicine from Happy Hospitalist, Nurse K, ERP and Reality Rounds.
It’s official. Michael Jackson had lethal levels of propofol in his system. The coroner’s office ruled Michael Jackson’s death a homicide.
So now that manslaughter charges are imminent, what will happen to the other doctors that prescribed propofol to Michael Jackson in the months and years before his death? Do they get off scot free even if they are the ones who addicted MJ to propofol?
Nurse K raises a point that the circumstances of this case are unique and that there wouldn’t likely be a precedent set if Dr. Murray was convicted. I disagree. The publicity that this case has received will make it a tremendous precedent. If a trial occurs, it will be like OJ Simpson’s trial all over again.
Happy asked whether criminal charges should be filed if the overdose was of Ativan or another medication used to induce sleep. In other words, if a patient dies, is it the medication causing the death that makes the act illegal or is it the fact that the medication causing the death was given “off label”?
Nurse K gave a pretty good definition of what type of acts should be criminalized, but even using her definition, some negligent acts could be unintentionally classified as being criminal. What about doctors prescribing large doses of medications in a pain clinic or an oncology clinic? How do we classify egregious acts as being criminal while excluding acts of simple negligence from the definition?
So Dr. Murray will be the personification of a medical criminal.