On Medico-Legal Issues

I'm kind of worried about the recent Murray/Jackson verdict. Don't get me wrong, Murray is clearly an idiot. Propofol is not a drug that should be used outside the operating room, emergency room, or intensive care unit. We're talking about a drug that should only be used in specialized parts of the hospital, certainly not in someone's bedroom*. You absolutely shouldn't leave a patient alone after dosing them with this med (which he did).

I agree Murray was negligent, stupid, and needs to lose his medical license. I do not agree that he was/is a criminal. Here's why: He did not set out to break any laws. His good-faith intent was to provide medical care to a patient with (apparently) some very complex medical, psychiatric, and toxicologic issues. He did not attempt to perform a physician-assisted suicide. He did not attempt to provide an abortion in a state where that is illegal. He tried to treat a patient, and his patient died. This is what is commonly known as a "bad outcome".

Bad outcomes happen, well, not OFTEN, but more frequently than we'd like. Some are really bad (death, vegetative state**). Some are less bad (loss of a limb, extended recovery time). Some are not even noticeable except to an expert (had to put in an extra stitch to close the wound). Bad outcomes happen. They don't mean the practitioner involved did something wrong, or isn't (overall) beneficial as a member of the medical profession. They are the medical equivalent of not closing the sale, or the part getting lost in shipping, etc.

Now there is legal precedent for the criminalization of the bad outcome. If the patient dies, the doctor can now go to jail. That's kind of terrifying.


*If you are a multi-millionaire rock star, you might be able to set up an ICU in your bedroom. Based on the publicity from the trial, Jackson had not done this.

**I will leave it to the reader to decide which of these is worse.