Precinct 333

Friday, January 07, 2005

Persecuting Physicians

My darling wife suffers from chronic degenerative conditions that cause her great pain. I won’t go into the details, but suffice it to say that we have a pair of doctors who do their best to keep her healthy and minimize her discomfort. We scrupulously adhere to her treatment regimen and medication schedule. That’s why the outrageous prosecution/persecution of Dr. Bill Hurwitz resonates with me so strongly.

On December 15, Dr. Bill Hurwitz was shackled in the courtroom and hauled away to jail. A federal jury in Virginia declared the doctor guilty of some of the drug-dealing charges the government brought against him - a conviction that carries a mandatory minimum prison sentence of 20 years to life.

Dr. Hurwitz specialized in treating patients suffering with chronic pain. Some of his treatment techniques were considered "controversial" a decade ago but are now widely accepted as standard practice by doctors working in medical schools as well as in private practice. These methods are now recognized in state law, for example, in Virginia.

Further, the doctor's plan or protocol for treating such patients was formally accepted in written agreements by both state and federal government officials in 1997 and 1998.

As part of these agreements, Dr. Hurwitz allowed federal government agents working for the Drug Enforcement Administration (DEA) access to all his patient records, at any time, without requiring a court order or search warrant. He also provided DEA agents with complete and ongoing records of all patients receiving powerful pain medicines every three months.

This isn’t a man trying to push drugs or hide anything. This is a doctor trying to treat patients. He even went above and beyond the call of duty in providing those records, because he wanted to make sure that his patients were not abusing or diverting the drugs. Now I’ll concede I am a bit disturbed by some of the privacy implications of the practices, but I assume that he made his patients aware of what was being done and referred patients with objections to other doctors.
So what did he get for his trouble? He got screwed.

During four years of providing prodigious amounts of patient information to government agents, DEA agents never advised him about any of the illegal activities of the few patients who did so.

Hurwitz himself became aware of illegal or unethical activities of 17 patients and refused to treat them further. After learning that four other patients suffering with chronic pain were arrested on drug charges, he watched these patients more carefully and used laboratory tests to confirm that these patients were indeed taking the drugs in the prescribed doses.

About 15 of his 400 patients lied to Dr. Hurwitz about their pain in order to get prescriptions for more medicine than they needed. When government agents discovered these patients were selling drugs illegally, they bribed them to testify against Dr. Hurwitz by offering lenient prosecution.

They also sent "patients" to him that were imposters, liars for hire, paid for by government prosecutors.

Given that government agents were given all the information they wanted and more, it would have made sense to let Dr. Hurwitz know when a patient was diverting drugs.

So let's recap. The DEA knew that two patients made nearly $4,000,000 selling their medications. Dr. Hurwitz was told nothing of this. The pushers were given deals, and the doctor was indicted and arrested on 62 felony charges, including conspiracy to traffic in controlled substances, drug trafficking resulting in death and serious bodily injury, and health care fraud.

The trial tactics were even more outrageous. The prosecutors tried to shift the burden of proof by insisting that the doctor show he didn’t know of the diversions. They got the judge to forbid the introduction of any evidence related to the doctor’s cooperation with the DEA. The sheer number of charges brought by the prosecution were designed to leave the jury convinced that even if a given charge wasn’t proved, Dr. Hurwitz must be guilty of something, making it much more likely that there would be a conviction one or more of the charges. Sadly, they succeeded.

When are we going to stop criminalizing the practice of medicine? When are we going to allow the “best practices” to be determined by physicians rather than bureaucrats and prosecutors? Prescription decisions need to be in the hands of doctors, not prosecutors. Prosecutions should be directed at criminals, not those who write a prescription in good faith.


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