Same Day Multiple Prescriptions
 Why is Our Government Pursuing a War on Doctors?

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Cases involving the criminal prosecution of careproviders are rare, those involving palliative care even rarer. Indeed, the casual observer would assume that prosecutors would steer well clear of palliative care cases so as not to create incentives or disincentives to bona fide decisions of medical professionals, the topic most often addressed by commentators. Palliative care, however, occupies legal and medical space that, for some, is close to that occupied by debates over physician-assisted suicide, withdrawal of treatment and the war against controlled substances.

According to Professor Ann Alpers:
"Physicians, like all citizens, must abide by the social norms of behavior that criminal laws reinforce. A crime usually contains two basic elements. First, there must be a criminal act. Second, with the exception of manslaughter statutes, most criminal laws covering unlawful deaths require the act to be intentional. Malice, whether express or implied, is always necessary to convict a person of any degree of murder. … A physician's use of opioids to treat a patient's pain, on the other hand, need not, and usually is not, an intentional criminal act. Prosecutors must find evidence of a physician's intent to kill or a reckless disregard for a patient's well-being.

…Detailed examination of these cases illustrates that fear of criminal liability or investigation should not deter physicians or nurses from aggressively using opioid analgesics to manage terminal pain, provided that pain has been carefully assessed and treated and communication with families and involved professional caregivers is thorough."
Ann Alpers, Criminal Act or Palliative Care? Prosecutions Involving the Care of the Dying, 26 J. LAW MED. & ETHICS 308, 310, 326 (1998). [HTML] [PDF] $[Westlaw]