Dr. Murray did NOT EVALUATE his patient, he
allowed his patient to DIAGNOSE what he was suffering from (insomnia)

Dr. Murray allowed his patient to determine the medication to be used for his aliment (propofol)

Dr. Murray administers the INAPPROPRIATE medication, for an ailment he did not DIAGNOSE his patient as having because he did not do an EVALUATION on his patient.

These steps are FUNDAMENTAL AND BASIC protocols for a Doctor with his patient. It’s actually the LAW that a Doctor take these steps for PRESCRIBING medication.

It is UNACCEPTABLE for a Doctor to put himself in a position where he has to warn a patient of the dangers of a drug which the patient SHOULD NOT HAVE. A WARNING IS NOT WHAT WAS NEEDED HOWEVER, WHAT WAS NEEDED WAS AN ALL OUT, FLAT OUT, STRAIGHTFORWARD, NO NONSENSE, NO STUTTERING, AN ETHICAL AND UNEQUIVOCAL ATTITUDE OF ABSOLUTELY NOT, UNDER ANY CIRCUMSTANCE WOULD I DO SUCH A THING.

Michael Jackson’s MONEY, DEMANDS or DESIRES had ABSOLUTELY NOTHING to do with Dr. Murrary’s decisions. When a Doctor puts himself in a situation where he can be INFLUENCED by a patient and that influence results in the Doctor compromising his ETHICS the Doctor, at that point no longer qualifies to be a Doctor.

Dr. Murrays’ unethical decisions ultimately killed Michael Jackson.

Your case seems to be based around an assumption that Dr. Murray explained the risks of administering these drugs to Michael. I do not believe that after the first doses of benzodiazepines were administered that Michael would have been able to make a rational, informed decision as to whether or not going on with administering additional drugs would be appropriate. With the amount of drugs that he had been given prior to the administration of propofol, his judgment would have been severely impaired.

I am a believer in putting patients more in control of their medical outcomes. Yet there is a point where the doctor (or nurse) does need to say, I am the trained healthcare provider, and this is not in your best interest, especially in the case of a person who is a possible addict. You can’t compare this case with the case of a person who has terminal cancer. At some point, Dr. Murray should have said, this is not in your best interests, and I cannot take part in enabling this to go on any further.

Nothing will ever excuse the choices that Dr. Murray made. He is ultimately responsible, because his patient was impaired at that point and could not make an informed choice about propofol administration. Let us also not forget that Dr. Murray chose to administer this drug without proper monitoring equipment, outside of a hospital setting.

I don’t think propofol’s off label use is really at debate anywhere here. I think Dr. Murray’s severe lack of judgment and disregard for ethics is up for debate. I’m unsure how someone with your credentials could really miss the true facts in the debate and actually come to his defense.

I think IdahoMD hit right on the head the damning reality that Dr. Veatch and our tabloid “media” seem to ignore:

…that the cardiologist, despite the $5K/night fees suggestive of the oldest profession, appears to have undertaken propofol anesthesia either WITHOUT INTUBATION equipment or without the skills or judgment to use it, or to monitor for its need.

That’s the elephant in the room.

Thus, the solution MJ was seeking was not the solution he needed. One could argue that endless nights of Propofil narcosis may itself have induced much of his odd, paranoid persona. Sleep and rest is a curiously active process in which our brain is for all intents as active or *more* active than when awake. So, was MJ an even greater victim of himself than we thought? And seeking opinions of specialists who were not specialists in the areas in he was ailing! Where is the ethic of the physician knowing his boundaries? For crying out loud, this is a cardiologist! Did he have no intensivist training?

So, Dr. Murray should never have gone there. Yet if he HAD to do this, why didn’t he install some life-saving equipment. For less than a third of his monthly salary he could have fitted the bedroom just like an operating room, with heart monitors, pulse oximeters (with ALARMS!) and a crash cart with reversal drugs aboard. If MJ had slipped to respiratory arrest the good doctor could easily have ventilated him with a mask (or intubated him!) until the Propofil wore off. Some aspiration risk, yes. But alive? Yes.

Alas, I fear there is no good defense here. He apparently failed to exercise due diligence in addition to demonstrating his poor judgement. The treatment was so outrageously out of phase with any rational decision-making that it borders on the absurd. BAd medicine done badly for bad reasons.

If this defense flies, I suppose we medics will have to comply with every crazy request that comes our way. In that case, why bother knowing anything. Just open the pharmacies and have at it!

Would perhaps “prostitution” be appropriate?

One also cannot defend giving this drug to a patient and then leaving him – regardless of the reasons. One cannot defend giving a patient the dose – very obviously much greater than 50 mg – that was given to this patient.

I can see how an MD desperate for money would get himself in this situation.

It is clear to me that considering the condition that Dr. Conrad states his patient was in, the reasonable response would be to call an ambulance and his patient be brought to the hospital for more appropriate care that would not have killed him.

It is also my understanding that when a patient dies at the hands of an MD – it is clearly homicide. Is this not why we don’t allow patients to die in the O.R.? We rush them to ICU doing compressions all the way. We continue a small code there and a patient is declared dead in the ICU – not at the hands of the Surgeon in the O.R.?

I think we’ll see Mr. Veatch taking the stand for the defence one of these days.

Eilleen, ER/ICU/OR RN of 28 years.