<p>[‘Lethal</a> levels’ of anesthetic propofol killed Michael Jackson | L.A. Now | Los Angeles Times](<a href=“Archive blogs”>Archive blogs)</p>
<p>Honestly I just happened to walk by the radio when this was announced
sad</p>
<p>Neither a lawyer nor a doctor, so what do I know? But ignorant me could imagine one could give a ‘lethal’ dose to someone already addicted to a drug in order for it to work (whereas for a non-addicted person without such tolerance it would kill him or her). As for murder, I think it requires intent of some kind, no? One might argue malpractice in this case, but I don’t see the murder part. But I defer to the experts on this one.</p>
<p>I have been reading that it is being called a homicide. From my somewhat limited understanding of the law that does not necessarily = murder.</p>
<p>Yes, homicide can be intentional (murder), negligent or grossly negligent (the latter two being charged as some degree of manslaughter). My guess is that the doc would be charged with gross negligence for administering a drug that is meant to be used in an operating room with life-saving technology and expertise available. The docs who prescribed the propofol and other meds found in Jackson may also be culpable. I find it astonishing that someone could go through all the education and training required to become a physician and then spiral down to the level of a drug dealer when enough money is offered.</p>
<p>it sounds like Michael was obtaining drugs from " drs" in “Europe”, he was well stocked by the time this most recent physician took over</p>
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<p>That I certainly believe, and that he would have continued using the drugs with or withoug the doctor’s help, but the doctor was still an idiot to actually help administer the drugs in such a negligent manner.</p>
<p>There is some fear in the medical community that, if convicted, and depending on how the ruling is worded, that this might open up the door to doctors being successfully sued for every instance of a bad outcome of a drug being used for other than its listed purpose. Now non-medical people might be thinking “well, sure that makes sense”, but you have to understand that doctors prescribe medications safely and appropriately for non-standard uses all the time. Most drugs have different effects that are useful in treating more than one condition, and drug companies sure as hell aren’t going to spend the time and money to get FDA approval for every possible use. Physicians receive education in pharmacology, and non-standard uses for drugs tend to be well-known.</p>
<p>On the other hand, it is also argued that this probably won’t happen because of how extreme this case is. Propofol is a very heavy sedative meant to be used under the most controlled circumstances. Clearly this use was so far outside of any reasonable attempt to use it safely (unless MJ’s house was stocked like an ER trauma bay and there was an RN and respiratory tech present during every administration) that the above situation likely won’t occur.</p>
<p>Apparently the doc was negligent in that not only did he administer every sedative known to man to Michael during that 12-hour period, but once he administered the heavy duty stuff, he went to the bathroom for a while and came back to discover Michael not breathing. Administering it is one thing; not monitoring the patient is something else.</p>
<p>It has been known, but it also his own fault.</p>
<p>Icarus, that would be an awful outcome. I am aware that drugs are very frequently prescribed for off-label purposes, and many people would suffer if this were no longer possible. </p>
<p>It is really too bad when one outlaw doctor misbehaves and there are calls to regulate the entire profession. This happened in the Octomom situation.</p>
<p>I just read the article on cnn.com. Wow…LOTS of drugs in a short time…then Michael “demanded” the propofol…What happens when the rest of us are in the hospital and have pressed the button of our pain pumps and are “locked out” because not enough time has passed? We are locked out. What happens when we call the nurse and demand more? He/she checks the levels and says “wait a bit then the pump will let you have more.” How does a doctor who has already given a guy a whole lot of drugs cave to a very dangerous demand?</p>
<p>My understanding is that this final drug-the propofol- has a tiny margin of error. Doctors have been known to abuse it themselves (self-administered) and if they make a mistake on the dosage they are dead before they can correct things.</p>
<p>Many of us have probably complained to a doctor when we or a member of our family didn’t get what we wanted - pain meds, antibiotics, etc. It is wild to think of a doctor being employed by one person…so when the “patient” demands meds, it’s a demand from the “boss.” That could tend to mess up one’s professional judgment.</p>
<p>I find it scary that people with sooooooo much money can hire their own doctors to be there at a moment’s notice and can basically get whatever they want, even if it winds up killing them. I’m thinking of not just Michael, but Elvis, Anna Nicole Smith, and maybe Marilyn Monroe. If I ever win the lottery and can have whatever I want, I sure hope it isn’t drugs.</p>
<p>Yes, he was possibly manslaughtered, which isn’t a surprise. In I think the entire US, manslaughter is not murder, which has only 2 degrees, with 1st being deliberate.</p>
<p>Can’t get much Doctor for $150K a month nowadays, can you? But sadly, you can get one who won’t say “no”.</p>
<p>Some might find this article enlightening. Be sure to click the link on the bottom to see how this case turned out for the prosecution. <a href=“http://www.law.uh.edu/Healthlaw/perspectives/Bioethics/980213NegligenceHomicide.html[/url]”>http://www.law.uh.edu/Healthlaw/perspectives/Bioethics/980213NegligenceHomicide.html</a></p>
<p>I believe the DA in the Jackson case has far better facts but…it is a very common criminal defense attorney’s dream situation to have a prosecutor “over-charge” a case. The defense attorney can , by choosing their tactics wisely (I won’t go into how as I am not familiar with California Criminal Procedure), sometimes walk their clients smooth out of court leaving the overly optimistic prosecutor with egg on their face.</p>
<p>From the OP post
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<p>Jackson OD’d with the supervision of his $150,000 a month MD. Sounds like the doc killed him to me. It was not intentional, but MJ died at the hands of/with the help of his personal physician. Jackson begged for more drugs that night/morning. His doc gave them.</p>
<p>I am a physician, and these drugs in this quantity, the “polypharmacy” used, all given IV, require administration in a health care facility with proper monitoring. The patient needs to be monitored, and the physician needs to be ordering the drugs NOT ADMINISTERING the drugs. They need to be ordered, the dosages and combination of drugs evaluated by a pharmacist before they are dispensed (one level of safety) and again reviewed by the RN/ARNP/PA that is administering the drugs (second level of safety). The patient needs to be on a monitor with a central monitoring station, so if a physician or nurse steps away, and the patient stops breathing, there is an alarm and another health care provider comes running (third level of safety.) Hospitals, surgery centers, etc have this system of checks and balances. Anyone who tries to do this in a bedroom IS A FOOL. And is negligent. This physician needs to be stripped of his licenses and needs to be prosecuted. Prosecuting this guy is NOT going to set a precedent and put doctors needlessly behind bars.</p>
<p>Was Jackson a drug addict --you bet. Did Jackson want the drugs, he sure did. Did he pay the doc well to administer what he wanted --yes sir. Did the doc leave his principles at the front door? Yes. He should have said NO and had MJ admitted to a proper facility for treatment. He was a cowboy, and he knew what he was doing was wrong.</p>
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<p>I am an anesthesiologist. Propofol is not suitable for sedation in an unfasted patient with an unprotected airway. Propofol sedation is only appropriate in two circumstances: first, in the operating room with an anesthesiologist in continuous attendance; second, in the ICU with an intubated patient and an RN in attendance acting on orders from a physician. (The use of propofol to induce or maintain general anesthesia also requires the continuous attendance of an anesthesiologist.)</p>
<p>Certainly overkill for insomnia!</p>