Regarding “Dr. Hurwitz’ Mysterious Motive”

Regarding “Dr. Hurwitz’ Mysterious Motive”; Mary Baluss, Esq.; Comment #10 in response to John Tierney post “Dr. Hurwitz’ Mysterious Motive” in TiernyLab; 2007-04-25

[I want to comment on Dr. Hurwitz'] motive. In the first Hurwitz trial the government emphasized that it didn’t have to show motive, only intent. Then they offered tattered evidence that Dr. Hurwitz has made $2.5 million from his practice over 4 1/2 years. Aha! They implied.Dr. Hurwitz’ attorneys failed to elicit the fact that this princely amount was gross income and the roughly $400,000/year covered the expenses of an office, malpractice insurance, two exceedingly competent nurses, a receptionist/bookkeeper, professional societies, etc.

Or that he didn’t own a house, drove an elderly (nice, but elderly) car, had two daughters in college. At the time of his arrest he was living with a neighbor of his former wife’s and taking care of this elderly gentleman in return for housing.

Know many doctors doing this well? Or drug dealers as poorly?

At some point during the first trial, the prosecution decided to switch motives. Choice number two: hubris. Megalomania. No sense of fear or a determination to tweak the DEA even at the risk of his freedom. In the present prosecution that remains the theme.

Yet the quote from his “Pain and Chemical Dependency” posting makes it clear that he did know fear, self-doubt and humility. [see: APPENDIX below] I know that he wrestled with the ethics of abandoning patients to pain and withdrawal.

I believe that his struggle to understand what was happening was far clearer in this trial. Hope the jury “gets it”.

– Mary Baluss, Esq.

========== APPENDIX

NOTE: The following is from “What’s an Ethical Doctor to Do” by John Tierney; TierneyLab; 2004-04-23. My personal thanks to Mr. Tierney for his long and consistent support of ethical medical care, concern for individual suffering, and understanding of the larger public health consequences and political causes of our current troubles.

I think I can speak for all Pain Relief advocates: “We are so very grateful to you… When’s the next war on doctors article coming out?” (smile) — ..alex…

“The post was submitted to a chat room run by the Project on Pain Management and Chemical Dependency, which brought together doctors, patients, lawyers and law enforcement officials to discuss issues. Here are excerpts of Dr. Hurwitz’s post:

‘A state regulatory policy that conditions medical licensure on the willingness of physicians selectively to violate a duty of care to the individual patient seems to me unethical and dangerous. It deputizes physicians as policemen for the state and necessarily undercuts confidence patients must have in their doctors to enable intelligent, dignified, and compassionate care based on candor and mutual respect.
‘My position [the policy of excluding patients who use illicit drugs] is an expedient accomodation to the state’s police power and a recognition of my vulnerability in the current legal and social context. By having patients consent to strict obedience to the drug laws as a condition of my treatment, I shift the burden to the patient and relieve myself of the ethical dilemma. Patient “misbehavor” is converted into the breach of a contract, which I have the right to enforce. A nobler conception of the physician’s role, in my view, would dispense with such a contract and accept all patients as they are without precondition and in broad acceptance of human frailty, moral as well as physical.
‘P.S. I am finding it very difficult consistently to enforce my contract. I feel that I am imposing misery and pain on the patients who have misbehaved, as well as on their spouses or close associates. They and I believe that, once discharged from my care, no one will undertake to treat their pain, at least in the near future, and that my discharge amounts to condemnation to prolonged suffering and disability.’ “

[END]