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April 24, 2007 -- 6:01 PM
posted by Par
William E. Hurwitz, M.D., is a Virginia based pain management physician who, in 2004 was aggressively prosecuted and convicted by the United States Government for prescribing pain medication to patients, some of whom subsequently abused and redistributed it on the black market. Before his conviction, Dr. Hurwitz had had a series of running battles with the Virginia Board of Medicine which, in 2003 found fault with some of his prescriptions but also held that all were written "in good faith".
Convicted of over 50 counts of distribution of narcotics, Hurwitz was originally sentenced to four 25-year sentences and forty-six 15-year sentences, all of which were to be served concurrently, and was fined more than $1 million (U.S.). During the prosecution of the first case, all of Dr. Hurwitz's property was seized.
In an NYT article today, two disquieting issues about this case are raised. The first is that of the lengths gone to by aggressive prosecution of drug offences, as highlighted above. The second is that of managing patient pain:
Surveys have found that one in five adults deals with chronic pain, and that it is treated adequately only about half the time.
Prescribing opioids was once taboo because of concerns over patients’ becoming addicted. But medical opinion gradually shifted over the past two decades as researchers concluded that high doses of opioids could sometimes be safer and more effective than alternatives like surgery or injections.
...
When Dr. Hurwitz testified last week, he spent hours going through the histories of those he called his “misbehaving patients,†[those who were refilling prescriptions early, or using illegal drugs, such as cocaine] telling why he believed they all had genuine problems. “Ultimately, pain is what the patient says it is,†he told the jury, contrasting his approach with what he called the traditional “Father Knows Best†approach of old-school doctors.
In retrospect, he acknowledged, he should have been more suspicious of patients who asked for early refills, reported losing prescriptions and tested positive for illegal drugs. He did get rid of the worst patients, he said, but he believed others were reforming, and he feared they would not get help anywhere else if he dismissed them.
“I felt that I had a duty to the patients,†he said. “I hated the idea of inflicting the pain of withdrawal on them.â€
Adequate pain control is a controversial issue in medicine. There is a fear of being responsible for starting a patient's addiction to opioids which is compounded by the lack of an objective measure of pain (how can you be sure they're not faking if you can't measure it yourself?) The fear of being duped by a patient is a real one, but perhaps not necessarily one that should prevent physicians from providing adequate care. That latter concern is embodied by that statistic that half of patients have poorly controlled pain. (Could you imagine if half of hospital in-patients had poorly controlled malnutrition or poorly controlled bleeding?)
To add political motivations in the way of wanting results in a failing "War on Drugs" seems at the least misguided and at the worst making tragic an already difficult situation.
The bottom-line, I think, can be summed up by my initial reaction when I read he had been sentenced the first time to 25 years in prison: That's fucking scary.
April 24, 2007 -- 5:43 PM
posted by alison
April 24, 2007 -- 3:11 PM
posted by alison
it's too bad it's not glassy or anything... forget green...
i would've thought something with boron and silicon (at least has the potential..) would be glassy... like pyrex. ooo! "The jadarite is fluorescent when exposed to UV light" and according to wikipedia (so it must be true!) kryptonite had fluorine in it, Jadarite does not.
then again, maybe Jeremy can shed further light on this: LiNaSiB3O7(OH)
April 24, 2007 -- 1:55 PM
posted by Par
Oi, this is dumb. Watch out, Superman! Kryptonite found on Earth.
What they really found is sodium lithium boron silicate hydroxide (I leave it to better minds to explain what that formula actually means.) Apparently, that's what was described as the chemical formula for Kryptonite in Superman Returns.
April 23, 2007 -- 6:34 PM
posted by Jere
Thanks andy!
Alright, for those of you that held on... we are planning on being at Brewstersaround 8ish if you guys would like to have a beer with me and celebrate my birthday and possibly the end of the Canucks stanley cup run...
Come on out if you can make it.
It just wouldn't be my birthday without true organizing last minute style
April 23, 2007 -- 5:42 PM
posted by Par
Curse you and your flash proficiency, Thompson!!!!!
(Although you're 10 candles short, goddamnit...)
April 23, 2007 -- 5:20 PM
posted by Jere
Thanks guys for your birthday wishes/comments about my goaltending/wishing everyone else happy birthday/calling me bumdink/competing for my affection.
Stay tuned...Sometime this week we should all go somewhere and meet at least for a drink and you guys can bask in my glory even more... and no I'm no egotistical.
Thanks again
April 23, 2007 -- 1:44 PM
posted by Par
Happy Birthday, bumdink.
May you continue to enjoy goaltending success unencumbered by a shoddy supporting cast.
Hmm... shoddy supporting cast, distinctive beard, quality goaltending but ultimately knocked out of the tournament. Why does that sound so familiar?...
