You probably have already heard by now that Dr. William Hurwitz (previous posts here) was convicted this past Friday afternoon on 16 counts of drug trafficking for prescribing opioid prescriptions to his chronic-pain patients. The New York Times’ John Tierney — who deserves an award for his coverage of the trial and the sad case of Dr. Hurwitz — interviewed three of the jurors after the trial and his findings are disturbing:

[The jurors] said that the jury considered Dr. William Hurwitz to be a doctor dedicated to treating pain who didnít intentionally prescribe drugs to be resold or abused. They said he didnít appear to benefit financially from his patientsí drug dealing and that he wasnít what they considered a conventional drug trafficker.
So why did find him guilty of ìknowingly and intentionallyî distributing drugs ìoutside the bounds of medical practiceî and engaging in drug trafficking ìas conventionally understoodî? After attending the trial and talking to the jurors, I can suggest two possible answers:
1. The jurors were confused by the law.
2. The law is a ass (to quote Mr. Bumble from ìOliver Twistî).
I canít blame the jurors for being confused, because thatís the norm in trials of pain-management doctors. The standard prosecution strategy is to charge the doctor on so many counts and introduce so much evidence that the jurors assume something criminal must have happened. Their natural impulse, after listening to weeks of arguments, is to look for a compromise by digging into the mountain of medical minutiae ñ and getting in so deep that they lose sight of the big picture.

According to Tierney’s inteview, the Hurwitz jury essentially convicted Hurwitz of not examining his patients adequately. Remarkably, the jurors were candid with Tierney that they did not understand the legal standard of “outside the bounds of medical practice.” Rather, they just decided “to go with our gut.”
Sound familiar?
Dr. Hurwitz’s conviction is troubling for medical professionals on several levels, not the least of which is described by a doctor in the following comment to Tierney’s post:

The Hurwitz persecution scares the bejabbers out of me. If I refuse to treat pain adequately that is a criminal offense. If I over treat pain that is a criminal offense. If I cannot tell a smooth, practiced, professional liar from real pain that is a criminal offense. I am expected to be all things to all people, omnipotent and infallible – and if I fail I will be stripped of my license or sent to prison.
Just recently I received a phone call that one of my patients was selling my narcotic prescription on the street. Was this real, a crank call, or a sting operation by the prosecutor? My only avenue of survival was to immediately file a complaint against the patient with BAYONET (a narcotics strike force). Welcome to 1984, Hurwitz jurors. So now that you have forced me to survive by turning people in to the secret police, how do you feel about coming to me and discussing your personal issues?

The message is clear. Pain specialists better be careful who they treat — and undertreat those patients who they elect to take on — or risk going to jail as a result of America’s draconian drug prohibition policy. The doctor-patient relationship has just become much more complicated. And not for the better.