2007.03.26: March 26, 2007: Headlines: COS - Brazil: Staff: Medicine: Crime: Pain: Jurisprudence: International Herald Tribune: Retrial of pain Doctor Hurwitz renews debate on M.D. prosecutions
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2007.03.26: March 26, 2007: Headlines: COS - Brazil: Staff: Medicine: Crime: Pain: Jurisprudence: International Herald Tribune: Retrial of pain Doctor Hurwitz renews debate on M.D. prosecutions
Retrial of pain Doctor Hurwitz renews debate on M.D. prosecutions
A prominent pain doctor whose methods have drawn government scrutiny for nearly 20 years went on trial a second time for drug trafficking on Monday, and the arguments changed little from the first trial. In opening statements in U.S. District Court, prosecutors labeled William E. Hurwitz no better than a common drug dealer, while the defense portrayed him as a physician who freed his patients from a life of debilitating pain. Hurwitz was a former volunteer medical director for the Peace Corps in Brazil in the 1970's.
Retrial of pain Doctor Hurwitz renews debate on M.D. prosecutions
Retrial of pain doctor Hurwitz renews debate on M.D. prosecutions
The Associated Press
Published: March 26, 2007
ALEXANDRIA, Virginia: A prominent pain doctor whose methods have drawn government scrutiny for nearly 20 years went on trial a second time for drug trafficking on Monday, and the arguments changed little from the first trial.
In opening statements in U.S. District Court, prosecutors labeled William E. Hurwitz no better than a common drug dealer, while the defense portrayed him as a physician who freed his patients from a life of debilitating pain.
Hurwitz, 61, whose pain management practice in McLean drew hundreds of patients from 39 different states, is facing one count of conspiracy and 49 drug trafficking counts, including one count of drug trafficking resulting in death.
He was convicted on identical counts in 2004 after a six-week trial and sentenced to 25 years in prison. But last year a federal appellate court tossed out the conviction and ordered a new trial. The three-judge panel ruled unanimously that trial judge improperly barred the jury from considering whether Hurwitz was acting in good faith.
Hurwitz has been an aggressive advocate of high-dose opioid therapy for pain patients, and has become a hero to patient advocates who believe that doctors routinely undertreat chronic pain.
But prosecutors say Hurwitz did little more than run a pill mill, prescribing massive amounts of drugs to addicts and patients who were obviously selling their medications on the street.
They said his waiting room was littered with stoned, sleeping patients with track marks on their arms. And the quantity of drugs prescribed to some patients was mind-boggling.
Patients with incomes of $30,000 (€22,615) to $50,000 (€37,690) a year and who lacked health insurance were filling $120,000 (€90,460) to $240,000 (€180,930) worth of prescriptions each year with no apparent means to pay for them.
One patient had a prescription for up to 1,600 pills a day, or 500,000 pills over a three-to-four year period, Fahey said.
But Hurwitz's lawyer, Richard Sauber, said Hurwitz was justified in prescribing massive amounts of drugs because the treatment gave relief to patients who otherwise suffered terribly.
Numerous physician and patient advocacy groups filed legal briefs on Hurwitz's behalf when he appealed his initial conviction. While they did not necessarily defend Hurwitz's treatment methods, they argued that prosecuting him deters other doctors from prescribing opiates to legitimate patients, and that state medical boards — not courts — should decide if a doctor's care is medically appropriate.
Dr. Jane Orient, executive director of the Association of American Physicians and Surgeons, said in a phone interview Monday that the prosecutions of Hurwitz and other doctors across the country has had a chilling effect on doctors' willingness to prescribe pain medicine. In the meantime, medical opinion about the use of high-dose opioids in recent years increasingly validates Hurwitz's theories, she said.
"He has been way ahead in promoting the idea that we are undertreating pain," Orient said.
The trial is expected to last about three weeks.
Sauber acknowledged that some patients may have scammed Hurwitz, but said Hurwitz's general instinct to trust patients was correct, especially since patient complaints about pain are hard to quantify.
Prosecutors countered that Hurwitz had been put on notice multiple times that his methods were outside the bounds of legitimate medicine. Regulators suspended Hurwitz's medical license twice, first in 1991 and again in 1996, and ordered him to take classes on weeding out addicts and dealers posing as patients.
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Headlines: March, 2007; Peace Corps Brazil; Directory of Brazil RPCVs; Messages and Announcements for Brazil RPCVs; Staff; Medicine; Crime; Jurisprudence
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Story Source: International Herald Tribune
This story has been posted in the following forums: : Headlines; COS - Brazil; Staff; Medicine; Crime; Pain; Jurisprudence
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