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Cutting calories ... continued
Such testimony does not make Hurwitz look like a drug trafficker. It makes him look like a sincere healer duped by tricky patients. Although prosecutors portray Hurwitz as a drug kingpin, they have no evidence that he received any money from drug sales. Instead, they say he profited by charging patients for his care.
Prosecutors cite Hurwitz's detailed medical records to support their allegation that "he prescribed incredibly large amounts of narcotics, well outside the boundaries of proper medicine." But as Patrick Hallinan, one of Hurwitz's attorneys, noted, "These medical records are in stone. You think someone involved in a scam selling pills would put it down in the records?"
That does not necessarily mean that every aspect of Hurwitz's practice was beyond reproach. But by threatening to imprison doctors for being less suspicious than the Drug Enforcement Administration thinks they should have been, the government puts the fear of pain patients into even the most scrupulous physicians.
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Russell Portenoy, a prominent pain expert, warns that a conviction in this case would have a "strong chilling effect" on pain treatment. "I have a very profound concern," he told the Washington Post, "that the appropriate way to deal with these issues is not through criminal prosecution but through an evaluation of medical practice."
In this connection, it's significant that the Virginia Board of Medicine, reviewing allegations similar to those underlying the Justice Department's case, chose not to revoke Hurwitz's license but to place him on probation. It's also telling that when federal investigators discovered that some of Hurwitz's patients were selling the drugs he prescribed, they chose to build a case against him rather than alert him to the diversion they supposedly were trying to prevent.
"In this particular area," Hurwitz told the Post before his indictment, "doctors are expected to have perfect knowledge of everything a patient does. That presumption is invalid. Nobody could treat pain if they're going to hold doctors to that standard."
In a pamphlet published last August, the DEA conceded that "any physician can be duped"; that it's hard to distinguish between addicts and patients in pain; and that prescriptions that look suspicious to the government may be perfectly justified. The pamphlet disappeared from the DEA's website last month, a few weeks after Hurwitz's attorneys tried to introduce it as evidence in his trial.||||
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