Via John Tierney
at the New York Times, posted late last night... Judge Leonie Brinkema sentenced pain physician Dr. William Hurwitz to 57 months, more than pain treatment advocates were hoping for but considerably less than the 25 years handed down in the first trial by Judge Wexler. With time served, he could be out in 17 months.
One paragraph in particular from Tierney's blog post encapsulates much of the backwardness inherent in the federal sentencing system, backwardness that affects many much more run-of-the-mill cases as well:
While there was no evidence that Dr. Hurwitz was profiting from the resale of his prescriptions -- and the jurors I interviewed said they didn’t think he intended the drugs to be resold -- he will still spend more time in prison than almost all the patients who admitting lying to him and reselling the drugs. Thanks to the deals they made to cooperate with prosecutors, seven of the nine patients got sentences ranging from 10 to 39 months. Only two got longer sentences than 57 months -- and one of them, who got 72 months, was also guilty of armed robbery and arson.
The other thing that is really troubling about this case is that jurors admitted to Tierney (previously
) that they were not clear on what the law says about whether a doctor who screws up and prescribes to the wrong people, but isn't intentionally diverting drugs to the black market, should be held criminally responsible. But that is precisely the point of law on which the verdicts turned. If jurors
don't understand the law they are judging, what is the justification for keeping the conviction and imprisoning someone for it? Despite the praise that has been given to Brinkema by Tierney and others for her handling of this case -- which admittedly was far better than other judges have done -- at the end of the day I have to say that I think she failed to do proper justice. I repeat, if the jurors
admit that they did not understand the key point of law before them, I see no reasonable way for the verdicts to be considered legitimate, because the process itself is simply unsound. I could see an argument (theoretically) for having a third trial, but Dr. Hurwitz should be at home tonight with his family, and it's a crime that he's not -- not only for his sake, but for all the pain patients who effectively are being tortured by denial of pain medication because doctors don't want to take the risk of getting sent to prison. Lastly on this theme, think about the fact that the first set of convictions were invalidated, and this second set for the aforementioned reasons clearly should have been. That's an extraordinarily poor track record. A criminal justice system that imprisons people even when jurors admit they didn't know what they were doing is a system that is fundamentally corroded and has lost its way. Don't be proud of yourselves, feds!
Despite all of the foregoing, I also have to say that I am relieved. 17 months is a long time to spend in prison, even if one hasn't already spent some years there already, but it could be much, much worse. Judge Brinkema could have given him the same 25 years, or life -- or 10 years, or 12 or 15. The trial also had a bright spot in that Brinkema saw through the misrepresentation about dosages that prosecutors had attempted:
Brinkema said she had read news accounts of the first trial and had seen some of the massive prescriptions Hurwitz had given out, including one patient who was given 1,600 pills a day.
"The amount of drugs Dr. Hurwitz prescribed struck me as absolutely crazy," the judge said.
But after hearing testimony from both sides, "I totally turned around on that issue," Brinkema said. "The mere prescription of huge quantities of opioids doesn’t mean anything."
In fact, there are known pain treatment cases in which the dosages were literally four times greater than the largest dosage prescribed by Hurwitz in the cases at stake (as I pointed out in a letter to Judge Wexler
before the first sentencing, though obviously to no avail). Now lawyers in other pain cases (current and future) can read Judge Brinkema's comments to judges and jurors to explain why the apparently large doses may have been appropriate. The problem hasn't been a lack of experts willing to say that in trials; the problem has been that for some reason it just seems to wash over people in the face of the large number of pills. I think that having a quote like that from a federal judge will help to break through.
I'm not a physician, and I'm not in a position to judge whether or not Dr. Hurwitz practiced good medicine in every case. But I'm completely confident that he did not engage any drug-dealing conspiracy. Perhaps the fact that I've met him several times in the past biases my view. But I've also met many of his former patients -- some of them I know well -- and it's a provable fact that he helped many people whom others doctors wouldn't help and who desperately needed the help, and that he gave them the benefit of thoughtful attention. A lot of these people were left in the lurch when the authorities moved against him, causing at least one suicide
and arguably a few of them.
Hopefully this outcome, while highly imperfect, has enough good points in it to help move things in the right direction; time will tell. You can keep with all of our pain reporting in our topical archive
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