Anyone is following Dr. Murray's trial?

[Rolfe]

Nope. Slam-dunk guilty. Doesn't matter that Jackson was the one who was paying him, in medical ethics paying the piper doesn't let you call the tune. Jackson was Murray's patient. It was Murray's responsibility, among other things, to make sure restricted drugs he had acquired were properly stored so that his patient could not gain access to them unsupervised. It was also his responsibility to ensure that his anaesthetised patient was properly monitored, and that the appropriate facilities were in place for dealing with an anaesthetic emergency, just as they would be in a hospital.

Completely correct conviction and sentence in my opinion.

Rolfe.

 

[katy_did]

Was it ever established when Jackson first started using propofol? Did other doctors administer it to him, or was Murray the first? And if he wasn't, were the other doctors giving the drug to him under controlled hospital conditions, or was that at home as well?

I can't build any case for Murray not being found guilty: it seems very clear from the evidence that he was, and that it was the right verdict. At the same time, I can't help feeling a little sorry for him. Jackson seems to have been a very messed up individual long before Murray ever knew him, and a great many people are responsible for that, none of whom will ever be held to account. And it's almost as if, with Murray's guilt established, that absolves anyone else who had a hand in the very long series of events (throughout his life) which eventually led to Jackson's death - as if the illusion is being created that he was a perfectly healthy and well-balanced individual before Murray entered the picture. There's something that doesn't sit comfortably for me about that. But again, I'd still have voted guilty.

 

[Rolfe]

That's all very true and I entirely agree with you. I don't know who first gave him the propofol, but I don't think it was Murray. And I very much doubt that its use was properly monitored, ever. I also think Jackson would have made continuing to supply him with propofol on his terms a condition of employment.

Murray was undoubtedly not the only culpable individual here. He was the one who had the misfortune to be holding the forfeit when the music stopped.

Rolfe.

 

[Mr.D]

Murray was undoubtedly not the only culpable individual here. He was the one who had the misfortune to be holding the forfeit when the music stopped.

It was his actions after the crisis started that got him the maximum sentence though.

Some of the talking heads on CNN this morning were saying that as a result of California's overpopulated prison system, Murray may not end up spending the full 4 years in prison, and could even spend much of his sentence under house arrest.

 

[Rolfe]

Indeed. He was far quicker to try to cover his own backside than to get help for his patient.

I wouldn't be that concerned about him serving the full sentence behind bars. For a professional, the very fact of being imprisoned at all is devastating. And he has lost his job and his professional status, and his livelihood. He isn't looking at a bed of roses.

Rolfe.

 

[davefoc]

I tried to come up with a defense for Murray, but I wasn't interested in it enough to pursue it very long.

My first thought was to go to the California manslaughter code. I thought I might find something in there to argue that while Murray might have been an idiot it didn't rise to the level of a manslaughter conviction.

Unfortunately, the statute is a bit vague and at least this non-lawyer couldn't find much there that was gong to help Murray:

(b) Involuntary--in the commission of an unlawful act, not amounting to felony; or in the commission of a lawful act which might produce death, in an unlawful manner, or without due caution and circumspection. This subdivision shall not apply to acts committed in the driving of a vehicle.

It sounds like all one needs to do is do something "without due caution and circumspection" that results in the death of another individual and you are guilty of involuntary manslaughter in California. Murray obviously met that criteria. However, I doubt the statue is interpreted that broadly so more research would be needed to figure out if what Murray did would normally constitute enough to be found guilty of involuntary manslaughter. I'm not interested enough to do that but the casual reading of the opinion of several lawyers seemed to be that what he seems to have done was bad enough to be found guilty of involuntary manslaughter.

2. I tried searching the web looking for people advocating for Murray. I only found obviously uninformed people making the case that Murray wasn't guilty.

3. I looked at what the defense had to say. I quickly realized that I didn't have enough knowledge of the case to analyze the defense points very well. TMZ's summary is here: http://www.tmz.com/2011/11/03/conrad-murray-closing-arguments-defense/#.TtVo3e3Nm0U

It's pretty hard to pick out a few that looked credible enough to mount a defense with though.

4. I also took a look at the testimony of the doctor that testified for the defense (White). I didn't see much there that was helpful to the defense. Especially, if you buy Rolfe's theory, that Murray is guilty even if Jackson self injected because Murray shouldn't have left the stuff around for Jackson to self inject it.

So bottom line, I don't seem to be able to mount much of a defense for Murray, but maybe somebody else could find something?

 

[Rolfe]

Especially, if you buy Rolfe's theory, that Murray is guilty even if Jackson self injected because Murray shouldn't have left the stuff around for Jackson to self inject it.

Well, unless medical ethics and the requirements imposed on those granted the privilege of prescribing restricted drugs are very different in California from what I'm used to (and I don't believe they are), that ain't a theory, it's fact.

I have similar prescribing privileges to Dr. Murray, and I am in no doubt at all that if I left something like that I had obtained on my prescription in a place where a lay person could get hold of it and self-administer, my backside would be toast in extremely short order.

Rolfe.

 

[davefoc]

Well, unless medical ethics and the requirements imposed on those granted the privilege of prescribing restricted drugs are very different in California from what I'm used to (and I don't believe they are), that ain't a theory, it's fact.

I have similar prescribing privileges to Dr. Murray, and I am in no doubt at all that if I left something like that I had obtained on my prescription in a place where a lay person could get hold of it and self-administer, my backside would be toast in extremely short order.

Rolfe.

Yes, but would you be found guilty of manslaughter in California if that was all you did? I doubt it. You might not even lose your license although I wouldn't look forward to paying your malpractice insurance premiums after the incident.

To be clear, I agree with you that Murray is guilty. I just wanted to examine the case a little bit better and see if there wasn't some kind of case to be made for Murray. If Jackson was known to be a propofol user before Murray and Murray was indeed reducing his dosage and Murray had engaged in reasonable medial practices like documenting the drugs he administered to Jackson and Jackson had self injected the bulk of the propofol that killed him and Murray had acted in a medically responsible way following the death of Jackson I could find some room for a not guilty verdict.

However, it sounds, like the only part of the above that was true was that Jackson was probably using propofol before Murray and it is vaguely possible that Jackson self administered some of the medication that killed him, so it doesn't seem like there is much of a case to be made for Murray, but I'd be open to one if somebody could make one. Murray's conflicted motivations here don't help him much either. It is hard to look past the promise of $150K a month if he does what Jackson wants and see Murray as a physician working in the best interests of his patient.

Challenge to the people participating in this thread: Think like a defense attorney. Figure out a defense for Murray. I have given up.

 

[Parallax]

This sounds pretty damning.

As a casual follower of the case, I was aware of a few lines of defense:
1. Interactions with other drugs that Murray wasn't involved in administering or prescribing caused the death.
2. Jackson, himself, administered the fatal dose while Murray was out of the room.
3. Jackson, before Murray, had become addicted to propofol and Murray was gradually reducing dosages to break Jackson's dependency.

The lack of written records by itself sounds pretty damning though. Did Murray's defense have an explanation for that?

It sounds like the gradually-reducing-the-dosage defense was pretty much shattered by the facts.

I take it the interaction theory was shot down because there weren't other drugs in Jackson's system that would have been consistent with that theory?

What about the, Jackson-administered-the-fatal-dosage-himself theory? Didn't the defense have a doctor that testified in favor of that theory?

1. Interaction with drugs that only Murray administered caused Jackson's death. IV Lorazepam and propofol.
2. Possible but unlikely.
3. Jackson had been receiving huge injections of demerol, that he was probably dependent on from his plastic surgeon, Dr Klein. Withdrawal from demerol can produce insomnia. The propofol was guaranteed to put anyone under and according to Murray Jackson begged for it as the lorazepam didn't do the trick.
There was no explanation offered for Murray not producing records. A defence doctor (Dr White) said that Jackson could have administered the fatal dose to himself but death could not have been the result of oral consumption.

 

[Parallax]

Was it ever established when Jackson first started using propofol? Did other doctors administer it to him, or was Murray the first? And if he wasn't, were the other doctors giving the drug to him under controlled hospital conditions, or was that at home as well?

Jackson was first introduced to propofol some years before in Germany and Murray said that another doctor was administering it to Jackson in Las Vegas just prior to Murray starting to work for him.

 

[Skeptic Ginger]

Well, unless medical ethics and the requirements imposed on those granted the privilege of prescribing restricted drugs are very different in California from what I'm used to (and I don't believe they are), that ain't a theory, it's fact.

I have similar prescribing privileges to Dr. Murray, and I am in no doubt at all that if I left something like that I had obtained on my prescription in a place where a lay person could get hold of it and self-administer, my backside would be toast in extremely short order.

Rolfe.

I also have prescriptive authority and I practice in the US. Any controlled substances I buy can only be delivered to my address and I have to personally sign for them, no one else can sign. I cannot return to the Fed Ex or UPS location and pick a controlled substance up like I can with anything else that I miss a delivery on, including other prescribed drugs and syringes. I have no doubt I'm responsible for controlled substances once they are delivered. If staff steal them I won't likely be blamed, the staff member would, but leaving them around at someone's house, yes, I'm sure pretty sure that would be illegal.

 

[tyr_13]

This is especially important in that Murray used false pretenses to obtain the mass quantities of the drug.

Really, the judge laid out his reasoning very well.

 

[Parallax]

Challenge to the people participating in this thread: Think like a defense attorney. Figure out a defense for Murray. I have given up.

The original defence was that Jackson, up to his eyeballs in debt, had a reason to kill himself. Dr White conducted a study with beagles and concluded that an oral overdose was not possible, therefore only possible by infusion or injection. Jackson administering drugs to himself was the only credible defence.

However, any serious doctor would have refused to administer propofol from day one. Dr Shafer the prosecution expert listed 17 egregious violations of care by Dr Murray, anyone of which could have lead to Jackson's death, 'He said four of the violations rose to the level of “unconscionable.” I don't think that there is anything to indicate that Murray's motives were anything other than supplying Jackson with what Jackson demanded albeit for a hefty fee, unfortunately, he also completely botched the administration of these drugs yet killing Jackson was not at all in Murray's interest.

 

[Parallax]

I also have prescriptive authority and I practice in the US. Any controlled substances I buy can only be delivered to my address and I have to personally sign for them, no one else can sign. QUOTE]

Murray had the propofol delivered to his girlfriends condominium in Los Angeles and told the pharmacist that it was the address of his clinic. His girlfriend testified that some, but not all of the signatures on the receipts were hers.
To clarify, Murray said that it was possible that he could have left a syringe and some propofol within Jackson's reach. However, the pharmacist testified that propofol was not a controlled substance.

 

[davefoc]

The original defence was that Jackson, up to his eyeballs in debt, had a reason to kill himself. Dr White conducted a study with beagles and concluded that an oral overdose was not possible, therefore only possible by infusion or injection. Jackson administering drugs to himself was the only credible defence.

However, any serious doctor would have refused to administer propofol from day one. Dr Shafer the prosecution expert listed 17 egregious violations of care by Dr Murray, anyone of which could have lead to Jackson's death, 'He said four of the violations rose to the level of “unconscionable.” I don't think that there is anything to indicate that Murray's motives were anything other than supplying Jackson with what Jackson demanded albeit for a hefty fee, unfortunately, he also completely botched the administration of these drugs yet killing Jackson was not at all in Murray's interest.

Good effort and now what was your case for the prosecution?

 

[Rolfe]

Give it up, Dave. He got what he deserved.

I'm especially unimpressed by his lack of any remorse. Apparently he's still insisting he did nothing wrong. If he was still on the medical register he'd be a candidate or forcible re-education.

Rolfe.

 

[davefoc]

Give it up, Dave. He got what he deserved.

I'm especially unimpressed by his lack of any remorse. Apparently he's still insisting he did nothing wrong. If he was still on the medical register he'd be a candidate or forcible re-education.

Rolfe.

OK, I'm done. The free Dr. Murray movement is just going to have to do without my support.

 

[Rolfe]

One thing to remember is that propofol is a general anaesthetic. There is a definite risk of death associated with general anaesthesia itself, regardless of any underlying morbidity suffered by the patient. We all accept that risk as being worth it, for a necessary operation. Or even, once in a while, for an unnecessary one. (Boob jobs, anyone?)

However, the more anaesthetics you have, the more goes you are having at that particular Russian roulette. Doctors understand that, and limit anaesthetics to very occasional use, or when absolutely medically necessary. Repeated non-indicated anaesthesia is simply irresponsible, even if full precautions are taken.

And Murray was negligent in the precautions as well.

Rolfe.