Conrad Murray Open Thread

There isn't much content for half-baked-political-grandstanding in the trial of Conrad Murray, the personal physician charged with manslaughter in the death of Pop King Michael Jackson.

But I have become a fan of the trial nonetheless. Los Angeles Deputy District Attorney David Walgren alleges that 58-year-old Murray in June 2009 gave Jackson a fatal overdose of propofol, a surgical anesthetic that Jackson was apparently using as a sleep aid despite very serious concerns about the drug's potency and contraindications with other medications.

In 12 days of trial, the prosecution has called 33 witnesses, some of them very memorable Hotel California types. Struggling actress Nicole Alvarez, one of three attractive women brought in to testify as former Murray girlfriends, gave testimony that seemed at times closer to an audition than a court appearance. Alvarez endured broad mockery for her statement, "As an actor, your instrument is yourself" — which is pretty funny for its flighty-sounding cadence but is nevertheless true. (People underestimate how demanding a performer's life can be.) 

An in-court playing of Murray's initial interview with police this week revealed the $150,000-a-month doctor's Las Vegas home address as of 2009. Take a look. Even in these uncertain times, $1.8 million in annual income can still buy a lot. 

As noted above, I can't discern any significant political angle in this story. Jacob Sullum has done excellent coverage for Reason of the dangers of charging doctors for supposedly overprescribing pain medications, but even by the most charitable interpretation the case against Murray seems to go substantially beyond that gray area. 

Which is not to presume anything about this case. The defense has promised to call 15 witnesses, including "police officers, experts and some character witnesses." As of Wednesday the crowd outside L.A. Superior Court contained quite a few Murray supporters. I think it's fair to say the case so far has not been promising for the defense, but the D.A. has a long way to go to get to a conviction. 

So I boil this down to an ethics-class conundrum: You're a doctor. You're offered a chance to make $150,000 a month to look after one patient. You know the patient is a reclusive genius with tastes that are difficult to satisfy (and whatever the outcome, I'm pretty sure it was Jackson, not Murray, who initially suggested using propofol or "milk" as a get-through-the-day medication). In fact, given the eccentric nature of your patient, there's a very strong probability that the job will end unhappily and with considerable risk to your ability to practice medicine in the United States in the future. But in the meantime you can make bank for as long as you keep him alive — and despite his many personal oddities (which include having dismissed some previous doctors for unclear reasons), the patient has no life-threatening ailments. Do you take the job? 

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  • Ice Nine||

    The old joke with the punchline, “We've already established that you're a whore; now we're just negotiating the price” comes immediately to mind.

  • rather||

    Most doctors are money whores; their patients are cash cows, not people

  • Professional Critic||

    In your fevered mind, since corporations treat people like cash cows, and doctors too, is there anyone who treats you like the princess you obviously are?

  • rather||

  • Live Free or Diet||

    Last I saw, doctors' life expectancy was less than 60. Sounds like a lot of stress to me... like maybe they care? Nah!

  • The Art-P.O.G.||

    I think the shortened life expectancy is due to the prevalence of Gregory House-like pill-popping in the medical community. Or at least I like to think so.

  • ||

    100 hour weeks during internship/residency, and (except for the "boutique" specialties) the tendency to frequently get roused in the middle of the night only to carry a full patient load the next day probably doesn't help.

  • .||

    Overworked doctors is the consequence paid for the artificial shortage of people who are allowed to practice medicine. High fees come with a price.

  • Root of all evil||

    Objectifying human relationships into economic-only associations is the only cure for empathy, the root of all evil.

  • rather||

    But I have become a fan of the trial nonetheless

    #34?

  • ||

    The MJ audio clips have been hilarious. Lay off the pills when ya can't talk properly no more bro!

  • ||

    The question, Tim, is one of jail time. I have no ethical problem with giving a patient what they want; it's their body, after all, and you can counsel them on whether or not certain things are really bad ideas. But if I could lose more than my license, such as my freedom by being sent to jail, then no.

    Otherwise, sure.

  • Ice Nine||

    Hard to believe that you would look on your license - which is your meal ticket - so cavalierly. But, hookay. Most would not. If you have no ethical problem with giving a patient what they want, OK there too. Most physicians would because most physicians are averse to causing their patients harm. If you think patients should be given whatever they want, fine as well. Just go get some gas station attendants or soda jerks to do the giving if it is as simple as that. The physicians can wait in the wings and give their advice to those that have so acquired whatever they want about what is likely to result from their uninformed choices. Screwy, dangerous system but, there ya go.

  • ||

    Hard to believe that you would look on your license - which is your meal ticket - so cavalierly

    Tim's entire implication was that you could make a metric fuckton of cash working for the guy, so losing your license down the road won't matter unless you're really stupid with your money.

    This dude was pulling down 1.5 mil a year. Let's say he did that for 10 years; now he's pulled down 15 mil. He'd lose a bunch to taxes, and would need to spend on housing and food, but at the end of the 10 years, with investing, he is set up for life.

  • Mr Whipple||

    You forgot the three bitches. I'm sure they weren't cheap to "maintain". That's at least half after taxes.

  • ||

    unless you're really stupid with your money

    Is in there for a multitude of reasons. If you're buying diamond necklaces and cars for your girlfriends, you might not be being smart about the eventual possibility of losing your license.

  • ||

    There is that whole "do no harm" bit though.

  • Paul||

    There's a physician-assisted suicide smackdown somewhere in there.

  • ||

    What's more harmful: giving your patient what he wants and trying to get him to be smart and safe about it, or getting fired because you won't give your patient what he wants and then no longer being able to try and get him to be smart and safe about it, and not knowing who is replacing you, and the fact they may be less concerned than you about keeping him safe?

  • Ice Nine||

    Door Number One. If he's trying to wheedle stuff out of you that you know is dangerous, he'll know it's dangerous too. These guys could write a PDR. And, trust me, being smart and safe about it is not on his to do list. Getting more and more, and dangerous be damned is all that's on that list. Maybe you have to intimately know the type to understand this.

  • SIV||

    Mainlining the paitient with the "treatment" he desires isn't what's harmful. Failing to monitor his vitals afterwards is. I assume MJ went with a doc rather than a dealer and some drug buddies because he wanted to stay alive.

  • ||

    Yeah true, giving a guy a reasonable amount of pills and keeping him on a "leash" is OK, but getting a guy absolutely fucked is unethical IMO. It depends on what the guy is used to of course - managing a junkie (not just a guy with a high tolerance who is in pain) with relatively high amounts may be necessary.

  • mark||

    for heaven's sake you are talking about PROPOFOL, that is not a drug that can be safely used recreationally unless you have a whole anaesthetic room set up and ready to go.

  • np||

    There is that whole "do no harm" bit though.

    should really mean: "do no involuntary harm"

    It is absolutely unethical to interfere with any voluntary exchange of informed consent. If the patient knows of the risks, if he's reminded of it, like in this case, then people--you, me, the government should not interfere. An organization may have certain guidelines or some people may refuse and that's fine. Simply, it shouldn't be banned or criminalized.

    The most that can and should be done is simply disclosure of any risks, side effects, etc involved.

  • Libertarian Ethics||

    I have no ethical problem with giving a patient what they want

    The hypochondriac patient wants a CAT scan once a week, which will greatly increase the patient's risk of cancer in 15 years.

    Hey, there's money to be made! And...there's money to be made!

  • ||

    99% RETARDED

  • ||

    Exactly - "you don't need a CAT scan" is quite different to let's manage your addiction and try to give you some pleasure.

  • ||

    "Exactly - 'you don't need a CAT scan' is quite different to let's manage your addiction and try to give you some pleasure."

    Not to a hypochondriac it's not.

  • cynical||

    If they're informed of the risks, isn't it on them? Whose body is it, the patient or the doctor?

  • R||

    Sure...if the patient owns the machine. But since most CAT scan machines are owned by the hospital, and they have other patients who actually need to use and can't have a hypochondriac tying the machine up all the time, they're well within their rights to tell them to STFU.

  • ||

    As long as the doctor tell the patient, "getting these once a week will greatly increase your risk of getting cancer," then fuck no, I have no problems with that.

  • ||

    Hey, looks like Tim had no trouble parsing the address from the tape they played in court.

  • ||

    Butthole a little puckered from earlier, Commodore?

  • ||

    STARFISHPWN'D

  • ||

    My strangulated hemorrhoids are none of your beeswax.

  • Scruffy Nerfherder||

    The rubber band man

  • BakedPenguin||

    So that's what the Spinners were singing about. Gross.

  • ||

    They were clearly referring to making an artificial va-jay-jay from rubber bands and olive oil. I'm sure Warty can explain it better than I.

  • Paul||

    So I boil this down to an ethics-class conundrum: You're a doctor. You're offered a chance to make $125,000 a month to look after one patient.

    I've wondered this myself in many of these celebrity, the-doctor-is-responsible cases.

    Some demanding celebrity with endless wads of cash pays you a huge sum to help him 'cope' and demands specific medications. If you get your 'dad' voice out with them and start, you know, demanding to know what the exact ailment is that requires this medical marijuana, they'll fire your ass in a second and hire someone else who will provide it without any questions. Probably tough to resist.

  • anon||

    All of which could be precluded with removing the FDA's ability to regulate drugs.

    MJ's doctor is simply the latest casualty in this shitty "war."

  • Dr. Nick||

    HI EVERYBODY..........

  • PantsFan||

    For transgender singles, online dating is a minefield

    “With few exceptions, people don't go to a dating site looking for a transperson,” Alex says. “And most transpeople who aren't out wouldn't want to date someone who is openly looking to date a transperson.

    http://www.theglobeandmail.com.....le2200256/

  • ||

    Oddly apt, Pants.

  • silent v||

    wait, transpeople don't want to date someone who wants to date a transperson?

  • ||

    I guess they're concerned about getting involved with people with odd sexual desires...!

    I've encountered them on OkCupid. I'd read a profile of someone who's a good match for me, and down in the details... gee, no wonder this person is so similar to me! They were born male....

  • ||

    Transperson?

    Wacky alternative lifestyles are an endless reservoir of inherently funny words.

  • Colonel_Angus||

    Whats a transperson- you mean like on Ghost in the Shell?

  • ||

    They sink like my stools when Arby's is running a 5 for $5 special.

  • SIV||

    This was one of those cases where I thought I'd love to be on the jury.Patient want's "X" and contracts with physician who agrees to provide it, just the way it is supposed to work in a free society.

    The little I've followed the trial, through radio news mostly, kinda complicates what I thought would be an open and shut case. It sounds like the Dr. was negligent at best and did not fulfill his contractual responsibilities.

    Keith Richards had "retainers" who did a better job of monitoring the boss's vitals and making sure he didn't croak.

  • ||

    Or possibly reanimating his dead body after he croaked, which is my deeply held belief.

  • Apatheist||

  • Denis Leary||

    Interesting

  • ||

    You know the patient is a reclusive genius...

    I thought we were talking about Michael Jackson.

  • foul taint||

    MJ reclusively got on stage in front of thousands of people and danced while grabbing his crotch - genius!

    Seriously though, MJ had a great deal of talent. Just listen to his singing as a tyke. Definitely more talented than your average performer. Then he got white and things started to fall apart.

  • ||

    Singing talent doesn't make one a genius.

  • ||

    Yes, he was hardly Schönberg.

  • foul taint||

    ... but crotch grabbing on stage does.

    Judging by his commercial success and even accounting for the hype, I'd say he had something extraordinary goin' on.

  • ||

    Toto as his backing band?

    /burn

  • ||

    "Michael Jackson was rushed to the hospital today after mistakenly grabbing a car windshield and smashing his crotch with a crowbar."

  • Bono||

    Singing talent doesn't make one a genius.

    What?

  • ||

    He put out some of the best pop music of the 80s, and somehow or another he's become some sort of Elvis like character that everyone knows. He's some kind of genius.

  • Jim Morrison||

    MJ reclusively got on stage in front of thousands of people and danced while grabbing his crotch - genius!

    All I have to say is Life is definitely NOT fair!

  • Zombie Jimbo||

    Ahh, you're both dead. It's all even, quit yer whining.

  • The Art-P.O.G.||

    I wish they had been some sort of duo. I like sound of the phrase "Lizard King of Pop".

  • BoscoH||

    So I boil this down to an ethics-class conundrum: You're a doctor. You're offered a chance to make $125,000 a month to look after one patient. You know the patient is a reclusive genius with tastes that are difficult to satisfy...

    Yeah, I'd be pissed off this week if I were Steve Jobs personal on-site doctor too. I mean shit, do I get to collect unemployment until Jeffrey Immelt comes down with Parkinsons?

  • yonemoto||

    I'd take the job and quietly do some moonlighting work (4 hours or so a week) at a free clinic to bolster my case for when the cops come after me. Also, you know, because it feels good to help people. Most of the time, anyway.

  • Colonel_Angus||

    The only reason you would help someone is because it makes you feel good? You selfish bastard.

  • RoboCain||

    Micheal Jackson was malnourished, emaciated, had numerous serious medical conditions, more surgery than Joan Rivers, and was high out of his mind for 20 years. Conrad Murray shouldn't be on trial for manslaughter. He should receive an Image Award for keeping him alive as long as he did.

    Just think of what he could do with a healthy person. He could probably make Terrell Owens fly, or transplant Herman Cain's head to the body of an invincible giant robot.

  • sevo||

    "Do you take the job?"

    Most anything can be monetarized, but: No. If you or your family are starving, looking in the mirror may not be expensive. I can understand (without condoning) "flexible" ethics under those sorts of conditions.
    Anything beyond that, you have to chose what that face in the mirror is worth to you.
    For me, no. That's all.

  • Copernicus||

    "In fact, given the eccentric nature of your patient, there's a very strong probability that the job will end unhappily and with considerable risk to your ability to practice medicine in the United States in the future. But in the meantime you can make bank for as long as you keep him alive — and despite his many personal oddities (which include having dismissed some previous doctors for unclear reasons), the patient has no life-threatening ailments. Do you take the job? "

    The correct answer is "No". If you answered "yes", see Dr. Murray.

  • Robert||

    Never thought I'd use Anna Nicole Smith as an example of anything, but it's a similar case of a whacked-out celeb surrounded by retainers and hangers-on who are more than happy to supply anything and everything celeb wants, including enough drugs to stop a bull elephant.

    Saying "no" apparently must be a fireable offense when it comes to those working and befriending celebs.

  • sevo||

    "Saying "no" apparently must be a fireable offense when it comes to those working and befriending celebs."

    Not only show bizz celebs. Politicos and (yes) bizz fubahs presume that any answer other than "yes" is enough to make you go away.
    In a lot of cases the "yes" maybe other than a matter of ethics, just how many insults you're willing to tolerate?
    Other than that, you get to place a value on what that face in the mirror is worth.

  • Robert||

    What is a "bizz fubah"?

  • ||

    I would definitely take the money, keep him alive as long as possible so I could keep collecting, and possibly try a "Weekend at Bernie's" type scam after his soul left the mortal coil so I could keep getting paid.

  • Paul||

    I would immediately start my own criminal defense fund.

  • .||

    try a "Weekend at Bernie's" type scam after his soul left the mortal coil so I could keep getting paid.

    Judging by MJ's looks during his last decade that may be exactly what someone did.

  • R||

    Alvarez endured broad mockery for her statement, "As an actor, your instrument is yourself" — which is pretty funny for its flighty-sounding cadence but is nevertheless true.

    It wasn't so much for the fact that she called herself an "instrument" as the way she did it. IIRC, when the prosecutor asked her what she was doing she said "maintaining her instrument" and then when asked WTF she meant went on to say she was "exercising" and explained that her instrument was herself.

    In other words, she injected possibly made-up jargon (do Hollywood types routinely refer to themselves as instruments?) into her answer in an awkward and obfuscating way that made her sound pretentious. That is what she was being mocked for.

  • ||

    I recall several times when devout Christians referred to themselves as "God's instruments". Probably not the case here.

  • The Art-P.O.G.||

    Asked what I was doing, I said 'being a tool'. I believe I am a Tool of the Lord when I am creating my art.

  • ||

    "Your honor, I was only polishing my tool, getting rid of the buildup."

  • BakedPenguin||

    Very nice, THE Art.

    Myself, I'm just surprised no one has suggested what Alvarez could do with their instruments, or that they could play her, too. I'm hoping that's just because it's a pretty cheap joke.

  • Paul||

    (do Hollywood types routinely refer to themselves as instruments?

    When talking to James Lipton, early and often.

  • The Art-P.O.G.||

    Should be written James LIPTON!

  • newshutz||

    Amongst other things, I am struck by how many of those houses on the Dr's street in L.V. look so much alike.

  • cApitalist||

    The real concern here is the precedent. This will have a horrible chilling effect (as if the war on drugs weren't enough). Dr. Murray should likely be sued by Jackson's family, but a criminal trial is pure insanity.

    It seems much of this debate arises from a misconception about the role of doctors in society. The public at large, the government, and too damn many of my colleagues seem to think of physicians as some combination of gate-keeper and magician. In reality, our day to day work is more a cross between mechanic, carpenter, and waiter. Its a service industry. If you ask a contractor to build an upside down house he'll likely tell you to go fly a kite, but you have the freedom to buy some supplies and give it a go yourself. If you desire a little propofol to take the edge off, no such option exists. If anyone could purchase any substance for any reason, issues such as those raised by this trial would disappear. A free society might not be a cure all, but things would improve.

  • ||

    I'd take the job and get really good at administering low doses of drugs and outright placebos. A surgical aesthetic as a sleep aid? Idiocy on a level such that I am not too upset at the criminal charges, despite the valid concerns mentioned above.

  • Doug||

    People die. That's what they do.

  • Dr. Dave||

    No, I am a physician and I wouldn't take the job.

    In all seriousness, I don't know of a single close colleague who would have taken the job.

    Dr. Murray's actions were grossly negligent and he is clearly guilty of manslaughter beyond a reasonable doubt. Use of IV propofol in an unmonitored setting is appallingly and ridiculously irresponsible.

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