Drug War

Prescribing Patients the Drugs They Want Is Not Murder

A California doctor's conviction is bound to have a chilling effect on pain treatment.



Last Friday a California jury convicted Hsiu-Ying Tseng, a Rowland Heights physician, of second-degree murder in connection with the deaths of three patients who overdosed on drugs she prescribed. Local prosecutors say this is the first time a doctor has been convicted of murder in the United States based on allegations of reckless prescribing, although a Florida doctor accused of similar practices was convicted of manslaughter in 2002. 

Cases like these stretch the criminal law to cover conduct that is more appropriately addressed by the civil courts. In fact, it is doubtful that what Tseng was accused of doing—basically, too readily giving patients access to the drugs they wanted—should be considered a tort, let alone murder.

Under California law, second-degree murder requires "malice aforethought," which means the defendant acted "with wanton disregard for human life" in doing something that "involves a high degree of probability that it will result in death." Examples of second-degree murder, which is punishable by a prison sentence of 15 years to life, include killing someone by firing a gun into a crowded room or by driving while intoxicated after a DUI conviction. But unlike a reckless shooter or a drunk driver, Tseng did not actually kill anyone; at most, she provided the means by which people killed themselves.

"The message this case sends is you can't hide behind a white lab coat and commit crimes," Los Angeles County Deputy District Attorney John Niedermann said after the verdict. "A lab coat and stethoscope are no shield."

In reality, the message this case sends is that prosecutors can and will treat medical mistakes as felonies—a message that is bound to have a chilling effect on pain treatment. The defense and prosecution agreed that Tseng should have been more careful in evaluating her patient's pain complaints and more vigilant for signs of abuse and diversion to the black market. As her lawyer put it, she "could've practiced medicine better." But since pain cannot be objectively verified, even the most scrupulous doctor can easily make the mistake of trusting the wrong patient. Should that patient die from an overdose, the doctor could face criminal prosecution along with a malpractice suit or scrutiny by state regulators.

The danger of losing your liberty as well as your license and your livelihood creates a strong incentive to distrust patients. That effect is welcomed by drug warriors like Niedermann, who are keen to prevent nonmedical use of narcotic painkillers. But it comes at the expense of legitimate patients who find that doctors conscripted into the war on drugs treat them like criminal suspects instead of customers. As the Los Angeles Times notes, "Some experts worried that a conviction would have a chilling effect on worried doctors and keep powerful painkillers from patients who need them." Good cops do not make good doctors.

[Thanks to Robert Woolley for the tip.]

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  1. Doctors are easy marks for prosecutors looking to make a name for themselves. They have offices and everything is documented.

    Is it any wonder that prosecutors want laws holding gun shops liable for crimes committed with the guns they sell?

    1. April Rovero, whose son, Joey, died nearly six years ago after mixing alcohol with Xanax and oxycodone he had obtained from Tseng, said she believes the verdict will resonate throughout the country.

      Lookee here. They can go after the alcohol producer, pharmaceutical company and the doc if they really want.

      1. Did the doctor tell him to take the oxy with Xanax and alcohol? No? If this is a legitimately filled prescription the ‘no alcohol’ warning is right there on the bottle. How could the doctor be in any way responsible to this death? The legal system of this country is fucked when sympathetic juries are manipulated into finding distantly connected parties responsible for the tragic outcome of someone’s disregard for their own safety.

        April Rovero, whose son, Joey, died nearly six years …she believes the verdict will resonate throughout the country.

        I hope she lives for a long time in pain, unable to get the medicine that would prevent it.

      2. Dear April, your little boy was a fuckup that ignored his medication risk sheets. Now the life of a legit doctor is completely ruined since your little snowflake has substance issues. April dear, you’re well beyond the initial grieving period, and are a confirmed pile of shit. Please rot in heel.

        1. FWIW I think Pompey and Ted S. miss what is a direct conflict between parents, especially mothers, and anyone who might help facilitate death for their child, but ascribing the son’s death here to an accident or “substance issues.” The very fact that he used “substances” was a choice, and one he made because he id not like the life his mother gave him. Parents will always go after anyone they can for any tiny bit of assistance they might have given their children to escape, either their own clutches or life itself.

          1. True. If this kid wanted to die then Mama is an even bigger pile of shit than I assumed. These kind of stories really get my fucking hackles up. I wish nothing but pain, misfortune, and a personal rain cloud over Mama Bear at all times.

        2. The rotting heel can be painful, but I think she deserves better. Think big

          1. Woodchippers are big. Or are they reserved only for politicians, judges, and the like?

      3. Just because your son was stupid enough to mix alcohol and narcotics doesn’t mean everybody else should be punished.

        I’m sure there are other people old enough to remember Karen Ann Quinlan.

      4. Fuck you, cunt. Your son liked what his doctor gave him (happiness and death) more than what you gave him (life and suffering). Never forget that.

    2. Those fucking doctors killed Michael Jackson! Good job.

  2. Toward the end of the trial, the prosecutor projected images of some of the victims ? round-faced young men with similar shaggy haircuts ? onto a screen.

    This is what infuriates me. They’re not victims. They chose to take those drugs. Yet without painting them as victims, there can be no crime. We’ve become a nation of victims and criminals, nothing more, nothing less.

    1. You mean obese people are not victims of Big Food?

      1. Ladies and gentlemen of the jury, that grocer knowingly and willingly sold those Entenmann’s mini-donuts to Mary Lou Lardass two days before she died of coronary heart failure.

        /Asst US Attorney

        1. I’m going to hazard a guess that the awful frosting on those things is in part illicitly reclaimed arterial wall plaque and liposuction waste.

          1. Dear Sir:

            As CEO of Entemann’s Foods, I must object in the strongest terms to your implication that our donut frosting is derived from medical waste. We here at Entemann’s Foods pride ourselves in using only the finest petroleum byproducts in production of our donuts. Delicious *and* waterproof, as we like to say.

          2. The rule of Fat Club is you do not talk about the frosting.

            1. Fuck. Really need and edit button. The first rule of Fat Club…

  3. Good cops do not make good doctors.

    Which is easier to see?

    1. The cops are usually larger, so I think that they would be easier to see. But sometimes they wear camo (but usually in inappropriate situations) and the doctors wear easy to spot white lab coats. It’s a tough call.

        1. I have trouble seeing ’em too Swissy.

  4. What a bunch of assholes. Murder? Fuck you, esteemed members of the jury.

    And it’s California, so… can this be used as precedent to go after a gun seller?

    1. I think we all know the answer to *that* question.

  5. After the trial Ms. Stent was quoted as saying: “Why’d I leave* Taiwan again? At least the weather wasv what everyone said it would be: dy-no-mite!!”

    *Trigger warning: I’ve only presupposed immigration without verification.

  6. “The message this case sends is you can’t hide behind a white lab coat and commit crimes,” Los Angeles County Deputy District Attorney John Niedermann said after the verdict. “A lab coat and stethoscope are no shield.”

    All very ironic coming from a profession that is given near complete proprietorial immunity. When they wrongly ruin someone’s life through overzealous prosecution, or by withholding critical exculpatory evidence, they are completely protected.

    Someone needs to send a truckload of woodchippers to California.


    2. “A lab coat and stethoscope are no shield.”

      Why do you think they call badges “shields”?

  7. Non-medical use is mostly self treatment for PTSD. Alcoholism is another name for he same thing when alcohol is involved.

  8. This doctor is not so much a casualty of the WOD as she is one of the War on Responsibility.

  9. “The message this case sends is you can’t hide behind a white lab coat and commit crimes,” Los Angeles County Deputy District Attorney John Niedermann said after the verdict. “A lab coat and stethoscope are no shield.”

    That’s right. You’ll need a darker colored shirt and shiny badge to hide behind while you commit crimes. Rookie mistake.

  10. Doctors have everything for which it can be very helpful.Doctors have every detail that can be use for many ways.Thank you for sharing such informative details.They should deserve the best position forever ,well for that you can go through physician recruitment and have a step forward.

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