'Dr. Hurwitz Is Always Concerned'

Prosecutors argue that McLean, Virginia, pain doctor William Hurwitz, who is on trial at the federal courthouse in Alexandria, knowingly supplied OxyContin and other narcotics to patients who sold them on the black market. Hurwitz, who faces a possible life sentence, is charged with 62 offenses, including drug trafficking and health care fraud. "A self-proclaimed healer, he crossed the line to dealer," Assistant U.S. Attorney Mark Lytle said in his opening statement. "He thought he could hide behind the pain he treated." Prosecutors have likened Hurwitz to "a street-corner crack dealer."

But certain details of the government's case do not fit this picture. For instance, 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 written in stone. You think someone involved in a scam of selling pills will document this?"

A former patient called as a prosecution witness testified that "I had a lot of pain, but I exaggerated it, trying to get the drugs." On cross-examination, he added that he had "played a lot of doctors" over the years. He characterized Hurwitz as naive, saying: "He was concerned about me and my wife. Dr. Hurwitz is always concerned."

Such testimony does not make Hurwitz look like a drug trafficker. It makes him look like a sincere healer duped by tricky patients, as his lawyers portray him. By prosecuting him for trusting his patients too much, the government is criminalizing the sort of mistake that doctors already are so keen to avoid that they routinely err in the other direction, turning away or undertreating patients whose suffering could be alleviated by opioids.

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 Washingtion Post "that the appropriate way to deal with these issues is not through criminal prosecution but through an evaluation of medical practice."