The U.S. High Court sides with doctors who have been convicted under the Controlled Substances Act.
The U.S. Supreme Court has ruled in favor of two physicians previously convicted of prescribing addictive opioid drugs without having a legitimate medical reason. Attorneys for the defendants appealed after they were convicted, stating that “a jury should have been able to consider whether they reasonably believed that they were acting within professional boundaries.” This was originally argued to be “unnecessary” by the government.
Justice Stephen Breyer, who wrote the opinion for the majority after a unanimous decision had been reached, said, “For the prosecution of the doctors to be successful, the government must prove beyond a reasonable doubt that the defendant knowingly or intentionally acted in an unauthorized manner.”
In light of the ongoing opioid epidemic, there has been a push to hold doctors accountable for dispensing addictive pain pills without a medical purpose. Their practices are typically referred to as “pill mills.” Often, medical practitioners running these operations overprescribe, or they prescribe without a medical purpose. Sometimes they even circumvent traditional procedures, including forgoing meeting with a patient during an office visit or writing out prescription slips for their staff to hand out.
Lower courts have remained divided on how to hold doctors accountable for unsafe prescribing practices, as far as making them criminally liable is concerned. All physicians must abide by the Hippocratic oath to do no harm, and while some courts have said a doctor’s good faith belief that he or she was acting within medical norms is not relevant to criminal liability, others have said that the government must proof this to be woefully neglected.
“Today’s decision puts the burden on the government when prosecuting doctors for wrongfully prescribing controlled substances, to show not only that the prescription did not serve a legitimate medical purpose, but that the doctor knew as much when they wrote it,” said Steve Vladeck, professor at the University of Texas School of Law. “In that respect, it likely arms doctors going forward with a strong defense that they made a good-faith mistake, which could help them avoid criminal liability, although perhaps not civil or ethical repercussions.”
The court case concerned pain management doctor Xiulu Ruan, who operated a medical clinic in Alabama called Physicians Pain Specialists, as well as Shakeel Kahn, who ran a pain management practice in Arizona. Both were convicted under the Controlled Substances Act, which makes it a crime for any person to “knowingly or intentionally dispense a controlled substance” without a medical reason.
Court records show that in the four-year span between January 2011 and May 2015, Ruan’s clinic issued nearly 300,000 controlled substance prescriptions earning him more than $3 million. And attorney for Kahn admitted his client’s practice also “did not live up to the model of consistency that one might hope for a practice specializing in long term pain management.” Many of his patients would turn around and sell addictive opioids on the streets. The attorney stated, “Dr. Kahn testified that he would not have issued prescriptions to individuals that he knew to be selling their medication.”