Propofol is typically used as a surgical anesthetic for a patient who is receiving mechanical ventilation. Because of well known side effects, doctors and nurses in a hospital operating room or a comparably equipped medical facility must continuously monitor the patient’s heart rate and breathing. For any ethical doctor, it would be unthinkable to use propofol outside those carefully controlled circumstances. But the unthinkable happened with Michael Jackson’s death.
Now a jury has convicted Dr. Conrad Murray of manslaughter for his role in Jackson’s death. Though Murray’s responsibilities to protect his patient were common to all doctors and all patients, his responsibility as Jackson’s personal doctor was virtually unique. Murray had only one patient, whose concert agency paid him $150,000 a month to keep the singer healthy.
Run of the mill medical malpractice occurs when a doctor violates essential patient safety rules, thus causing harm to a patient. But this case is more sordid.Dr. Murray was guilty not just of breaking rules, but of a fundamental, and eventually deadly, conflict of interest. Perhaps seduced by his enormous monthly salary, Murray abandoned his medical judgment and allowed his famous patient to cajole him into dangerous behavior with extremely powerful prescription drugs. Had he resisted the temptation like any ethical, responsible physician should have, Jackson presumably would have located some other doctor with more pliable morals. It may not have saved Jackson’s life, but at least his untimely death would be on someone else’s hands and Murray would not be facing prison and being stripped of his medical license.
While this is a particularly egregious and uniquely high profile example, conflicts of interest are common in medicine. Usually, instead of a high power client, it’s a doctor’s relationship with drug and device manufacturersthat lead to unnecessary surgery or advocating drugs, surgical devices and other treatments based on something besides the best interests of the patient.
Patrick Malone is a medical malpractice attorney who blogs about medical malpractice in Washington, D.C., Maryland and Virginia for PatrickMalone & Associates.