Insanity X Lives (-X1) Blanaid X Lives

1/17/11

CONRAD MURRAY HIPPOCRATIC OATH 2

BANISHING THE MYTHS WHILE FOCUSING ON THE FACTS

X1:

Quite to the contrary regarding how I may feel about Conrad Murray's actions I must contemplate in consideration of just what this means to a patient from a medical standpoint.  I will now look at this from a perspective of the medical community and what they are voicing regarding the actions of Conrad Murray.

Click To View PR Stunt
Ethically, if you analyze from this perspective Conrad Murray is a looser. There are not enough PR Stunts [Here is another PR Stunt!] in the world to mask the unethical behavior of Conrad Murray as a physician. We are looking at an Involuntary Manslaughter charge here unfortunately  the evidence does not support Murder In The Second Degree.  Therefore, beyond a shadow of a doubt Conrad Murray is guilty under the charge of Involuntary Manslaughter--when considering what the petition states--gross negligence and misconduct as a member of the medical community.
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The Hippocratic Oath: 
*The Hippocratic Oath States*

I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of over-treatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given to me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

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The Ignorance--Non-Acknowledgment Of The Facts Therein

X1:

How you attempt to dissect this is irrelevant!  The fact remains that Conrad Murray disregarded his ethical duties as a physician and he blatantly ignored the Hippocratic Oath that  which each and every physician in the United States has avowed to stand by. This must be the case with no deviation for the care and ethical treatment of millions in a doctor patient relationship. 

They may attempt--try as they may--to shift the focus off of the Hippocratic Oath which Conrad Murray took as a physician and agreed to uphold. Nevertheless, this oath stands--every medical practitioner is bound by it in the United States of America--state what you like this is a fact. Let's address this right here right now shall we? Conrad Murray is on trial here for his unethical behavior, NOT Michael Jackson the victim! Perhaps, if Michael Jackson were to have survived this by some stroke of luck he would have been able to provide his testimony as an expert/star witness for the prosecution.  This testimony most certainly would consist of the unethical treatment rendered by Conrad Murray. Moreover, it would be afterward, when Michael Jackson obtained proper medical attention as a direct result this horror!  We will not ever get that chance to hear from Michael Jackson because Conrad Murray has assured his death.  I have heard many people argue that Michael Jackson was responsible for his own demise as much as Conrad Murray was.  If you look at the facts Michael Jackson did NOT have a medical license nor did he go to any sort of  medical training to administer any pharmaceuticals!  However, it is apparent that Conrad Murray did not take any training to properly administer the anesthesia Propofol to Michael Jackson or anyone else.  

What would possess Conrad Murray to anesthetize Michael Jackson ever when he did not perform a surgical procedure on Michael Jackson?  Moreover, what would possess Conrad Murray to presume that he could properly control the situation without any of the training required! Beyond that Conrad Murray did not even have the proper medical monitoring equipment in place to have ensured that Michael Jackson would not meet his imminent demise as a direct result of this negligence! 

For any legal body to disregard the Hippocratic Oath here may just set precedent for the next physician that chooses to come along and do the exact same thing!  This oath was put in place for a reason!  It states "Do No Harm"!  It is there as an established guideline, as a pillar of the medical community and core--it epitomizes medical professionalism!

The People vs. Conrad Robert Murray
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The Hippocratic Oath--Real Doctors Weigh In: 

Hippocratic Oath Cartoon

  • "The Hippocratic Oath is an oath historically taken by doctors swearing to practice medicine ethically. It is widely believed to have been written by Hippocrates, often regarded as the father of western medicine, in Ionic Greek (late 5th century BC) or by one of his students, and is usually included in the Hippocratic Corpus. Classical scholar Ludwig Edelstein proposed that the oath was written by Pythagoreans, a theory that has been questioned due to the lack of evidence for a school of Pythagorean medicine. Although mostly of historic and traditional value, the oath is considered a rite of passage for practitioners of medicine in some countries, although nowadays the modernized version of the text varies among the countries. The Hippocratic Oath (orkos) is one of the most widely known of Greek medical texts. It requires a new physician to swear upon a number of healing gods that he will uphold a number of professional ethical standards. Little is known about who wrote it or first used it, but it appears to be more strongly influenced by followers of Pythagoras than Hippocrates and is often estimated to have been written in the 4th century BCE. Over the centuries, it has been rewritten often in order to suit the values of different cultures influenced by Greek medicine. Contrary to popular belief, the Hippocratic Oath is not required by most modern medical schools."
http://en.wikipedia.org/wiki/Hippocratic_Oath 

Conrad Murray Leaving Pratice
  • "Why would an accomplished cardiologist who took the Hippocratic Oath, swearing to ethically practice medicine, perform such an unethical act. It appears that the optimum word is DEBT. It is reported that Dr. Murray has over $400,000 in court judgments assessed against him for failure to pay child support. He had Tax liens in California and Arizona, and non-payment of credit card and loan payments. His total debt is estimated to be around $780.000. Dr. Murray saw a way out and he indicated that in a June 15, 2009 memo to his patients. “Because of a once in a lifetime opportunity, I have made a most difficult decision to cease practice of medicine indefinitely”
http://hubpages.com/hub/autopsyresultsofmichaeljackson
  • "People from all walks of life fall prey to debt. Basically, it invades your home, your work, your total way of life. The question becomes what are our moral boundaries when it comes to debt. Debt is a powerful weapon, its causes people commit suicide, steal, cheat lie, anxiety, depression, and do things that are morally unethical. Dr. Murray accepted a position with Michael Jackson knowing that he would have to administer propofol, a drug that is only administered in a hospital by anthologists and with the proper equipment. If this drug is administered in any other environment the consequences could be devastating if something went wrong. Well something did go wrong on June 25th 2009, Michael Jackson died. Murray now faces being prosecuted and losing his medical license. The mounting debt is still there and even more to come with the enormous lawyer fees. He took a bad risk and now must face the inevitable consequences. We all must ask ourselves, are we ready to face the consequences of our actions if something goes wrong?"
http://hubpages.com/hub/autopsyresultsofmichaeljackson

 

Dr. Marc Siegel Internist and Associate Professor NYU School of Medicine:
  • "The drugs that were found in Michael Jackson’s body included the sedative lorazepam, midazolam, diazepam, lidocaine, ephedrine, and most importantly propofol. These are not the kinds of medications that good medical standards of practice would allow. And yet, very little was done by the board of medical examiners, both in California and in Texas, where he practices, to keep Murray from continuing to practice medicine."
  • "I believe that anyone is “innocent until proven guilty.” But the oath to “do no harm” taken by all physicians must to be taken seriously. Patients and families trust physicians to do good by them. When any patient – including celebrities – requests that we provide them with things that we as scientists know can be harmful, there is very little one can do but to take away the privilege from the health care provider"
http://health.blogs.foxnews.com/tag/dr-conrad-murray/%20
Conrad Murray Medical License California

Dr. Elaina George An Otolaryngologist In Atlanta:
  • "No," says Dr. Elaina George, an Otolaryngologist out of Atlanta. Dr. George argues that Jackson was not the one to blame for his untimely death. She explains that physicians have an oath to "not do harm" to their patients and that by giving Jackson such a deadly combination of drugs, Dr. Murray violated that oath. Michael Jackson did not have a chance' was my first thought when I read the report that just came out about what caused his untimely and tragic death," says Dr. George, who generally serves as an advocate for other physicians. "I was unprepared for the absolute disregard for the first tenant of the doctors' Hippocratic Oath – 'First do no harm." There was no way that harm would not have come to Mr. Jackson. It was beyond negligent to give him a mixture of three different kinds of sedatives, a muscle relaxant, an antidepressant in addition to Propofol, a general anesthetic that is only used in an operating room setting (because it can stop someone’s breathing). Each of these drugs by themselves can be lethal, but together it is a recipe that will almost definitely kill someone. I can think of no medical scenario that would justify mixing these kinds of drugs. Hopefully, Mr. Jackson’s death will teach us that prescription drugs, though helpful are no substitute for doctors doing everything in their power to protect the health of their patients, including just saying no when it is appropriate.

    Anna Nicole and Heath Ledger are two celebrities that died from drug interactions. The death of Michael Jackson and his relationship with Dr. Murray is the most recent example that highlights the danger of the ‘doctor on retainer’. This relationship is based on a contract that makes the doctor an employee, in essence changing a relationship that should be equal, to one where the patient can dictate the course of treatment. This shift in power can potentially blur the lines that must be maintained for a healthy doctor/patient relationship. It then can place a physician in a position where he/she may be prescribing medication in a way that is not clinically appropriate because the patient demands it. This needs to be examined and changed.

    As a society we need to take a look at the culture of prescription medication as the cure all. There is a perception that we can treat anything by taking a pill. This concept has been fostered by the pharmaceutical industry and their constant advertising. There are pills to make you happy, perform better sexually, help your memory, make you feel younger etc… In reality all of these medications have one thing in common; they simply manage the symptoms instead of healing the problem. Perhaps the best thing that can come out of the tragedy of Michael Jackson’s death is the examination of our culture of disease. Maybe it will change the paradigm to prevention and to healing disease instead of managing it with an endless list of prescription medications."
http://www.bvonmoney.com/2009/08/24/michael-jackson-murder-conrad-murray/
http://elainageorge.wordpress.com/


Dr. Lloyd Saberski, A Yale University Anesthesiologist Editor In Chief The Pain Clinic:
  • "Propofol has no place in a household," said Dr. Lloyd Saberski, a Yale University anesthesiologist and editor in chief of the journal The Pain Clinic. "This alone is a deviation, and many laws were likely violated just to get the propofol there." 
http://abcnews.go.com/Health/MichaelJackson/story?id=7994823&page=2

Dr. Howard Nearman, Chairman Of The Anesthesiology DepartmentUniversity Hospitals Case Medical Center Cleveland:
  • "Moreover, an injection of the drug requires that someone be present to continually administer it intravenously, said Dr. Howard Nearman, chairman of the anesthesiology department at University Hospitals Case Medical Center in Cleveland. Nearman said there "absolutely" had to be a second party with Jackson if indeed he was using the drug to sleep."

  • "But despite the effects and risk profile of the drug, Nearman said that patients who've had the drug describe it as inducing "a very pleasant sleep" that "has the potential to be habit-forming."
http://abcnews.go.com/Health/MichaelJackson/story?id=7994823&page=2
http://abcnews.go.com/Health/MichaelJackson/story?id=7994823&page=3

Dr. Richard Page, Head Of Cardiology University Of Washington Medical Center:

  • "Propofol is an agent that requires very close monitoring and is often limited only to use by anesthesiologists," said Dr. Richard Page, head of cardiology at the University of Washington medical center. "The main issue with this agent is respiratory depression, which in turn could cause cardiac arrest." 
http://abcnews.go.com/Health/MichaelJackson/story?id=7994823&page=2

Dr. Brian Olshansky, Cardiologist University Of Iowa: 
  • "It is a very dangerous drug," said Dr. Brian Olshansky, a cardiologist at the University of Iowa who said he often uses the drug to place patients in deep sedation for certain heart procedures. "It is not for sleep. I cannot imagine anyone would use this outside a very regulated environment such as the availability of emergency respiratory equipment."  

  • "It rapidly induces unconsciousness and apnea," Olshansky said. "People stop breathing within seconds of being given the drug."
http://abcnews.go.com/Health/MichaelJackson/story?id=7994823&page=2
http://abcnews.go.com/Health/MichaelJackson/story?id=7994823&page=3

Dr. Jeff Guy Vanderbilt University:
  • "These characteristics of the drug make it an exceedingly unusual choice for abuse, said Dr. Jeff Guy of Vanderbilt University, who said such a situation would represent "a quantum leap in the issue of substance abuse." 
http://abcnews.go.com/Health/MichaelJackson/story?id=7994823&page=3

Daniel K Sokol, Lecturer: Medical Ethics & Law, St George’s, University of London:
  • In medical school we teach students to be aware of the power differential between doctor and patient. In a hospital setting, patients may be sick, frightened, and medically unsophisticated. Doctors, on the other hand, are generally healthy, medically knowledgeable, and in a familiar environment. Such is the typical clinical encounter.
http://www.bmj.com/content/339/bmj.b3535.extract
  • Strapped for cash, the physician left his low-income patients and signed on as Jackson's personal physician for $150,000 a month, only to become a target of a manslaughter investigation amid reports he injected the pop icon with a powerful anesthesia the night before his death.
http://www.people.com/people/article/0,,20295384,00.html%20

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X1:

Let's summarize this:

There is no basis here for argument!  This is factual! Conrad Murray did indeed disregard medical ethics by administering these drugs to Michael Jackson.  Thus, this ultimately caused the death of his patient.  This is an open and shut case as Conrad Murray disavowed all knowledge of the Hippocratic Oath.  Conrad Murray had an ethical duty to do no harm this was his obligation--not an insinuation, justification, or deviation.  His gross misconduct as a practitioner here paves the way for more cases of this kind which will exploit the former!  My hopes are this mock hearing will assess the need for this to be addressed by further accentuating this travesty--injustice.

We have a serious issue to contend with here--this is a consensus.  This matter does NOT solely rest with Michael Jackson the victim.  This matter is with the medical community as a whole.  Michael Jackson would not be the first patient to have had fatal results at the hands of a physician that has just run amuck from an ethical standpoint.  Please do not neglect this opportunity.  Not to address this responsibility in an open court of law upon presentation would mean to open a can of  medical worms for the diagnoses of death for millions.  In fact in essence what this would be is a get out of jail free card as this case will be cited by many other physicians wishing to pass the buck and escape the responsibility for their actions.

This is it, for opportunity knocks--the legal system must correct a wrong here!  We have currently exceeded the amount--the threshold of doctors over-medicating their patients just for the monetary perspective!

I appeal to the legal system to step in by taking control of the situation to do the right thing here!  Please send a clear and transparent message to the medical community that this is not to be tolerated via Conrad Murray! 

-X1 
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1. The Legal Definition of Involuntary Manslaughter in California:

California Penal Code 192(b) PC

Involuntary manslaughter differs from Penal Code 187 PC murder in that it involves an unintentional death.2

California Penal Code 192(b) PC defines "involuntary manslaughter" as an unlawful killing that takes place

   1. during the commission of an unlawful act (not amounting to a felony), or

   2. during the commission of a lawful act which involves a high risk of death or great bodily harm that is committed without due caution or circumspection.3

Involuntary manslaughter does not apply to acts that you commit while driving a car (those are covered by California's vehicular manslaughter laws, discussed under 
Section 4. Related Offenses).4

Let's take a closer look at some of these terms to gain a better understanding of their legal meanings.

An unlawful act (not amounting to a felony)

An "unlawful act" (not amounting to a felony) is either a misdemeanor or an infraction. There is no requirement that the unlawful act be inherently dangerous…that is, an act that carries a high probability that it will result in death. Rather, it is the manner in which this act is performed that creates the criminal liability for this offense.5

    Example: A husband and wife are involved in a heated argument. In an effort to "threaten" his wife into silence, the husband retrieves his gun…a misdemeanor pursuant to Penal Code 417 PC California's brandishing a weapon law.6 The wife struggles to get the gun out of her husband's hands and, in doing so, causes the husband to pull the trigger and kill her.

    Even though the husband didn't have the intent to kill his wife, the fact that she was killed while he engaged in misdemeanor conduct makes involuntary manslaughter the appropriate charge.

Without due caution and circumspection

The phrase "without due caution and circumspection" is basically synonymous with California's legal definition of "criminal negligence." It is an act which is "aggravated, reckless and flagrant and which is such a departure from what would be the conduct of an ordinary prudent, careful person under the same circumstances as to be in disregard for human life, or an indifference to the consequences of such an act."7

Criminal negligence means that the death was not the result of inattention, mistaken judgment or misadventure. But rather it was a reasonably foreseeable consequence of the aggravated, reckless or negligent conduct.

    Example: In People v. Conrad Murray…the pending case against Michael Jackson's doctor…the Los Angeles District Attorney's Office charged Dr. Murray with violating Penal Code 192(b) PC California's involuntary manslaughter law for allegedly administering lethal doses of an anesthetic (propofol) to Jackson while treating him for insomnia. And although this case is still ongoing, it serves as a good example, since it is currently one of the most famous cases dealing with California's involuntary manslaughter laws.
In their complaint, the D.A. stated that "Dr. Murray did unlawfully kill Michael Joseph Jackson by acting without due caution and circumspection". Prosecutors will attempt to prove that Dr. Murray acted with criminal negligence when he administered such a large dose of the anesthetic…an anesthetic that they contend is used in preparation for surgery, not as a sleep aid (which is why it was being used). The D.A. will argue that a reasonable doctor in the same situation would not have authorized the same quantity of the drug.

    Currently, Dr. Murray's California preliminary hearing is scheduled for January 4, 2011.8


2. Legal Defenses

When someone dies under any kind of "suspicious" circumstances, law enforcement officers and prosecutors are bound to get involved. Police want to hold someone accountable. And often times, as a result, they jump to conclusions or rush investigations, leaving innocent people to defend against false accusations and wrongful arrests.

Fortunately, there are a variety of legal defenses to California's involuntary manslaughter law that a skilled California criminal defense attorney can present on your behalf. Below are some of the most common.

2.1. Self-defense / defense of others / imperfect self-defense

If you reasonably believed that you were protecting yourself or another person from imminent death or great bodily harm, you may be entitled to an acquittal under California's self-defense laws.9 This defense applies so long as

   1. you acted reasonably under the circumstances, and

   2. used no more force than was reasonably necessary under the circumstances.

    Example: Bill and Rich were involved in a bar brawl. Bob, Rich's friend, saw Bill…who was the aggressor in the fight…grab a knife out of his back pocket. As Bill lunged toward Rich with the knife, Bob intercepted the knife, stabbing Bill one time in the chest. Bill died instantly.

    Given these facts, Bob's conduct would likely be excused under California's self-defense laws.

If, however, your belief that

   1. you or another person was about to suffer imminent harm, or

   2. you needed to use deadly force

was unreasonable, this defense…known as imperfect self-defense…does not excuse involuntary manslaughter. It will, however, reduce a murder charge to involuntary manslaughter if you can prove that you didn't have the intent to kill.10

    Example: Changing some of the facts from the last example, let's say that Bill had no knife and that Bill and Rich were simply engaged in a brutal fist fight. Bob…believing that Bill would seriously hurt Rich…grabbed a beer bottle, broke its neck, and slashed Bill across the throat, killing him rather quickly.

    Given these facts, Bob's belief that he needed to use deadly force…while likely honest…was not reasonable. But because he was trying to protect Rich during a fight, he would be guilty of manslaughter, not murder.


2.2. Accidents

Sometimes accidents happen – period. Accident is a valid California legal defense when you can prove that you

   1. had no criminal intent to do harm,

   2. were not acting negligently at the time of the accident, and

   3. were otherwise engaged in lawful behavior at the time of the accidental killing."11

The difference between involuntary manslaughter and killing someone by accident is that with involuntary manslaughter, you are necessarily involved in either

   1. an unlawful act (not amounting to a felony), or

   2. a lawful act which involves a high degree of risk of death or great bodily injury (and you failed to act in the same manner as another "reasonable person" would have)

at the time you kill the other person.12 However, when you accidentally kill another person, you are not violating any laws at the time of the killing. The unfortunate fact that someone dies doesn't make he act any less accidental.

    Example: You are playing baseball with some friends. You hit a foul ball so hard that it hits a child playing in the playground next to the field. The force of the ball knocks the child off the swing where he hits his head on the metal pole, suffers a concussion, and dies the next day.

    These facts…while tragic…do not subject you to criminal liability. This was an "accident" in the truest sense of the word, and you should not be held criminally responsible for the child's death.


2.3. Insufficient evidence

Similarly, sometimes in what seems like an "open and shut" case, the police make a snap decision regarding the death. They present their case to the prosecutor who simply buys into the cop's account.

This is just one reason why hiring an experienced California criminal defense lawyer is critical. Skilled criminal defense lawyers conduct their own investigations. They invest the time and resources to interview witnesses, reexamine evidence, and routinely consult with independent forensic scientists to uncover what really happened.

Many times, this is why the defense attorney can obtain a favorable outcome for his/her client. After highlighting the flaws in the prosecutor's case, the attorney can explain why the victim's death couldn't possibly have been caused in the manner alleged.
2.4. False accusations / wrongful arrest

Along these same lines, people sometimes falsely accuse others of this devastating offense. There are almost countless reasons why someone may do this. Accusers can range from an individual trying to cover up his/her own involvement in the victim's death to overzealous law enforcement officers who conduct a shoddy investigation and simply need someone to present to the D.A.

In either event, our team of veteran attorneys know the most effective ways to establish your innocence and clear your name.

3. Penalties, Punishment and Sentencing

Penal Code 192 PC California's involuntary manslaughter law is a felony. A conviction subjects you to

    * formal probation with up to one year county jail, OR

    * a two, three, or four-year California state prison sentence.

Plus these additional consequences:

    * a maximum $10,000 fine,

    * the loss of the right to own or possess a firearm pursuant to Penal Code 12021 PC California's "felon with a firearm" law, and

    * possible professional discipline (if you hold a professional license).13

In addition, involuntary manslaughter often triggers a civil lawsuit as well. Wrongful death lawsuits are quite common in this state. If found liable, you face additional fines…oftentimes, very substantial fines...in the form of a civil judgment.