The Salt Lake Tribune
07/01/2000 

Experts Back Weitzel Morphine Use 
Doctors, pharmacist say doses didn't kill Davis County 
psychiatrist's patients

FARMINGTON -- The morphine psychiatrist Robert Allen Weitzel 
allegedly used to kill five elderly patients actually was beneficial 
to them, defense experts testified Friday.
Three witnesses -- all from Weitzel's home state of Texas -- said 
that based on their reviews of the patients' medical records, they 
categorically denied morphine had anything to do with the five 
deaths.
"They did not die a morphine-induced death," testified C. 
Stratton Hill Jr., a physician on the faculty of the University of 
Texas and a pain management specialist. "These are not lethal 
doses."
Weitzel, 44, is standing trial in 2nd District Court on five 
charges of first-degree felony murder, each count punishable by up 
to life in prison.
Weitzel claims he was providing "comfort care" to patients who 
suddenly began dying from complications of old age. The five were 
sent to Weitzel's geriatric/psychiatric unit at the Davis Hospital 
and Medical Center in Layton for treatment of loud and combative 
behavior associated with senile dementia.
But prosecutors allege Weitzel murdered the five -- who all died 
in a 16-day period beginning in December 1995 -- by prescribing 
various sedative drugs that weakened them, then following those 
drugs with lethal doses of morphine.
The patients were Ennis Alldredge, 85; Ellen B. Anderson, 91; 
Mary R. Crane, 72; Judith Larsen, 93; and Lydia M. Smith, 90.
Hill said morphine can kill by switching off the portion of the 
brain that controls breathing. But he said breathing patterns in 
such deaths are clearly identifiable by a gradual decrease in 
respiration rate.
Respiration rates in the five alleged victims, however, "remained 
pretty constant throughout" their time on Weitzel's unit, Hill said. 
In fact, he added, increases in some patients' respiration rates 
toward the end of their lives indicate the morphine was producing 
the desired effect of allowing them to breathe easier.
Joe Cannon Jr., a family practitioner who recently worked with 
Weitzel at a Matagorda Hospital geriatric/psychiatric unit in Bay 
City, Texas, testified Weitzel's use of morphine was "entirely 
appropriate."
"A doctor has a duty to alleviate pain, suffering and 
restlessness . . . and morphine is still the best pain reliever 
available," Cannon testified. "It also produces a feeling of 
well-being in patients who may be suffering anxiety or fear." 
Robert Supernaw, a professor at Texas Tech's school of pharmacy 
in Amarillo, Texas, and editor-in-chief of the American Journal of 
Pain Management, testified that none of the five deaths was related 
to the morphine doses. To reach that conclusion, Supernaw said he 
plotted the peak effect of morphine doses against the patients' 
times of death.
While drawing graphs for the jury, he explained that the patients 
either died long after any harmful effects of the morphine would 
have dissipated, or that they were given doses too low to adversely 
affect their breathing.
He added that the sedating effects of other drugs given to the 
patients would also have disappeared by the time they died.
Supernaw said the round-the-clock morphine doses that Weitzel 
ordered in some cases were "desirable" to maintain constant pain 
relief. "We try to minimize the peak and troughs to keep a patient 
pain-free," Supernaw said.
On cross-examination, Supernaw -- a pharmacist, not a medical 
doctor -- conceded he was not qualified to assess how the patients' 
medical conditions and advanced age would affect their ability to 
cope with morphine and other sedating drugs.
Supernaw also acknowledged he had taken into account only those 
drugs given in the 48 to 72 hours prior to the patients' deaths.
Prosecutor Charlene Barlow noted that some patients were given 
multiple sedatives for weeks before Weitzel began prescribing 
morphine.
Weitzel's trial resumes Wednesday in 2nd District Court.

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