Rx ruling may affect Weitzel 

            Prescription ruling may affect Weitzel 
            Family won case after claiming doctor underprescribed for pain 
            Thr, June 28, 2001 00:00:00 
            By NESREEN KHASHAN
            Standard-Examiner Davis Bureau 

            FARMINGTON -- A landmark ruling issued earlier this month awarding 
            damages to a family who accused a doctor of underprescribing pain 
            medication has cast new scrutiny on the trial of a Farmington doctor 
            accused of causing the deaths of five elderly patients by 
            overprescribing drugs. 
            In the Northern California case, a jury awarded $1.5 million to the 
            family of William Bergman, who died of cancer in 1998 at the age of 
            85. According to the family, Dr. Wing Chin underprescribed Bergman 
            pain medication although the terminally ill man was in excruciating 
            pain.

            The ruling was the first of its kind because it likened the 
            underprescription of pain to elder abuse, said Kathryn Tucker, legal 
            director of the Oregon nonprofit Compassion in Dying Federation and 
            co-counsel in the civil suit. 
            In a May 8 brief to Davis County Attorney Melvin Wilson and Utah 
            Attorney General Mark Shurtleff, Tucker urged the prosecutors not to 
            proceed with the retrial of Farmington physician Dr. Robert Weitzel, 
            accused of murdering five of his patients by prescribing lethal 
            doses of morphine. Although convicted on lesser homicide charges, 
            Weitzel earlier this year won the right to a new trial. 
            Tucker said her fear is that the Weitzel case, contrasted with the 
            case of Chin, could send confusing signals to a medical community 
            already grappling with pain-management issues. 
            "What we were trying to do was bring to the attention of prosecuting 
            authorities that there is already a terrible problem of 
            undertreatment of pain, particularly in the elderly population," 
            Tucker said. 
            "We are concerned that when physicians treating the pain of elderly 
            terminally ill patients are punished, it increases the chill in this 
            environment that causes them to be unwilling to prescribe 
            adequately." 
            Instead, Tucker urges authorities to resolve criticisms regarding a 
            physician's care of patients in a professional disciplinary context. 

            Wilson, defending his office's decision to reprosecute, said the 
            doses administered by Weitzel indicated an intent to euthanize the 
            patients. Weitzel is scheduled to be back in court for a double 
            jeopardy hearing on Friday. 
            "I'm all for appropriate treatment," Wilson said. "But the medical 
            treatment rendered by Dr. Weitzel had nothing to do with pain." 
            A Brown University study released in May that ranked Utah lowest in 
            the country in providing pain relief to elderly patients in nursing 
            homes has sharpened the end-of-life care debate even more locally. 
            A letter published in the Journal of the American Medical 
            Association summarizing the study stated that on average 41.5 
            percent of the nation's nursing home residents suffered from 
            persistent pain, with Utah leading the country at 49.5 percent. 
            Utah medical personnel and administrators working in the nursing 
            home or hospice care fields will meet in Salt Lake City this week to 
            discuss the Brown study. Dr. Greg Miller, medical director of 
            Intermountain Health Care Hospice for Salt Lake City and Ogden, said 
            Weitzel's retrial could thwart this and other ongoing statewide 
            efforts to educate doctors and patients on pain-management issues. 
            "We are all very concerned about any event that would increase the 
            barriers for people to receive adequate management to their pain," 
            said Miller. 
            Although there is new evidence that the data used by Brown 
            researchers was either flawed or misinterpreted, the Utah medical 
            community can still benefit from the report, said Allan Elkins, 
            director of the Utah Department of Health Bureau of 
            Medicare/Medicaid Program Certification. 
            Brown researchers apparently overestimated by more than 5,000 the 
            number of patients in Utah's nursing homes in the spring of 1999, 
            said Elkins, whose agency compiles the data for the federal 
            government. Elkins said his agency is looking into the discrepancies 
            and is planning to replicate the Brown study to see if the same 
            conclusion is reached. But until then, he hopes to make strides in 
            teaching patients and doctors alike about pain-management 
            assessment. "Certainly we agree that pain management is very 
            important and something all facilities should do a good job on," 
            said Elkins. 
            Not everyone, however, is convinced that Weitzel's retrial will 
            cause physicians to reconsider treating their patients properly for 
            pain. Mark Fotheringham, spokesman for the Utah Medical Association, 
            called the Weitzel case, both last July's trial and the upcoming 
            prosecution, "more of an aberration than a trend." 
            "We have gone to great lengths to educate our members that they 
            should not fear prescribing narcotics for pain control," 
            Fotheringham said. "There is no evidence of a statewide witch hunt. 
            Nobody has anything to fear."     Right...
            

      Copyright ©2001, Ogden Publishing Corporation

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