What started all of this in the first place?
Dr. Weitzel was practicing in a headache clinic, and attracted the attention of regulators as a “psychiatrist prescribing opiates”. That didn’t really pan out. They then looked at his hospital practice, looking for Medicare billing irregularities. Still no success, but while there, a nurse pointed out a string of deaths that had occurred in the past, and mischaracterized them as questionable. The regulators were then off and running. ( See Legal History>> )
Why did
they charge him with murder?
The medically-ignorant county prosecutor was lead by the nose into the case, thinking that care that really amounts to palliation equaled active euthanasia. Some think he may have wanted to further political ambitions; the prosecution would have been a springboard to state judge.
Why was a psychiatrist doing end-of-life, palliative care?
Why (or
how) did the doctor get convicted?
The jury didn’t seem to understand the medical care rendered or the import of expert testimony that consistently exonerated the doctor. Over and over the trial judge allowed the prosecution to inject civil issues ("malpractice") into the case, questioning of the medical care which evidently confused the jury. They were allowed to vote on “lesser included” charges, and apparently “compromised” with a mixed verdict rather than deliberate responsibly. There was no Henry Fonda* on this jury. Even more important, an important defense witness, who destroyed the state’s case, was suppressed by the prosecution.
Was this
active euthanasia?
Absolutely not. Active euthanasia involves intervening in some manner with the objective of ending life. The patients were demonstrably terminal and their families opted to withdraw further interventions. The patients were then given palliation: “comfort care”, including moderate amounts of morphine to prevent suffering, pain, or indignity. Not one patient died immediately, overdosed, but only later, from the underlying pathology.
What doses
of opiate were used?
Moderate doses, starting in the range of morphine 5 to 10 mgs. IM each 3 to 4 hours, on a routine basis, with prn’s and ‘now’ orders for breakthrough pain. ( Merck Manual>> ) One patient had higher doses given on the last day, after the nurse had completely held all opiate medication for twelve hours, whereupon the pain of course got seriously out of control.
Where can
I get actual chart copies?
There are a few copies of the complete chart with Dr. Weitzel, and any physician who writes or e-mails him with a request will get one from him. The handwritten portions of the charts have been difficult to put on the Internet, because they would have to be “scanned” into the site, and thus represent many pages of .jpg pictures; this is very data-heavy. However, they are now complete; one can find all of the clinically relevant data on the Internet.
What about
the Federal prescription diversion charges?
At the same time that the state brought homicide charges, the DEA brought these other, unrelated charges. They are frequently brought up to attempt to taint the doctor’s state case. The doctor had plead ‘innocent’ in this federal case, but has now accepted a "plea bargain" in order to put those charges to rest, so that the much more serious homicide charges can be faced without distraction. He acknowledges that mistakes were made in keeping records of unused leftovers.
What about
this case in Texas?
Dr. Weitzel was never the attending physician for this patient, who he was asked to consult on in the hospital. She was discharged from the hospital and in a nursing home when she died, and Dr. Weitzel had not seen her in some time. Her family, on learning of the charges against Dr. Weitzel, has used his notoriety to try to extort a settlement from the attending physician and the hospital. It is simply not a "case" at all, but the authorities there evidently had to investigate, and did so.
Did the
doctor overmedicate these patients with psychotropic medications?
No, and the medical charts prove it. These patients were terribly agitated and demented, and it was Dr. Weitzel’s job to attempt to find a way to pharmacologically reverse their agitation, settle them down so they could return to nursing home care. The alternative is to use physical restraint; tie them down, hardly a humane alternative.
Why is Dr.
Perry Fine’s testimony so important?
First, he is the foremost expert in this end-of-life care in the state, perhaps the nation. He is board certified in anesthesiology, is a bioethics expert, and is a hospice director, frequently working with this type of patient. Even more important, he was recommended to the prosecution as an expert witness by the very “expert” who went on to be the “star witness” against Weitzel. This puts the lie to that testimony. (See the Motion for New Trial>>)
Why
doesn’t the Utah Medical Association help more?
Apparently the UMA is taking a head-in-the-sand approach to this case. Although the evidence is against it, they claim that the case does not affect the provision of end-of-life care. This is patently ridiculous, and contradicted by an AAPS survey. ( See the poll>> )
What can I
do to help?
*Reference is to the film "Twelve Angry Men", in which Henry Fonda plays a jury member who convinces the other jurors to reason a case through, not jump to conclusions, but deliberate fully and act responsibly.