When the Paycheck Takes Precedent Over the Patient
Posted by realityrounds on August 24, 2009
The results of Michael Jackson’s autopsy have come back, and the results show he was given a fatal overdose of the anesthetic propofal (LA Times) Michael Jackson had a cocktail of drugs administered to him via intravenous injection in his private home. Given to him by a doctor. A doctor who should of, and probably did know better. Propofal is given to patients when they go in for surgery, or for procedures performed in the ICU. It is given in a hospital, with constant monitoring, and with staff who are skilled in immediate intubation. Patients given this medication need an IV line started, and need to be on continuous cardiac and respiratory monitoring. According to reports, MJ’s doctor gave him various drugs to help the entertainer sleep. Nothing worked. Michael Jackson’s personal physician stated he only gave him propofal because the singer insisted upon it. Dr. Conrad Murray was paid an astonishing $150,000 per month to take care of one patient, Michael Jackson.
Some would argue that it was all MJ’s and his friends and family’s fault that he died from this drug overdose. They knew he had an addiction problem, yet they enabled him and they remained quiet about it. He DEMANDED the drug. What choice did his physician making $150,000 a month to care for him have? He had the choice to adhere to the Hippocratic oath to ,”first do no harm.” The paycheck took precedent over the patient.
I understand that the draw of money can be a powerful motivator. I once took care of a baby of a very wealthy family, many moons ago. The baby was very stable, and only needed a small amount of Neonatal Intensive Care Unit, care. The mother was recruiting the NICU nurses to leave their jobs and work for her as a personal nanny. She was offering a salary of $75,000 per year to care for one newborn. Back then, that was a lot of money for a nurse, and it was almost $30,000 a year more than I was currently making as a night shift nurse in a very stressful Level III NICU. I thought about the job offer, but one irritating thought kept getting in the way…..Integrity. I did not go through all those years of education and all those years of NICU training to become some rich lady’s nanny. No way. I could use my skills and experience in so many better ways.
Health care professionals have to know when to say “no” to a patient. Patient’s can not “demand” that we perform dangerous, or not the standard of care procedures on them. We are not obligated to medically treat a patient based on their whims or quirks, or addictions. We must adhere to the “first do no harm” philosophy of health care. We must not let the paycheck take precedent over the patient.
Click here for other health care professionals opinions on this matter, Whitecoat, Nurse K, Happy Hospitalist, ERP
RR
Rachael C. said
*applause* Well said! It’s like I’ve been saying all along, this doc was careless, wreckless, and negligent in his care of MJ.
M'Lynn said
It was $150,000 a month. He was supposed to go to London with him for the shows he was doing there. It was going to have him in a very good position, except for, you know, the DEATH.
It’s the same reason that I watch surgeons put breast implants in teenage girls who aren’t even done growing yet. “If I don’t take their money, someone else will. I might as well be the one getting paid.”
realityrounds said
Damn girl, you’re right. Just corrected in my post, thanks!
midwest woman said
This scenario has a distant cousin called the VIP patient. No money exchanging hands but let’s coddle them and please them so they’ll give us free advertising so all their rich insured friends come. We have a VIP now who just happens to be the #%^*$# of a %*()&)^$##& (HIPPA IS TO BE RESPECTED) on the forefront of healthcare reform. My my my, the courtesy carts overfloweth and an attending we never see has now moved in.
lilibet said
extremely well said!
Happy Hospitalist said
SO I have to ask the question, if Conrad got paid $2 a month instead of $150K a month, would he still be criminally negligent? You can’t have laws on the books that are based on income requirements. Perhaps the poor people who commit homicide go free while only the rich and greedy ones get charged.
And you can’t argue that he wouldn’t have done it for free. Maybe he would have, just to get the publicity of being a celebrity doctor.
realityrounds said
No Happy, income level does not the crime make. But as the old saying goes, “avarice is the root of all evil.” You can not tell me that making $150,000 per month is not a powerful motivator to sweep your ethics under the rug. I am sure at his criminal trial they will get to his motivation for being such a dumb ass, criminally negligent doctor.
Happy Hospitalist said
Your whole argument seems to say he made a lot of money for being stupid, therefor he should be thrown in jail. Now you’re saying it’s not. I guess I could live with that, except your whole post is based on him cleaning house and there for he is a killer. You may want to addend your original post to clarify your position.
realityrounds said
Give me a break Happy. That is some twisted logic. This doctor made a shit load of money to illegally treat a patient with addiction and mental health issues. My post is about this doctor, who took the money, and forgot the patient. He looked the other way, and kept secret about it. He did not even report to the first responders that he gave the propofol. The money kept him quiet and motivated him to act criminally. Let’s see what the courts will say about it.
M'Lynn said
I’ve seen plenty of doctors (and other people) behave badly for nothing. The chance to make a million off of the patient motivated Dr. Murray to not say, “no.”
Just like someone who gets busted for agreeing to off someone for $10,000. That person might not have done it for free, but the monetary incentive pushed them to do the justify the behavior.
A patient without the means to motivate him wouldn’t have gotten something so outlandish. It’s the old “we’re just negotiating over price” here.
R. May said
Not related at all to this but to an earlier discussion regarding shckling during labor and birth. I just read it and thought of you.
http://www.msnbc.msn.com/id/32554695/ns/us_news-crime_and_courts
realityrounds said
Crazy that this is still happening. I would like to shackle, or muzzle that Happy Hospitalist. He is getting on my nerves today.
atyourcervix said
I recently had a prisoner as a patient. She was handcuffed and shackled. When I asked the attending police officer to please unshackle her, he did so without question. Then I asked him to please uncuff her so I could help her change into a hospital gown. He uncuffed her. After she was changed into a gown, I told him that if he needed to, I had no problem with him placing one cuff on her wrist and cuffing her to the bedrail. He actually didn’t cuff her to the bedrail until after the MD examined the woman and determined she wasn’t in labor. (PS – she also was not a violent criminal. She was arrested on a warrant for a court appearance for a misdemeanor charge.)
DreamingTree said
You make an excellent point, RR!
Wanderer said
That’s the problem with Jacko: no said NO to him, ever. The doc gave a medicine in a criminally negligent manner, end of story. However much he made off it is pointless.
realityrounds said
The money is pointless, unless the prosecution uses it as a motivating factor for why this doctor acted so egregiously. *sigh*…..Watching too much Law and Order lately.
Patients For A Moment: Vol. 1, No. 6 // Emergiblog said
[...] Rounds takes a page out of the headlines as Michael Jackson’s death shows us what happens When the Paycheck Takes Precedent Over the Patient. I wonder what part of “do no harm” the doctor didn’t [...]
MomTFH said
Great post, and great analogy to integrity in health care. I was just thinking of you as I was researching for my project, and I stumbled across this article:
http://www.ncbi.nlm.nih.gov/pubmed/15020016
…among others.
Sigh.
MomTFH said
I reread your post and had more to say, but my problem with the comment and my paper is that it is hard to say what we are saying. Uncontrolled autonomy is not the answer. Paternalism on the part of the medical team is not the answer. A healthy balance of the two is the key, I think, with beneficence and the best outcomes being the basis for the decisions made for treatments.
Michael Jackson’s Doctor to be Charged with Manslaughter « WhiteCoat’s Call Room said
[...] discussion about the criminalization of medicine from Happy Hospitalist, Nurse K, ERP and Reality Rounds. It’s official. Michael Jackson had lethal levels of propofol in his system. The [...]
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