Ohio doctor accused of overprescribing fentanyl to the dying found not guilty of murder
Source: CNN/Eric Levenson, Jean Casarez, Lauren del Valle
The Ohio doctor accused of overprescribing fentanyl to his critically ill patients and hastening their deaths was found not guilty of 14 counts of murder on Wednesday.
William Husel and his attorney embraced at the defense table after the 14th and final not guilty verdict was read in court. He was subsequently discharged from the courtroom.
The decision comes just over a week after jurors began deliberating and days after they said they were at an impasse and could not reach a unanimous verdict, leading Franklin County Judge Michael Holbrook to instruct them to continue their deliberations.
Read more: https://www.cnn.com/2022/04/20/us/william-husel-ohio-doctor-murder-trial/index.html?utm_term=1650465396875f032f8b7a5b5&utm_source=cnn_Breaking+News&utm_medium=email&bt_ee=5ybnOsWYzLtuEeHAZ5ew7qGhtYhw%2BYI48rPwkpq5ajDSSbzpHrQUqRSjXNKICb6g&bt_ts=1650465396878
Mr.Bill
(24,262 posts)Hoyt
(54,770 posts)Hoyt
(54,770 posts)Irish_Dem
(46,767 posts)I have seen some dying patients screaming in pain and the medical staff won't give them adequate pain management due to fear of hastening their death.
Please hasten my death in these circumstances.
Mr.Bill
(24,262 posts)have been helping people in this fashion for years. I won't go into detail, but I have relatives who were Hospice Nurses.
Irish_Dem
(46,767 posts)The patients I saw were on general medical floors. Not hospice.
I know Hospice nurses and they do not let their dying patients scream for hours in pain. Totally against their philosophy of care.
Aristus
(66,307 posts)The 'bible' of clinical opiate treatment, Responsible Opioid Prescribing, clearly states that if a patient is dying, under 'Do Not Resuscitate' orders, and in 'comfort measures only' status, the upper limit of dosing is basically however much keeps the patient comfortable, regardless of standard of care.
Irish_Dem
(46,767 posts)The docs are afraid of legal liability and losing their licenses.
And some docs say they don't want the patient to get "addicted."
All of it is just plain wrong.
PatrickforB
(14,566 posts)pain for a couple years now and no one at our HMO really gives a shit. They don't. Of course, they are FAR too concerned with cutting costs to actually do what a patient really needs, or test until they find out what that patient needs.
Nope. Here in 'Murika, we operate a monetized healthcare system where profits are held above people every single time.
Every single time.
See, the role of government can easily be identified by every one of our congress critters if they really wanted to do the right thing. Government is a service. The government should step in whenever the profit motive is in direct conflict with the interests of those being served.
Consider your 911 dispatcher. If you have a fire in your kitchen you cannot put out, and call 911, what if the dispatcher wanted to take payment over the phone with a credit card prior to sending the fire trucks. Or what if an intruder has broken into your house and you've locked yourself in the bathroom, and the dispatcher tries to collect a fee before sending the police.
Why, that is ridiculous! Isn't it?
So why do we allow the same thing to happen to us with healthcare? Dental care? Congress didn't bat a collective eyelash when they passed the bloated $770 billion WAR bill this year, and we squandered over $4 trillion on the forever wars. And the 2017 tax cut for billionaires and corporations? If you look at the federal budgets year over, you will see that right now individual taxpayers pay in $0.86 out of every dollar the US government collects in income tax while corporations only pay in $0.07 (6.8%).
I mean, that is unsustainable. Go back to 1970 and that ratio was corporations ~35% : individuals ~45%. Seriously.
Look, if Congress was actually operating unfettered by MASSIVE corporate donations from special interest groups, and was instead allowed to do the right thing in governing this country, we would have had Medicare for all Americans a long time ago, it would cover all medical costs instead of having large 'donut' holes, and you wouldn't have to hire a consultant and read a bunch of books to figure out how to sign up and get the best long term benefit. You'd just go in, be seen, be treated, and hopefully get well - all without worrying about being wheeled in your gurney through accounting to figure out how you will 'handle' your copay, coinsurance, self-pay or whatever other bullshit term they use.
Seriously, we squander all that money on shit that doesn't do us and our families a BIT of good. Where is our healthcare? Where is our dental care? Where is the kind of medical service that works in the patient's best interest instead of the best interests of shareholders? Where is debt-free healthcare? Where are there no healthcare bankrupcies?
Hint: EVERYWHERE ELSE BUT HERE.
As long as shareholder profit is king, most nurses and doctors will heroically 'tolerate' pain on the part of their patients in order to cut costs and maximize revenue.
Every time I think of our fucked up healthcare system I want to hurl.
Elessar Zappa
(13,941 posts)My dads opiate was discontinued due to the doctor being afraid to prescribe pain meds. Now my dad is in agony 24/7 and cant get any relief. He has debilitating osteo-arthritis and has tried every alternative to opiates. None of it touches his pain. The war on opiates is ridiculous.
Joinfortmill
(14,404 posts)Harker
(14,007 posts)made it very clear, with an accompanying piercing look, what would constitute a lethal dose of painkiller.
Had an aunt who worked for Hospice for thirty years.
"
LisaL
(44,972 posts)NT
Mr.Bill
(24,262 posts)to ask for anything. That's why we have advance directives.
LisaL
(44,972 posts)Hospital already paid millions to the families.
lookyhereyou
(140 posts)what is the point of agony , pain on pain , vegetative state.
LET ME GO WHEN i SAY GO .
We can decide for our pets when they have had enough.
Phoenix61
(16,999 posts)I wouldnt wish it on anyone and hope someone would be kind and help me on my way if I end up with it.
Hoyt
(54,770 posts)JohnnyRingo
(18,622 posts)People hear the buzzword Fentanyl and assume that's what killed the patient. In this case it appears to have been administered to give comfort to the dying.
According to the defense:
"Baez argued prosecutors had not proven beyond a reasonable doubt that the doses actually hastened the patients deaths or that Husel purposely intended to kill the patients."
Somewhere there's a knee jerk republican behind this who probably complained that the patient could become addicted.
LisaL
(44,972 posts)One lady got a dose described as "enough to kill an elephant."
momta
(4,079 posts)Prescribing Fentanyl or any opioid is always going to depend on the patient's tolerance, which, in chronically ill people can be quite high.
JohnnyRingo
(18,622 posts)We have weekly overdoses here too, but I'll go along with the jury that the doctor did not overdose anyone. Fentanyl is an effective medicine, not just an illegal drug.
riversedge
(70,173 posts)LisaL
(44,972 posts)and the doctor gave the kind of dose these people got, you'd still think doctor didn't overdose anyone? He was prescribing high enough doses of fentanyl that likely would have killed at least some healthy people, especially in combination with other drugs.
JohnnyRingo
(18,622 posts)Unlike you and me they heard all the facts.
Cancer was trying to kill me a couple years ago. I almost died from the chemo, but in the end, when I finally emerged from the ICU, the cancer was gone. So medical science won and no one was arrested.
You can bet there are people on the street doing double that "lethal dose" because they have a resistance built up.
LisaL
(44,972 posts)fentanyl.
But if somebody had done so, sounds like that would have been just fine with you?
JohnnyRingo
(18,622 posts)They loaded me up with chemo drugs and cost me both kidneys.
Saved my life, for what it's worth now, but I was in a coma for a week and spent months in ICU. They had to teach me to walk again, but the cancer was adios. I guess I win this time, but who should be arrested if I didn't?
LisaL
(44,972 posts)If somebody administered a potentially lethal dose of fentanyl to you when you were in a coma, would that be o'key with you?
Doses he administered would have been likely enough to kill even some completely healthy people.
JohnnyRingo
(18,622 posts)...Fentanyl? Both have legitimate medical uses and both can kill. I got a near lethal dose of chemo drugs that worked. As time went on my body built a resistance until at the end when I was getting doses that would kill a healthy person, but it poisoned the cancer first.
People hear the word Fentanyl and assume illegal drugs. It's not. People in Hospice care get it all the time to ease the suffering, but they build a resistance until they need doses that would kill a healthy person.
Do you know why so much heroin is produced? The vast majority of it goes legally to pain medication. Some spills out onto the streets for people who don't know what they're doing.
LisaL
(44,972 posts)He worked in ICU. They were ICU patients.
It's a good bet these patients weren't building up a resistance to fentanyl in there.
tavernier
(12,374 posts)We were keeping tabs on you through your friend. You went through hell heres hoping that you have only good days coming.
JohnnyRingo
(18,622 posts)Some days are better than others however.
Karma13612
(4,547 posts)Presenting to the doctors office (quite obviously this implies mobility to get to the docs office, as opposed to being on their death bed) needing pain meds with those patients who are suffering incredible pain, and with incurable, debilitating, deteriorating illness. TERMINAL ILLNESS.
According to the article, these patients were dying, and in agony.
Here is a snippet from the CNN article:
He was helping them to die because they were in horrible states of suffering. This isnt Mr. Patient showing up at the local clinic asking for short term meds to get over a sore back.
I dread being in this situation, and I hope to heck there is a compassionate doctor or nurse around for when I am in this state of terminal illness. I agree that docs should not prescribe high doses of fentanyl or any narcotic for short-term pain in non-terminal illness. But this is not what the article reflects. Not by a long shot.
LisaL
(44,972 posts)As for the defense, they had one witness claiming patients died from their medical issues.
While prosecution had numerous witnesses. Doses this doctor administered were not standard medical practice.
It also doesn't appear that all the patients were terminal.
"One patient, 82-year-old Melissa Penix, was given 2,000 micrograms of fentanyl and died a few minutes later. Dr. John Schweig of Tampa Bay General Hospital testified for the prosecution that Penix "definitely was not terminal, nor was continuing medical care futile.""
https://www.fox6now.com/news/dr-william-husel-found-not-guilty-in-14-ohio-patient-deaths
Skittles
(153,138 posts)I wish the good doctor well.
LisaL
(44,972 posts)His medical license was suspended.
Ruby the Liberal
(26,219 posts)A little sanity prevails for a change.
Botellos
(24 posts)We live in an unfair world.
niyad
(113,204 posts)AZLD4Candidate
(5,656 posts)with dignity, not in anguish and suffering.
area51
(11,902 posts)LisaL
(44,972 posts)I am very surprised by the verdict. I guess former lawyer for Casey Anthony really can do wonders for ones defense. Although how he does it is beyond my understanding.
momta
(4,079 posts)She spent months dying at home, and was in agony the whole time. The doctors weren't around to hear her cry, but my brothers and I were...night after night after night. We didn't want to lose her, but we knew she was dying, and just wanted her to not be in pain anymore. We were all teenagers at the time, and we still talk about it today. It was horrific.
Good for this doctor for not allowing that kind of agony.
Hekate
(90,616 posts)manicdem
(388 posts)I'm all for people having the choice to end their lives. However this article didn't state this was medically assisted suicide or it was the patients choice to die.
I'm sure it's likely not, but did he give patients an overdose against their will?
LisaL
(44,972 posts)NT
Sick_n_Tired
(21 posts)Suicide is far too stigmatized. We encourage autonomy with every other aspect of our lives - body positivity, gender acceptance, abortion, etc - but when it comes to suicide we wring our hands and feel like there must be something wrong, mentally with the person. Sometimes life isnt what its chalked up to be and we were never given a choice to be born in the first place. Its my life (or yours) and if we decide we want to end it, we should be able to with dignity. Healthy or not.
Owl
(3,641 posts)Karma13612
(4,547 posts)There is a Patient Bill of Rights, at least in NY state. Within those rights is one regarding Pain management. All patients have the right to be free of Pain while in the hospitals care.
I can recall in the 80s visit a terminal patient in the hospital who was in agony with pain. The RN (following normal standards at the time) was not allowed to give the patient pain medication outside the normal strength, dosage and frequency recommended and ordered by the patients doctor. I remember the patient saying that they were suffering and why was everyone worried about them getting addicted? They were going to die soon! Ive never forgotten that.
It was some time after that, not sure when, that NY State enacted the Patient Bill of Rights.
No one should suffer in pain, especially those on their death bed. And I am 1000% supportive of a human beings right to die when they want. Under their own determined circumstances. If they want to die, there must be a darn good reason. Ive lived long enuf to feel that desperation, and have seen it in others.
LisaL
(44,972 posts)NT
Hela
(440 posts)"Husel's defense called just one witness, Dr. Joel Zivot, who studied the medical records of the 14 patients and determined they had severe and unrecoverable illnesses. Zivot also testified that recovery to a normal state of health was not possible for the patients, and he determined underlying medical issues caused their deaths."
LisaL
(44,972 posts)the doctor take it upon himself to administer large doses of fentanyl?
Perfectly healthy people die each day in this country because they overdose on drugs laced with fentanyl. In fact it is an epidemic. Deaths from fentanyl poisoning are going up.
So there is a reason why large doses of fentanyl should not be administered. Obviously, because a large dose can kill even a healthy person.
So this one witness claiming these patients died from their medical issues doesn't amount to a bag of beans to me.
If the doses weren't lethal, I would have asked the witness if he would agree to have these doses (and in combination with other drugs) administered to him.
After all, he is healthy, so there would be no reason for him to decline, would there be?
Hela
(440 posts)This case is not about doctors administering fentanyl in large doses to just any patients. This is about a respected doctor, with a long history of caring and healing, administering fentanyl to 14 hospitalized patients with documented end-of-life status.
I get the sense that you have never been a caregiver for someone at the end of their life, whether they passed peacefully or in great pain. As someone who cared for her mother-in-law for 9 months through lung cancer, who gave her injections, spoon-fed her, wiped her butt, cared for the huge bedsore she developed from laying in bed and not being able to move, and who administered morphine under the tongue at home, I can tell you that I wish I'd had one of those hospice nurses give me the meaningful look with information about the overdose limit. I can tell you I wouldn't have hesitated to give my MIL that dose and help her avoid the last two weeks of her life which were primarily spent in pain or so doped up that she didn't know who she was, where she was, or who her grandchildren were.
I applaud this doctor and others like him who judiciously use all the tools available to them to help patients, whether that means they heal them and help them recover, or they help them transition to a comfortable and painless death when there is no other outcome.
LisaL
(44,972 posts)They weren't all "terminal."
"One patient, 82-year-old Melissa Penix, was given 2,000 micrograms of fentanyl and died a few minutes later. Dr. John Schweig of Tampa Bay General Hospital testified for the prosecution that Penix "definitely was not terminal, nor was continuing medical care futile.""
https://www.fox2detroit.com/news/dr-william-husel-found-not-guilty-in-14-ohio-patient-deaths
LisaL
(44,972 posts)definitely considered a lethal dose. Which is what the 82 years old was administered. And smaller doses could easily result in death as well.
https://www.harmreductionohio.org/how-much-fentanyl-will-kill-you-2/
moriah
(8,311 posts)Fentanyl is no different from any other opiate/opioid in that respect. Nor are the rise in deaths from fentanyl linked to doctors giving it (nor prescribing it in patch form or lollipop form).
Fatal dose amounts vary significantly -- there really isn't any one "ceiling" dose one can say is always fatal even in very opiate-tolerant individuals, and the amount some sick/frail people take to stay at a 4 instead of a 9 or a 10 on the pain scale could quite likely kill an opiate-naïve "healthy" person (especially if combined with other medications).
I don't regularly take opiates. I would be considered opiate naïve and given a lower dose. My father when he went into hospice? *Definitely* opiate-tolerant, as he'd been on methadone (cheaper for long-acting pain relief than Oxycontin, so that's what Medicaid covered) and Percocet for breakthrough pain. So depending on each apparently already dying patient's serious illness, need for pain relief, and prior opiate usage, a doctor could and should adjust the dosage for each individual.
--------
I don't think any of us knows all the facts here, and I'd want to know a lot of them before passing judgement. If these patients were like this patient, I would not judge him for a 2000 microgram dose if such a patient ended up in the hospital at the end of their life. Nor would most palliative care specialists, because of the principle of "double effect" -- in an already-dying person, aggressively treating pain is ethical if the physician's intent is to relieve suffering (and don't intend to relieve it *by* hastening death). If they were admitted like my grandmother was when she died (not on any pain medications, had congestive heart failure) and were given even 500 micrograms of fentanyl.... uh, no. Bad doctor.
Family members can influence a patient's decision about whether to go the hospice pathway or keep fighting a futile fight if they know death is coming -- if their family thinks hospice is basically euthanasia, they're far more likely to end up dying in the ICU instead of at home or in an inpatient hospice setting (like my father was). The nurses being asked to push meds may not know the patient's daily opiate dosage before admission, and legitimately question the treatment plan.
But until I know more, all I can say is he was acquitted by a jury of his peers. Hopefully the medical records were admitted into evidence and they were able to ensure he wasn't giving those doses to people like my grandmother -- but instead people like the guy titrated up to 1000 micrograms per hour transdermally, or even higher when admitted because they can't manage at home anymore/no inpatient hospice beds available.
LisaL
(44,972 posts)opiate tolerance.
moriah
(8,311 posts)... identify what opiates (and preferably also any other meds, like benzos) they have been taking. If they've been taking them for a long time vs less than a week, especially if they're trying a new opiate, the idea is to convert their daily dosage to their "Morphine Equivalent Dose", then the new opiate is given at a slightly lower dose than its equivalent Morphine Equivalent Dose and titrated upward.
If you don't ask what pills a patient is taking, you risk things like what happened to my grandfather -- he was hospitalized for his heart and assumed the doctors were giving him all his routine meds. He was psychotic within 3 days, and the psych doc consulted finally asked what all he took. My grandmother came up there with a suitcase full of pill bottles, because she didn't know which ones were current or leftovers from a discontinued med. (He took both Valium and Empirin-4, so yes, withdrawal psychosis from one or the other.)
Did you know they make fentanyl nasal inhalers for severe breakthrough pain? Highest dose they make is 800 micrograms (400 mcg in each nostril), but that's more than the 500 mcg one they were attempting to call murder.
--------
One other factor here is that anger is part of grief. When my mother passed away, I was angry at her for drinking herself to death and blowing it off when the doctor found bilirubin in her urine and wanted her to go back (her body, her choice.... but it hurt to watch).
But because of the *way* she died -- from a bowel perforation after she was given (over mine and my sister's objections, because she had a previous gastric bypass and already had constant loose stool) the standard dose of lactulose for a person with a normal gut... and COVID protocols meaning we couldn't sit with her and advocate for her.... the doctor NEVER calling to give us an update themselves or to talk about alternatives to lactulose... yes, I was VERY angry at the hospital/that doctor.
She might have had a few more months if the lactulose overdose didn't cause intramural gas and a perforation. But that time would have not been fun for her. She only realized her liver had complexly given out on her less than three weeks before her death, and a lot of that time was in the hospital alone. She didn't have time to make a will, or tell us what she wanted (when she was in her right mind, which she was after two days in the hospital on the first admission). or even really come to terms with the fact she was dying.
I don't know this case intimately, but I've seen people keep on fighting a futile fight because of their family's views too many times -- death and the process of dying is never "pretty", but some are harder to see than others. I've lost both my parents, and while I won't say anything about either was "easy"... it was harder to deal with a phone call from someone asking us (since Mom wasn't considered competent right then) what we thought she wanted regarding resuscitation, life support, etc than the phone call I got from the doctor who was treating my father to tell me HE was hospitalized and out of his right mind so his refusal of medical care had been deemed unreliable. Maybe it was harder because a call like that told us indirectly she was at death's door, but no doctor had ever spoken to either of us to tell us that.
But I only filed a JCAHO complaint, a Medicare complaint, and briefly considered suing for at least her copays from those two hospitalizations. They went ahead and waived them without me asking -- doubt that's standard after a death, so I guess they knew I was pissed.
If someone from the Medicare complaint people had told me that yes, he really should have considered he fact she already had nearly liquid stool as a result of the gastric bypass, and said yes the alternative drug should have been given instead.... I would have felt my anger was then justified by an outside party who didn't know her or me, and then HATE that doctor forever. I can only imagine what these families are going through, regardless of if he was simply negligent or really trying to be the Angel of Death to elderly patients without their consent.
I assume you've been following this case awhile, yes? I apologize for my ignorance on specifics.
LisaL
(44,972 posts)standard medical practice. Or he wouldn't be giving patients potentially lethal doses of fentanyl.
slightlv
(2,782 posts)I'm 66 years old and I fear getting older. I mean, I'm scared to death of it. As we get older, people "there, there" us to death. We lose all rights to how we feel. People stop believing us. They treat us like children. If it's this bad at 66, what's it going to be like at 76? At 86? God forbid, at 96? If I'm still at these pain levels or worse? I'll buy a damned gun and put myself out of my own misery. It's the only surefire way of legally doing it! -- republican style!
Truly -- I deal with pain that would put a full grown man down on the ground in agony and I'm afforded FOUR pain pills a day. Period. And, at that... I'm only given enough of those to last two weeks at a time... those I have to stretch for a whole month. I've been doing pretty good, mixed with the non-narcotic meds that I take for my fibromyalgia/lupus. But a perfect storm of weather conditions, allergens, and various other stressors, in addition to gastro issue where I can't swallow anything again, and I'm ready to pull my hair out. I've lost two of my cats to old age and/or diabetes. I've got another just diagnosed today with thyroid issues. She's 20. Because of my Pain levels and not being able to properly manage them, I'm damned ready to cross the rainbow bridge myself.
This WILL be the hill I die on. It's not fair for people fighting constant, chronic pain to be cast off as some kind of junkies jonesing for a fix. We don't need rehab. I've got so much titanium in my body, I laugh at all the hoopla about jet flights. I'll never be able to fly in a jet again, because I'll never be able to get past the security check in!!!! I already feel like a cyborg... just a very pain-filled cyborg. Why can't people have a little more compassion for people like us? And for those who do try to help us?
Karma13612
(4,547 posts)Please accept these:
I cant imagine what you are going thru, but my heart goes out to you tonight and for the foreseeable future.
We all deserve to be pain free, and have complete body autonomy. I agree that much more is need in this country regarding those two elements. I am 68 and still dont have a living will. I need to get that done so that my wishes are met.
💗💗💗
Emile
(22,607 posts)NT