Who is responsible?

[wring]

Some people are addicted to prescription drugs. Sometimes, these folks die of drug interactions. There's been several celebrity deaths over the last while (Heath Ledger, Anna Nichole, Michael Jackson to name a few), wherin prescription drug interactions have been the cause. In two cases (Anna Nichol and Michael Jackson), there's been some rumbling about making criminal cases over the deaths.

Now - if a single doctor is prescribing all the drugs, I think there should be some accountability (the vast quantities prescribed for Elvis for example). But where's the addicts responsability? And what of the hanger ons? (such as Howard K Stern, who may indeed be a douchebag of the first water, an enabler in the first degree etc, but if a doctor is prescribing drugs, patient is demanding them, how come he's supposed to be in the know enough to refuse to administer?)

My mom died of accute alcoholism. I chose not to serve booze to her in her last years, but that was a choice I was making. I would not have wanted criminal responsability to be attached to my siblings who didn't make that choice.

So, what level of responsability do the non addicts have in these cases?

[Sybarite]

Tough question. I'm looking forward to the day when all of our medical records are in one database so doctors/pharmacists can see just how many painkillers a patient is being prescribed (plus all other drugs that may interact), but as for laymen that may help an addict feed an addiction, I think each person has to look into their own heart. In this case I would follow the Buddhist principle of doing no harm - I would not supply an addict with a drug that is harming them.

People facing criminal charges over this? Extremely grey area. It's like charging bartenders with over-serving customers, or customers drinking in a bar then driving and causing a collision. Nobody is pouring the drinks down the patron's throat, but we sort of have responsibilities as human beings to not keep serving drinks to someone who is already falling down drunk.

[wring]

I agree that if you serve a shit eating drunk additional booze you should be held somewhat accountable, but they'd have to be pretty obviously drunk in my book. Too often, unfortunately, really good drunks are really good at hiding it. And it's even murkier for the enablers around the prescription folks (like aforementioned Howard K. Stern, and god do I hate to be defending him). How's he supposed to know what level of any drug is theraputic or not or how they interact together?

ON the other hand, on a moral basis, I'd hold him and Jackson's whole entourage/hangers on/enabling shits accountable, since it seemed obvious that it was in their interest to allow Anna Nichole and Michael to remain sick enough to be used.

Depending on how the doctor stuff shakes out, not sure MJ's doctor should be held criminally responsible - (though the whole concept of using a drug that's generally only administered in a hospital seems iffy). It also seems clear that MJ was using multiple physician resources to fuel his drug habit.

[Zeener Diode]

I think personal responsibility should outweigh every decision. If a person really wants to do terrible things to themselves, we can try to dissuade them but ultimately they will have to decide what is right.

Back to Syb's comment: A bartender serving alcohol to a visibly intoxicated person is irresponsible. But where does accountability end? Suing cigarette manufacturers for giving you cancer has to be the dumbest thing ever. I don't want to make light of anyone who has had or knows someone who has cancer: but to blame Big Tobacco for making cigarettes that you smoke, regardless of all the warnings said for the last 50 years, is ridiculous. We might as well sue GM for making cars that go too fast. Or sue Springfield Arms for making guns that kill people. Product liability aside--- manufacturers hold responsibility for the safety of products deemed safe by regulators--- we take it upon ourselves to do things that may or may not produce serious effects to ourselves and those around us.

[Fish]

Suing cigarette manufacturers for giving you cancer has to be the dumbest thing ever. I don't want to make light of anyone who has had or knows someone who has cancer: but to blame Big Tobacco for making cigarettes that you smoke, regardless of all the warnings said for the last 50 years, is ridiculous.
I dunno about this one in particular... as I recall, there seemed to be evidence that the tobacco companies had reliable data on the lethality of their product, and the addictive nature of it, which they conspired to conceal and deny. I don't have a problem with making someone responsible for his own informed choices, but I do have a problem when the company conspires to keep its customers in the dark about the real risks. Cigarettes "may be" hazardous to your health? That warning didn't go as far as it ought to have, and Big Tobacco knew it.

Back on the subject, though, I agree with Sybarite. Medical records are so fragmented and proprietary, and none of these systems and databases interact or play nicely together. How can one hospital know what a person's medical history is, even when the patient isn't actively trying to scam the doc for pain pills? It's hard enough to treat a patient off the street in any given emergency room as it is.

I'd go a step further and take all the damn pharmaceutical commercials off the air. Those companies go out of their way to make it sound like their medication is sunshine and light. Take Whizzo Pills and go to heaven! And after they give you the hard sell, they pass off responsibility by saying "ask your doctor about Whizzo Pills." Can't have it both ways.

[wring]

Additionally wrt the cig co's ISTR they'd intentionally increased the addictive chemicals, which makes them more culpable, IMHO.

But back to the topic the fragmentation of medical records issue is why I am reluctant to go after the doctors involved since they'd generally not have any way of knowing what others had prescribed. I mean, all my docs ask me and I tell them, but that's 'cause I'm not trying to hide an addiction.

[Radical Edward]

I think the only person responsible is the one who is putting the pills in their mouth and swallowing. Period.

[Mako]

I'd like to agree with you, Radical Edward, because I'm all for personal accountability and the dismantling of our blame culture.

But somehow, there must be a mechanism in place for punishing those who would attempt to coldly profit from that addiction by feeding it, when others might be endangered by it; and I'm not just talking about the addict themselves.

[Uthrecht]

Is it too late to go after those bastards that repealed Prohibition, then? Frickin' enablers.

ETA: Okay, I kid. Here's my take: if it's an unregulated substance, like Nytol or spraypaint cans, if someone abuses it and gets dead, they're the only ones on the hook. There are no laws saying you can only sell spraypaint cans to authorized folks or whatever. If it's a regulated substance, like prescription medication or alcohol, the seller is on the hook if they provide it outside the scope of the regulations. Further, the physician providing the medications is under some requirement to do due diligence on how often the person is going through the prescription. If they just gave the patient a three-month prescription yesterday, they shouldn't write out a new one if the person is looking strung-out and claiming they lost the bottle.

[CrazyCatLady]

We actually have a controlled-substance tracking database here in Kentucky. Any physician in the state who has filled out the paperwork can type in your vital info and see all the controlled scripts you've had filled in the state since reporting began--what you got, how much you got, who wrote the script, and where you got it filled. It's a hugely useful tool for screening out drug seekers, and it really kind of boggles my mind that there are places where a doctor can't do that.

If MJ had lived here, his Kasper would be...well, a massive red flag, even if he was only getting reasonable amounts of stuff from any given doctor. Any doctor who ran a Kasper report on him and still wrote him any sort of narcotics would be, imo, acting irresponsibly enough to be open to a malpractice suit and criminal charges in his resultant death. Any doctor who looked at the man, listened to his requests, and didn't run a Kasper on him would, again imo, acting equally irresponsibly but might be juuuust within the bounds of the law and prescribing guidelines.