Jackson's Doc Conrad Murray Case Sends Signal to Docs

Parts of Murray's experience not too uncommon, experts say.

ByABC News
November 8, 2011, 4:34 PM

November 9, 2011 — -- Conrad Murray's conviction of involuntary manslaughter in the death of Michael Jackson sent a loud and clear message to many experts managing the care of patients who may be abusing pain medications: Hold your professional ground.

"Never forget that you are a physician," said Dr. Mark Schlesinger, chairman of the department of anesthesiology at Hackensack University Medical Center in New Jersey. "Regardless of what pressures exist, never lose your judgment and do a patient harm."

Murray, who was convicted on Monday, may spend as little as a few months behind bars with only a temporary medical license suspension – an outcome perhaps "too lenient" given the conviction, say some medical experts surveyed by ABC News' Medical Unit.

Murray was accused of giving Jackson a fatal dose of the powerful hospital-grade anesthetic drug, propofol. He has contended that Jackson gave himself the fatal dose while the doctor was out of the room.

Jackson had already been given lorazepam, an anti-anxiety drug, and midazolam, a sedative usually administered before anesthesia; then he took Valium to help him fall asleep.

Murray was also under fire during the trial for not properly supervising his patients or taking proper steps to resuscitate Jackson after he stopped breathing.

Murray, a cardiologist, crossed over the medical specialty line when he agreed to manage Jackson's pain medications, according to Dr. Charles Kim, assistant professor of anesthesiology at NYU Langone Medical Center.

Prosecutors contended that Murray was willing to give Jackson propofol, which Jackson affectionately referred to as "milk," in return for a $150,000 a month paycheck. Murray told police that for two months leading up to Jackson's death, he had administered propofol to Jackson in his bedroom almost nightly.

"Clearly, the drug involved is not intended to take a nap," said Dr. Eugene Viscusi, director of acute pain management services at Thomas Jefferson University, in Philadelphia. "There was nothing here that came close to reasonable practice in medicine."

Although Murray could legally prescribe and oversee the medications found in Jackson's system at the time of his death, some experts say he may not have been experienced with administering these heavy sedatives as an anesthesiologist would.

Jackson's case of seemingly exorbitant compensation for a hospital-only drug propofol was unique, but in many ways the underlying issue of pain medication dependence is not uncommon, said Viscusi.

The supply of prescription painkillers is larger than ever, according to the Centers for Disease Control and Prevention. And pain doctors carry an even heavier burden to monitor patients who may be crossing the line into addiction.

Viscusi said some patients who seek unnecessary prescription medication are so convincing that many new and undertrained doctors become manipulated without even realizing it. He recommended honest conversations between a patient and a doctor, and setting reasonable goals in pain management.

Patients also have the power to help avoid medical errors by finding a doctor who has experienced performing a medical procedure, said Dr. Michael Roizen, chief wellness officer at the Cleveland Clinic.

"Ask your doctor, have you prescribed this pill before? How often? Have you done this procedure before? How often?" said Roizen. "If the answer isn't more than 25 [times] this year, my opinion, go for another doctor."