Re: Cruel and Disgusting: Pain Patient Appeal Denied

March 22, 2007

I posted it to bring it to the attention of the folks on the lists. I don't

vouch for the facts. I have no way of knowing them. I said that it should

cause us to take a deep breath and consider just how civilized we are because

I was accepting the article for what it stated.

I am always interested in whether or not the law is applied correctly, and

with justice. Law was not meant to be rigid, yet many people want it enforced

with rigidity. The DEA fosters a climate of rigid enforcement. There is no

place in its culture for sympathy, understanding, or flexibility.

The scenario bears scrutiny, I think. I am not impressed that two courts

upheld the result because the appeal courts only look at the issues on appeal,

which often have nothing to do with the merits of the case.

The two appeal courts did not review the facts in the case. They only

reviewed the process.

If a jury makes the wrong decision it will be upheld unless there was NO

evidence to support it.

The jury in the O.J. Simpson case obviously made the wrong decision, but for

the right reasons. They failed to find him guilty beyond a reasonable doubt

because the prosecution was so stupid.

The jury in this case may well have made the wrong decision for the right

reasons also. They may have found the technical requirements of the charge

were

proved, and they listened to the judge and followed his instructions, and

found the defendant guilty. But the better question is what was the

prosecution

thinking? Why did they prosecute this guy? Are they rigid automatons

without a shred of human compassion? We don't know, because we don't have all

the facts.

The greater question is what our government's role should be in regulating

the medical practice of physicians who are called upon to do pain management.

If we allow our government to impose rigid limits on the abilities of

physicians to practice medicine in the area of pain management, we are making a

terrible mistake. When doctors become bureaucrats, they give up their

independence, and they sign on to spout the party line in order to keep their

jobs.

There is no medical independence in government employees. Politicians

generally

know nothing about medicine, so they listen to the loudest lobbyists and,

[OH, SLAP MY HANDS!!] the ones who pay them the most in political

contributions. Politicians are bought, sold, and owned by the folks who

contribute to

them. The do as they're told.

The right to have medical care that is appropriate and not regulated by

bureaucrats is, in my view, a Constitutional right. But I am in the minority,

because the great majority of folks now believe that government is always right,

can never do wrong, and that if a smiling politician tells us something we

must believe it. Most of us dare not dissent. We are afraid of being wrong,

of being an outsider, for not following the party line.

We have become a nation of idiots, a nation of followers, a nation of

apologizers, and a nation of people who dare not express any disagreement with

the

party line. We have become what Orwell envisioned us to be, except that it took

us 23 years more than he estimated.

Here's the party line on pain management: Pain is not so bad. If we give

you enough medicine to control your pain, you may end up being an addict. So

we trust that you will understand why we will keep you in pain while you die.

God forbid that you should be addicted to pain killers as you die.

And if your doctor should be stupid enough to have some humanity in her or

him, we'll squash that right away. If he or she prescribes too much pain

killer for you, as determined by US, we'll put him or her in jail too. Our

government will protect your morals by denying to you pain relief, because it's

just

what government does. Don't worry! You may be in agonizing pain, but you

will be among those we recognize for being true patriots. Suffering brings

recognition.

Of course the literature shows comprehensively that pain management and addict

ion are two different things, but the politicians, and too many physicians,

are oblivious to that. It's not popular. It's not macho. COWBOY UP, BOY!

Don't think that you're pain is bad. You want us to relieve that? What

pseudo-world do you live in? If we stop you pain, your ER physician may not

be able to figure out that your speen is busted. She may not be able to

figure out that you've got a lacerated liver. He may not be able to evoke

schricking pain when he does the rebound tenderness test for the 5th time.

So we have people going to prison for just wanting to be pain free. What a

GREAT COUNTRY THIS IS!

I expect that many of you will disagree. So let's hear your arguments.

GG

>

> So we have one obviously biased blog from an unknown author, a guy

> that got busted for forging prescriptions, and at least two courts

> that have evaluated the case and made their decisions.

>

> How can we evaluate this case based only on this information, let

> alone know enough about it to be outraged?

>

> LT

>

> wegandy1938@wegandy wrote:

> > Here's something that should make you take a deep breath and wonder just

> how

> > civilized we really are.

> >

> > Gene G.

> >

> >> Cruel and Disgusting: Pain Patient Appeal Denied

> >>

> >> Maia Szalavitz

> >> Huffington Blog

> >> March 12, 2007

> >>

> >> Florida's Supreme Court has rejected an appeal from Paey, a

> >> wheelchair-using father of three who is currently serving a 25-year

> mandatory prison

> >> sentence for taking his own pain medication. In doing so, the court let

> stand

> >> a decision which essentially claims that the courts have no role in

> checking

> >> the powers of the executive and legislative branches of government when

> an

> >> individual outcome is patently unjust.

> >> Paey-- who suffers both multiple sclerosis and from the aftermath

> of

> >> a disastrous and barbaric back surgery that resulted in multiple major

> >> malpractice judgments--now receives virtually twice as much morphine in

> prison

> >> than the equivalent in opioid medications for which he was convicted of

> forging

> >> prescriptions.

> >>

> >> He had previously been given legitimate prescriptions for the same doses

> of

> >> pain medicine-- but made the mistake of moving to Florida from New

> Jersey,

> >> where he could not find a physician to treat his pain adequately. Each of

> his

> >> medical conditions alone can produce agony. Paey has described his pain

> as con

> >> stantly feeling like his legs had been " dipped into a furnace. "

> >>

> >> The Ivy-league educated attorney has no prior criminal convictions and

> weeks

> >> of surveillance by narcotics agents did not find him selling the

> >> medications.

> >>

> >> The Florida Court of Appeals had upheld his conviction-- despite the lack

> of

> >> evidence of trafficking and despite the fact that most of weight of the

> >> substances he was convicted of possessing (higher weights lead to longer

> >> sentences) was made up of Tylenol, not narcotics. The majority suggested

> that Paey

> >> seek clemency from the governor, claiming that his plea for mercy " does

> not

> >> fall on deaf ears, but it falls on the wrong ears. "

> >>

> >> In a jeremiad of a dissent, Judge Seals called the sentence

> >> " illogical, absurd, unjust and unconstitutional, " illogical, absurd,

> unjust and unconsti

> >> Seals called the sentence " illogical, absurd, unjust and

> unconstitutional,<

> >> wbr> " noting that Paey " could conceivably go to prison for a longer

> stretch

> >> for peacefully but unlawfully purchasing 100 oxycodone pills from a

> pharmacist

> >> than had he robbed the pharmacist at knife point

> >>

> >> But the Florida Supreme Court disagreed, letting the sentence stand,

> without

> >> comment. It released its cowardly decision in the media quiet of a Friday

> >> night. As Siobhan Reynolds, founder of the Pain Relief Network points

> out,

> >> " Where Florida stands now is that individuals have no recourse to the

> courts when

> >> the executive and legislative branches behave tyranically. the executive

> a

> >> Supreme Court disagreed, letting the sentence stand, without comment. It

> >> released its cowardly decision in the media quiet of

> >>

> >> Paey's only other alternatives now are an appeal to the U.S. Supreme Court

>

> >> or clemency from Governor Charlie Crist.

> >>

> >> Writing in support of clemency, leading academic pain specialist

> >> Portenoy, MD, said, " the information available indicates that any

> questionable

> >> actions [Paey] took, actions which led ultimately to his arrest, were

> driven

> >> by desperation related to uncontrolled pain. "

> >>

> >> He noted that such cases " may increase the reluctance of professionals to

> >> treat pain aggressively.

> >>

> >> Portenoy wrote that despite the fact that Paey required high doses of

> >> opioids, those doses were " clearly in the range used by pain specialists

> in this

> >> country. " He stressed that, " The number of pills or milligrams of an

> opioid

> >> required for analgesia says nothing about any of the negative outcomes

> associa

> >> ted with these drugs-including abuse, addiction and diversion-and

> reference to

> >> the amount of drug as evidence of these outcomes by regulators or law

> >> enforcement should not be condoned. "

> >>

> >> Unfortunately, across the country, pain patients are being undermedicated

> >> and doctors are going to prison because the Justice Department refuses to

> >> believe this.

> >>

> >> People profess to be experts about addiction because they have personal

> >> experience with drugs or addicts; they think they know about opioid drugs

> because

> >> they've watched a few episodes of E.R. or been through DARE classes at

> >> school. The truth is that opioids are amongst the safest drugs known to

> humanity--

> >> when given appropriately, they do not kill.

> >>

> >> Unlike aspirin, Tylenol, Vioxx, Celebrex, Advil, Alleve and every other

> >> known class of pain medications, opioids do not harm any organs and there

> is no

> >> maximum dose once a person has become tolerant to them. People need to

> educate

> >> themselves about the complexities of how drugs, brains and settings

> interact

> >> before making policies about them that send people like Paey to

> >> prison.

> >>

> >> Who is served by the incarceration of Paey? Certainly not his

> >> family, certainly not the taxpayers and absolutely not the image of

> America as a

> >> decent, humane country. Certainly not the interests of pain patients or

> even

> >> drug addicts-- neither of whom benefit from viewing drugs as a criminal

> justice

> >> issue. Not one child will be deterred from taking drugs, nor one mother

> >> saved the horror of an overdosed teen because we lock up those who need

> opioids

> >> to relieve their pain.

> >>

> >> Governor Crist, please, do the right thing and send Paey home.

> >>

> >

> > ************ ******** ******** *******

> > AOL now offers free email to everyone.

> > Find out more about what's free from AOL at http://www.aol.http

> >

March 23, 2007

" Palliative Care - On Our Own Terms " is a program everyone in healthcare,

especially physicians should go through. It teaches logical pain management

practices and takes the " spooks " out of getting patients pain free. Tolstoy

wrote a short story " Ivan Illiach " . It's about a Russian aristocrat who was

dying due to an injury and describe the ridiculous bureaucracy and inappropriate

physician " courtesy " provided to him in his dying hours. Written in 1908 -

nothing has changed.

-MH

________________________________

From: texasems-l [texasems-l ] On Behalf Of

wegandy1938@... [wegandy1938@...]

Sent: Friday, March 23, 2007 1:38 AM

To: ltorrey@...; Paramedicine

Cc: texasems-l

Subject: Re: Cruel and Disgusting: Pain Patient Appeal Denied

I posted it to bring it to the attention of the folks on the lists. I don't

vouch for the facts. I have no way of knowing them. I said that it should

cause us to take a deep breath and consider just how civilized we are because

I was accepting the article for what it stated.

I am always interested in whether or not the law is applied correctly, and

with justice. Law was not meant to be rigid, yet many people want it enforced

with rigidity. The DEA fosters a climate of rigid enforcement. There is no

place in its culture for sympathy, understanding, or flexibility.

The scenario bears scrutiny, I think. I am not impressed that two courts

upheld the result because the appeal courts only look at the issues on appeal,

which often have nothing to do with the merits of the case.

The two appeal courts did not review the facts in the case. They only

reviewed the process.

If a jury makes the wrong decision it will be upheld unless there was NO

evidence to support it.

The jury in the O.J. Simpson case obviously made the wrong decision, but for

the right reasons. They failed to find him guilty beyond a reasonable doubt

because the prosecution was so stupid.

The jury in this case may well have made the wrong decision for the right

reasons also. They may have found the technical requirements of the charge were

proved, and they listened to the judge and followed his instructions, and

found the defendant guilty. But the better question is what was the prosecution

thinking? Why did they prosecute this guy? Are they rigid automatons

without a shred of human compassion? We don't know, because we don't have all

the facts.

The greater question is what our government's role should be in regulating

the medical practice of physicians who are called upon to do pain management.

If we allow our government to impose rigid limits on the abilities of

physicians to practice medicine in the area of pain management, we are making a

terrible mistake. When doctors become bureaucrats, they give up their

independence, and they sign on to spout the party line in order to keep their

jobs.

There is no medical independence in government employees. Politicians generally