Murder charge in painkiller case an injustice

The recent arrest on murder charges of Dr. Richard Teh, a Las Vegas internal medicine practitioner, raises some significant questions about the lengths to which investigators and prosecutors will go in the war on drug users and whether they are in the best interest of justice or pain sufferers.

As in most states, Nevada statutes define murder as "the unlawful killing of a human being: With malice aforethought." But in an effort to target dealers who sell lethal concoctions of street drugs, Nevada classifies it as murder "if the death of a person is proximately caused by a controlled substance which was sold, given, traded or otherwise made available to him or her by another person."

To apply this statute against a licensed physician is a stretch beyond any reasonable rationalization.

A Drug Enforcement Administration task force arrested Dr. Teh, 49, on March 8 for prescribing pain medication that authorities say caused the death of a 39-year-old female patient. Mace Yampolsky, Dr. Teh's attorney, was flabbergasted by the charge, saying his client clearly never intended to harm a patient by prescribing pain medication. "There was no malice, no intent to kill," he said. "If he's prosecuted for murder, does this mean that every doctor that prescribes medication is potentially going to be charged with murder?"

That is precisely what some leaders in the medical community fear.

Dr. Mitchell Forman, president of the Clark County Medical Society, wrote in the society's bulletin: "I predict that many more patients in chronic pain will not be treated."

Sunday's Review-Journal account of Dr. Teh's arrest, written by Paul Harasim and Mike Blasky, noted Clark County prosecutor David Stanton wouldn't comment on the case because it is in its early stages. But if District Attorney David Roger has any common sense and common decency he will pore over the case documentation for flagrant disregard for prudent medical care, and, if none is found, toss out the murder charges as an affront to any semblance of justice.

Other doctors might have disagreed with Dr. Teh's decision to prescribe painkillers to the patient in question, but palliative care is an often subjective field where patient outcomes can vary wildly. Accidents happen. Patients fail to obey ibstructions. Sometimes, they even lie.

There are avenues for addressing doctor failures, through malpractice litigation in the civil courts and through license review by the State Board of Medical Examiners.

When the Nevada statute in question was amended in 1985, one senator went out of his way to observe it did not apply to doctors. "It's predicated, of course, upon the sale of a controlled substance in violation of the chapter, which means it's not a lawful sale by a physician. ... It's unlawful."

Dr. Teh is free on $50,000 bail. A preliminary hearing is set for May 18. Tellingly, the medical board has taken no action against the doctor's license.