A physician’s legal ability to prescribe drugs does not afford them special immunity from criminal drug charges. The U.S. Supreme Court is reviewing the appeal of an Alabama physician who was convicted in a federal court for prescribing controlled substances outside the usual course of professional practice. He claimed that he believed or subjectively intended that the prescriptions fall within the course of his professional practice.
Good faith defense
This doctor and his partner prescribed large amounts of oxycodone, morphine, and fentanyl to their patients between Jan. 2011 and May 2015. They made over $3.7 million from their medical clinic and over $550,000 from prescription service fees from an affiliated pharmacy they ran.
The federal government claimed that they were operating a pill mill, investigated their practices and obtained a grand jury indictment. The doctors were later convicted of multiple controlled substances and other charges.
In his criminal defense, the physician proposed a jury instruction that good faith means good intentions and the honest exercise of professional judgment to a patient’s needs. This means that the physician acted in accordance with his belief of proper medical practice.
The judge rejected this instruction because it found that the term good faith was subjective and the standard should be objective. Instead, the court instructed the jury that the doctor violated federal drug laws if the government proves beyond a reasonable doubt that his actions were not for a legitimate medical purpose or outside the usual course of professional medical practice.
This doctor and his partner appealed. The 11th Circuit Court of Appeals affirmed their convictions and the judges’ jury instruction. It ruled that a physician may claim good faith only if his conduct is in accordance with medical practice standards that are recognized and accepted in this county.
Federal courts divided
According to the doctor’s argument, federal circuit courts have taken three different approaches to this good faith issue. The Second, Fourth and Sixth Circuits require that prosecutors prove that the doctor did not believe that their prescriptions fell within professional norms.
The First, Seventh and Ninth Circuits also have a higher burden. Prosecutors overcome a good faith defense when they prove the doctor subjectively intended a prescription to exceed professional norms.
The defense claims that these good faith defenses are unavailable in the 11th Circuit which has jurisdiction over Alabama. Prosecutors must prove only that the doctor’s prescription did not fall within accepted medical standards. This, according to the doctor, violates the principle that a criminal injury must be intentionally inflicted.
Federal prosecutions may be complicated and intimidating. Attorneys can help assure that you rights are protected.