Wow. I just read an email about a story that I was vaguely aware of– about a doctor in Kansas and his wife, who were together linked to scores of overdose deaths. But that is just the beginning. The doctor was supported, during his trial, by Siobhan Reynolds, founder of a nonprofit advocacy group called ‘Pain Relief Network.’ She started the group back in 2003, when her ex-husband was suffering from severe pain from a congenital connective tissue disorder.
He (the ex-husband) found relief in combinations of high-dose opioids and benzodiazepines, at least until his doctor, Virginia pain specialist William Hurwitz, was convicted on 16 counts of drug trafficking. The ex died, by the way, in 2006. Are you still with me?
The trial of the Kansas doctor, Stephen Schneider, went on for years. During the trial, Ms. Reynolds apparently helped support what she considered to be a ‘dream team’ of attorneys. She used the case as an opportunity to increase her visibility, encouraging the Schneiders to aggressively fight the charges against them on the basis of ‘patient rights.’ Ms. Reynolds, through the Schneiders, argued that suffering patients are being denied appropriate care because of a war, waged by overly-aggressive prosecutors, against doctors who prescribe pain medication.
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Isn’t it possible, though, that suicidal people went to Dr. Schneider because he had a reputation for liberal prescribing – that is, that the overdoses compiled above were not accidental?
In one or two cases, perhaps– but I see many chronic pain patients, and true suicidality is not common. I realize that people are desperate, and write about suicidality- but intent is another thing.
One of the things that Ms. Reynolds was criticised for was a case where a person was close to suicide, and she told the person that ‘when he does it, he should make it count’– making it as high profile as possible. The person didn’t commit suicide, instead choosing to live (and to share the story).
Even if we were to assume they were suicides, a doctor is (rightly) held responsible if he/she places lethal meds into the hands of a suicidal patient. That is a consideration, for example, whenever a psychiatrist prescribes lithium or the older TCA’s– both are lethal in overdose, and so the standard of care is to be particularly careful about suicidal patients, when prescribing those medications. If one person died by suicide with meds that Dr. Schneider prescribed, he should have taken caution to prevent it from happening again… and again, and again.
J. Miller
4:18 am on
January 24th, 2012“In one or two cases, perhaps– but I see many chronic pain patients, and true suicidality is not common. I realize that people are desperate, and write about suicidality- but intent is another thing.”
Actually studies show that the suicide rate in chronic pain patients is 2 to 3 times the rate of the rest of the population.
Two or three times a low number is still a low number. You also have to look closely at the studies; trying to determine suicide rates among pain patients requires a number of baseline assumptions– you need the ‘denominator’ of the number of patients with pain disorders, then you need to define the numerator– i.e. determine which of the suicides are truly suicides, vs. accidental overdose deaths. The numbers used for the ‘studies’ vary widely, depending on what the person doing the study is trying to show…. and so it is not surprising that agencies that lobby for greater access to narcotics find high suicide rates in pain patients. The same cautions are necessary for interpreting ANY study— but particularly studies that rely on assumptions, as in this case.
Nomoremommyfood
12:26 pm on
January 28th, 2012I can’t help but wonder what was actually discussed in these appointments, as well as the short distance between final appointment and fatal overdose. Were these patients in chronic pain due to terminal illness, perhaps expected to die from their condition? I’m no conspiracy theorist, but such a staggering list of suicides seems to imply an active desire to end one’s life and, knowing physician-assisted suicide is illegal in this country (and controversial), may this doctor have consciously supported the patient’s “right to die”?
An interesting thought. Again though, it is hard to imagine that many people coalescing around one person, all with the intent to end their lives. Even Dr. Kevorkian only found a person every few months!
I see many people who talk about suicide. But the percentage of those people with actual intent is thankfully low. There is almost always an ambivalence surrounding suicide, even in people who are very depressed; those who successfully end their own lives often have an impulsive side to the decision, such as a surprising blow to their ego. It is hard to imagine so many people methodically going through actual suicides, unless they are brainwashed in some way (thinking of the Jonestown or Davidian mass suicides).
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