6 ms·

That just means we should treat low level criminals humanely. Four years is plenty. The thing where decade plus sentences are fairly common is unique in the fi

That just means we should treat low level criminals humanely. Four years is plenty. The thing where decade plus sentences are fairly common is unique in the first world: only in America. It’s barbaric and embarrassing. The science is pretty unambiguous—a high likelihood of being caught and punished is a better deterrent than a low-probability but larger punishment. So I don’t want to see this doctor get a 40-year sentence. I’d rather see lots of doctors who accepted gifts from opioid manufacturers get one-year sentences. Most important is that the pharma executives go to jail, too. Criminal justice should never be about retribution. In this case, the purpose is to keep future patients safe.

koolba 9y ago
It’s really not. Four years is hardly a deterrent. It’s barely a slap on the wrist considering the number of lives destroyed by that plague. What’s makes this particularly heinous is the trust we place as a society in medical providers. The vast majority of people will take whatever medicine a doctor prescribes. No questions asked. Abusing that position of power is sickening.
- rhizome 9y ago
  Four years is hardly a deterrent What do you know? Do tell.
  - CamperBob2 9y ago
    Honestly, if you could make $10M as a mid-level distributor, squirrel most of it away tax-free, with the downside risk being only four years in the pen, that would be a massive rational win for most people. Of course, the only reason you can make millions of dollars illegally at this racket is because it's illegal in the first place, so never mind. Drug laws cause far more harm to society than the drugs themselves ever could. Any argument to the contrary can trivially be resolved to a special-pleading fallacy.
    - maxerickson 9y ago
      There's a famous paper about drug gang economics: http://pricetheory.uchicago.edu/levitt/Papers/LevittVenkateshAnEconomicAnalysis2000.pdf http://pricetheory.uchicago.edu/levitt/Papers/LevittVenkates... It suggests that $10 million of profit would be quite the success.
    - csallen 9y ago
      For reference, the doctor in the story "pleaded guilty to taking more than $188,000 in kickbacks disguised as speaker fees." As a result, he "lost his medical license and was ousted from his post as a Brown University professor, … the judge sentenced him to 51 months and ordered restitution of $754,000," and I'm sure he's gotten a heap of public shame and humiliation. Is it possible he has enough cash hidden away to make this all worthwhile? Yes, but I'd bet against it.
  - paulcole 9y ago
    Couldn’t the same be said of, “Four years is plenty.”? 2 different opinions, neither sourced nor backed by data.
- csallen 9y ago
  > Four years is hardly a deterrent. It’s barely a slap on the wrist considering the number of lives destroyed by that plague. This is the exact kind of emotional thinking that makes it so easy to jack up sentencing to an unreasonable degree. It's why we spent so many millennia of human history insensitive to the torture and abuse of our fellow man so long as he could be labeled a criminal. First, you're comparing a single doctor's sentence to the entirety of the misery caused by a crisis caused by many, many people and systems. Second, what makes you think four years isn't a deterrent? Maybe it is, maybe it isn't, but we should be using evidence to decide that, not knee-jerk emotional reactions.
  - loufe 9y ago
    I have to agree. It's not "a slap on the wrist" at all. A criminal record is a massive hurdle to overcome in finding work or keeping standing with any professional association. Not to mention the damage to reputation, personal relationships, finances, and family dependencies. Purely emotional thinking does not help the problem.
  - KMag 9y ago
    This. Deterrent effectiveness is quantifiable and repeated psychological studies show that increasing the expected chance of getting caught is a much higher deterrent value than increasing the expected number of years behind bars. One's subjective feeling of deterrence is strongly influenced by one's natural subconscious desire for mob revenge. Cultural change away from mob revenge starts with changing the dialogue. The cost to society is roughly linear in the number of years behind bars, and the deterrent factor gets dramatically sub-linear pretty quickly as number of years behind bars increases. That money spent on guards, etc. and opportunity cost (including lost taxable income) of having a potentially productive member of society behind bars are better spent on better monitoring and other measures that increase the likelihood that offenders are prosecuted. Increasing publicity of convictions would presumably also be a pretty cheap way to reduce crime by increasing the perceived chances of getting caught. I would really like to see it be a common thing for criminals to cut plea deals including recording public service announcements publicizing that they got caught. Though, this would also probably make it harder for reformed ex-convicts to escape their pasts.
- tinokid 9y ago
  This is absolutely correct and should not have been downvoted. It is the abuse of a position of trust that aggravates this crime relative to that of a simple outlaw street dealer. Commenters who are concerned with the effect on the convict's reputation and future employability are simply not in touch with reality....this was a grave breach of the basic ethics of the medical profession and seriously harmed the innocent patients involved. There is no return to work after something like this...any more than with a scientist who falsifies data, a teacher who sleeps with minor students, a lawyer who steals from escrow, etc. I find it highly disturbing that there is more discussion in this thread as to the effect on the doctor's return on investment from his medical degree rather than on the individuals who bodies were damaged by someone they were supposed to be able to trust.
  - csallen 9y ago
    Nobody is "concerned" about the convict's reputation and future employability. You are misreading people's statements and thus misunderstanding their points. Namely, that the justice system serves a greater purpose than simply making you and me feel better and causing harm to perpetrators. What point is there in discussing the so-obvious-it-goes-without-saying good-bad polarity of this situation? If we myopically give in to our emotions, rather than dispassionately examine the best course of action, then we'll miss an opportunity to improve the system and deter future incidents. Stated another way, by attempting to redirect the course of this conversation, you are saying that virtue signaling by pitying current victims and demonizing the perp is more important than preventing future victims. If anything is highly disturbing, it's that.
    - deleted 9y ago
      [deleted]
    - tinokid 9y ago
      You're missing the point because you don't understand the gravity of the crime. A minimum wage fast food worker is constantly observed by a phalanx of cameras that will incriminate her should she attempt to steal five dollars from the till, but a surgeon in an operating room performs an infinitely more consequential task with nary a recording device in sight. Why? The immense trust and responsibility invested by society in medical doctors. There is a common misconception that a medical license is basically just a reward for a demonstration of technical mastery, much as a developer job flows from passing a coding interview. But in reality the technical aspect is only secondary; the primary purpose of all those years of training is to ensure that the student understands the fullness of the obligations associated with the profession and is properly disposed to accept them. In a case like this, the person understood and accepted those grave obligations, as well as all the privileges that came with them, only to toss them out the window when the opportunity arose to make a few extra dollars. That is what is being punished here. Four years is hardly too long, or cruelly retributive.
j_jochem 9y ago
> That just means we should treat low level criminals humanely. Four years is plenty. And the street dealers’ customers know full well that they’re buying a very addictive substance which is not medically indicated.
- andybak 9y ago
  > And the street dealers’ customers know full well that they’re buying a very addictive substance You're forgetting the large number of non-addictive substances that carry long sentences.
  - j_jochem 9y ago
    I was thinking of dealers selling heroin in particular, since that feels like the appropriate thing to compare fentanyl-pushing MDs to, but in a broader sense, your point is if course correct.
    - jjeaff 9y ago
      Ironically, fentanyl is more dangerous than heroin and a large amount of heroin overdose have supposedly been because fentanyl was mixed in with the heroin unbeknownst to the user.
      - skellera 9y ago
        It’s more dangerous because you don’t know how much you’re getting on the streets. In a prescription, it’s a regulated medicine that is exactly the amount the label says. I’m not defending the doctor but the point being made doesn’t apply.
      - stordoff 9y ago
        It's more dangerous in street drugs because it is potent at extremely low doses, so poorly mixed drugs can contain fatal doses very easily. In a controlled setting, where the dose is precisely known, that is not an issue. I did some reading of fentanyl vs. morphine a while ago, and found that fentanyl is often preferred for acute pain due to faster onset, shorter duration (which may make controlling adverse reactions/overdoses easier), fewer side-effects and less histamine release. Specifically: > When adverse event rates were counted across both the out-of-hospital and ED phases, morphine's and fentanyl's safety levels were extremely close, erasing even the suggestion of a trend toward safety in one drug or the other. Our data do not suggest that further work should be done to try to determine which drug is safer: The low absolute rates and small difference between the two drugs make it unlikely that this difference would become either clinically or statistically significant, even with a larger sample size. I don't believe the notion that fentanyl is per se more dangerous, rather than being dangerous when misused/poorly handled, is supported. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2924527/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2924527/
owly 9y ago
The deterrent and long term way to keep patients safe is not just the 4 years in prison, it is losing his medical license in perpetuity throughout the USA. Not sure if his sentence includes this but it should be in public records. My PCP in MA was busted for a different charge and lost his ability to practice medicine FOREVER throughout the USA. Way to throw all those years of med school in the dustbin!
- esturk 9y ago
  He did lose his medical license but he's also 63. After he's out, he's most likely going to retire.
  - dmoy 9y ago
    If he saved enough, ha. You'd be surprised at how many doctors making $300k+/yr have less than a couple years' worth of expenses saved up :/
    - ekianjo 9y ago
      any source for that claim?
      - dmoy 9y ago
        Alan Reynolds' book "Income and Wealth". I mean doctors in particular, but other high income earners in professional areas as well.
        overcast 9y ago
        Football players for one.
        KMag 9y ago
        Don't forget parachute pants enthusiasts. https://en.wikipedia.org/wiki/MC_Hammer#Bankruptcy,_lawsuits_and_media_reaction https://en.wikipedia.org/wiki/MC_Hammer#Bankruptcy,_lawsuits...
namelost 9y ago
Street dealers, "low level" or not, do actually kill their clients. Prison sentences for dealing hard drugs should be in line with prison sentences for murder, otherwise the implication is that the lives of drug users are much less valuable than the lives of regular people.
- mattnewton 9y ago
  Manslaughter is different from murder.. selling someone something that they use to kill themselves, is different from selling something stronger than they anticipated, is also different from pulling the trigger yourself. Intent matters in the eye of the law.
- throwaway2048 9y ago
  and so do doctors prescribing unnessisary opiates.
- dragonwriter 9y ago
  > Street dealers, "low level" or not, do actually kill their clients. In much the same sense as people who sell cigarettes do; perhaps we should, therefore, have life without parole for convenience store clerks.
- ajmurmann 9y ago
  If I buy drugs from a street dealer I know what I'm getting into. If I get prescribed opioids from a supposedly trained professional whom I'm supposed to be able to trust I don't. So as far as I'm concerned adults should be allowed to take whatever drugs they want. However, it should be illegal to bullshit them into taking them. Especially as a medical professional.
  - freedomben 9y ago
    Don't worry, we've so over-corrected this thing as a society due to our knee-jerk emotional reactions and mob mentality, you won't be getting any opioids prescribed. Fourth stage cancer patients are now having a hard time getting them. Chronic pain patients that have been stable for decades are being heartlessly dropped by doctors that now fear the DEA. We are turning our backs as a society on the most vulnerable among us.

koolba 9y ago

It’s really not. Four years is hardly a deterrent. It’s barely a slap on the wrist considering the number of lives destroyed by that plague. What’s makes this particularly heinous is the trust we place as a society in medical providers. The vast majority of people will take whatever medicine a doctor prescribes. No questions asked. Abusing that position of power is sickening.

rhizome 9y ago
Four years is hardly a deterrent What do you know? Do tell.
- CamperBob2 9y ago
  Honestly, if you could make $10M as a mid-level distributor, squirrel most of it away tax-free, with the downside risk being only four years in the pen, that would be a massive rational win for most people. Of course, the only reason you can make millions of dollars illegally at this racket is because it's illegal in the first place, so never mind. Drug laws cause far more harm to society than the drugs themselves ever could. Any argument to the contrary can trivially be resolved to a special-pleading fallacy.
  - maxerickson 9y ago
    There's a famous paper about drug gang economics: http://pricetheory.uchicago.edu/levitt/Papers/LevittVenkateshAnEconomicAnalysis2000.pdf http://pricetheory.uchicago.edu/levitt/Papers/LevittVenkates... It suggests that $10 million of profit would be quite the success.
  - csallen 9y ago
    For reference, the doctor in the story "pleaded guilty to taking more than $188,000 in kickbacks disguised as speaker fees." As a result, he "lost his medical license and was ousted from his post as a Brown University professor, … the judge sentenced him to 51 months and ordered restitution of $754,000," and I'm sure he's gotten a heap of public shame and humiliation. Is it possible he has enough cash hidden away to make this all worthwhile? Yes, but I'd bet against it.
- paulcole 9y ago
  Couldn’t the same be said of, “Four years is plenty.”? 2 different opinions, neither sourced nor backed by data.
csallen 9y ago
> Four years is hardly a deterrent. It’s barely a slap on the wrist considering the number of lives destroyed by that plague. This is the exact kind of emotional thinking that makes it so easy to jack up sentencing to an unreasonable degree. It's why we spent so many millennia of human history insensitive to the torture and abuse of our fellow man so long as he could be labeled a criminal. First, you're comparing a single doctor's sentence to the entirety of the misery caused by a crisis caused by many, many people and systems. Second, what makes you think four years isn't a deterrent? Maybe it is, maybe it isn't, but we should be using evidence to decide that, not knee-jerk emotional reactions.
- loufe 9y ago
  I have to agree. It's not "a slap on the wrist" at all. A criminal record is a massive hurdle to overcome in finding work or keeping standing with any professional association. Not to mention the damage to reputation, personal relationships, finances, and family dependencies. Purely emotional thinking does not help the problem.
- KMag 9y ago
  This. Deterrent effectiveness is quantifiable and repeated psychological studies show that increasing the expected chance of getting caught is a much higher deterrent value than increasing the expected number of years behind bars. One's subjective feeling of deterrence is strongly influenced by one's natural subconscious desire for mob revenge. Cultural change away from mob revenge starts with changing the dialogue. The cost to society is roughly linear in the number of years behind bars, and the deterrent factor gets dramatically sub-linear pretty quickly as number of years behind bars increases. That money spent on guards, etc. and opportunity cost (including lost taxable income) of having a potentially productive member of society behind bars are better spent on better monitoring and other measures that increase the likelihood that offenders are prosecuted. Increasing publicity of convictions would presumably also be a pretty cheap way to reduce crime by increasing the perceived chances of getting caught. I would really like to see it be a common thing for criminals to cut plea deals including recording public service announcements publicizing that they got caught. Though, this would also probably make it harder for reformed ex-convicts to escape their pasts.
tinokid 9y ago
This is absolutely correct and should not have been downvoted. It is the abuse of a position of trust that aggravates this crime relative to that of a simple outlaw street dealer. Commenters who are concerned with the effect on the convict's reputation and future employability are simply not in touch with reality....this was a grave breach of the basic ethics of the medical profession and seriously harmed the innocent patients involved. There is no return to work after something like this...any more than with a scientist who falsifies data, a teacher who sleeps with minor students, a lawyer who steals from escrow, etc. I find it highly disturbing that there is more discussion in this thread as to the effect on the doctor's return on investment from his medical degree rather than on the individuals who bodies were damaged by someone they were supposed to be able to trust.
- csallen 9y ago
  Nobody is "concerned" about the convict's reputation and future employability. You are misreading people's statements and thus misunderstanding their points. Namely, that the justice system serves a greater purpose than simply making you and me feel better and causing harm to perpetrators. What point is there in discussing the so-obvious-it-goes-without-saying good-bad polarity of this situation? If we myopically give in to our emotions, rather than dispassionately examine the best course of action, then we'll miss an opportunity to improve the system and deter future incidents. Stated another way, by attempting to redirect the course of this conversation, you are saying that virtue signaling by pitying current victims and demonizing the perp is more important than preventing future victims. If anything is highly disturbing, it's that.
  - deleted 9y ago
    [deleted]
  - tinokid 9y ago
    You're missing the point because you don't understand the gravity of the crime. A minimum wage fast food worker is constantly observed by a phalanx of cameras that will incriminate her should she attempt to steal five dollars from the till, but a surgeon in an operating room performs an infinitely more consequential task with nary a recording device in sight. Why? The immense trust and responsibility invested by society in medical doctors. There is a common misconception that a medical license is basically just a reward for a demonstration of technical mastery, much as a developer job flows from passing a coding interview. But in reality the technical aspect is only secondary; the primary purpose of all those years of training is to ensure that the student understands the fullness of the obligations associated with the profession and is properly disposed to accept them. In a case like this, the person understood and accepted those grave obligations, as well as all the privileges that came with them, only to toss them out the window when the opportunity arose to make a few extra dollars. That is what is being punished here. Four years is hardly too long, or cruelly retributive.

j_jochem 9y ago

> That just means we should treat low level criminals humanely. Four years is plenty. And the street dealers’ customers know full well that they’re buying a very addictive substance which is not medically indicated.

andybak 9y ago
> And the street dealers’ customers know full well that they’re buying a very addictive substance You're forgetting the large number of non-addictive substances that carry long sentences.
- j_jochem 9y ago
  I was thinking of dealers selling heroin in particular, since that feels like the appropriate thing to compare fentanyl-pushing MDs to, but in a broader sense, your point is if course correct.
  - jjeaff 9y ago
    Ironically, fentanyl is more dangerous than heroin and a large amount of heroin overdose have supposedly been because fentanyl was mixed in with the heroin unbeknownst to the user.
    - skellera 9y ago
      It’s more dangerous because you don’t know how much you’re getting on the streets. In a prescription, it’s a regulated medicine that is exactly the amount the label says. I’m not defending the doctor but the point being made doesn’t apply.
    - stordoff 9y ago
      It's more dangerous in street drugs because it is potent at extremely low doses, so poorly mixed drugs can contain fatal doses very easily. In a controlled setting, where the dose is precisely known, that is not an issue. I did some reading of fentanyl vs. morphine a while ago, and found that fentanyl is often preferred for acute pain due to faster onset, shorter duration (which may make controlling adverse reactions/overdoses easier), fewer side-effects and less histamine release. Specifically: > When adverse event rates were counted across both the out-of-hospital and ED phases, morphine's and fentanyl's safety levels were extremely close, erasing even the suggestion of a trend toward safety in one drug or the other. Our data do not suggest that further work should be done to try to determine which drug is safer: The low absolute rates and small difference between the two drugs make it unlikely that this difference would become either clinically or statistically significant, even with a larger sample size. I don't believe the notion that fentanyl is per se more dangerous, rather than being dangerous when misused/poorly handled, is supported. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2924527/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2924527/

owly 9y ago

The deterrent and long term way to keep patients safe is not just the 4 years in prison, it is losing his medical license in perpetuity throughout the USA. Not sure if his sentence includes this but it should be in public records. My PCP in MA was busted for a different charge and lost his ability to practice medicine FOREVER throughout the USA. Way to throw all those years of med school in the dustbin!

esturk 9y ago
He did lose his medical license but he's also 63. After he's out, he's most likely going to retire.
- dmoy 9y ago
  If he saved enough, ha. You'd be surprised at how many doctors making $300k+/yr have less than a couple years' worth of expenses saved up :/
  - ekianjo 9y ago
    any source for that claim?
    - dmoy 9y ago
      Alan Reynolds' book "Income and Wealth". I mean doctors in particular, but other high income earners in professional areas as well.
      - overcast 9y ago
        Football players for one.
        KMag 9y ago
        Don't forget parachute pants enthusiasts. https://en.wikipedia.org/wiki/MC_Hammer#Bankruptcy,_lawsuits_and_media_reaction https://en.wikipedia.org/wiki/MC_Hammer#Bankruptcy,_lawsuits...

namelost 9y ago

Street dealers, "low level" or not, do actually kill their clients. Prison sentences for dealing hard drugs should be in line with prison sentences for murder, otherwise the implication is that the lives of drug users are much less valuable than the lives of regular people.

mattnewton 9y ago
Manslaughter is different from murder.. selling someone something that they use to kill themselves, is different from selling something stronger than they anticipated, is also different from pulling the trigger yourself. Intent matters in the eye of the law.
throwaway2048 9y ago
and so do doctors prescribing unnessisary opiates.
dragonwriter 9y ago
> Street dealers, "low level" or not, do actually kill their clients. In much the same sense as people who sell cigarettes do; perhaps we should, therefore, have life without parole for convenience store clerks.
ajmurmann 9y ago
If I buy drugs from a street dealer I know what I'm getting into. If I get prescribed opioids from a supposedly trained professional whom I'm supposed to be able to trust I don't. So as far as I'm concerned adults should be allowed to take whatever drugs they want. However, it should be illegal to bullshit them into taking them. Especially as a medical professional.
- freedomben 9y ago
  Don't worry, we've so over-corrected this thing as a society due to our knee-jerk emotional reactions and mob mentality, you won't be getting any opioids prescribed. Fourth stage cancer patients are now having a hard time getting them. Chronic pain patients that have been stable for decades are being heartlessly dropped by doctors that now fear the DEA. We are turning our backs as a society on the most vulnerable among us.