Do you believe a physician should be held to the highest standards of ethical behavior? If you do, consider the appropriate penalty for a doctor who is convicted of gross violation of the law and failure to maintain accepted standards of ethical practice. Imagine, if you will, how a doctor can knowingly and willingly contribute to the deaths of at least eleven people.
The Oath of Hippocrates
"The Oath of Hippocrates" holds the American Medical Association's Code of Medical Ethics. The Oath is perhaps the most widely known of Greek medical texts. In its classical, original form, it requires a new physician to swear upon a number of healing gods that he will uphold a number of professional ethical standards.
The Oath is also meant to strongly bind the medical student to his teacher and the greater community of physicians with responsibilities similar to that of a family member. In fact, the creation of the Oath may have marked the early stages of medical training to those outside the first families of Hippocratic medicine, the Asclepiads of Kos, by requiring strict loyalty.
Over the centuries, the Oath has been rewritten often to suit the values of different cultures influenced by Greek medicine.
The English translation from the Greek is attributed to Ludwig Edelstein in 1943.
Today, most graduating medical-school students swear to some form of the oath, usually a modernized version. Indeed, oath-taking in recent decades has risen to near uniformity, with just 24 percent of U.S. medical schools administering the oath in 1928 to nearly 100 percent today.
But, contrary to popular belief, the Hippocratic Oath is not required by most modern medical schools, although nearly all have adopted modern versions that suit many in the profession in the 21st century. To many, it remains in Western civilization as an expression of ideal conduct for the physician.
While the original, classical version of the Oath calls for "the opposite" of pleasure and fame for those who transgress the oath, fewer than half of oaths taken today insist the taker be held accountable for keeping the pledge.
So, now, some doctors see oath-taking as little more than a pro-forma ritual with little value beyond that of upholding tradition.
"The original oath is redolent of a covenant, a solemn and binding treaty," writes Dr. David Graham in JAMA, the Journal of the American Medical Association (December 13, 2000). "By contrast, many modern oaths have a bland, generalized air of 'best wishes' about them, being near-meaningless formalities devoid of any influence on how medicine is truly practiced."
Some physicians claim what they call the "Hippocratic Oath" should be radically modified or abandoned altogether. And, evidently, these days, more than a few doctors have no intention of upholding ethics in their practices.
(Peter Tyson, The Hippocratic Oath Today, NOVA, March 27 2001)
The Modern Version of the Hippocratic Oath
"I swear to fulfill, to the best of my ability and judgment, this covenant:
"I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.
"I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.
"I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.
"I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.
"I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.
"I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.
"I will prevent disease whenever I can, for prevention is preferable to cure.
"I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.
"If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help."
-Written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine
at Tufts University, and used in many medical schools today.
at Tufts University, and used in many medical schools today.
Dr. Anita T. Dawson
and a Damning Affidavit
According to a federal search warrant affidavit unsealed in April 2010, a Milton, West Virginia doctor, Anita T. Dawson, knowingly prescribed pills to patients whom she already knew to be abusing the medications.
The 23-page affidavit outlined Dr. Dawson's practice and linked her to various patients, including one that caused a triple-fatality vehicle crash and another who traded pills for sex with a local stripper. It quotes one inmate in an unidentified prison telling another that Dawson "would write her a prescription for whatever she wanted."
The affidavit stated: "Dr. Dawson's disregard or willful blindness to her patients' abuse or use of controlled substances for illegal purposes endangers her patients, as well as the general public who may suffer the consequences of her actions."
(Curtis Johnson, "Affidavit: Dawson Knew Patients Were Abusing Prescriptions,
The Herald-Dispatch, April 15 2010)
Federal, state and local authorities used the affidavit and its companion warrant April 7, 2010, to search Dawson's office in Milton. They confiscated lists of her current and former patients, along with cashier records, telephone messages, time sheets, two computers and boxes of shelf filings.
The search of her offices took place a day after a complaint was issued against Dawson by the West Virginia Board of Osteopathy.
That complaint claimed that she contributed
through her drug prescribing practices
to eight drug overdose deaths
and to a fatal accident that killed three people
over a period of nearly six years.
Dawson Is Charged and Pleads Guilty
On June 4, 2010, the 55 year old Dr. Dawson was charged in U.S. District Court with aiding and abetting prescription drug fraud. According to a press release from U.S. Attorney Booth Goodwin's office, she was charged by information, "which typically signals that a defendant has agreed to plead guilty and is cooperating with prosecutors."
In July 2010, Dawson pleaded guilty to aiding and abetting in obtaining controlled substances by misrepresentation, fraud, forgery, and subterfuge. During her plea hearing, Dawson admitted that from July 2006 until May 21, 2009, she wrote prescriptions for addictive pain medications to an individual identified as “E.B.”
Dawson said she wrote a total of nearly 6,000 pills containing oxycodone and a total of more than 220 pills for the painkiller Endocet to "E.B" during that time. Dawson further admitted that at the time she wrote the prescriptions for “E.B.,” she was aware that the patient was seeking pain medication for an addiction and other inappropriate reasons.
The West Virginia Board of Osteopathy suspended Dawson’s medical license in April 2010, the same day that federal and state investigators raided her Milton office. Dawson's attorney sent a letter to the in July offering to forfeit her license. Dawson then permanently gave up her license in September 2010.
The Fatalities of the Car Crash
On April 2, 2009, Erma Brown was driving a car that crossed the center line on Alternate Route 10 near Barboursville and hit the car the driven by 47-year-old Carole Crawford. Crawford, her daughter Meaghan, 16, and Kelsey Kuhn, 15, died in the crash after their car caught fire.
In February 2010, Brown pleaded guilty in Cabell County Circuit Court to three counts of DUI causing death. She was later sentenced to a maximum penalty of three, two to 10-year sentences for the deaths.
Dr. Dawson prescribed Clonazepam, which is used to control seizures and relieve panic attacks, and oxycodone to Erma Brown, according to court documents. It was determined Brown was under the influence of Clonazepam the morning of the deadly crash.
Brown told the court she was addicted to her prescribed medication and had been abusing them for a long time.
In separate lawsuits filed April 1, 2011 in Kanawha Circuit Court, the families of Carole Lynn Crawford and Meaghan McGuire Crawford and Kelsey Rebecca Kuhn sued Dr. Anita Dawson and alleged she had ignored signs that her patient Erma Marie Brown was dangerously addicted to prescription narcotics.
In painstaking detail, the lawsuits describe prescription after prescription written by Dawson for Brown, who had been involuntarily committed to a psychiatric facility in 2004 with a diagnosis that included opiate abuse. Dawson knew about Brown's history with drug abuse after she began treating her in July 2005, according to the lawsuits.
(Andrew Clevenger, "Families of Crash Victims Sue Driver's Doctor,
The Charleston Gazette, April 5 2011)
Over the years, Dawson had multiple indications that Brown was abusing pills, including repeated excuses when Brown ran through her prescribed doses ahead of schedule, multiple emergency-room visits for pain issues and prescriptions issued by other doctors, the lawsuits maintain. Sometimes Brown used her middle name and obtained prescriptions under "Marie Brown," including prescriptions issued by Dawson, the suits allege.
"Dawson substantially encouraged and assisted Brown's drug addiction and impairment by continuing to prescribe drugs to her and it was reasonably foreseeable to Dawson that her patient, Brown, would operate a vehicle while under the influence of prescribed controlled prescription drugs," states the lawsuit filed by Charleston lawyer Brent Kesner on behalf of Stephanie Call, Kuhn's mother.
The other lawsuit, filed by Huntington lawyer Chad Lovejoy on behalf of Jeff Crawford, Carole's husband and Meaghan's father, similarly accuses Dawson of gross negligence.
"During her course of treatment, Dawson exhibited poor record keeping and treatment processes, failed to use preventative care measures and screening tools, exhibited poor charting of patient status, kept incomplete progress notes and failed to follow-up with reported problems, provided patients, including Brown, with escalating doses of narcotics and/or benzodiazepines without sufficient indications or documentation in her charts, ignored repeated signs of drug-seeking behavior, and failed to take reasonable precautions to detect and prevent substance abuse by her patients," the Crawfords' suit states.
Both lawsuits seek unspecified compensatory and punitive damages.
Other Evidence Long Before the Fatal Accident
The Board of Osteopathy's executive director, Diana Shepard, affirmed it wasn't the complaint arising from the fatal 2009 crash that first drew attention to Dawson.
"Our investigation began with the follow-up of an initial complaint in 2006," Shepard said. "It was made by a family member of a patient who died."
Like the others named in the complaint against Dawson, the patient was taking several prescription medications and abusing other drugs and alcohol.
"We began to look at pharmacy profiles,
death records of patients who were expiring," said Shepard.
"And we found a connection with her patients."
Then, when the accident occurred and her guilty plea came up in February, the driver's name was in that mix of profiles," she said. "And we saw Dr. Dawson as the treating physician."
The board then decided to take steps.
"We put things together and decided to take action," Shepard said. "For the protection of the public, we decided to suspend her license immediately so this can be resolved as soon as possible."
In its complaint against Dawson, the board called the doctor's practices "professional negligence, gross malpractice and a willful departure from accepted standards of professional conduct."
(Cheryl Caswell, "Doctor Under Scrutiny for Years,"
The Charleston Daily Mail, April 9 2010)
Many wonder why wasn't something done sooner to save lives. Director Shepherd says these type of medical probes take time -- time that may soon be shortened with more public and government awareness.
"Our hopes are that there may be some legislative changes to make these investigations a little more open," Shepherd said. "Creating better resources for us to use."
Dawson evidently had some very happy patients during her criminal enterprises."Some of them paid her bills," Jimmy Smith of Milton said, referring to Dr. Dawson's patients. "They brought her cakes, pies, eggs..."
"I've always heard that she's a wonderful person," Sue Benedict of Milton told WSAZ.com.
Jim of Jim's Car Wash and Sue of Ladies Plus Consignment shop are two of Dr. Dawson's neighbors. Both say the doctor office stayed open late -- sometimes until 3 a.m. -- but they both hedge on placing blame.
And, Now For the Classic Scapegoating:
"Yes, she did write the prescriptions and stuff,
but the patients are the ones
who abused them," Sue Benedict said.
"That's on her defense."
"She helped her patients;
she was there;
she was there all hours," Jim explained.
(WSAZ TV Update, April 8 2010)
The Problem of Improper Prescribing Is Increasing
Shepard said the problem of physicians improperly prescribing medications is increasing and obtaining evidence of improper practice isn't easy.
"The problem is if a patient is receiving what they want, they aren't going to complain about it," she said. "We rely on the public at large and other health facilities to provide information."
"Is it unusual? No," she said of a medical license suspension for prescription abuse. "Is it something we do on a regular basis? Yes."
Dr. Wayne Coombs, research director for the West Virginia Prevention Resource Center, said the problem is a complicated one and physicians can't be the only targets of scrutiny.
"There are people who have legitimate needs for pain medication," Coombs said. "It's more complicated than it seems. But it takes that kind of investigation to get a handle on it."
WVPRC has studied national surveys, trends and statistics, he said, and the numbers for West Virginia are concerning. "The vast majority of unintentional overdose deaths in West Virginia from prescription drugs usually come about because of mixing with other drugs and alcohol," Coombs said. "And the number rose drastically from 1999 to 2006 - by about 550 percent.
"West Virginia leads the nation in over 18 prescriptions per person per year," Coombs said. "The national average is 12.
"And we looked at how people are getting prescription drugs," he said. "About two thirds are getting them from family and friends. The major problem is that most of it doesn't come from doctor shopping or illegal sales."
(Cheryl Caswell, "Doctor Under Scrutiny for Years,"
The Charleston Daily Mail, April 9 2010)
"Don't suspend them. Take them. And don't bring them back," she said of licenses held by what she calls "scrip docs."
"These doctors are using this
as a money-making machine," Crouch said.
"It's a profit motive, plain and simple.
You can't stop the problem by shutting down the scrip docs,
but you can hold them liable, and have an impact."
"We're hunting elephants with a squirt gun," she said. "But we keep hunting."
Crouch said her patients didn't choose to become addicts.
"Nobody signs up for it. Nobody," she said. "Most people start as kids and don't know they picked up a loaded revolver. Or they were prescribed by a doctor and got hooked. They don't know they are playing with fire until they get burned."
Crouch believes physicians are "under the gun" because they are afraid to treat chronic, acute pain and because somebody could come hunt them.
"How do you take care of patients and dance with this monster?" she said.
(Cheryl Caswell, "Doctor Under Scrutiny for Years,"
The Charleston Daily Mail, April 9 2010)
Dawson Is "Sentenced"
Before Dawson's sentencing in January of 2013, family members of the three victims killed in that 2009 automobile accident spoke to the court in the hopes of a strong sentence for Dawson.
Dawson also spoke to family members in court. She said, "I'm so sorry. I didn't intend to hurt anyone. I've read your statements (provided to the judge) and they will remain a part of my life forever."
Dr. Anita Dawson was sentenced
to two years in prison on January 7, 2013,
during a hearing in U.S. District Court in Huntington.
In handing out the sentence, U.S District Judge Robert C. Chambers said this type of responsibility by doctors is no different than what is seen on the streets.
"Doctors are doing nothing different
than the drug dealers from Detroit on the streets
and if we're going to deal with this horrible problem,
doctors have to be held responsible," Judge Chambers said.
Can you believe that the the two-year sentence is four times the maximum recommended by federal guideline which called for a sentence of zero to six months, according to federal prosecutors?
And, oh yes, in addition to her two-year sentence, Dawson also will serve a one-year term of supervised release.
(WSAZ TV, "Former Milton Doctor Sentenced to Two Years in Prison, Huntington News Update, January 7 2013)
"Something is better than nothing."??
Those words were spoken by Jeff Crawford, a local radio personality and the station manager at The Dawg, 93.7-FM., in response to a two-year prison sentence given to Dr. Dawson. The crash killed Crawford's wife, Carole, his 16-year-old daughter, Meaghan, and her 15-year-old classmate Kelsey Kuhn on April 2, 2009
Crawford said the only thing he can ask is that his wife and daughter not be killed in vain.
The Final "Pain" Prescription
A defendant's sentencing memorandum
filed on Dawson's behalf last month in U.S. District Court
requested a sentence of probation for Dawson,
because imprisonment will affect her ability
to care for her husband and other family members.
Her husband is bound to a wheelchair
after a car accident years ago.
The memorandum said Dawson persevered in her medical career while caring for him and other family members and "chose to practice in medically underserved areas of West Virginia, first in West Hamlin and then in Milton.
"Unfortunately, as the prescription pill scourge ravaged West Virginia, Mrs. Dawson failed to act as aggressively and assertively with her patients to not aid and abet in their drug abusing behavior," the memorandum said.
The document said the loss of her medical license has left 56-year-old Dawson without means to support herself, and so she and her husband have been living with family members and have been treated for depression.
(Jean Tarbett Hardiman, "Dawson Sentence in Pill Case,
The Herald-Dispatch, January 7 2013)
Two years in prison as punishment in eleven deaths. That equates to about two months per death. Is this justice? Justice for the mass devastation she caused?
Dr. Anita T. Dawson was a physician who was entrusted with the lives of hundreds, if not thousands, of patients? If the entire truth be known, Dr. Anita T. Dawson likely killed and injured many more than eleven of her patients, their families and their friends as she illegally prescribed prescription drugs. She is a criminal of the worst kind -- a professional without a conscience who used and abused people to line her pockets.
Dawson was an evil, greedy drug dealer at one of the highest echolons of the drug abuse epidemic that is currently sweeping our nation. She was a physician who once swore to the Oath of Hippocrates and later made the conscious decision to break her sacred promise when she succumbed to the "twin traps of overtreatment and therapeutic nihilism." She became a monster.
Did Carole Crawford receive justice? Did Meaghan Crawford receive justice? Did Kelsy Kuhn receive justice? Can Jeff Crawford really believe that the meager sentence is "better than nothing"? I think this sentence is a travesty of justice as it pertains to criminal physicians.
I am angry and deeply disappointed that our legal system claims the two-year sentence is "four times the maximum recommended by federal guidelines." I have fought the battle against pill mills, corrupt physicians, and drug abuse for many years now. I do not plan to stop until major reforms are made. I feel so sorry for victims of abuse lying in the killing fields cultivated by the powers that be.
I can see no reason for these "smacks on the wrist" when harsh punishment is in order. We must change our court system and its ridiculous carriage of "justice." I sincerely believe Big Pharma, Big Government, Big Money, Big Medicine, and Big Prejudice collude to make Aldous Huxley's prophetic vision of a Brave New World a lingering reality.
''Hug me till you drug me, honey;
Kiss me till I'm in a coma;
Hug me, honey, snuggly bunny;
Love's as good as soma."
Kiss me till I'm in a coma;
Hug me, honey, snuggly bunny;
Love's as good as soma."
- Aldous Huxley
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