Supreme Court raises bar for criminal conviction of unreasonable prescriptions

Following the consequences of the opioid epidemic, people have been looking for people and companies to blame. The pharmaceutical companies that manufactured and marketed the opioids have been involved in the highest profile cases. However, the Department of Justice (DOJ) has also been going after doctors who wrote many prescriptions. Kaiser Health News reported on how the Supreme Court reached a unanimous decision that doctors who wrote multitudes of prescriptions -- far beyond what other medical professionals would consider reasonable -- are not necessarily vulnerable to a criminal conviction. The threshold appears to be that the doctors must have "knowingly or intentionally" written improper prescriptions, a charge that doctors can likely easily deny, given that no one else knows what they were thinking at the time of prescriptions.

If a doctor's workload becomes dominated by patients asking for prescriptions for an addictive substance -- to the point that even most other medical professionals think is unreasonable -- what responsibility does the doctor bear in investigating further to determine if his or her patients are addicted? If the courts rule that there is no criminal liability, who else would enforce accountability? The most obvious other body would be the medical licensing board, but those boards tend to respond to patient complaints, which likely are not common in this case. The Supreme Court rationale appears to be the justices' reluctance to punish behavior that might be permissible, given that doctors are expected to write prescriptions. This decision seems to raise the bar for criminal conviction so high that perhaps too many professionals can get away with negligence.