Husel Trial -- NOT GUILTY

[Birdstrike]

I see, but I’m confused as to your point. He was acquitted of all the others and vowed to continue committing euthanasia aka mercy killings unless he was arrested.

My only point is that although there are similarities in the cases of Kevorkian and Husel, there are significant differences.

Random anecdote: One day in the '90s, I was walking into a post office to mail something. A short, thin, elderly man with pants too short for his legs, was standing out side the front door. He made eye contact with me, smiled and said, "Hello. He outstretched his hand to shake mine. I shook his hand as he asked if I would sign his petition to get the issue of physician assisted suicide on the ballot, so it could be voted on. Thinking the voters had a right to decide the issue, one way or the other, I signed the petition. The man was Jack Kevorkian.

His ballot drive was successful in getting the vote on the ballot. The vote was not. Physician assisted suicide was voted down, by a large margin.

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[Tigers540]

My only point is that although there are similarities in the cases of Kevorkian and Husel, there are significant differences.

Random anecdote: One day in the '90s, I was walking into a post office to mail something. A short, thin, elderly man with pants too short for his legs, was standing out side the front door. He made eye contact with me, smiled and said, "Hello. He outstretched his hand to shake mine. I shook his hand as he asked if I would sign his petition to get the issue of physician assisted suicide on the ballot, so it could be voted on. Thinking the voters had a right to vote on the issue, I signed the petition. The man was Jack Kevorkian.

His ballot drive was successful in getting the vote on the ballot. The vote was not. Physician assisted suicide was voted down, by a large margin.

I think the biggest difference is that Kevorkian said what his intentions were. There was zero doubt he was committing euthanasia.

We have no tangible evidence at all that Husels actions were euthanasia. None.

 

[neurodoc]

You imply that he will sue because he’s a narcissist. I’ll ignore the completely baseless claim that he’s a narcissist...

I agree he may have added difficulties in civil court. His opponents may as well, and they will endure the ongoing humiliation in the press as long as this goes on.

Not completely baseless...his criminal behavior and convictions (as an adult and not a juvenile) suggest a character pathology (mainly sociopathy, but that frequently goes with narcissistic personality disorder)...But I admit that's speculative as most of the comments in this thread have been.

 

[dadaddadaBATMAN]

Not completely baseless...his criminal behavior and convictions (as an adult and not a juvenile) suggest a character pathology (mainly sociopathy, but that frequently goes with narcissistic personality disorder)...But I admit that's speculative as most of the comments in this thread have been.

Given that we’ve spent 1000+ posts speculating on his guilt or innocence of murder/euthanasia I guess speculating on what personality disorder he may or may not have is hardly the worst thing possible.

I’ve always felt that personality disorders should be left for actual assessments though.

 

[Birdstrike]

Pop quiz. Two responses to the verdict:

A) “Yikes, that was close. I better be even more careful about what medications I give and how much.”

B) “Whoo-hoo, not guilty! Now, I can give fentanyl boluses of unlimited size with no fear of consequences! Party time, sue employer for FIRE.”

Choose.

 

[Robotic Wis-Hipple]

Yes I agree with you. In fact one of my hills to die on at my hospital is not "titrate infusion to sxs" which unfortunately is ordered far too often. Bolus bolus bolus as you say. Use the data to guide subsequent infusion changes. Agreed.

However there were no symptom-focused infusions in this case? Just sedation for intubation? Or were there?

I'm not necessarily looking at infusions as quick on or off, or time patients maintain concentration after dc'ing an infusion secondary to dynamic context sensitive half-life... As you know for these patients an infusion rate would have likely only gone in one direction and not discontinued. But rather focused on selection of opioid (in this case fentanyl) for a stand alone bolus in regard to duration of effect (not even necessarily serum level) as things can get more hairy when we introduce the partial agonists.

Very interesting nonetheless. Is your specialty anesthesiology?

EDIT: thank you for the awesome second chart with opioids. I saved it for future lectures.

You’re welcome. And yes, I’m an anesthesiologist.

 

[dpmd]

Thank you for this. From what you can recall on the case, were infusions continued? What rate were they running? When were these bolus doses given temporally in relation to extubation? How did he arrive at 1000mcg as a selected dose?

Please don't feel obligated to spend your time looking for those answers... more so just musing and thinking outloud on my part.

So the medical records were not made available now was there much reported about the actual administration around the time of extubation. I didn't listen to all the testimony so all I know is what was reported. I'm not sure we know for sure any of the doses were one time bolus versus a total of accumulated boluses over time. There is testimony about at least one bolus the nurse questioned as high that the doctor reduced the dose on and after administration the nurse realized the reduced dose was ineffective and had to get another order for the originally selected dose. There is also testimony about at least one high dose that was ineffective and had to be repeated with other meds added in I think. From what I recall some of the doses were given before or during extubation, also after extubation in at least some.

 

[bravotwozero]

Pop quiz. Two responses to the verdict:

A) “Yikes, that was close. I better be even more careful about what medications I give and how much.”

B) “Whoo-hoo, not guilty! Now, I can give fentanyl boluses of unlimited size with no fear of consequences! Party time, sue employer for FIRE.”

Choose.

eh, I'd say somewhere between A and B, but a LOT closer to A than B, lol. Unlike Husel, I've never given out doses of medications that would be way out of the ordinary, so I'm not worried, and don't plan to change my practice. I would be, if he were found guilty.

 

[ACSurgeon]

Pop quiz. Two responses to the verdict:

A) “Yikes, that was close. I better be even more careful about what medications I give and how much.”

B) “Whoo-hoo, not guilty! Now, I can give fentanyl boluses of unlimited size with no fear of consequences! Party time, sue employer for FIRE.”

Choose.

Option 3. It changes nothing because I’ve never felt restrained with end of life opioids yet never come close to these high doses.

 

[Señor S]

Pop quiz. Two responses to the verdict:

A) “Yikes, that was close. I better be even more careful about what medications I give and how much.”

B) “Whoo-hoo, not guilty! Now, I can give fentanyl boluses of unlimited size with no fear of consequences! Party time, sue employer for FIRE.”

Choose.

A, of course. But self preservation is my #1 goal, always. No desire to be a martyr and try to fight this corrupt, hysterical system, however righteous I might feel the cause to be.

But realistically I have always just put in the "End of Life" order set and will continue to do so. Where I do have some pause is around issues of GOC, as I said above. That was a sticking point in this trial and seems to be a major point of contention in the civil lawsuits as well. I know enough about plaintiff's lawyers and their methods to "prep" people for depositions...like I said, it may be better to do things a little more formally going forward. More Palliative consults, maybe.

 

[emergentmd]

So 24 pages, we can't even get 9 well trained/educated critical care docs to agree. Thus he is NOT guilty, move on.

 

[DocEspana]

Pop quiz. Two responses to the verdict:

A) “Yikes, that was close. I better be even more careful about what medications I give and how much.”

B) “Whoo-hoo, not guilty! Now, I can give fentanyl boluses of unlimited size with no fear of consequences! Party time, sue employer for FIRE.”

Choose.

B. Obviously.

fentanyl for everyone!

 

[IMGASMD]

B. Obviously.

fentanyl for everyone!

You get a fentanyl patch, you get a patch. YOU, sir, get a lollipop (of course fentanyl flavored).

 

[coffeebythelake]

You get a fentanyl patch, you get a patch. YOU, sir, get a lollipop (of course fentanyl flavored).

Why not

 

[coffeebythelake]

On an unrelated but similar theme, did the whole anti-opioid crusade that the medical establishment has been pursuing these last few years affected how palliative patients are treated? (Hopefully not)

 

[Tenk]

On an unrelated but similar theme, did the whole anti-opioid crusade that the medical establishment has been pursuing these last few years affected how palliative patients are treated? (Hopefully not)

I’ve 100% seen it negatively impact some cancer patients.

 

[Tigers540]

‘Holbrook admitted that during an in-chambers meeting, he sarcastically suggested Husel be referred to as “the killer, Dr. Husel.”

According to a transcript of the event, Holbrook then said: “Sorry, that’s bad humor.”
When defense attorney Diane Menashe said: “I’m trying to absorb the court’s comment.”

Judge Holbrook then replied: “That was bad humor on my part because I’m tired. I’m sorry for that rude comment. It would never have come to my mouth.”’

This is at least part of the reason they wanted Holbrook removed as judge.

 

[coffeebythelake]

it appears I was correct.
Baez confirmed in an interview that the jury was deadlocked 11-1 for the 13 counts of 1,000mcg and deadlocked 10-2 on the remaining count.

Also, he said that their motion to recuse the judge will be made public as well. I will be interested to see their accusations, as the judge certainly appeared biased when watching the trial. At one point the judge was told by a neutral party that he was "making faces during defense examination", and had to instruct the jury to disregard it. He was definitely odd.

So what do you mean? 11-1. 10-2. Most of the jurors were in favor of conviction? Or acquittal?

 

[Tigers540]

So what do you mean? 11-1. 10-2. Most of the jurors were in favor of conviction? Or acquittal?

Yes there was one hold out for guilty in the 13 1,000mcg doses and 2 in the 2,000mcg dose

Sorry I answered poorly. The majority was in favor of acquittal.

 

[neurodoc]

Here is an interesting and very balanced conversation between Dr. Ely and Dr. Zivot regarding their opinions of the case and the verdict:

'Euthanasia Pivots on Intent:' Physician Witnesses in Husel Trial Speak Out

Physician expert witnesses on either side of the Husel trial dive into case's gray areas

www.medpagetoday.com

 

[Rekt]

So 24 pages, we can't even get 9 well trained/educated critical care docs to agree. Thus he is NOT guilty, move on.

It's really just 24 pages of people injecting their own nonsense beliefs into the case.

He did those patients a favor.

 

[Robotic Wis-Hipple]

Here is an interesting and very balanced conversation between Dr. Ely and Dr. Zivot regarding their opinions of the case and the verdict:

'Euthanasia Pivots on Intent:' Physician Witnesses in Husel Trial Speak Out

Physician expert witnesses on either side of the Husel trial dive into case's gray areas

www.medpagetoday.com

Ely comes off much more thoughtful and well read in this than any of his testimony. He’s still arguing for starting at 50ug’s and societal guidance to that end which I again think may increase the percentage of patients who suffer during a palliative extubation.

I think it’s interesting that both had more thoughts/concerns in common than they did in opposition. Thx for that.

 

[WilcoWorld]

Here is an interesting and very balanced conversation between Dr. Ely and Dr. Zivot regarding their opinions of the case and the verdict:

'Euthanasia Pivots on Intent:' Physician Witnesses in Husel Trial Speak Out

Physician expert witnesses on either side of the Husel trial dive into case's gray areas

www.medpagetoday.com

Thanks, I look forward to reading.

 

[thegenius]

Here is an interesting and very balanced conversation between Dr. Ely and Dr. Zivot regarding their opinions of the case and the verdict:

'Euthanasia Pivots on Intent:' Physician Witnesses in Husel Trial Speak Out

Physician expert witnesses on either side of the Husel trial dive into case's gray areas

www.medpagetoday.com

Very fine conversation. Zivot sounds nice and dances around. Ely gets lost in the details of studies. Ely is more convincing. Anyway...the guy is still guilty of hastening death. It's so obvious. Whether hastening death = murder? (I think so.)

Ely said that the pain scores for most of these patients were documented as ZERO prior to palliative extubation. What more evidence do you need

 

[dpmd]

Very fine conversation. Zivot sounds nice and dances around. Ely gets lost in the details of studies. Ely is more convincing. Anyway...the guy is still guilty of hastening death. It's so obvious. Whether hastening death = murder? (I think so.)

Ely said that the pain scores for most of these patients were documented as ZERO prior to palliative extubation. What more evidence do you need

Zero on high doses of fentanyl and versed by drip that you plan to stop isn't the same as zero on no meds. And hastening death isn't murder when doctors do it in a variety of ways (not murder when we do it by not starting a fifth pressor, or by not operating on the emaciated patient with malignant obstruction, or by removing an ett in a vent dependent patient, and still not murder when we give respiratory depressants as long as we do so to provide comfort)

 

[IMGASMD]

Very fine conversation. Zivot sounds nice and dances around. Ely gets lost in the details of studies. Ely is more convincing. Anyway...the guy is still guilty of hastening death. It's so obvious. Whether hastening death = murder? (I think so.)

Ely said that the pain scores for most of these patients were documented as ZERO prior to palliative extubation. What more evidence do you need

Other than Husel himself admit to the intent, there is no murder…. And like everyone else has argued, that we will never know. Some other less charges, perhaps. But no way 1st degree murder should stick.

 

[thegenius]

Oh boy here we go again! As an esteemed member of our group once wrote, there isn't a single doctor on here who would ever push 2000 mcg after pulling a tube.

'Nuff said.

Other than Husel himself admit to the intent, there is no murder…. And like everyone else has argued, that we will never know. Some other less charges, perhaps. But no way 1st degree murder should stick.

I hate our legal system but thank god it doesn't work this way. That the accused has to admit to intent.

 

[Tigers540]

Oh boy here we go again! As an esteemed member of our group once wrote, there isn't a single doctor on here who would ever push 2000 mcg after pulling a tube.

'Nuff said.



I hate our legal system but thank god it doesn't work this way. That the accused has to admit to intent.

They don't necessarily have to admit to murder and say "im giving this fentanyl to kill these patients".
But they needed SOMETHING. A comment, email, text, or something alluding to his intentions. Something along the lines of "these patients aren't dying fast enough". Not only did they have no proof of murderous intent, but all of his actions and comments proved the opposite.
The prosecution literally had zero evidence of intent and they offered zero motive. They don't have to provide a motive because some people are truly psychopaths and kill for no reason, but a motive goes a long way. I watched almost the entire trial and I can't stress this enough - the prosecution had nothing.

Let's just be real here.......if Husel was found guilty of murder he would quite literally be the single dumbest serial killer in history.

 

[neurodoc]

I've actually met some real serial killers and in IMHO only one of them seems smarter than Husel.

 

[WilcoWorld]

Let's just be real here.......if Husel was found guilty of murder he would quite literally be the single dumbest serial killer in history.

This is a common, but lousy defense. "You'd have to be dumb to do that, so they must not have done that."
Each of our memories abound with examples of smart people doing things that, in retrospect, appear colossally stupid.

In any case, the trial is over. I think a more interesting discussion is what the House of Medicine is to do going forward.

 

[Tigers540]

This is a common, but lousy defense. "You'd have to be dumb to do that, so they must not have done that."
Each of our memories abound with examples of smart people doing things that, in retrospect, appear colossally stupid.

In any case, the trial is over. I think a more interesting discussion is what the House of Medicine is to do going forward.

I didn’t say it was a defense of his actions, just that in the absence of literally any evidence, it makes it even more of a leap to meet the high burden

 

[Tigers540]

I've actually met some real serial killers and in IMHO only one of them seems smarter than Husel.

Im not referring to their actual IQ, more so the weapon/method of choice. Can’t think of any serial killers who broadcasted their murders to their entire place of work…..but that’s probably bc people usually don’t get away with it 15 times when they do that.

 

[yeasports]

I've actually met some real serial killers and in IMHO only one of them seems smarter than Husel.

go on please

 

[WilcoWorld]

I didn’t say it was a defense of his actions, just that in the absence of literally any evidence, it makes it even more of a leap to meet the high burden

You are saying the stupidity of a crime speaks to ones innocence. I disagree.

 

[Tigers540]

You are saying the stupidity of a crime speaks to ones innocence. I disagree.

That is not what I said, but interpret it as u wish.

 

[WilcoWorld]

They don't necessarily have to admit to murder and say "im giving this fentanyl to kill these patients".
But they needed SOMETHING. A comment, email, text, or something alluding to his intentions. Something along the lines of "these patients aren't dying fast enough". Not only did they have no proof of murderous intent, but all of his actions and comments proved the opposite.
The prosecution literally had zero evidence of intent and they offered zero motive. They don't have to provide a motive because some people are truly psychopaths and kill for no reason, but a motive goes a long way. I watched almost the entire trial and I can't stress this enough - the prosecution had nothing.

Let's just be real here.......if Husel was found guilty of murder he would quite literally be the single dumbest serial killer in history.

That is not what I said, but interpret it as u wish.

Please correct me then. What were you trying to say when you wrote "Let's just be real here.......if Husel was found guilty of murder he would quite literally be the single dumbest serial killer in history"?

 

[Tigers540]

Please correct me then. What were you trying to say when you wrote "Let's just be real here.......if Husel was found guilty of murder he would quite literally be the single dumbest serial killer in history"?

my point was, as I explained in my subsequent post, that for a jury to find him guilty beyond a reasonable doubt in the absence of literally any other shred of evidence pointing to intent/motive.......they would have to make the mental leap that a man basically sent an email at work saying "i'm committing murder today" 25+ times and got away with it. If you don't think that doesnt add even more reasonable doubt then we have nothing left to discuss.

 

[BoardingDoc]

This topic appears to have run its course as a verdict has been rendered and people have expressed a variety of opinions on said verdict. We are now branching off into hypothetical legal arguments. If anyone has a specific offshoot topic they want to discuss, feel free to create a new thread addressing it a la the euthanasia thread.

Closing.