Archive for September, 2007
Does it Really Matter What the Doctor Does?; James Stacks, Ph.D.; War on Doctors/Pain Crisis blog of the Pain Relief Network; 2007-09-30. No. Although there is a lot of effort going into discussion of what constitutes proper prescribing, attempts to protect oneself by staying within those ever-shifting ‘bounds of acceptable medical practice‘ may be futile. Our society and legal system have deteriorated to a point where old ideas about criminal trials no longer apply. In jury trials, what is more important than factual guilt or innocence is the reasoning and beliefs of the jurors. If the trials of Richard Paey, William Mangino, and others have taught us anything, it is that actual innocence is not a reliable defense. I think I know why. To understand what is going on, you have to place yourself in a real courtroom, and think of how it works in terms of how our society works in general. For the past 30 years, our society has increasingly expressed a desire to return to simple values and respect for authority. That has resulted in an extraordinary amount of power delegated to police and prosecutors. Jurors, who are just legally inexperienced citizens, are drawn into a strange and somewhat threatening situation that they really do not understand. They are isolated, among strangers, and out of their comfort zone. They do understand the forces of authority that they have been taught to recognize and obey, to whom they look for instructions on how to behave in order to stay out of trouble. Jurors do not evaluate evidence for innocence or guilt. Instead they actually feel guilt and fear if they publicly disagree with the symbols of authority, the police and prosecutors. A ‘not guilty’ verdict by a jury amounts to a public challenge of Authority, and usually jurors just won’t risk it. They don’t want to behave “badly” in front of authority figures, and express obedience by repeating their opinions and orders. Medicine is technical and complicated; jurors do not have anything like a peer understanding of it. But it takes no special training to know who the Authority is, and Jurors naturally side with them. Siding with authority is what we as a society have preached for some time now, and the evening news and police dramas on TV persistently warn that it is the only safe thing to do. We shouldn’t be surprised when juries behave this way. George Lakoff, the renowned linguist at Berkeley, has noted that voters do not vote for candidates based on the candidate’s position on specific issues. Rather, voters identify with what they believe to be the candidates’ overall values. Appealing to juries with evidence of factual innocence is like appealing to voters about issues. When facts conflict with values, facts lose. In Lakoff’s words, “the facts bounce off” of the voter’s belief system. In a courtroom, most people naturally believe the prosecutor is the “good guy” who shares their values. Every citizen is led to believe they must support and defend the acts and claims of the authority figures at all times. In the current political environment, to disagree is tantamount to “supporting criminals”, just as lawful dissent is labeled as “treasonous.” Should proponents of pain medicine challenge the current Federal rampage against pain medication by defending physicians at jury trials? I think I believe some efforts should be put on legal defense of pain treating physicians and pain patients if only because common decency demands we defend the weak and the sick. But I also think we need to acknowledge that the jury trial approach to activism may not be the best place to concentrate efforts. The revolution of the sixties succeeded largely because a benevolent judiciary favored individual rights and advocated questioning of authority. That judiciary has been replaced with a very conservative group who have largely turned their backs on individual rights. This is why many reformers today are aiming directly at the legislative branch for justice. So I believe it makes sense that the lion’s share of the pain relief advocacy effort be aimed at Congress. The Pain Relief Network seems to have recognized this, and are currently focused on implementing a Congressional strategy. [END] As always, we ask that you help PRN fight to protect the rights of patients and the doctors who treat them. Thank you for clicking the link below.
www.painreliefnetwork.org Originally Syndicated via RSS from War on Doctors / Pain Crisis
Linda Paey to Pain Relief Advocates…; Linda Paey; War on Doctors/Pain Crisis blog of the Pain Relief Network; 2007-09-29. Friends, Family and Media Friends, WOW! What a week we had! It’s been truly amazing, we feel blessed, it must have been all the prayers that people sent our way. We were shocked on Thursday when Governor Crist sent the order to have Richard released from prison. We have been grinning ear to ear this past week. Richard and I look at each other daily and exclaim “Can you believe this?!” We now recognize the rarity of such an action by the clemency board, it appears that this was an unprecedented occurrence. I remember my early meeting with the clemency aides, I was surprised by the number of questions regarding the details of our case. I was told by friends that I should act contrite, but expressing regret conflicts with our stated belief in Richard’s innocence. It is possible that the answers I gave at that meeting and documents I gave to the board, led them to believe that Richard did not commit trafficking, yet alone prescription fraud as the state contends? Three quarters of the board came from law enforcement backgrounds, yet they came to the conclusion that a pardon was appropriate. This tells volumes about the strength of the state’s case against Richard. Richard has come back to a family that was injured by his absence but we are now on the mend. Ben has been watching TV with his father, Elizabeth is finally getting help with her history and English, (they are my weak subjects) and Catherine is rethinking her plans for college, she is now believes she will commute from home for the first two years. Our lives sound like any other family’s, in other words, life is good. We will concentrate our efforts in this upcoming year on improving our family’s finances so I may soon go back to a five day work week. Richard will reestablish contacts with his local doctors in an effort to control his fatigue and pain. Richard expects to work closely with Pain Relief Network to better inform the public on chronic pain issues, along with FAMM and November Coalition. And lastly, we hope to meet with many family and friends who have given me and my family support during the years Richard was incarcerated. Thank you for helping make our family whole again. You made a big difference in our lives and I want to express our deepest gratitude to you all. This is better than a Rocky movie! Sincerely, Linda Paey [END] Originally Syndicated via RSS from War on Doctors / Pain Crisis
PRN: the Richard Paey Pardon; Press Release, Siobhan Reynolds; Pain Relief Network; 2007-09-27 See also:
Dear Members and Friends, As you may know, Richard Paey was given a full pardon by Governor Charlie Crist and his cabinet (9-20-07) in what was the most principled and simply decent political action we have seen from those in power since we began to challenge the system’s disgraceful behavior toward people in pain way back in 2003. [PRN to FDA, 2003] We applaud Governor Crist for initiating the process that resulted in Richard’s release and also wish to thank all the people and organizations that pulled together to keep Richard’s story before the public. From the American Pain Foundation, to the November Coalition, from the members of the Pain Relief Network to Dr. Russell Portenoy, from The Pumpsters to DRC Net, from the Association of American Physicians and Surgeons (AAPS) to kids recruited off the internet, a virtual army of people sent letters and made phone calls to the Governor. They didn’t let up until Richard was at last released. The New York Times, John Tierney in particular, 60 Minutes, Nightline, Radley Balko, Jacob Sullum, Maia Szalavitz and countless other writers and commentators ran stories that helped the public understand the blatant injustice of Florida’s treatment of Richard. One person in particular needs to be acknowledged for her extraordinary role in this miracle. Jennifer Santiago, a reporter with CBS 4 in Miami, approached the governor and gave him a copy of my film, The Chilling Effect, and John Flannery’s book, Pain in America. It was shortly thereafter that Richard’s case was pushed to the front of the line for clemency consideration and we were off and running. Jennifer, therefore, played a crucial role in saving Richard’s life and in restoring some modicum of hope to the tattered and terrorized pain community. We all owe her an enormous debt of gratitude. [Jennifer Santiago’s website and blog] Pain Relief Network is proud to be able to say that we took on Richard’s case just after he was wrongly convicted and worked all the way through to secure and train counsel for the family and to answer the media’s questions about what seemed to be an impossibly absurd case. Linda Paey demonstrated extraordinary perseverance and savvy as together we fought our way to her husband’s freedom. We are delighted that he is at last home with his family and friends, noting that he hasn’t lost his way with words. According to the Tampa Tribune’s account of his homecoming, as he first laid eyes on his house,
– Siobhan Reynolds [END] As always, we ask that you help PRN fight to protect the rights of patients and the doctors who treat them. Thank you for clicking the link below.
www.painreliefnetwork.org Originally Syndicated via RSS from War on Doctors / Pain Crisis
The Mangino Trial - a Mockery of the Constitution; Dr. Paul Heberle; War on Doctors/Pain Crisis blog of the Pain Relief Network; 2007-09-14; posted: 2007-09-23. Public Declaration of truth and support for the Natural-bourne American (and convicted felon) William Mangino; provided in a Court of Record in the State of Pennsylvania See also the: I am present today to speak on behalf of the American known as William Mangino with name properly expressed in both capital and small letters. I am compelled to do so by virtue of having experienced a similar plight in the recent past. I had the unfortunate experience of being victimized by supposed public servants in an intentionally orchestrated false prosecution. The experience has forever changed my impression of the nature of our country and our justice system. Being thrown into such circumstances allowed me to witness many things that would make any honest American shudder.
I could go on at great length enumerating the blatant corruption and criminality that I witnessed on the part of public servants, but it would serve no purpose in this forum. I do not know whether or not the case against William Mangino was as intentionally malicious as the case against me was. We did, however, have one fraud investigator named Sean Murphy in common. This was the only public servant that I encountered who appeared to be honest. He spoke for the prosecution at my trial, but was no longer serving as fraud investigator by that time. This same agent was involved in the investigation of William Mangino, yet he was not used in the trial against him. I believe that the court and any American would do well to learn this honest man was not used for condemnatory testimony against this innocent physician. Assuming the case against William Mangino was not malicious in nature, we still have a travesty of justice before us. I have practiced as a physician. I have had the opportunity to manage pain patients and I have treated addiction patients extensively as well. This man has not violated any principle of medicine. I cannot see where he has even violated a law. The law in question says nothing of the “bounds of medicine.” This is not in the letter of the law. It is a concept, verbiage added to confuse the jury about medical practice, and prejudice them against the accused physician. Obviously this corrupt tactic works quite well. William Mangino is also accused and convicted of Medicaid fraud. He was not contracted with a Medicaid program. He never billed a Medicaid program. He never engaged such an entity. How is it possible to defraud an entity with which you have not had contact or exchanged information? Even the simplest minds should see a problem here. Even worse, the amount of time that will be erased from William Mangino’s life by incarceration comes down to the weight of Tylenol. This is a common, uncontrolled substance that any one of us can purchase freely in a pharmacy, grocery store, or gas station. A result such as this is an embarrassment to our justice system and our country. Perhaps worst of all, is the fact that Dr. William Mangino has not received a trial by jury of his peers. In the constitutional sense, peers are not the persons that we know. They are not people that work in the same profession as we do. Our constitution is the rule book for public servants to follow in order to preserve the rights described in our foundational document. (Not) Submitted (but) Expressed this 14th day of September, 2007, in the 231st year of Declared American independence, respectfully by Dr. Paul Heberle, Inhabitant of Pennsylvania, American Union of States and Constitutional Republic, to Judge Motto in the Sentencing hearing of Dr. William Mangino. [END] Originally Syndicated via RSS from War on Doctors / Pain Crisis
Initial Reflections on the Case of Richard Paey; John P. Flannery II, Esq; War on Doctors/Pain Crisis blog of the Pain Relief Network; 2007-09-21
I’m just back to Northern virginia, by way of Charlotte, after what happened at the Florida State Capitol this morning. When Linda and the family and I went into the Cabinet room this morning, jam-packed with people, the Florida Parole Commission had recommended against granting Richard any relief. But the Governor and the Cabinet decided otherwise. The room erupted in applause and Linda said it was like a scene from Rocky. There is no question that all the letters and calls and e-mails and demonstrations came together to make a significant difference. The warden volunteered to get Richard home - even as we sent Linda off to meet him at the prison in Daytona while I stayed at the Capitol to make sure there were no problems there. You all must know how strongly that Siobhan believed that this case was wrong and could be righted from the start. Linda’s resolve to reunite her family and Richard’s devotion to his family and to Linda makes me think of the iron will of Frank Fisher that got him through his challenge. Gumption is required absolutely in order to have a chance of success in these assaults on your reputation and freedom. When Siobhan called in January 2006 and asked if I would make the argument to the Court of Appeals for Richard based on her reading of a Washington Post editorial I’d written, she explained what we were up against in these pain cases. Thus did Siobhan’s cause became my own. We would have never gotten to this success had it not been for Siobhan and Frank and so many others who believed in Richard’s cause and poked and prodded with suggestions and support at critical junctures in this war. As Siobhan indicated earlier today, if it wasn’t also for enlightened and disciplined thinking by journalists and columnists, there wouldn’t have been a voice separate from our own that confirmed the injustice that was Richard Paey’s case. Siobhan and Frank Fisher came to the oral appellate argument before the Florida Appellate court in February 2006, but they also gathered the people from the media at that time as well, got them to the court house, briefed them, and this was so critical to opening up this argument, so that it was not just in court but in the streets and beyond the state of florida as well. Frank was always full of examples and insights we could use to explain the argument to the court. Siobhan’s single-minded devotion to the cause generally, and to helping Richard gain his freedom, combined with the efforts of so many other people, again made this the kind of ensemble effort that can and did make a difference for the better - resulting in Richard’s pardon. Like Frank’s ordeal, this was a painful 10 year odyssey from the first charges in 1997 to the release today after 3 1/2 years in jail. We can hope that this will help illuminate the darkness that is the government’s intolerant pain policy toward chronic pain patients. How many other people must endure what Richard did? In any case, at the very least, the Paey family went to sleep tonight intact, and as one family again, under the same roof with their father — home at long last. Each of you have made a difference if you only wrote a letter or said a silent prayer in support of Richard’s release. Thank you one and all for your insights and support.
– John [END] As always, we ask that you help PRN fight to protect the rights of patients and the doctors who treat them. Thank you for clicking the link below.
www.painreliefnetwork.org Originally Syndicated via RSS from War on Doctors / Pain Crisis
Gallows Art in the War on Docs; Alex DeLuca; War on Doctors/Pain Crisis blog of the Pain Relief Network; 2007-09-21 ‘ToonsThe November Coalition has a wonderful collection of Toons by Paey. Also on the above-linked page, is a poem by Richard’s daughter, Catherine, which was read aloud by Catherine at Richard’s 2007-08-08 waiver hearing, and at yesterdays clemency hearing where he was granted a full pardon by Florida Governor Charlie Crist. But while I’m basking in relief and joy in Richard’s pardon, most of our people remain incarcerated. This cartoon surfaced circa December 2004 just around the time of the first Hurwitz conviction. I am not able to make out the name of the author, nor do I know where it was originally published. Several people in the pain relief advocacy community have commented that the Doc in the cartoon looks more than a little like Billy Hurwitz.  The caption reads: “Whatda ya think I am Stupid, doc? Youse tryin to tell me you servin 15 years of hard time for violating a CPT code? Whatever dat is. C’mon Doc, ya killed somebody, didn’t ya? Smoked the old lady, I bet!” Documentary FilmThe Chilling Effect - Pain Patients in the War on Drugs; Siobhan Reynolds; On Beyond Films. ImagesHere are some images produced by a physician who shall remain anonymous for now. I’ve always loved these. In the first two images, Tandy drinks the kool-aid.
  I think I’ll call this next series of three, “See One, Do One, Teach One:”    And now, the Photo of the Day. This is a great photograph.This is what today looks like. Welcome home, Richard. Be at peace, Richard’s family. Thank you everyone who gave a good God damn and helped right this particular, and all too common, wrong. Hey Richard? Hey Linda: You never gave an inch. They threw EVERYTHING at you, only because you wouldn’t crawl. You made them choke on their own insane laws. Your family did this for us. Wow - thanks. I think we owe you one lifetime of having your collective back watched. For starters. The Paey’s have brought us a new day. Now is the time to examine the process through which this travesty occurred. Gov. Crist said so himself: “Obviously, this case cries out for a review of that process.” Amen. Let the Truth and Reconciliation begin. We are all watching. We have millions of witnesses to call. You may begin, Florida.  No Caption Necessary StoryLove’s Loss - Faye F.; 2007-09-16. PoemsThe Plan - Ed Swaim; 2007-09-16. Billy’s Lament and The Appeal - two poems by Dr. Hurwitz; Federal Detention; 2005. The truth about OxyContin from a medical point of view - DeLuca; 2001. How to understand chronic pain - DeLuca; 2003. [END] As always, we ask that you help PRN fight to protect the rights of patients and the doctors who treat them. Thank you for clicking the link below.
www.painreliefnetwork.org Originally Syndicated via RSS from War on Doctors / Pain Crisis
Paey Clemency Update; Siobhan Reynolds; War on Doctors/Pain Crisis blog of the Pain Relief Network; 2007-09-17  “This final meeting determines Richard’s fate, either they allow him to come home to his family after 3 1/2 years in prison, or he will have to serve his mandatory 25 year sentence.” - Linda Paey (Richard’s Wife) Governor Crist and the Board of Clemency has granted Richard Paey a waiver of the rules so that his petition for clemency can be considered immediately. His hearing before Governor Crist and three members of the clemency board will take place on Thursday, September 20th. Richard Paey, a chronic pain patient, is serving a mandatory 25 year sentence for possessing 100 percocets, necessary to relieve his chronic pain. Richard’s petition for clemency is available on-line , as is his request for the waiver. [END] Originally Syndicated via RSS from War on Doctors / Pain Crisis
Free Richard Paey!; Alex DeLuca; War on Doctors/Pain Crisis blog of the Pain Relief Network; 2007-09-19
Rationally, I think We Win. I just don’t think Gov. Crist would have made the positive efforts his office has made recently, essentially moving Paey to the head of the clemency hearing line, only to ultimately deny clemency. [See: Paey to get Shot at Early Clemency; Drug War Chronicles;2007-08-24]
Both Paey and O’Hara were convicted for drug trafficking because the weight of the pain medications they were prescribed. Since medications like Vicodin are over 95% Tylenol, essentially both were sent to jail for decades for possessing a drug commonly available at gas stations, diners, and bodegas. Both cases represent the horrific judicial excesses that characterize our nation’s obsession with criminalizing drug users, even if those users are pain patients taking legal medicine. I highly recommend reading attorney Flannery’s Petition for Clemency for Richard Paey. Mr. Flannery is on his way to Florida to represent Richard. Dr. Frank Fisher is engaged in another case at the moment, nor will Siobhan Reynolds or myself be attending the hearing tomorrow. I will be available by phone should medical questions arise during the hearing. But Richard and Linda Paey know the Pain Relief Network loves them Readers - this is a great day for you to meet Siobhan Reynolds and Ronan Greenwood and the deceased Sean Greenwood, and the Paey family. See this wonderful documentary film: Can’t wait to meet you Richard - all cross-able appendages maximally crossed! As always, we ask that you help PRN fight to protect the rights of patients and the doctors who treat them. Thank you for clicking the link below.
www.painreliefnetwork.org [END] Originally Syndicated via RSS from War on Doctors / Pain Crisis
Stickshifts and Safetybelts and Love You Madly (Live); Cake; War on Doctors/Pain Crisis blog of the Pain Relief Network; posted: 2007-09-17. Source >>>> [END] Originally Syndicated via RSS from War on Doctors / Pain Crisis
Mangino Sentencing: a Crime-less Conviction; Christine Heberle; War on Doctors/Pain Crisis blog of the Pain Relief Network; 2007-09-15. [Note: Re-titled 2007-09-16 without changing post slug.] I have heard cases, seen charges, sat in on trials, but today I think I have seen one of the most egregious of them all. Dr William Mangino was sentenced today, 2007-09-14, in Newcastle PA. A few people were there to speak on his behalf including my husband, Dr. Paul Heberle, Dr. Alex DeLuca, Attorney Michaelson (who also took the stand to give testimony about his decades long friendship and working relationship with Dr. Mangio), and Dr. Mangino himself. The goal was to convince the judge that Dr. Mangino needed to be allowed to remain out on bond while he makes his appeals. We failed. First let me say for those unfamiliar with the case that this is truly a crime-less conviction. He was charged with the typical state charges of prescribing outside the bounds of a responsible segment of the medical community. Now I know that is not what the statute says, but it is how the prosecution phrases it. The prosecutions expert witness (Dr. Evanko) said that Dr. Mangino’s prescribing was not excessive, and the charts reviewed were of chronic pain patients who needed care. In Dr. Evanko’s opinion it was only Dr. Mangino’s charting that put him on the wrong side of that elusive “responsible segment.” Hmmm! This is the prosecution saying this. Interesting. Dr. Forest Tenant also agreed that Dr. Mangino was not prescribing frivolously, that his dosages were on the lower side, and that he physically examined each patient. So where is the crime? As Alex, Paul, Michaelson, Attorney Leslie, and myself listened to the prosecuting attorney and the defending attorney interact they each were clearly stating, and the transcript will show this: “Yes the jury convicted and there are major issues there (with the jurists who were coerced to find him guilty) and other major appeal able issues.” But no one spoke about any evidence that a crime was committed. Nonetheless the judge denied Dr. Mangino’ s freedom and sentenced him with 8 1/2 to 20 years. They also fined him some $10,000 in “restitution” going to the only victim, apparently, identified by the government in the commission of this heinous offense. The “victim” in this case? A Medicaid HMO called Gateway Insurance. Gateway was awarded triple the damages for prescriptions filled unnecessarily. Another Hmmm! Where is the crime? This case is obscene and the verdict and sentence absolutely insane. I truly believe the defense team failed Dr. Mangino Not necessarily on cross exam, but on there defense strategy. They only had one witness testify (their expert) and then they closed. [See: Mangino II - Conviction] I believe this was a major error. I am not trying to bash his attorneys, both great guys who worked pro bono. I am not trying to bash Mary B. either who also helped for free. But the decision to stop because they knew their client was innocent and they knew the defense did not prove guilt to any degree gave them a false sense of security. I think that once they had that first day of Dr. Tennant’s defense expert testimony under their belt they should have kept hitting with facts and proof beyond any doubt that this man was innocent, but they didn’t. Attorneys still believe that the burden of proof is on the prosecution, but as we have seen time and time again the defendant is presumed guilty. Wrong as this is, it appears to be the fact. This is rock bottom. If you are a physician and you prescribe (not just C-II), but really anything controlled, you are doomed. The walls of justice have truly crumbled. – Christine [END] Originally Syndicated via RSS from War on Doctors / Pain Crisis |
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This is it, tomorrow is the day, and I am at once elated and anxious. Tomorrow, the petition for clemency for 48 year old Richard Paey, a wheelchair-bound Florida man with failed back syndrome and Multiple Sclerosis, and a morphine pump in his spine courtesy of the State of Florida Dept. of Corrections, will be heard. [See: 
And I think the 
