The patient, Mr. R. O. Canada, brought suit against his physician, Dr. J. Chretien.

The patient had suffered severe rejection complications following a constitution transplant in the early 1980s. Starting in 1995 he had been prescribed numerous painkillers by Dr. Chretien.

In 2004, shortly after Dr. Chretien retired from practice, Mr. Canada brought his personal medical chart to a friend, Ms. Fraser, for review. Ms. Fraser discovered a variety of errors and oversights in the care of the patient, but one fact became glaringly obvious from the chart review: Dr. Chretien’s team of physicians had been stealing Mr. Canada’s painkillers, and selling them to other patients. The whole fraud had been hidden under layers of referrals and consultations, so that Mr. Canada had never known, until Ms. Fraser’s review, that he had been victimized.

Mr. Canada sued Dr. Chretien for malfeasance and fraud. The case seemed pretty clear: even Dr. Chretien admitted, on the stand, that the drugs had been stolen (although by whom, exactly, Dr. Chretien wouldn’t say). But rather than address the theft and the fraud, Dr. Chretien did something unusual on the stand. He gave a lengthy dissertation on the patient’s diagnosis. He brought evidence for why the painkillers had been prescribed initially. He accused a few people of being “cruel and ‘eartless” for opposing the prescriptions in the first place. He finished his testimony by declaring himself a thoroughly noble defender of the Hippocratic oath, who had been willing to treat Mr. Canada even when others would have written him off. And when he was finished testifying, the gallery erupted in cheers.

Mr. Canada was puzzled. He hadn’t accused his doctor of prescribing the drugs in error. He didn’t take issue with the doctor’s diagnosis. But he had clearly been defrauded and robbed: the medications he had paid for, the medications he needed to survive, had been stolen and used to enrich some of Dr. Chretien’s friends.

Sadly for Mr. Canada, the judge in his case was sufficiently impressed by Dr. Chretien’s flair that he dismissed the lawsuit. In his written opinion, the judge commented that “Dr. Chretien did a good thing in prescribing these painkillers…it was crucial for the physician in this case to govern his care by the best understanding of the patient’s interest, even if it looked ‘confrontational’ at times…”

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Do you think the judge missed the point here?

Me too.

Maybe we should both let Paul Wells know…