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Is Dr. Conrad Murray the Health Industrys Smooth Criminal? I remember it like it was yesterday. It was a Wednesday afternoon at a local movie theater; I sat along with 20 other individuals in high anticipation of viewing This Is It a documentary and performance that would be Michael Jacksons last contribution of talent to the world. On June 25, 2009, Michael Joseph Jackson, known as the King of Pop and often noted as the greatest entertainer of all time, was pronounced dead of an overdose. Even to this day, the words dead of an overdose in the same sentence with Michael Jackson name seem so strange. What seemed to be even more difficult to comprehend, is announcement that Jacksons overdose was ruled a homicide. Dr. Conrad Murray, Jacksons physician, was charged with involuntary manslaughter, convicted, and sentenced to the maximum of four years in prison. Many argue that Dr. Murray was wrong and feel as if he should be thrown under the jail. On the other hand, many feel that Dr. Murrays sentencing was too strict, unnecessary, or Dr. Murray is innocent and Michael Jackson is at fault of his own death. Even though it appears that Michael Jackson abused his power by demanding and paying extensive fees for drugs and treatments, Dr. Murray performed unethical acts and is guilty of violationing oaths he took as a physicians to uphold ethical practices as a physician. In this essay, I will expose Dr. Conrad Murray as the health industries Smooth Criminal.

The news of Jacksons death spread all over the world rapidly. Following the news of Jacksons death, the world impatiently awaited an explanation and someone to blame. Initially reports indicated that Jackson died of cardiac arrest; however, on August 28, 2009, Jacksons death was declared a homicide by the Los Angeles County Coroner. Drugs such as Lorazepam

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and midazolam which are anti-anxiety drugs were found in Jackson system along with a more dangerous drug called propofol. Propofol is a potent drug. According to ABC News, propofol is normally only used in hospital settings with a trained anesthesiologist who monitors the patient's heart rate and breathing continually while they are unconscious during a surgical procedure. Propofol is so powerful that it is critical that a licensed professional be available to administer CPR in the event that breathing cease or if some other critical failure occurs. Propofol can trigger cardio-respiratory effects that are potentially fatal. Dr. John Dombrowski, a 16 year veteran anesthesiologist says, It is never used outside of a medical setting during a procedure and it is never used as a sleeping aid. Ive never heard of that in my 16 years of practice. Official autopsy reports indicated that the mixture Lorazepam, midazolam, and propofol were the cause of Jackson death. The autopsy report also indicated that the drug propofol was the primary drug in Jacksons system; hence Jacksons death was ruled a homicide by acute propofol intoxication. Shortly after Jacksons autopsy report was released, rumors and speculation emerged. The primary question the world wanted to know was if the anesthetic propofol is so powerful how did Jackson get access to it outside of a medical institution? Soon thereafter, all fingers pointed to Michael Jacksons physician, Dr. Conrad Murray. Dr. Murray is a cardiologist and personal physician. He is the founder of the Acres Homes and Vascular Institute which is a community clinic in Houston, Texas. Many in the Houston community view Dr. Murray as an amazing citizen that gives back to the community. On the other hand, there are many that view Dr. Murray as irresponsible, a fraud, and unethical. According to an online source, Biography.com, Unpaid debts, lawsuits, and tax liens have followed Dr. Murray's life. More than $400,000 in court judgments alone were issued against his Las Vegas practice, and in December 2008 Dr. Murray, who has an unknown number of

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children, was ordered to cough up $3,700 in unpaid child support. With this information given, there are several areas of character flaws and unethical practices attached to Dr. Murray. Michael Jackson and Dr. Murray first met in 2006 in Las Vegas, Nevada. Initially Dr. Murray was contacted to treat one of Jacksons children for a medical condition during their stay in Las Vegas. Shortly thereafter, Jackson and Dr. Murray became friends. In 2009, when Jackson began preparations for his upcoming This Is It tour, he request for Dr. Murray to become his personal physician. This request would not come cheap. Reports indicate that Dr. Murray and Jackson agreed that Dr. Murray would be paid a hefty amount of $150,000 per month. Reports showed that Dr. Murray stayed with Jackson a total of six nights per a week. Testimony during Dr. Murrays trail indicated that Jackson often requested and even begged for drugs powerful enough to for him to sleep. This request was made by Jackson due to a health condition he suffered from called insomnia. In most cases, this would result in doses of propofol being administered to Jackson by Dr. Murray. While Dr. Murray was taking advantage and cashing-in on Michael Jacksons vulnerability and health condition, little did he know that his lack of ethics would soon lead to the death of the King of Pop. According to biography.com, the events that took place the day of Jacksons death are as follows: On June 25, 2009, when Jackson, exhausted from a long rehearsal session at the Staples Center in Los Angeles that went past midnight, returned home and tried to get some rest. A familiar routine followed, with Murray hooking up his client to an IV in order to administer the propofol. Dr. Murray also gave Jackson lorazepam, an anti-anxiety medicine, and midazolam, a muscle relaxant. According to records, the doctor then left Jackson's side for a few minutes to go to the bathroom. When he returned he found the singer with a weak pulse and had stopped breathing. Reportedly, Murray immediately started applying CPR to revive the singer. In addition, in what has garnered plenty of

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controversy, Dr. Murray also administered another drug, flumazenil, to try to offset the sedatives already circulating in Jackson's body. Some experts have said Murray's use of this additional medicine may have actually exacerbated the problems propofol had caused. While questions remain about Dr. Murray's work to try and save Jackson's life in those first harried moments, what is clear is that 82 minutes passed before the doctor or anyone else at Jackson's home called paramedics to the house. When emergency officials did finally arrive, Dr. Murray at first failed to tell them about the drugs he injected into the singer. Jackson was officially pronounced dead at Ronald Reagan UCLA Medical Center, where he had arrived via ambulance with Dr. Murray at his side. On February 8, 2010, Dr. Murray was charged with involuntary manslaughter and
pleaded "not guilty." September 27, 2011 Dr. Murrays Trail began in Los Angeles, California.

During Dr. Murrays trial, Dr. Steven Shafer, a professor of anesthesiology at Columbia University and Stanford University testified that he found seventeen Separate and distinct egregious violations of the Standard of Care which includes: 1. The lack of the basic emergency airway equipment. 2. The lack of the advanced emergency airway equipment. 3. The lack of suction apparatus. 4. The lack of an IV infusion pump. 5. The lack of alarmed pulse oximetry. 6. The failure to use a blood pressure cuff. 7. The lack of an electrocardiogram. 8. The lack of capnography. 9. The failure to maintain a doctor-patient relationship. 10. The failure to continuously monitor the mental status of the patient. 11. The failure to continuously monitor the breathing of the patient. 12. The failure to continuously monitor blood pressure and pulse oximetry, and to have heart monitors. 13. The failure to call 911 immediately. 14. The failure to chart at the outset of the procedure (egregious and unconscionable). 15. The failure to maintain written informed consent (egregious and unconscionable). 16. The failure to document throughout the course of sedation (egregious and unconscionable).

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17. The failure to disclose to both the paramedics and UCLA the use of Propofol and What Murray witnessed at the arrest. When Dr. Shafer was asked Each one of these seventeen egregious violations is individually likely to result in injury or death to Michael Jackson? His response was Yes. Dr. Shafer also stated that four of the violations were unconscionable. With this information, one can conclude that Dr. Murray is not only in violation of Standard of Care but also of the oath he took as a doctor which states: 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. In conclusion, propofol is a highly dangerous drug that can cause death if it is not administered correctly. Dr. Murray is not a trained anesthesiologist and should have never administered such drug to his patient. In fact, medicinenet.com, an online medicine resource states, Actually, propofol (Diprivan) should never be carried by a doctor making a house call. It's meant for hospital use in the intensive care unit or the operating room, for patients who are incubated and on a ventilator. It's meant for the emergency room when people have to be sedated for a few seconds to undergo a painful procedure such as cardiac shock, or to fix a joint dislocation. The drug is meant to be given by physicians trained in critical care with equipment available to deal with any complication that might occur. It is not meant to be used as a sleeping pill. Dr. Murray is an unethical doctor. His practice has a long history of character flaws, abuse of privileges afforded to doctors, and corrupt tactics aimed for his personal gain. In this case Dr. Murrays personal gain came at the expense of Michael Jacksons life. On Tuesday November 29, 2011, Dr. Conrad Murray was convicted of involuntary manslaughter in the case of Michael Jacksons death. He was sentenced to the maximum penalty of four years in prison. His motives and hunger for money led him down a path to compromise morality. Dr. Murrays conviction and extensive amounts of unethical practices contributes to my conclusion; Dr. Conrad Murray is the health industrys Smooth Criminal

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Works Cited
Wedro, B. C., & Stppler, M. C. (2011, November 9). Michael Jackson's Death: propofol (Diprivan) FAQ. Inmedicinenet.com. Retrieved February 8, 2012, from http://www.medicinenet.com/script/main/art.asp?articlekey=113188

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WHITCRAFT, T., Brown, K., & PISARCIK, K. (2010, June 23). TIMELINE: Michael Jackson's Final Days. In ABC 2020. Retrieved February 8, 2012, from http://abcnews.go.com/2020/MichaelJackson/michael-jackson-final-days-timeline-yeardeath-king/story?id=10974394#.TzQh8sWXSAU

Medina, J. (2011, November 7). Doctor Is Guilty in Michael Jacksons Death. In New York Times. Retrieved February 8, 2012, from http://www.nytimes.com/2011/11/08/us/doctor-found-guilty-in-michael-jacksons-death.html?pagewanted=all

(n.d.). Retrieved February 8, 2012, from http://en.wikipedia.org/wiki/Trial_of_Conrad_Murray (n.d.). Retrieved February 9, 2012, from http://en.wikipedia.org/wiki/Propofol

Kaufman, G. (2009, July 1). What Is Propofol And Why Was Michael Jackson Allegedly Using It?. In MTV. Retrieved February 8, 2012, from http://www.mtv.com/news/articles/1615103/what-propofol-why-was-michael-jacksonallegedly-using-it.jhtml