This Is It: Dr. Conrad Murray & Michael Jackson’s Death by Propofol

It’s been over two years since the death of Michael Jackson and the much anticipated trial of Dr. Conrad Murray has finally begun.

Murray has been charged with involuntary manslaughter in Jackson’s death. Involuntary manslaughter is the “unlawful killing of a human being without malice aforethought”. It is distinguished from voluntary manslaughter by the absence of intention.

His death was ruled a homicide with a cause of “Acute Propofol Intoxication.”

Those looking for drama in the courtroom have not been disappointed: The prosecution opened the trial by showing a video of Jackson practicing at a rehearsal for his upcoming “This Is It” tour, followed by a picture of the lifeless body of Michael Jackson on a hospital gurney less than 24 hours later.

They also played an audio recording of Jackson, speaking in a slow, deep, slurred fashion. The recording was made by defendant Murray himself on his cell phone several weeks before Jackson’s death:

The defense maintains that Dr. Murray was trying to wean Jackson off of Propofol, and even suggested that Jackson may have given himself a lethal dosage while Dr. Murray was out of the room.

“Milk of Amnesia”

As we have described before, Propofol (brand name Diprivan) is an intravenous (injected into a vein) sedative-hypnotic medication used to sedate patients as they are being put under anesthesia.

It is frequently used during outpatient surgical or diagnostic procedures, such as a colonoscopy, and inpatient procedures.

It is a safe drug when used in the proper settings, and with the proper monitoring of a patient, usually by an anesthesiologist. Patients must be attached to a heart rate monitor and to what is called a pulse oximeter, to measure the amount of oxygen in the blood.  Emergency resuscitation equipment must be nearby.

Dr. Murray had been treating Michael Jackson for insomnia (sleeplessness) for several weeks prior to Jackson’s death. Dr. Murray was using the following drugs: propofol (Diprivan), lorazepam (Ativan), midazolam (Versed) and diazepam (Valium) in various combinations and doses.

None of these drugs are FDA-approved for treating insomnia.

However, once drugs are on the market, physicians may legally prescribe and administer FDA-approved drugs for any disease or condition and indeed such off label use is extremely common. It is up to the individual doctor to understand the latest medical information and their own qualifications and experience when giving any drug.

According to the FDA recommendations on the proper use of propofol:

Sedated patients should be continuously monitored, and facilities for maintenance of a patent [open] airway, providing artificial ventilation [breathing], administering supplemental oxygen, and instituting cardiovascular resuscitation must be immediately available. Patients should be continuously monitored…”

These were not the conditions under which Michael Jackson received the drug.

Do you think these circumstances make Dr. Murray guilty of involuntary manslaughter?

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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