The blog WhyQuit.com asks: “How should your family describe your cause of death? Was it suicide, murder, an accident or stupidity?” Playing Russian roulette, engaging in extreme sports, taking large doses of soporific drugs, and many other activities fit each of these options. When do we blame such deaths on the deceased, and when do we not? The answer lies mainly in the language and setting in which the question is framed.
Our basic biological needs are air, food, water, sleep, and sex. We are provided with air by our normal environment. We trade food and water in the free market. Buying sex was generally legal in the past, while selling it was often prohibited. Now in many “advanced” societies selling sex is legal but buying it is penalized.
The trade in sleep belongs in a different category. Most chemicals for inducing sleep are available only to medical personnel for specific purposes, or to private individuals indirectly, with the assistance of licensed physicians or drug dealers in the black market. We must keep this legal-social context in mind if we wish to understand and judge certain contemporary “tragedies,” such as the deaths of two of the most popular American entertainers of their times, Elvis Presley and Michael Jackson.
Screaming into a microphone on a brightly lit stage in the evening in front of a wildly cheering crowd is not conducive to sleeping soundly later that night. “Downers” in the evening and “uppers” in the morning may be regarded as part of a popular entertainer’s professional equipment, as well as an occupational health hazard for the profession. However, prescription laws prevent performers from procuring the drugs they want, turning them into dependents managed according to what doctors deem they need, ostensibly for the proper treatment of their fictitious diseases. This arrangement makes doctors necessary for VIPs seeking “controlled substances” and endangers VUPs (very unimportant physicians) willing to succumb to the temptation to service them. In a free society adults would pay for the drugs they want and would be responsible for their use.
Elvis Presley started to use drugs early in his career and, as his fame grew, became a big-time drug user. On December 21,1970, when President Nixon received Presley in the White House and presented him with a Bureau of Narcotics and Dangerous Drugs badge, identifying him as an agent of the government’s drug enforcement apparatus, Presley was heavily drugged. He took the opportunity to express his patriotism by telling Nixon that the Beatles, whose songs he regularly performed, exemplified what he saw as a trend of anti-Americanism and drug abuse in popular culture. After Presley died of a drug overdose on August 16, 1977, at age 42, President Jimmy Carter issued a statement that credited Presley with having “permanently changed the face of American popular culture.”
In 1980 Presley’s personal physician, Dr. George Nichopoulos, aka “Dr. Nick,” was indicted on several counts of “overprescribing drugs.” The jury acquitted him on all counts. The Tennessee Board of Medical Examiners then found him guilty of overprescribing, imposed a three-month suspension of his license and three years’ probation, and then in 1995, permanently revoked his license. Evidently it never occurred to the Tennessee judicial authorities, or anyone else, to blame Presley’s death on his doctor and charge him with killing his patient.
Contributory negligence is the legal defense against a claim based on negligence, where the plaintiff/claimant, through his own behavior, contributes to the harm he suffers. The knowing and deliberate use of prescription drugs—categorized as treatment for the disease called “drug addiction”—fits that criterion perfectly. In the past we did not demonize drugs; we called persons who traded in sedatives “druggists,” “pharmacists,” “doctors,” or simply “sellers.” Now we call them “enablers,” another weasel word generated by the therapeutic state.
In the 1950s and 1960s, when President and Mrs. John F. Kennedy were “enabled” by the now-forgotten Dr. Max Jacobson, aka “Dr. Feelgood,” the drug dispenser was not yet called an “enabler.” Jacobson’s customers, in addition to the President and First Lady, included many celebrities. Before the first debate with Nixon on September 26, 1960, Jacobson injected Kennedy with a combination “of amphetamines, steroids and vitamins. Within minutes Kennedy felt a surge of energy and optimism. Kennedy then had sex with a young woman brought to his room so that by the time he confronted Nixon, he was going to feel both energetic and relaxed” (tinyurl.com/86ey8hz). Jacobson was also part of the presidential entourage at the Vienna summit in 1961.
By May 1962 Jacobson had visited the White House to treat JFK 34 times. In 1972 Jacobson told New York Times science writer Boyce Rensberger: “I worked with the Kennedys; I traveled with the Kennedys; I treated the Kennedys; they never could have made it without me.” In 1975 the New York State Board of Regents revoked Jacobson’s medical license. Sic transit gloria pharmacopolae. (So passes the glory of the quack.)
No physician was blamed for the suicide-“murder” of Marilyn Monroe, one of JFK’s, and RFK’s, paramours. Indeed, Dr. Ralph Greenson—a prominent Los Angeles psychoanalyst who, qua psychoanalyst, was not supposed to have used drugs in his practice but had prescribed large quantities of barbiturates to her and was one of the first persons to see Monroe after her death—was quickly exonerated as attempting to wean her off drugs. Neither he nor another physician who had prescribed sedatives for Monroe was deprived of his license.
De facto, Michael Jackson killed himself or contributed heavily to his own demise. De jure, his physician, Dr. Conrad Murray, killed him. Jackson was exonerated of any role in his own death. Having medicalized suicide, we delude ourselves into believing we have made large advances in the diagnosis and treatment of self-killing but are unaware of having lost our ability to see what’s in front of our nose. In 1899 a certain Dr. Ward in Arizona observed: “I have never been called to attend a case of Gila monster bite, and I don’t want to be. I think a man who is fool enough to get bitten by a Gila monster ought to die. The creature is so sluggish and slow of movement that the victim of its bite is compelled to help largely in order to get bitten” (tinyurl.com/6vwex6j).
After Murray was convicted he was denied bail. “This is not a crime involving a mistake of judgment. . . . This was a crime where the end result was the death of a human being,” explained Judge Michael Pastor. “That factor demonstrates rather dramatically that the public should be protected.”
Dr. Ward disagreed that the public needed to be protected from Gila monsters. I disagree that public security requires that Murray be incarcerated. Taking away his license would suffice to accomplish that end. (This statement must not be interpreted as an endorsement of medical licensure laws. Here I address the drug-related death of certain celebrities and the legal fate of their physicians. I have critiqued our drug laws elsewhere.)