Last Monday, the final defendant in the Buymeds case pled guilty and the U.S. Attorney’s Office announced that all defendants have now entered guilty pleas. Including what the USAO calls “related prosecutions,” it’s a long list:
ORLANDO BIRBRAGHER, 51, of Miami, Florida; MARSHALL NEIL KANNER, 53, of Miami Beach, Florida; PETER LOPEZ, 54, formerly of Puerto Rico, and DOUGLAS WILLIS BOUCHEY, 53, formerly of Dubuque, Iowa, were convicted of charges related to an Internet pharmacy operating the website BuyMeds.com.
According to the USAO:
A doctor may not authorize a prescription for these drugs unless there is a legitimate medical need for the drug, and then only if the doctor has a real medical relationship with the patient. Likewise, a pharmacist may not dispense these drugs based on a prescription if that pharmacist knows, or should have known, the prescription was not lawfully issued. Internet pharmacies operate illegally if they allow Internet customers to receive drugs without proving a medical need for the drugs, and without establishing any real doctor/patient relationship with the authorizing physician.
First, what does it mean to “prove” a medical need? As I’ve mentioned before, there is no blanket requirement that doctors demand “proof” of medical necessity. Instead, it’s a question of reasonable medical judgment and good faith. Is the government alleging that these people knew the patients didn’t need the drugs? Then it should say so. But if it’s just a lack of proof, I’d ask the government to prove that proof is needed.
Second, though I’m sounding like a broken record, I’d ask the government to prove that a “real doctor/patient relationship” a) is even an element of medical care and b) doesn’t exist here.
The more I hear about this phrase/element, the more it’s clear that it is an entirely circular and meaningless in that it assumes its own truth without proving anything. Specifically, the doctor/patient-relationship argument goes like this: (1) Every prescription (supposedly) requires a doctor/patient-relationship that (2) cannot be created online, therefore, (3) every online prescription is invalid. I’ve yet to see any proof of either point (1) or point (2), which means that this assertion is a conclusion, not a proof of anything. And I must add, that if it’s going to support criminal charges, it can’t be just a nice idea. It has to be clear enough that all reasonable people must admit that it’s correct. It has to be beyond debate. And not only is this assertion not beyond debate, it’s demonstrably and provably wrong!
I’m getting frustrated so I’m going outside for some fresh air. Back later.
