Three years after Anna Nicole Smith died of an accidental prescription drug overdose, California prosecutors are trying two of her doctor’s and her attorney/boyfriend, Howard K. Stern. The three are being tried for conspiracy to prescribe controlled substances to an addict. Assistant District Attorney Renee Rose made opening statements to a jury on Wednesday, saying that the defendants had violated the trust that Smith put in them by “recklessly funnel[ing] powerful drugs to the pill-popping model.”

Although none of the defendants are being charged with contributing to Smith’s death, unlike the Michael Jackson trial where Dr. Conrad Murray is being charged with involuntary manslaughter, prosecutors have already hinted that her death could have been avoided if she hadn’t been recklessly provided with drugs. Because of concerns about lack of fairness, California Superior Court Judge Robert Perry has barred all evidence linking the defendants to the overdose that caused Smith’s death. However, in a pre-trial hearing last week, prosecutors made allegations that suggest they consider Smith a co-conspirator and may add her as an uncharged defendant in order to gain the admission of certain key evidence.

Smith, who worked as a model and then gained notoriety for marrying an 89 year-old oil billionaire, had a history of drug problems and made national headlines for her “loopy” behavior at the American Music Awards in 2004. However, the defendants deny knowing that Smith was an addict and claim that they were working to treat Smith’s documented chronic pain and depression.

Smith’s death was the first in a series of celebrity deaths from prescription drugs, including the deaths of Heath Ledger and Michael Jackson. California Attorney General Jerry Brown has said that the trend must stop and that “just because it’s in a nice little package and has a name on it . . . doesn’t mean it can’t kill you.”

Given how well-documented Smith’s struggle with drugs was and her often erratic behavior, it seems like a stretch for her doctors to claim that they were unaware of her problems. Even if they were unaware, it’s not clear that that would absolve them from liability. In a culture where celebrities often use and have access to drugs, it seems especially reckless for doctors to prescribe strong prescription pills without finding out the patient’s drug history. An online investigation would most likely have revealed an interview that Smith gave to ABC news in 2000, in which she admits that she has been addicted to prescription drugs.

Doctors dealing with celebrities may gain a window into the lifestyles of the rich and famous, but they should not forget that their first duty is to “do no harm.” That means not allowing the Hollywood glitz and glamour to distract from the seriousness of the situation and focusing on what the patient needs as opposed to what they want. If, as prosecutors claim, Smith was having sex with her doctors to keep the medications coming, then lines were definitely crossed.

Although celebrities may not be used to hearing the word “no,” doctors should invoke it more often; otherwise their patient may become the next Anna Nicole Smith or Michael Jackson, leaving the doctor facing criminal charges. Regardless of whether these specific individuals should be held criminally responsible for their role in providing Smith with drugs, things clearly should never have reached the point that they did and doctors treating celebrities need to seriously examine whether they are solving medical problems or enabling troubling behaviors.

- Joanna Barry

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