Who is Responsible for Michael Jackson's Death?

Because Michael Jackson’s death has affected us all, I’m going to deviate from my usual posts to share my thoughts. Many individuals have asked me, in my role as a physician, to comment. His tragic death (and life) has brought up many important controversial issues.

First, let me be clear: I am not condoning any irresponsible or criminal behavior on the part of a physician. If these medications were not prescribed responsibly then, of course, this needs to be addressed, as it should be in any situation in which doctors are prescribing irresponsibly. When a person is addicted, they will use extreme means to obtain the addictive substance, and anyone with power or money will be more successful in obtaining these substances.

1. Michael Jackson was misunderstood by many. He viewed the world differently from others. We need to be very careful when judging another human being whom we do not understand. I would go so far as to say that we probably shouldn’t be judging him at all. But it is clear to me that he suffered from being misunderstood. It is also clear that he was dealing with both emotional and physical problems that were not treated by addressing the underlying causes. Conventional medicine is limited in diagnosing and treating underlying causes. This needs to be acknowledged. Addictions are also extraordinarily difficult to treat, and, when treated, relapses are the rule rather than the exception. Also, perhaps most important, the individual needs to want to heal (or be forced by those around him to seek treatment).

2. This leads me to the next point. Did Michael choose treatment for his addiction? Did those closest to him fail in getting him help? These are loaded questions. It is near impossible for someone who is addicted to “choose” treatment. It is equally difficult for others to enforce treatment, especially with someone so independently powerful and isolated.

3. So who, ultimately, is responsible? The doctors who filled his prescriptions? Michael, himself? Michael’s friends and relatives who were unable to recognize that he needed help, or recognized this need but were unable to intervene? What about those making career-related demands? How about society as a whole? What about all of the people who misunderstood him? And those who may have abused him emotionally or physically?

I feel that the issue of responsibility is too complex to blame any one person. If we look deeper, we will probably find many responsible. I was surprised by the extent of Deepak Chopra's anger. I have no reason to doubt his allegation that this is a common occurrence between celebrities and their doctors, and, as a physician who can’t remember the last time she wrote a prescription for a narcotic, I certainly understand his anger. I can’t help but notice, though, that his anger seems personally charged, and this makes me ask the question of whether or not he personally feels responsible for not being able to help Michael. I heard the same anger in the Jackson family attorney’s voice when he said that he had “warned” the family. I understand this all too well. Patients frequently expect me to take responsibility for their health. We each need to start taking responsibility for our own health and choices, rather than passing off this responsibility to others.

The chronic pain management situation has become almost schizophrenic. As physicians, we, in the past, have been so hesitant to prescribe narcotics that many patients who truly need them have been undertreated, and their chronic conditions have worsened. This has become so common that the State of California now requires all physicians to take a twelve-hour course about chronic pain management and end-of-life care. I hope that the outcome of this “investigation” of Michael Jackson’s death does not have the undesired effect of decreasing access of these medications to those who are in true need. I also hope that his death will bring more attention to finding viable solutions to addiction and chronic pain.

Lastly, I hope that Michael Jackson has finally found peace. We honor him, and we will miss him.

I would love to hear your thoughts about this.