Fentanyl overdose deaths: Why was this doctor allowed to study and practice medicine?
In his application for an Ohio medical license in 2013, Dr. William Husel wrote, “My passion is taking care of sick patients in the ICU. Please give me the opportunity to practice what I love doing.”
How then did he go from doctor to accused murderer? And how could tragedy have been prevented? These are pressing questions about the Ohio critical care physician who is charged with prescribing massive doses of fentanyl that killed 25 patients. William Husel pleaded not guilty in one of the largest murder cases ever brought against an American doctor.
It might seem Husel’s behavior developed from the ether, but a closer look reveals that his trouble started in college. As freshmen, Husel and a friend ran a car stereo theft ring; built, stored and detonated a pipe bomb; and obstructed justice by attempting to frame a classmate. Husel agreed to a plea deal in 1996 that would forever stamp a federal misdemeanor conviction to his record.
What blows our minds is that a convicted pipe bomber was accepted to medical school, then rose through a complicated, intricate system to become a practicing physician!
William Husel, a former doctor in Columbus, Ohio. (Photo: Franklin County Sheriff’s Office via AP)
As practicing anesthesiologists at two large academic medical centers, we’re uniquely qualified to opine on Dr. Husel’s poor ability to keep his nonterminal patients alive. If anyone understands how high-dose fentanyl affects patients, it’s anesthesiologists like us who spend years training to safely and effectively administer medications for major surgeries. We are ashamed that our specialty board certified this person. His very existence in our profession is an embarrassment.
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Up until the murder accusations rolled in, Husel’s life made for a feel-good redemption story: a highly intelligent, handsome ex-basketball star who, while troubled in his youth, makes good by working diligently, studying hard and charming his way over the many hurdles that medical school applicants and young physicians face.
We have carefully reviewed his 113-page medical licensing application, including details of his criminal acts. We simply can’t understand the logic of allowing him to practice. Even though Husel expertly downplayed his criminal past to regulators, he was actually part of a small, inglorious group. Only 336 people were prosecuted nationwide for federal arson and explosives charges from Oct. 1, 1996, to Sept. 30, 1997.
Medicine ignored Husel’s warning flag
The medical board and institutions appear to have taken Husel’s application at face value while writing off his transgressions as the folly of youth. How heavily did the board rely on the fact that he had performed well according to two faculty members at his training hospital? Husel waved his warning flag high, but the system was easily distracted by a transformation story it wanted to believe.
Protecting patients from unprofessional and incompetent care are the most important aims of medical practice and regulation. It isn’t until students are in the medical training system that they gain access to vulnerable populations. Yet schools, hospitals and regulatory agencies looked past credible, alarming evidence and admitted him anyway.
Enough highly qualified, intelligent people apply to medical school each year to fill every seat in America. Admissions committees sift through hundreds of thousands of applications to find the few thousand they deem worthy of admission. Those of us in medical education and licensure cannot accept letters like Husel’s at face value. The capacity to forgive and believe in second chances led our profession to make a grave mistake that appears to have cost the lives of more than two dozen people.
Doctors have terrifying power
We must accept that applicants with serious criminal behavior in their pasts do not belong in medicine. Yes, some promising students with troubled pasts who have genuinely changed will be excluded, but that’s a price we’re willing to pay for the health and safety of the public. If a medical school, training program or medical board really wants to take chances on a candidate who has committed serious ethical violations, dig deep into their motivations, background and personal life. Convince the community beyond a doubt that this person is worth the risk.
Because here’s the thing: As hard as it is to be accepted to medical school, once in, it’s shockingly difficult to get kicked out of medicine, even with bad behavior. Few physicians are ever sanctioned or lose their licenses.
William Husel is a walking example of the terrifying power of admittance into the practice of medicine. As a profession and as a society, we must demand even more rigorous screening before medical school entry, especially for applicants with serious ethical violations in their pasts. If we fail to do so, more physicians like Husel may end up at our bedsides, prescription pads in hand.
Alyssa Burgart is an assistant professor of anesthesiology at Stanford University, faculty member at the Stanford Center for Biomedical Ethics and medical director of clinical ethics at Lucile Packard Children’s Hospital. James Lozada is an assistant professor of anesthesiology at Vanderbilt University Medical Center. Follow them on Twitter: @BurgartBioethix and @drjlozada
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