Supreme Court clarifies liability standard for physicians prescribing controlled substances

The U.S. Supreme Court clarified June 27 what the "knowingly or intentionally” standard is for prosecutions against physicians accused of overprescribing medication, according to an article in JDSupra.

Federal prosecutors accused two physicians of illegally prescribing large volumes of opioid painkillers to patients in Ruan v. United States and Kahn v. United States. Under the Controlled Substance Act, prosecution must prove that a physician "knowingly" broke the law. 

According to the defense in the two cases, physicians knew they were prescribing opioid painkillers, but believed the prescriptions were authorized because the prescriptions were "issued for a legitimate medical purpose by an individual practitioner acting in the usual course of his professional practice."

The trial courts applied a standard of "objectively reasonable good-faith effort," asking juries to decide not whether a physician subjectively knew the prescriptions were not for a legitimate medical purpose, but whether a "hypothetical reasonable doctor" objectively would have known the prescriptions were unauthorized.

The Supreme Court sided with the physicians, saying that the prosecution's objective standard would put the liability on a hypothetical physician rather than the mental state of the physician. The Supreme Court concluded that prosecution must prove beyond a reasonable doubt that the physician subjectively knew a prescription was unauthorized under the Controlled Substances Act.

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