Were These Doctors Treating Pain or Dealing Drugs?

Over the past 15 years, as federal agents have raided pill factories and prosecutions have increased, the language around “legitimate medical purpose” and “professional practice” has been interpreted differently by various federal appeals courts. These readings determine how the judge instructs the jury on what they must find to convict or acquit the appointer.
Briefly asking for a clear legal standard, professors of medical law and politics argue that several appellate courts, including the US Court of Appeals for the 11th Circuit, which upheld Dr. Ruan’s conviction, and the US Court of Appeals for the 10th Circuit, which upheld Dr. Kahn’s conviction, allow doctors to be convicted if they deviate from accepted medical practice. , without the jury also found that the doctor did it “without a legitimate medical purpose.” This standard, they say, lacks an essential component of criminal law: intent.

This element, the professors wrote, distinguishes well-meaning, perhaps negligent, doctors from criminals. Without requiring intent, the Controlled Substances Act “has been used as a weapon against medical practitioners in response to the overdose crisis,” they said. Prosecutions have increased, they say, and standards of conviction are “continuously eroding.”
The professors argue that this broad standard can trap physicians into determining that an individual patient requires an opioid prescription that exceeds generally accepted limits. Physicians who prescribe off-label drugs, which is common practice, may also fall under this standard.

Conversely, other schemes require prosecutors to prove beyond reasonable doubt that doctors knew not only that they were deviating from accepted medical practice but, most importantly, that they were prescribing drugs without a legitimate purpose.
But how far can a good faith defense go? Is it sufficient for physicians to simply state that they believed the prescriptions served a legitimate medical purpose?
Thus, “good faith” may appear to be a subjective criterion; “legitimate medical purpose,” objective. If so, then they are inherently in conflict.