In a January 23 hearing, the terms of Nicholas Alahverdian’s probation were altered by Judge Carl Henderson. The change was made in response to a complaint by the Chief Probation officer Joel Zeugner regarding Mr. Alahverdian’s holiday travel after receiving a travel pass. Both sides of the case were in agreement that the trip did not violate the terms of Mr. Alahverdian’s probation, but the court determined that the officer’s objection to his route merited limiting his travel to only what is necessary due to legal action in Rhode Island.
Following that, Judge Henderson asked about the other stipulations in the probation order. Officer Zeugner informed Judge Henderson that he has been sending requests to see Nicholas to doctors in the area, but Zeugner added, “…however, you know, I feel that I’m under some obligation to give full disclosure to these doctors that I’m interviewing.” Previously, Mr. Alahverdian filed legal action against Dr. David H. Roush over ethics violations. Officer Zeugner is choosing to call Mr. Alahverdian a litigation threat when contacting doctors about his treatment. According to officer Zeugner, for that reason, none so far have been willing to take his case.
The “treatment” in question is a standard thing in people who have been convicted; the courts will routinely order psychiatric evaluation, which can only be performed by court-approved psychiatrists or psychologists, and the court usually has a very short list. These psychiatrists evaluate and recommend treatment, and if they say none is needed then there will be none, but if they recommend treatment the probationer has to comply, and continue to pay that psychiatrist, or face jail time.
Judge Henderson responded to this information by stipulating that jail time would result if a physician is not found who will take Mr. Alahverdian’s case. This was followed by the statement that if Mr. Alahverdian does “anything to interfere” with the next doctor, that would also result in jail time.
This places Mr. Alahverdian in a precarious position; whether or not he is considered compliant with the requirements of his sentence is now out of his control. Because his treatment is court ordered and specific in nature, he is required to treat with a state-approved physician, meaning that he must depend on the state to contract a physician for his treatment. The ruling makes it possible for Officer Zeugner to use Mr. Alahverdian’s history with Dr. Roush to make put him in violation of the terms of his probation through no action of Alahverdian’s own. Further, if Mr. Alahverdian encounters another doctor who violates standards of ethics the way Dr. Roush did, this ruling is an order to tolerate the abuse, or face jail time.
The American Medical Association’s Principles of Medical Ethics states that a physician must “recognize responsibility to patients first and foremost,” and “shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights.” Ordinary patients can abandon treatment with a physician who they feel is not upholding those standards. A patient ordered by the state to be treated by a specific physician, however, cannot. The judge’s order negates the patient’s legal right to refuse medical treatment.
This type of treatment is unlike ordinary medical care. A physician treating a patient ordered by a judge to receive treatment has, in effect, a captive audience. Treatment is over when the physician says the patient doesn’t need further treatment. An ethical physician will honestly evaluate and treat patients ordered to see him or her just the same as any other patient, but an unethical physician could extend the patient’s treatment (and therefore, his obligation to pay the physician) indefinitely with a variety of claims about evaluation and treatment. Because the patient’s right to refuse treatment has been denied under threat of incarceration, his only recourse, should a physician misstate his condition in order to continue collecting payment for treatment, is legal action. Refusing Mr. Alahverdian the right to recourse for ethics violations–Alahverdian reports abusive behavior and demands by the physician that he “admit” to things that were not true–in effect removes all oversight from the equation. Anyone with whom the state orders him to treat is now free to violate the patient’s human rights without fear of any repercussions.
The American Medical Association’s Principles of Medical Ethics states that a physician must “recognize responsibility to patients first and foremost,” and “shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights.”
It is troubling that the courts can specify a small number of physicians whom they will be acceptable, and these physicians know each other, and have a financial motive for negative findings on whoever the court assigns them to. This is yet another aspect of why cases like Nicholas’ are so important.
We will continue to support Nicholas in his quest for justice, and will continue to provide updates as we have them.