The Passing of Michael Jackson and the Investigation, Part 4

Recent media reporting on Michael Jackson’s investigation suggested that the drug, "Propofol may have been the cause of his death. According to Lehne (2007), "Propofol (Diprivan) is an IV sedative-hypnotic used for induction and maintenance of anesthesia…unconsciousness develops within 60 seconds and lasts for 3-5 minutes following a single injection" (Pg. 255). A question remains, "Why would any doctor use this medication in a home setting?" If in fact, the superstar was having trouble sleeping and/or experiencing pain and became addicted to previous medications that no longer provided relief, was this the next potent drug of choice? Another medication that was also reported being repeatedly prescribed was OxyContin, a drug to relieve pain for extended periods of time. Lehne (2007) stated, "In recent years, there have been increasing reports of OxyContin abuse. As a result, safety warnings have been strengthened" (Pg. 269). Yet another question; is safety deemed a priority when treating the rich and famous? Undercovering what exactly were the causes of Jackson’s death could take years. Drugs documented on his toxicology report, however, will undoubtedly provide nursing forensic prevention guidelines when encountering patients making such medication requests. Opioids are medications that need to be more closely monitored in order to provide patients with a balanced approach to health care and pain management. Lehne (2007) noted, "When opioids are administered in high doses for 20 days or more, clinically significant physical dependence may develop" (Pg. 271). Since there were a number of medical professionals involved in Michael Jackson’s life over many years, can this one doctor, Conrad Murray, be the only liable party? Addiction happens over a period of time and it is most likely that other health care providers were witness to his lifestyle and reported odd behavior. Antidepressant drugs such as Zoloft and Xanax could also be contributing factors in Jackson’s death. It is conceivable that the cocktail of drugs in his body caused cardiac arrest, since the most serious adverse effect is cardiotoxicity. According to Lehne (2007), cardiac toxicity affects the heart by decreasing vagal influence on the heart and acting directly on the bundle of His to slow condition. To minimize risk, all patients should undergo electrocardiographic (ECG) evaluation prior to treatment and periodically thereafter (Pg. 335). How many times did Jackson get his heart evaluated over the years? How many mental health professionals prescribed these medications? Demerol was another medication on his list of choice drugs throughout the years that was noted as a possible contributor to his demise. Serious concerns with such analgesics are respiratory depression, circulatory depression, respiratory arrest, shock and cardiac arrest. In addition, one of the many side effects of this drug is loss of appetite. Since Michael Jackson’s weight was exceptionally low for his height, medications such as this, if frequently used, could have created harmfully abusive health habits. Jackson’s reported sleep problems may have resulted from an array of reasons, necessitating the consumption of multiple medications to relax his state of mind. Lehne (2007) noted, "Chronic insomnia is a major risk factor for automotive and industrial accidents, marital and social problems, major depression, coronary heart disease and metabolic and endocrine dysregulation" (Pg. 373). With his upcoming 50-concert tour in London unfolding at the age of 50, his self image and self-esteem may have caused more stress than he could handle, combined with the responsibility for single parenting his three young children. There seems to be so many lingering questions surrounding the investigation of this celebrity’s sudden death, the answers from which could serve as a meaningful learning experience for forensic nursing. References Lehne, R. A. (2007). Pharmacology for Nursing Care (Sixth Edition). Pgs. 255-373.

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