By ANTHONY McCARTNEY, Associated Press
LOS ANGELES — Michael Jackson's personal physician was giving the pop superstar a modern drug to help him sleep, but a prosecution expert told jurors Wednesday that in doing so he violated ancient principles for conduct between doctors and patients.
Dr. Steven Shafer, an expert in the anesthetic propofol that Jackson's doctor had been using as a sleep aid, said there were 17 violations by Dr. Conrad Murray that each put Jackson's life at risk.
Murray has pleaded not guilty to involuntary manslaughter. He was Jackson's personal physician for roughly two months before the singer's unexpected death in June 2009. The cardiologist's attorneys will cross-examine Shafer on Thursday.
Many of the violations concerned modern life-saving equipment that Murray lacked when he gave Jackson propofol in the bedroom of his rented mansion, but Shafer said among the cardiologist's worst transgressions was he put his own interests ahead of Jackson's.
Since Ancient Greece – and probably before – Shafer said societies had held doctors to high standards. He quoted the Hippocratic oath, "'In every house where I come, I will enter only for the good of my patients.'"
Instead of honoring the ancient creed, Murray came to Jackson's rented mansion nightly and gave the singer propofol, a drug as a sleep aid, a use it was never intended for, Shafer said. He likened the Houston-based cardiologist to an employee, akin to a housekeeper, who wouldn't tell his boss no.
"Saying yes is not what doctors do," he testified. "A competent doctor would know you do not do this."
Shafer, a Columbia University professor and researcher who helped write the guidelines and warnings included with every vial of propofol, repeatedly said Murray's actions were unconscionable, unethical and illegal. He frequently travels to lecture on propofol's effects, and his testimony took a global view Wednesday as he described attending anesthesia conferences in China, research from Canada, and how hieroglyphs in ancient Egypt showed doctors interacting with patient.
But he said Murray's case is unlike any he's seen before.
"We are in pharmacological never-never land here, something that was done to Michael Jackson and no one else in history to my knowledge," he told jurors.
Shafer's testimony tied together pieces of prosecution's case against Murray laid out over four weeks. The professor reminded jurors that Murray had bought more than four gallons of propofol to use on the singer during his employment, was on the phone in the hours before Jackson's death and delayed calling 911 when he found the singer unresponsive.
"A patient who is about to die does not look all that different from a patient who is OK," Shafer said, adding that doctors cannot multitask and properly monitor a patient who is sedated.
"The worst disasters occur in sedation and they occur when people cut corners," Shafer said. In Jackson's case, "virtually none of the safeguards were in place," he added.
Shafer, who wrote the package insert that guides doctors in the use of the anesthetic, leaned forward and spoke to jurors directly at times, as if he were in a classroom. Indeed, the early portion of his testimony was a crash course in propofol, explaining its effects on the body and why despite being a remarkable drug, it needed to be used by skilled people in the proper medical setting.
The researcher told jurors that it appeared Murray intended to give Jackson large doses of propofol on a nightly basis. He said records showed Murray purchased 130 100ml vials of propofol in the nearly three months before Jackson's death.
Shafer said that is "an extraordinary amount to purchase to administer to a single individual."
Like other expert witnesses, Shafer based much of his opinions on the case on Murray's own words during a lengthy interview with police two days after Jackson's death.
He said the lack of record-keeping was a violation of Jackson's rights, especially since something went wrong.
"He has a right to know what was done to him," Shafer said. "With no medical record, the family has been denied that right."
When Shafer spoke of Jackson's family, a couple jurors looked out into the audience, where the singer's mother, father, sister Rebbie and brother Randy were seated.
Testimony has shown that Murray took no notes on his treatment of Jackson and didn't record his vital signs in the hours before the singer's death.
Shafer said he was testifying for the prosecution without a fee because he wants to restore public confidence in doctors who use propofol, which he called a wonderful drug when properly administered.
"I am asked every day in the operating room, `Are you going to give me the drug that killed Michael Jackson,'" Shafer said. "This is a fear that patients do not need to have."
Defense attorneys will begin calling their own witnesses. One of them will be a colleague of Shafer's at Columbia, Dr. Paul White, who was sitting in the courtroom during Wednesday's testimony.
Murray was mainly stoic as he listened to his medical skills and judgment were repeatedly called into question. White, seated behind him, took notes.
AP Special Correspondent Linda Deutsch contributed to this report.
Michael Jackson as part of the Jackson Five.
FILE - In this Feb. 26, 1986 file picture, Grammy winners Dionne Warwick, Stevie Wonder, Quincy Jones, Michael Jackson and Lionel Richie pose together backstage at the Grammy Awards show in Los Angeles. Jackson has died in Los Angeles at the age of 50 on Thursday, June 25, 2009.
FILE - In this Dec. 1, 1984, file photo, pop artist Michael Jackson, center, is shown onstage at opening night of his Victory Tour at Dodger Stadium in Los Angeles.
Singer Michael Jackson, performs during "Victory Tour" in this July 1984 file photo taken in the USA. Bidders from around the world bought up Michael Jackson memorabilia worth nearly $1 million at an auction on the anniversary of his death, Friday June 25, 2010 including $190,000 for the Swarovski-crystal-studded glove he wore on his 1984 Victory Tour.
FILE - In this Aug. 25, 1993 file photo, American pop star Michael Jackson performs during his "Dangerous" tour in Bangkok. Ein New Yorker Bundesrichter hat die Millionenklage eines Konzertveranstalters gegen Michael Jackson abgewiesen. Richter Harold Baer gab am Donnerstag, 19. August 2010, einem entsprechenden Antrag der Nachlassverwalter des verstorbenen Popstars statt
FILE - In this Dec. 30, 1992, file photo, Michael Jackson sings "Black or White" while Guns n' Roses Slash plays the guitar during his Danergous World tour in Japan at Tokyo's indoor stadium.
FILE - In this Jan. 31, 1993 file picture, Michael Jackson performs during the halftime show at the Super Bowl XXVII in Pasadena, Calif. Jackson, the sensationally gifted "King of Pop" who emerged from childhood superstardom to become the entertainment world's most influential singer and dancer before his life and career deteriorated in a freakish series of scandals, died Thursday, June 25, 2009.
Larry Feldman, center, attorney for the 14-year-old boy that accused Michael Jackson of alledgedly molesting him, a decade ago answers reporters questions, in this Jan. 25, 1994 photo, outside Santa Monica Superior Court.
Michael Jackson waves to fans as he arrives to the Santa Barbara County Courthouse in Santa Maria, Calif., Monday, June 13, 2005.
Michael Jackson prepares to enter Santa Barbara County Superior Court in Santa Maria, Calif., with his brother Randy Jackson, right, to hear the verdict read in his child molestation case Monday, June 13, 2005.
Michael Jackson blows a kiss to his fans as he leaves the Santa Barbara County Courthouse in Santa Maria, Calif., Monday, June 13, 2005. The jury in the Jackson child molestation case found the pop star not guilty on all counts.
The body of musical legend Michael Jackson leaves in a Los Angeles County helicopter from the UCLA Medical Center on June 25, 2009 in Los Angeles, California. Jackson died after suffering a cardiac arrest, sending shockwaves sweeping across the world and tributes pouring in for the tortured music icon revered as the 'King of Pop.'
Jackie Howe (R) of Flint, Michigan, her daughter Taylor, age 13, and son Piper (bottom), age 4, embrance as supporters of recently deceased pop star Michael Jackson hold a candlelight vigil for the singer outside of 'Hitsville USA', the nickname given to Motown Records' first headquarters now the Motown Historical Museum on June 28, 2009 in Detroit, Michigan. Jackson died at UCLA Medical Center after going into cardiac arrest at his rented home on June 25 in Los Angeles, California at the age of 50.
Israeli fans of Michael Jackson mourn during a memorial service for the pop legend in Tel Aviv on June 28, 2009. Michael Jackson died on June 25, 2009 after suffering a cardiac arrest, sending shockwaves sweeping across the world and tributes pouring in for the tortured music icon revered as the 'King of Pop.'
FILE - In this Jan. 25, 2011 file photo, Dr. Conrad Murray, singer Michael Jackson's personal physician, appears in Los Angeles Superior Court where Murray pleaded not guilty to a charge of involuntary manslaughter in the pop star's 2009 death. In an 11th hour appeal Friday, Sept. 2, 2011, Murray's attorneys sought to overturn a judge's refusal to sequester jurors, arguing they would be "poisoned" by publicity unless they were kept in isolation during the involuntary manslaughter trial.
In this Thursday, Aug. 25, 2011, file photo, the attorneys for Michael Jackson's Doctor, Conrad Murray, Ed Chernoff, left, and Mike Flanagan, right speak to media after a hearing in Los Angeles. In an 11th hour appeal Friday, Sept. 2, 2011, Chernoff and Flanagan sought to overturn a judge's refusal to sequester jurors, arguing they would be "poisoned" by publicity unless they were kept in isolation during the involuntary manslaughter trial.
Michael Jackson fan Bristre Clayton of Las Vegas stands outside court during the trial of Conrad Murray, Michael Jackson's doctor who has been charged with involuntary manslaughter in the pop icon's death, in Los Angeles, Tuesday, Sept. 27, 2011. Murray has pleaded not guilty and faces four years in prison and the loss of his medical license if convicted of involuntary manslaughter.
Paul Gongaware, Co-CEO of AEG Live and Concerts West, gestures while on the stand for the prosecution in the involuntary manslaughter trial of Conrad Murray at Superior Court in Los Angeles, Tuesday, Sept. 27, 2011. Murray has pleaded not guilty and faces four years in prison and the loss of his medical license if convicted of involuntary manslaughter in Michael Jackson's death.
Michael Jackson's personal assistant, Michael Amir Williams, testifies during the second day of Conrad Murray's involuntary manslaughter trial in the death of pop star Michael Jackson in downtown Los Angeles, Wednesday, Sept. 28, 2011. Murray has pleaded not guilty and faces four years in prison and the loss of his medical license if convicted of involuntary manslaughter.