Grandstaff v. State
In Grandstaff v. State, 171 P.3d 1176 (Alaska App. 2007), the defendant was also convicted of numerous counts of unlawfully distributing controlled substances by writing prescriptions that served no medical purpose. Grandstaff argued that the superior court's instructions to the jury erroneously allowed the jury to convict him of those offenses if the State proved that his decision to write the prescriptions fell below the standard of practice "generally recognized and adopted within the medical community," even if he honestly believed there was a medical purpose for writing the prescriptions.
In other words, Grandstaff argued that the instructions allowed the jury to convict him for medical malpractice. He also argued that the instructions allowed the jury to convict him if he had some non-medical purpose for prescribing the drugs, even if he also had a proper medical purpose.
In Grandstaff, the Court acknowledged that the instruction defining "legitimate medical purpose" in terms of the standard of practice generally accepted in the medical community, considered in isolation, potentially violated due process by allowing the jury to convict the defendant of a criminal offense for providing negligent medical care.
The Court also acknowledged that a jury instruction that allowed the jury to convict the defendant if he had any non-medical purpose for writing a prescription -- even if he also had a medical purpose -- might also violate due process.
The Court noted, for instance, that it would be unconscionable to convict a doctor for prescribing a medication for valid medical reasons just because the doctor also hoped that the success of his treatment decisions would improve his reputation and allow his practice to grow.
But the Court found no error in Grandstaff's case because the instruction defining the elements of the charged offenses of misconduct involving a controlled substance required the State to prove beyond a reasonable doubt that Grandstaff recklessly disregarded the fact that the prescriptions he wrote served no legitimate medical purpose. As the Court explained, "the elements instruction required the State to prove that there was no valid medical purpose for writing the prescriptions -- and that Grandstaff knew of, or was at least reckless concerning, this circumstance."