In Ruan, the lower court judge rejected defendant’s request to instruct the jury that “good faith” was a defense to the criminal charges of unlawful distribution under the Controlled Substances Act. The judge explained how 11th U.S. Circuit Court of Appeals held that a good faith instruction could only be granted to those whose conduct was considered within professional norms.
However, in a newly filed amicus brief to the Supreme Court, longtime federal criminal defense attorney Ronald W. Chapman II of Chapman Law Group notes that this denial eliminates the mental aspect of what makes up a criminal act:
A crime generally consists of a wrongful act (actus reus), a mental state (mens rea), and concurrence between the act and the mens rea where the mental state actuates the wrongful act. … In most criminal matters, “some form of mental state is a prerequisite for guilt,” unless strict liability is involved which is liability without regard to mental state.
Further, the Supreme Court in Gonzales v. Oregon, 546 U.S. 243 (2006), citing U.S. v. Moore, 423 U.S. 122, 96 S. Ct. 335 (1975), questioned the basis of professional norms:
“Who decides whether a particular activity is [per 21 U.S.C. § 829 and 21 U.S.C. § 830] in ‘the course of professional practice’ or done for ‘a legitimate purpose?’”
The Court’s inquiry also raises two (2) additional questions: how do they decide, and what standards do they use? The [Controlled Substances Act] is of no help in that regard, and neither is 21 C.F.R. § 1306.04(a) [the Purpose of Issue of Prescription]. … [The Controlled Substances Act] does not contain the phrase “standard of care” or the equivalent “standard of medical practice,” let alone define it.
Chapman, who represents the defendant in one of Ruan’s consolidated cases, Couch v. U.S., adds that:
[T]he standard of care is not only challenging for juries, its evolving nature and inherent conflicts pose challenges to practitioners as well because the medical judgment of how to treat opioid use disorder and chronic pain with opioids is not an exact science and unavailable … .
In the end, risks are present in every treatment scenario. Differences within the medical community and among experts hired by the government reveal the myriad realities and challenges of how chronic pain and opioid use disorder is actually treated and the minefield that all practitioners must navigate. The standard of care is not a proxy for [the Controlled Substances Act’s] requirements, nor should it be used as a mechanism to ease the prosecution’s path to conviction for violations of a standard without proving the defendant’s purposeful intent to engage in illicit drug trafficking.