Two months after Michael Jackson's untimely death, the Los Angeles County Coroner has concluded that it was a homicide. According to Associate Press reports, forensic tests show that a lethal combination of prescription drugs caused Jackson's sudden death. The drug propofol, a powerful anesthetic generally used only for hospital sedation, and at least two other sedatives were found in Jackson's bloodstream.

The Coroner's homicide ruling paves the way for criminal charges to be filed against Dr. Conrad Murray. Murray, a Las Vegas cardiologist, was the personal physician attending Jackson when he died.

Murray admits he used propofol to treat Jackson for insomnia, but says he was trying to wean the star off of the drug. The night before Jackson's death, Murray first tried a combination of other drugs to induce sleep. The doctor said that after giving Jackson at least four injections, he gave into Jackson's demands for propofol. He administered a relatively small dose of the drug, and Jackson stopped breathing a short time later.

Types of Homicides

The coroner's homicide ruling does not necessarily mean that a crime was committed. A homicide simply means that one person was killed by another. Criminal homicide encompasses a class of crimes that vary in degree according to the intent of the perpetrator. The following lists the types of criminal homicide recognized under California law:

• First degree murder: Murder is the unlawful killing of another with malice, meaning a knowing disregard for human life. Murder is in the first degree when it is deliberate and premeditated. First degree murder also includes murder done with explosives, poison, torture, or armor penetrating ammunition or after lying in wait for the victim. A murder during the commission of other specific felonies, like kidnapping and robbery, is also in the first degree.
• Second degree murder: Murder is in the second degree when it's done without the reflection or preparation required to show premeditation or deliberation. Second-degree murders also include those done during the commission of felonies inherently dangerous to human life.
• Manslaughter: Manslaughter is an unlawful killing without malice. There are three kinds of manslaughter:
• Voluntary manslaughter: An intentional killing of another without malice constitutes voluntary manslaughter. Someone who kills suddenly in an argument after sufficient provocation, or someone who kills unreasonably in self-defense might be convicted of voluntary manslaughter
• Involuntary manslaughter: Involuntary manslaughter includes unintentionally killing someone when performing a lawful act with criminal negligence. Criminal negligence means acting recklessly to create a dangerous risk of death
• Vehicular manslaughter: Vehicular manslaughter includes homicide caused by driving a vehicle illegally or with extreme negligence.

Criminal Charges for Medical Errors

Although it is common for civil lawsuits to be filed against doctors for medical malpractice, it is relatively rare for doctors to be criminally charged for fatal mistakes. Yet doctors throughout the United States have been charged with varying degrees of criminal homicide for killing patients with prescription drugs. In 1992, the California Court of Appeal affirmed the conviction of a California obstetrician, Milos Klvana, of nine counts of second-degree murder. Among other things, the doctor was found guilty of killing infants by administering the labor-inducing drug Pitocin to their mothers in dangerous circumstances and without proper monitoring.

More often though, a doctor is changed only with involuntary manslaughter, not murder, when a patient dies of a drug overdose. To sustain a manslaughter conviction, prosecutors must prove that the doctor acted in an extremely irresponsible or reckless manner when compared to what a reasonably competent doctor would have done in the circumstances. Medical expert opinion showing that a doctor over-prescribed barbiturates to a teenager was enough to convict the doctor of involuntary manslaughter in a 1981 Pennsylvania case.

The California coroner's ruling that Jackson's death was a homicide is only the first step toward the filing of criminal charges. Investigators continue to look at the quantities and frequencies of drugs prescribed by Murray and Jackson's other doctors. However, evidence that Murray administered the powerful anesthetic propofol to Jackson right before his death could mean the filing of manslaughter charges against the doctor who maintains his innocence.

Questions for Your Attorney

• How does a prosecutor decide whether to bring criminal charges against a doctor?
• Could a doctor be convicted for manslaughter even though he only meant to help the patient and give him the medication he demanded?
• How could a doctor be held responsible for a patient's death when several other doctors are treating the patient and giving him drugs?

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