Expert witness from Michael Jackson case encourages young UF physicians to serve

Steven Shafer, M.D. Photo by Maria Farias/University of Florida

Steven Shafer, M.D., knows a lot about medicine. He’s a professor of anesthesiology at Columbia University, editor-in-chief of the journal Anesthesia and Analgesia and a prolific researcher in his field. But his turn as a prosecution witness in the trial of Conrad Murray, the physician eventually convicted of killing pop superstar Michael Jackson in 2009, taught him something he didn’t know.

In Shafer’s usual world of work, if someone puts forward a claim, it is reviewed by a jury of peers who are considered very knowledgeable about the topic. As a witness, however, he found himself having to convince a jury that, by definition, knew nothing about the case he was discussing with them.

“It was an extremely educational experience,” Shafer said. “What amazed me at the end of this process is, I came to the conclusion that a lay jury is competent to assess complex issues.”

A guest of the UF College of Medicine anesthesiology department, Shafer drew a standing-room-only crowd to a recent early morning lecture at the Shands at UF north campus. Titled “The role of clinical pharmacology in the trial of Conrad Murray,” the talk was streamed live to the Shands at UF south and Jacksonville campuses, the Shands Florida Surgical Center and the North Florida/South Georgia Veterans Health System.

When Shafer started working on the trial, he was concerned that fellow physicians might think he was helping to criminalize medicine by testifying against a physician facing criminal, rather than malpractice charges, for his work.

But Shafer received assurance from colleagues who told him that Murray’s actions — providing drugs in a way that went against standard medical practice guidelines — were outside the bounds of the physician-patient relationship.

“What he did was so out of line with how doctors behave and practice. He was behaving as a technician who was able to get drugs his client wanted,” Shafer said.

During Murray’s trial, Shafer’s task was to simplify complicated concepts relating to pharmacology and medicine. He used basic diagrams, images and charts to help make his case.

To refute the defense’s claim that Jackson was still alive after receiving a fatal intravenous dose of the drug propofol, Shafer conducted a series of physiological experiments and made intricate calculations of how the body processes the drug. He showed that based on the concentrations of the drug near where the drug was infused into the body, the concentration in the heart and the concentration in a large artery on the right side of his body, Jackson must have died during the infusion.

And to beat back arguments that Jackson had essentially killed himself by drinking some of the drug, Shafer commissioned a study of what happens when people ingest propofol. The results showed that when taken orally, the drug does not have its trademark numbing effect. That’s because it is sopped up by the liver as quickly as it becomes available via the stomach, so it doesn’t get the chance to get into the bloodstream, Shafer explained to the jury.

Many medical residents were among the almost 200-strong crowd at Shafer’s UF talk. And if the feedback that Shafer’s host Mark Rice, M.D., a UF clinical associate professor of anesthesiology, got was any indication, Shafer touched a chord with the young doctors.

“Rarely do our residents learn something and get entertained at the same time during our 6:30 a.m. conference,” Rice joked. “I’ve been getting text messages from them all day.”

Shafer advises his younger colleagues to be open to serving as expert medical witnesses later in their careers. That allows them a glimpse into how the legal system works, gives them invaluable experience in presenting complex ideas to lay audiences and helps them give the public an insight into what it means to be a physician.

“Medicine is a noble profession, and I think physicians go through a lot of training and personal hardship in exchange for the ability to help others and to have a stable lifestyle,” Shafer said. “In court you can demonstrate your humanity and dedication to patients and to being scientifically rigorous.”

Shafer does not charge a fee when he serves as an expert witness, though he doesn’t say others shouldn’t. When the money element is removed, he said, he is free to devote as much time as needed to do the job properly, rather than having his time and effort limited by what a payment covers.

“I would encourage people to at least consider doing it free or for only a modest reimbursement,” Shafer said. “Do it right, do it for all the right reasons and do it in a way that makes you proud to be a physician and that makes the public see your values and proficiency as a physician.”