I went through some of this plus a lot of civil litigation. Great comments. I would add: never respond to legal challenges by yourself. Whoever is on the other end will see you as a soft target. Always use a lawyer. That said, you need to craft your responses and the rest of your defense. It's your problem and you are overwhelmingly likely to be the smartest guy in the room. Average lawyer IQ is 115, for MDs, 125, nearly a standard deviation higher. If you don't understand what they say, it's their fault, not yours. They are working you.
Your lawyer is but a counselor. You are the only one who understands the entire situation: your plans, finances, insurance costs, reputation, etc. etc. Take charge but take advice from them as you would a radiologist.
If you find an attorney who is competent and cares, PAY them. Never be late. For all the others, have a low threshold for firing them. Any excuse will do. They may hit you with a big bill as retribution on the way out. You can often ignore this. You may have to write a threatening letter. They usually are ignoring your wishes, missed a deadline, or made some other mistake. Be creative.
Again, if you find someone with your own professionalism, hold them tight. The majority have little "patient first" ethical structure and the most kindly description of their species is opportunistic. If you smell someone taking advantage of you, they are. Draw limits and look around. No one is irreplaceable.
The last thing is that you will have to do all the work. Make the briefs, do the research, and cooperate by training your lawyers about the issues and sometimes the law. Expect this.
There are occasional situations where you have to hire a co counsel to watch the first one. I'm mentioning this not because it's common, but so you can have it in your databank.
Dec 13, 2022·edited Dec 13, 2022Liked by Meryl Nass
Meryl. I think this is important for every doctor challenging any medical board on these issues. Look up the "Hesinki Declaration" of the World Medical Association. Note that AMA is a member organization of the World Medical Association. The original ethics statement by the World Medical Association was adopted in 1964, it was revised and each time approved by the member organizations in each updating. Now the most recent approved version is 2013 which has precedence over all the other prior versions. In the 1964 version it says this: "In the treatment of the sick person, the doctor must be free to use a new therapeutic measure, if in his judgment it offers hope of saving life, reestablishing health, or alleviating suffering."
Thus, when the NIH published their first guidance on Covid for practicing physicians, they said something like (paraphrased) "We recommend no treatment because the research has not been done, and we have no earthly idea what would help or hurt, so therefore, don't do anything unless they turn blue from no oxygen, and then go ahead and admit to hospital and put them on a ventilator. If you want to prescribe meds, get them into a clinical trial and let them be a guinea pig for pharma, or lab rat, if you will." I know it was not exactly that, but when I read it the first time, I was horrified, and I thought - there is no one with any ethics at all, for them to have said that - don't treat. They are so totally enamored of clinical trials, they can't treat without a randomized placebo controlled clinical trial they can't treat patients who are in danger of dying because "we don't know." I would say, the WMA guidelines, which speak of treating if there is HOPE of saving a life or HOPE of alleviating suffering, to give it a try. A far cry from what NIH said. And this is even worse in that, back when it was SARS a few years back, Fauci at the time recommended HCQ for SARS, so now it is a different corona virus and he has no clue what could possibly work? And with Ivermectin, and HCQ both, there were enough positive trials early on and data from many countries to give "hope." Hope of saving lives. The most recent iteration of the WMA ethics statement was very similar.
It does mention if possible to get "consent" from the patient or their guardian, though it does not say it must be signed consent. I always do very careful, detailed patient education with every med I prescribe, and Ivermectin is known to be very safe, and none of my paitents have died, but I don't know why "informed consent" necessarily would have be written to count with outpatients, considering that if they buy it and put in their mouth, seems to me that is implied consent. Also, I do not see this as "experimental" at all even though some of these meds have their detractors, as well as fraudulent research having been created as proof against their use. If you look at documents from the FDA from the past, and also the FDA website from not so long ago, you will see that the FDA clearly admits that their mandate from Congress is only to regulate new drugs coming to market, and they do regulate what drugs can come to market, and they regulate what indications the meds can be MARKETED for - they regulate the drug companies. They have ZERO authority to regulate physicians, ZERO authority to regulate regulate what we prescribe and when and to whom and for what. None. They admitted this in, I think, a 1982 newsletter, the FDA Bulletin. They particularly said that off-label prescribing was legal and ethical and often beneficial to the patient. I am aware just for example that when Lamictal was in trials for being approved for epilepsy, it was observed that Lamcital (lamotrigine) also seemed to help people with Bipolar Disorder. Because at the time, there were not very many options for treating Bipolar, psychiatrists started using it rather often, even while some small studies weere done, then clinical trials were undertaken. This fits with the WMA ethics in that there definitely was "hope" of alleviating suffering even though it didn't have an FDA indication for Bipolar. Eventually it was approved for Bipolar, and it was somewhat simiarl with Depakote, that it came into use in psychiatry because of need for more meds that would work for more people, and that hope of alleviating suffering. In psychiatry, these meds have been used for decades now, and not always for the narrowly defined diagnosis categories specified by the FDA. They may have studied it for one type of Bipolar, but everyone uses it for other forms of Bipolar or even other psychiatric diagnoses. According to what the FDA has said in the past, there should be no negative connotation about prescribing something that is "unlabeled." Once it is approved, it has to be safe to be approved, and if in your medical judgment you think it will help the patient, you as a physician can do it, and they said we can use it "unlabeled" because there is no specific labeling information for whatever diagnosis we might want to use it for, but "unlabeled" would be preferred rather than saying it is an "unapproved" use. It does NOT require "approval" by FDA for us to use it according to our judgment of what may help our patient. Same thing, if a patient gets a rare cancer, we don't say "So sad, too bad, you die." We find some similar cancer med and use it even if it is an "unlabeled" use. You will find certainly purists among academics who will gnash their teeth at anyone prescribing "off label," but you can also find other studies, besides the FDA's words on this and the WMA documents, to support unlabeled prescribing as normal and a good thing. Here are links to two versions of the WMA ethics statements that I have used in the past:
World Medical Association (1975). Declaration of Helsinki 1975. Retrieved from
One of the nice things about the WMA statements - they would potentially be usable in any country, or most, since most national medical associations are members of the World Medical Association.
On patient autonomy which is really paramount in informed consent these days moreso than in the past - two potentially helpful items and I would say, read carefully and think about them.
Chervanek in particular - it's about OB ultrasound, so you would not immediately think it is pertinent, but it is. It says that the patient may have very different values, beliefs and preferences than the MD, and they may even be idiosyncratic, but still, the physician has some responsibility to help the patient to receive her preferred treatment - I'm paraphrasing here, so read what it actually says, but that seems to me that if we have some evidence that Ivermectin is safe and effective, and the patient wants that instead of some treatment the academics like better - okay, so the dean of the local medical school and everyone on the faculty loves, loves, loves Paxlovid and the Pfizer vax, but your patient for idiosyncratic reasons of her own only wants vitamins, herbs, and Ivermectin - why should she not have her autonomy to make this choice? So these two are good with autonomy -
Chervenak, F.A., & McCullough, L.B. (1989). Ethics in obstetric ultrasound. Journal of
I’m a practicing ER nurse of 25 years. The amount of blood clots, strokes, cardiac events like myocarditis/pericarditis, Bell’s Palsy, shingles, etc. that I’ve seen since the vaccine rollout is more than I’ve ever seen in the previous 23.5 years combined. I don’t know how anyone can’t be frightened by what we are seeing. When I try to discuss this with my coworkers, they turn their heads and look downcast, but will rarely speak. I think it’s because like me, they feel betrayed for following the narrative, but unlike me they won’t open their eyes and speak out (they’re afraid for their careers and also are scared to death that their bodies are ticking time bombs). It’s easier to ignore than to acknowledge.
Meryl, thank you for all that you do. I listened to most of the two days of your hearing, and I was worried for you, and scared for myself if I ever end up in similar position. I have had to respond to board complaints on two occasions, and even though there was no substance in either case and they were eventually dismissed, they were ordeals to navigate. You are an inspiration.
Not quite the same but I had a bogus board complaint filed against me (by a dental colleague who later accidentally admitted it was about the patient not being able to afford a high profit margin procedure with her because the patient was paying me, but that is another story).
My attorney pretty much said the same thing you said. He handled my case from the start and it quickly ended. But he told me of other clients of his who were blatantly obviously innocent but tried to handle it themselves and got severely punished. (Then finally went to him to try to save themselves).
A friend of mine is an attorney representing another HCP who had his license suspended over Covid “misinformation”. Speaking out against masks and prescribing ivermectin.
In this case to get around the law, they hunted and nitpicked over interpretations of the telehealth law and also said he was harassing a hospital because he called back (even though the first nurse told him to)
This is why legislators and bureaucrats love having lots of poorly written laws and rules. They can always find SOMETHING.
Dr. Nass. I think your future lawsuit needs to be directed at the NGO as a class action. I bet you will find the tentacles of deep medicine all over it. Just to get discovery would be victory enough. Youll in my opinion find all the usual suspects and could win big money from them for harassment and interference with the actual medical board.
Doublespeak from boards is not news to doctors who treat pain. The 2016 CDC guidelines were described as advisory only, yet were used to not only suspend, but imprison doctors. Same thing with the written and unwritten rules for early COVID treatment.
Thank you for your bravery and courage to fight for your license. I have been so impressed by you throughout and much of your advice also applies in the terminated employee setting. I am a non-medical professional terminated for refusing, and I will be seeking justice against my former employer. As I read your post about making connections so that you feel not alone, I want to make the point that I would love to see a similar connection service for terminated employees fighting this battle - because I feel very much alone. Anything you and CHD can do to create this connection would be much appreciated. Finding legal counsel is very hard, finding experts willing to testify is also hard. I've done it, but sharing resources would be great.
"We at Childrens Health Defense in the US and in Europe (the same tactics are being used in both places) would like to establish a place where doctors can anonymously connect online with each other. Boards in the US are going after hundreds, if not thousands, of doctors who failed to follow the COVID narrative. They want you to feel alone and vulnerable. But you are not. Let me know how to connect you and help you as best I can."
Excellent advice. I'd like to see more doctors have enough courage and integrity to do what you and other courageous doctors have done - speak the truth in the face of extreme censorship and suppression. I'd like to see a lot more doctors put themselves out there enough to be able to follow your advice. It's a paradox: The vast majority of doctors are too afraid to speak out against the lies. But if more did, then the dam would burst and no medical board would be able to attack the truth, because too many doctors would be speaking it. Unfortunately, the past 3 years have show that most doctors are cowards.
Want to say how much I admire your tenacity. You are a pit bull in poodle's clothing. I hope you will nail the Maine medical board to the ceiling. Personally, I did not resist when my hospital privileges were "summarily terminated without appeal" in 2016 after I declined and publicly objected to NYU Langone's mandatory influenza vax policy. After 35 years of voluntary hospital practice I confess I was "done" with fighting that administration "from the inside". Although I have no claim to any professional achievement remotely approaching your admirable career, I think I have clinically practiced very much as you have, right up to this moment. It gives me no joy to say that If they came for my license tomorrow I confess that I would probably close my shop after 38 years of private practice and find another way to fight this important battle. Although I am quietly proud of the work I have done, the larger profession of medicine has been a disappointment to me. I wish you success and above all continued motivation to inform and inspire the general public and we your readers.
I went through some of this plus a lot of civil litigation. Great comments. I would add: never respond to legal challenges by yourself. Whoever is on the other end will see you as a soft target. Always use a lawyer. That said, you need to craft your responses and the rest of your defense. It's your problem and you are overwhelmingly likely to be the smartest guy in the room. Average lawyer IQ is 115, for MDs, 125, nearly a standard deviation higher. If you don't understand what they say, it's their fault, not yours. They are working you.
Your lawyer is but a counselor. You are the only one who understands the entire situation: your plans, finances, insurance costs, reputation, etc. etc. Take charge but take advice from them as you would a radiologist.
If you find an attorney who is competent and cares, PAY them. Never be late. For all the others, have a low threshold for firing them. Any excuse will do. They may hit you with a big bill as retribution on the way out. You can often ignore this. You may have to write a threatening letter. They usually are ignoring your wishes, missed a deadline, or made some other mistake. Be creative.
Again, if you find someone with your own professionalism, hold them tight. The majority have little "patient first" ethical structure and the most kindly description of their species is opportunistic. If you smell someone taking advantage of you, they are. Draw limits and look around. No one is irreplaceable.
The last thing is that you will have to do all the work. Make the briefs, do the research, and cooperate by training your lawyers about the issues and sometimes the law. Expect this.
There are occasional situations where you have to hire a co counsel to watch the first one. I'm mentioning this not because it's common, but so you can have it in your databank.
Meryl. I think this is important for every doctor challenging any medical board on these issues. Look up the "Hesinki Declaration" of the World Medical Association. Note that AMA is a member organization of the World Medical Association. The original ethics statement by the World Medical Association was adopted in 1964, it was revised and each time approved by the member organizations in each updating. Now the most recent approved version is 2013 which has precedence over all the other prior versions. In the 1964 version it says this: "In the treatment of the sick person, the doctor must be free to use a new therapeutic measure, if in his judgment it offers hope of saving life, reestablishing health, or alleviating suffering."
Thus, when the NIH published their first guidance on Covid for practicing physicians, they said something like (paraphrased) "We recommend no treatment because the research has not been done, and we have no earthly idea what would help or hurt, so therefore, don't do anything unless they turn blue from no oxygen, and then go ahead and admit to hospital and put them on a ventilator. If you want to prescribe meds, get them into a clinical trial and let them be a guinea pig for pharma, or lab rat, if you will." I know it was not exactly that, but when I read it the first time, I was horrified, and I thought - there is no one with any ethics at all, for them to have said that - don't treat. They are so totally enamored of clinical trials, they can't treat without a randomized placebo controlled clinical trial they can't treat patients who are in danger of dying because "we don't know." I would say, the WMA guidelines, which speak of treating if there is HOPE of saving a life or HOPE of alleviating suffering, to give it a try. A far cry from what NIH said. And this is even worse in that, back when it was SARS a few years back, Fauci at the time recommended HCQ for SARS, so now it is a different corona virus and he has no clue what could possibly work? And with Ivermectin, and HCQ both, there were enough positive trials early on and data from many countries to give "hope." Hope of saving lives. The most recent iteration of the WMA ethics statement was very similar.
It does mention if possible to get "consent" from the patient or their guardian, though it does not say it must be signed consent. I always do very careful, detailed patient education with every med I prescribe, and Ivermectin is known to be very safe, and none of my paitents have died, but I don't know why "informed consent" necessarily would have be written to count with outpatients, considering that if they buy it and put in their mouth, seems to me that is implied consent. Also, I do not see this as "experimental" at all even though some of these meds have their detractors, as well as fraudulent research having been created as proof against their use. If you look at documents from the FDA from the past, and also the FDA website from not so long ago, you will see that the FDA clearly admits that their mandate from Congress is only to regulate new drugs coming to market, and they do regulate what drugs can come to market, and they regulate what indications the meds can be MARKETED for - they regulate the drug companies. They have ZERO authority to regulate physicians, ZERO authority to regulate regulate what we prescribe and when and to whom and for what. None. They admitted this in, I think, a 1982 newsletter, the FDA Bulletin. They particularly said that off-label prescribing was legal and ethical and often beneficial to the patient. I am aware just for example that when Lamictal was in trials for being approved for epilepsy, it was observed that Lamcital (lamotrigine) also seemed to help people with Bipolar Disorder. Because at the time, there were not very many options for treating Bipolar, psychiatrists started using it rather often, even while some small studies weere done, then clinical trials were undertaken. This fits with the WMA ethics in that there definitely was "hope" of alleviating suffering even though it didn't have an FDA indication for Bipolar. Eventually it was approved for Bipolar, and it was somewhat simiarl with Depakote, that it came into use in psychiatry because of need for more meds that would work for more people, and that hope of alleviating suffering. In psychiatry, these meds have been used for decades now, and not always for the narrowly defined diagnosis categories specified by the FDA. They may have studied it for one type of Bipolar, but everyone uses it for other forms of Bipolar or even other psychiatric diagnoses. According to what the FDA has said in the past, there should be no negative connotation about prescribing something that is "unlabeled." Once it is approved, it has to be safe to be approved, and if in your medical judgment you think it will help the patient, you as a physician can do it, and they said we can use it "unlabeled" because there is no specific labeling information for whatever diagnosis we might want to use it for, but "unlabeled" would be preferred rather than saying it is an "unapproved" use. It does NOT require "approval" by FDA for us to use it according to our judgment of what may help our patient. Same thing, if a patient gets a rare cancer, we don't say "So sad, too bad, you die." We find some similar cancer med and use it even if it is an "unlabeled" use. You will find certainly purists among academics who will gnash their teeth at anyone prescribing "off label," but you can also find other studies, besides the FDA's words on this and the WMA documents, to support unlabeled prescribing as normal and a good thing. Here are links to two versions of the WMA ethics statements that I have used in the past:
World Medical Association (1975). Declaration of Helsinki 1975. Retrieved from
https://www.wma.net/what-we-do/medical-ethics/declaration-of-helsinki/doh-oct1975/
World Medical Association (2013). WMA Declaration of Helsinki – Ethical principles for
medical research involving human subjects. Retrieved from https://www.wma.net/policiespost/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-humansubjects
And from the FDA which I found from a document in which I had referenced these:
FDA (2018). Understanding unapproved use of approved drugs "off label." Retrieved from
https://www.fda.gov/patients/learn-about-expanded-access-and-other-treatmentoptions/understanding-unapproved-use-approved-drugs-label (Current as of 02/05/2018).
FDA (1982, April). Use of approved drugs for unlabeled indications. FDA Drug Bulletin 12(1),
4-5. Retrieved from http://circare.org/fda/fdadrugbulletin_041982.pd
One of the nice things about the WMA statements - they would potentially be usable in any country, or most, since most national medical associations are members of the World Medical Association.
On patient autonomy which is really paramount in informed consent these days moreso than in the past - two potentially helpful items and I would say, read carefully and think about them.
Chervanek in particular - it's about OB ultrasound, so you would not immediately think it is pertinent, but it is. It says that the patient may have very different values, beliefs and preferences than the MD, and they may even be idiosyncratic, but still, the physician has some responsibility to help the patient to receive her preferred treatment - I'm paraphrasing here, so read what it actually says, but that seems to me that if we have some evidence that Ivermectin is safe and effective, and the patient wants that instead of some treatment the academics like better - okay, so the dean of the local medical school and everyone on the faculty loves, loves, loves Paxlovid and the Pfizer vax, but your patient for idiosyncratic reasons of her own only wants vitamins, herbs, and Ivermectin - why should she not have her autonomy to make this choice? So these two are good with autonomy -
Chervenak, F.A., & McCullough, L.B. (1989). Ethics in obstetric ultrasound. Journal of
Ultrasound Medicine, 8, 493-497. Retrieved from
https://onlinelibrary.wiley.com/doi/pdf/10.7863/jum.1989.8.9.493
Hall, D.E., Prochazka, A.V., Fink, A.S. (2012). Informed consent for clinical treatment.
Canadian Medical Journal, 184(5): 533–540. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3307558/
I am sure there are many good articles on patient autonomy, but I do very much like these.
Thank you and I hope and pray you win every bit of your case. Be healthy and be safe. God bless you and yours.
A common comment on medscape:
Note the Ticking time bomb
------------------------------------
I’m a practicing ER nurse of 25 years. The amount of blood clots, strokes, cardiac events like myocarditis/pericarditis, Bell’s Palsy, shingles, etc. that I’ve seen since the vaccine rollout is more than I’ve ever seen in the previous 23.5 years combined. I don’t know how anyone can’t be frightened by what we are seeing. When I try to discuss this with my coworkers, they turn their heads and look downcast, but will rarely speak. I think it’s because like me, they feel betrayed for following the narrative, but unlike me they won’t open their eyes and speak out (they’re afraid for their careers and also are scared to death that their bodies are ticking time bombs). It’s easier to ignore than to acknowledge.
"The more numerous the laws, the more corrupt the state." - Tacitus
Meryl, thank you for all that you do. I listened to most of the two days of your hearing, and I was worried for you, and scared for myself if I ever end up in similar position. I have had to respond to board complaints on two occasions, and even though there was no substance in either case and they were eventually dismissed, they were ordeals to navigate. You are an inspiration.
Not quite the same but I had a bogus board complaint filed against me (by a dental colleague who later accidentally admitted it was about the patient not being able to afford a high profit margin procedure with her because the patient was paying me, but that is another story).
My attorney pretty much said the same thing you said. He handled my case from the start and it quickly ended. But he told me of other clients of his who were blatantly obviously innocent but tried to handle it themselves and got severely punished. (Then finally went to him to try to save themselves).
A friend of mine is an attorney representing another HCP who had his license suspended over Covid “misinformation”. Speaking out against masks and prescribing ivermectin.
In this case to get around the law, they hunted and nitpicked over interpretations of the telehealth law and also said he was harassing a hospital because he called back (even though the first nurse told him to)
This is why legislators and bureaucrats love having lots of poorly written laws and rules. They can always find SOMETHING.
Dr. Nass. I think your future lawsuit needs to be directed at the NGO as a class action. I bet you will find the tentacles of deep medicine all over it. Just to get discovery would be victory enough. Youll in my opinion find all the usual suspects and could win big money from them for harassment and interference with the actual medical board.
I want to grow up to be like you!
Doublespeak from boards is not news to doctors who treat pain. The 2016 CDC guidelines were described as advisory only, yet were used to not only suspend, but imprison doctors. Same thing with the written and unwritten rules for early COVID treatment.
Thank you for your bravery and courage to fight for your license. I have been so impressed by you throughout and much of your advice also applies in the terminated employee setting. I am a non-medical professional terminated for refusing, and I will be seeking justice against my former employer. As I read your post about making connections so that you feel not alone, I want to make the point that I would love to see a similar connection service for terminated employees fighting this battle - because I feel very much alone. Anything you and CHD can do to create this connection would be much appreciated. Finding legal counsel is very hard, finding experts willing to testify is also hard. I've done it, but sharing resources would be great.
"We at Childrens Health Defense in the US and in Europe (the same tactics are being used in both places) would like to establish a place where doctors can anonymously connect online with each other. Boards in the US are going after hundreds, if not thousands, of doctors who failed to follow the COVID narrative. They want you to feel alone and vulnerable. But you are not. Let me know how to connect you and help you as best I can."
Excellent advice. I'd like to see more doctors have enough courage and integrity to do what you and other courageous doctors have done - speak the truth in the face of extreme censorship and suppression. I'd like to see a lot more doctors put themselves out there enough to be able to follow your advice. It's a paradox: The vast majority of doctors are too afraid to speak out against the lies. But if more did, then the dam would burst and no medical board would be able to attack the truth, because too many doctors would be speaking it. Unfortunately, the past 3 years have show that most doctors are cowards.
Great advise / info to share. Two thumbs up Meryl.
Thank you for this excellent advice! I shall pass it on here in Canada, as I expect that much of it is applicable!
Have you contacted Thomas Renz? He has numerous lawsuits pending, mostly dealing with the CDC I believe. Seems very well versed in this whole scam .
Want to say how much I admire your tenacity. You are a pit bull in poodle's clothing. I hope you will nail the Maine medical board to the ceiling. Personally, I did not resist when my hospital privileges were "summarily terminated without appeal" in 2016 after I declined and publicly objected to NYU Langone's mandatory influenza vax policy. After 35 years of voluntary hospital practice I confess I was "done" with fighting that administration "from the inside". Although I have no claim to any professional achievement remotely approaching your admirable career, I think I have clinically practiced very much as you have, right up to this moment. It gives me no joy to say that If they came for my license tomorrow I confess that I would probably close my shop after 38 years of private practice and find another way to fight this important battle. Although I am quietly proud of the work I have done, the larger profession of medicine has been a disappointment to me. I wish you success and above all continued motivation to inform and inspire the general public and we your readers.