The Court of Appeals issued a decision at the end of last month arising out of the growing opioid crisis that raises issues concerning the appropriate standards for recklessness and causation in criminal actions. In a near unanimous opinion written by Judge Eugene M. Fahey in People v. Li, the Court of Appeals upheld the manslaughter convictions of a physician who prescribed opioids to two individuals who subsequently died from overdoses. Judge Rowan D. Wilson authored a dissent in which he expressed concern that the majority’s holding would dramatically expand the potential criminal liability of prescribing physicians. Regardless of whether one agrees with the analysis of the majority or the dissent, this case evidences the growing effect that the opioid crisis is having on our society, including with respect to criminal jurisprudence.

Defendant was a board-certified doctor in anesthesiology and pain management and was accused of running what is commonly known as a “pill mill” in Queens where he would prescribe medically unnecessary high doses of opioids and other drugs with little or no examination of his patients. When two of defendant’s patients died in December 2009 and September 2010, respectively, from overdoses of a combination of oxycodone and Xanax (alprazolam) shortly after filling prescriptions for those drugs issued by defendant, defendant was arrested, charged and convicted of 198 crimes including manslaughter, reckless endangerment, criminal sale of a prescription, grand larceny and falsifying business records. The Appellate Division, First Department, unanimously affirmed the convictions, and the Court of Appeals granted leave to appeal.