You are the director of pharmacy at a large regional medical center. It has come to yourattention that Dr. Smith, a hospital oncologist, has been prescribing medicines for cancer patients thatare not labeled for cancer treatment. While “off-label” prescription is not against the law, you nowrecall a recent interview Dr. Smith did on a radio talk show. During that interview Dr. Smith talkedabout his discovery of the effectiveness of green-tea, honey and homeopathic treatments for cancerpatients. Such a “holistic” approach to medicine has a certain appeal, especially to patients who havereceived a poor prognosis. Many cancer patients who were told they have only a few months to live bytheir doctors have come to your hospital from hundreds of miles away to be treated by Dr. Smith.In addition to his work at your hospital, Dr. Smith owns and runs a clinic located in a poorMississippi Delta community. When your hospital recently replaced its old outdated sterilizer machines,Dr. Smith asked if he could have one of the old machines for use at his clinic. Dr. Smith is well knownand most of his patients like him. Last year he received an award from a religious group for his serviceto the poor. However, you know that Dr. Smith recently divorced his third wife. Her lawyer, known forher aggressive style and hard bargaining, won a huge alimony and support judgment worth $3 millionagainst Dr. Smith. Rumor is that Dr. Smith is struggling financially, because he sold one of his sportscars.How should you handle this situation? In your paper, be sure to consider the responsibilities andinterests of your department, as well as the hospital. Include the issues of insurance reimbursement,standard of care, informed consent, public image of the hospital, and Medicare/Medicaidreimbursement. Are there other legal issues? Are there other moral or ethical issues?

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