Drugging Kids

I’m sure at one time or another all parents have wished for a magic pill that would make their kids easier to deal with. No shortage of hucksters and snake-oil salesmen stand ready to fulfill that need. I believe most parents realize no magic pill exists and most child psychiatrists are reticent about over-prescribing potent pharmaceuticals. But sometimes things go very wrong, even at prestigious medical schools.

Dr. Kayoko Kifuji, a child psychiatrist at Tufts Medical Center, testified under a grant of immunity at the murder trial of Carolyn Riley last year, charged along with her husband, Michael, in the death of their four-year old daughter, Rebecca.

After her first interview with Rebecca, then two, Dr. Kifuji started her on clonidine, a blood-pressure drug sometimes used as a sedative in kids with ADHD. Dr. Kifuji eventually prescribed Rebecca 750 milligrams a day of Depakote, an anti-seizure drug also used as a mood-stabilizer; 200 milligrams a day of Seroquel, an antipsychotic; and .35 milligrams a day of clonidine. Rebecca stopped breathing on December 13, 2006.

The parents were making up symptoms to tell Dr. Kifuji in an effort to obtain disability benefits. For whatever reason, Dr. Kifuji kept writing more and more prescriptions whenever Carolyn or Michael would complain about Rebecca’s behavior. Michael was convicted of first-degree murder and got life without parole; Carolyn was convicted of second-degree murder and got 15 to life.

Shortly after Rebecca’s death, Dr. Kifuji entered a voluntary agreement with Massachusetts’ Board of Registration in Medicine to stop practicing medicine. But, in September 2009, after the grand jury failed to indict her, Dr. Kifuji was allowed to practice psychiatry again.

This past week, Tufts medical center settled with Rebecca’s surviving siblings for the $2.5 million policy limits. Dr. Kifuji is still practicing psychiatry.

These facts are crazy. Although Michael and Carolyn might well have found another reason to murder Rebecca, entitlement fraud bugs me in particular because I don’t believe in these programs. The government robs, i.e., taxes, its citizens and then uses the loot to pay social workers, psychologists, and other assorted bureaucrats to treat kids who often don’t even need the treatment, e.g., Rebecca, and to support freeloading sociopaths, like Michael and Carolyn. Government also gave Dr. Kifuji a medical license, took it away, then gave it back again — an enormous waste of money with each transaction, but steady work for the Board of Registration in Medicine. Tufts denies all wrongdoing while throwing $2.5 million at the problem to make it go away. I hope Tufts is at least taking a closer look at prescribing practices of its staff.

Unfortunately, these problems defy any practical solution.

Glenn L. Goodhart, M.D., J.D.