When a patient dies under a doctor’s care, the question is rarely whether the treatment worked. The question is whether the doctor had permission to try it.
During the COVID-19 pandemic, that distinction cost lives and ended careers — selectively, and not at random.
Ivermectin had been FDA-approved for human use since 1987. The World Health Organization lists it as an essential medicine. In spring 2021, the FDA launched a public campaign against its off-label use for COVID treatment, posting on social media that patients should stop taking it. The posts implied the drug was only for livestock. That was false — a human formulation had existed for decades.
Three physicians who had treated more than 9,000 COVID patients with the drug sued the FDA in 2022. One was forced to resign her hospital privileges at Houston Methodist. Another lost his positions at Eastern Virginia Medical School and Sentara Norfolk General Hospital. A third faced referrals to state medical boards in Washington and Arizona for disciplinary proceedings. Their patients were alive. Their careers were under attack.
In September 2023, the Fifth Circuit Court of Appeals ruled the FDA had identified no legal authority to tell patients to stop taking an approved medicine. The agency settled in March 2024 and agreed to remove its posts. It admitted no wrongdoing.
The physicians who administered the protocols those same patients died under faced no equivalent scrutiny. Remdesivir, fast-tracked under emergency authorization, carried documented risks of kidney toxicity. Ventilator protocols applied broadly in early 2020 produced mortality rates in some hospitals above 80 percent for intubated COVID patients. No physician faced a board referral for following those guidelines. No hospital lost accreditation. The treatments were sanctioned. The outcomes were not their problem.
The mechanism was built long before COVID. The Federation of State Medical Boards, which coordinates licensure across the country, issued a formal warning in July 2021 that physicians spreading COVID “misinformation” — a term the board did not precisely define — risked losing their licenses. The warning landed as doctors were still piecing together what worked and what didn’t. It told them the cost of being wrong in the unsanctioned direction was career-ending. Being wrong in the sanctioned direction carried no equivalent penalty.
That asymmetry is structural, not incidental. A licensed physician operates within a system that absorbs liability upward — to hospitals, to guidelines, to the standard of care. An unlicensed practitioner has no such shield. The same outcome — a patient who deteriorates, a patient who dies — triggers different legal machinery depending entirely on whether the person treating them had institutional cover.
Colorado made this explicit in statute. A practitioner without a license who causes a patient’s death faces criminal homicide charges. A licensed physician whose patient dies under equivalent circumstances faces a malpractice attorney, not a prosecutor. The treatment doesn’t have to be better. The credential only has to exist.
That machinery is not new. Decades before COVID, before state medical boards became gatekeepers of acceptable treatment, the federal government used it to destroy a man who ran the largest independent cancer clinic in the country. His name was Harry Hoxsey. What happened to him — and who made it happen — is the subject of our next installment.
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