you are within the norms
NORMAN J CLEMENT RPH., DDS, NORMAN L. CLEMENT PHARM-TECH, MALACHI F. MACKANDAL PHARMD, BELINDA BROWN-PARKER, IN THE SPIRIT OF JOSEPH SOLVO ESQ., INC., SPIRIT OF REV. IN THE SPIRIT OF WALTER R. CLEMENT BS., MS, MBA. HARVEY JENKINS, MD, PH.D., IN THE SPIRIT OF C.T. VIVIAN, JELANI ZIMBABWE CLEMENT, BS., M.B.A., IN THE SPIRIT OF THE HON. PATRICE LUMUMBA, IN THE SPIRIT OF ERLIN CLEMENT SR., EVELYN J. CLEMENT, IN THE SPIRIT OF WALTER F. WRENN III., MD., JULIE KILLINGSWORTH, RENEE BLARE, RPH, DR. TERENCE SASAKI, MD LESLY POMPY MD., CHRISTOPHER RUSSO, MD., NANCY SEEFELDT, WILLIE GUINYARD BS., JOSEPH WEBSTER MD., MBA, BEVERLY C. PRINCE MD., FACS., NEIL ARNAND, MD., IN THE SPIRIT OF RICHARD KAUL, MD., IN THE SPIRIT OF LEROY BAYLOR, JAY K. JOSHI MD., MBA, AISHA GARDNER, ADRIENNE EDMUNDSON, ESTER HYATT PH.D., WALTER L. SMITH BS., IN THE SPIRIT OF BRAHM FISHER ESQ., MICHELE ALEXANDER MD., CUDJOE WILDING BS, MARTIN NJOKU, BS., RPH., IN THE SPIRIT OF DEBRA LYNN SHEPHERD, BERES E. MUSCHETT, STRATEGIC ADVISORS
ALLEGORY OF THE AMERICAN PAIN REFUGEE
In this legal affidavit, Dr. Mark S. Ibsen provides a harrowing account of the regulatory hostility facing physicians who treat chronic pain, arguing that government overreach has turned both doctors and patients into opiate refugees. He asserts that medical boards and law enforcement agencies have replaced scientific understanding with a reckless ignorance of pain management, leading to the systematic undertreatment of suffering individuals and an increase in patient suicides.
The document details Dr. Ibsen’s own professional and personal price paid for defending his clinical decisions, including a lengthy, contentious battle with the Montana Board of Medical Examiners that he characterizes as a procedural railroad. This article further serves to defend the good faith basis of medical practice against a criminalized atmosphere that confuses legitimate physical dependence with addiction and ignores the genetic variations that necessitate individualized dosing.
Prescribing Pain Relief Is Now ‘Criminal
The Ignored Science: Your Genes Can Determine Your Need for Pain Medicine
The current regulatory environment often treats pain medication dosages with a one-size-fits-all approach, but established science directly contradicts this. Dr. Ibsen points to Cytochrome P450 (CYP450) tests, which analyze how an individual’s unique genetic makeup influences how they process, or metabolize, drugs. This genetic science, established over 20 years ago, demonstrates that different people require vastly different doses to achieve the same effect.
Despite this scientific certainty, medical boards and law enforcement often ignore it. Dr. Ibsen highlights the statistical reality of human variation: there is a 100% chance that 5% of the population will fall two standard deviations from the “average dose.”
This means a significant number of patients will genetically require much higher or lower doses than what guidelines might suggest. This willful disregard for established genetic science means current regulatory guidelines may be systematically forcing physicians to either undermedicate or overmedicate a significant portion of the population. This rejection of basic science creates an impossible situation for doctors, forcing them into a legal minefield.
The Doctor’s Dilemma: Prescribing Pain Relief Has Become
“Criminal Russian Roulette”
According to Dr. Ibsen, the legal landscape for physicians who treat pain has become treacherous and unpredictable. Law enforcement and regulatory boards often lack clear standards, creating an “ambiguous changeable law enforcement mist” where a doctor may unknowingly cross a line despite acting in good faith. Consequently, many doctors have ceased treating pain entirely to protect their livelihoods.
He describes the act of prescribing necessary medication as “criminal Russian roulette for physicians,” where a doctor’s career, reputation, and freedom are on the line with every prescription. The core of the problem lies in legal ambiguity.
The Controlled Substances Act requires prosecutors to prove a physician acted “knowingly or intentionally” with “a vicious will” to commit a crime. However, doctors are often prosecuted under a much lower standard that more closely resembles medical malpractice than criminal intent. This confusion creates an environment of intense fear, where medical decisions are driven by legal risk rather than patient well-being. Unsurprisingly, when many physicians refuse to treat pain altogether, leaving patients with nowhere to turn.
This legal paralysis effectively removes a physician’s professional judgment from the equation, replacing patient-centered care with a defensive posture that prioritizes legal self-preservation above all else.
The Human Cost: America Is Creating a Generation of “Opiate Refugees”
The direct human consequence of this “criminal Russian roulette” is the creation of a desperate and abandoned population Dr. Ibsen calls “opiate refugees.” These individuals, suffering from “relentless mind-numbing pain,” are forced to fend for themselves after being dropped by doctors who are too afraid to treat them. They are refugees in their own country, exiled from the care they desperately need.
The consequences of this abandonment are dire. With no hope for relief, many patients turn to suicide as a “deathly off ramp” to escape their unbearable suffering. They are not addicts seeking a high; they are people in agony seeking an end to pain that the medical system will no longer treat. Dr. Ibsen quotes T. S. Eliot to reflect on this moment of national crisis:
“The awful daring of a moment’s surrender which an age of prudence can never retract, by this, and only this, we have existed.”
Dr. Ibsen uses these words to question whether our nation’s ‘surrender’ to a misguided policy can ever be undone, or if the damage to suffering patients is permanent. The emergence of this refugee class represents a profound failure of health policy, transforming a system of care into an engine of suffering and despair.
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HANK ASHER AND THE RISE OF ARTIFICIAL STUPIDITY
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The Anand-Clement Rule and Predictive
This document synthesizes an analysis of the “Anand-Clement Rule of Artificial Stupidity” (The AC Rule), a concept positing that an Artificial Intelligence (AI) system using a flawed algorithm inevitably produces “Artificial Stupidity” (AS). The rule, expressed as AI (alg*) = AS, is examined through the primary case study of Palantir’s AI systems, particularly their application in law enforcement and healthcare fraud detection.
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BACKGROUND
Extensive Clinical Experience: My career spans decades and includes practice in a wide variety of demanding clinical settings, providing me with a comprehensive view of patient care in America. I have served as a staff physician in emergency rooms and urgent care clinics across Montana—including in Helena, Great Falls, Butte, and Kalispell—as well as in California, Wyoming, and Utah. My leadership roles have included serving as Medical Director of an Emergency Department and its associated A.L.E.R.T. Helicopter program, and as owner and operator of an urgent care clinic.
• Commitment to Public Service: My medical practice has always been informed by a deep-seated commitment to serving the poor and underserved, both domestically and internationally. This experience has provided an invaluable perspective on the universal nature of human suffering. My service includes:
◦ Working with Mother Teresa’s Missionaries of Charity in Kolkata, India.
◦ Providing medical care at the Dalai Lama’s hospital in Zanskar, India.
◦ Serving patients in Nepal and Bombay.
◦ Serving patients on multiple Native American reservations, including the Mescalero Apache Reservation.
◦ Volunteering in inner-city free clinics and at St. Jude’s Hospital in St. Lucia, West Indies.
ALL WATCHED OVER BY MACHINES OF LOVING GRACE
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REFERENCES:
*THE TENNANT PROTOCOLS
FOR PAIN CARE
The Anand-Clement Rule and Predictive Justice Systems
Executive Summary
PART-1
PART-2
