The Virginian-Pilot
                             THE VIRGINIAN-PILOT 
              Copyright (c) 1996, Landmark Communications, Inc.

DATE: Saturday, September 21, 1996          TAG: 9609210251
SECTION: LOCAL                   PAGE: B5   EDITION: FINAL 
                                            LENGTH:   92 lines


A Norfolk Circuit Court jury awarded $235,715 Friday to the family of a man who died of cancer while receiving homeopathic therapy, a type of alternative medicine.

The seven-member jury debated for about five hours Thursday afternoon and Friday morning before deciding. Norfolk doctor Dr. Vincent J. Speckhart was ordered to pay the wife and daughter of Robert A. Rizzi, who died in 1993.

It was not clear how the jury calculated the amount of the award. Attorneys for the Rizzi family had sought $2.3 million in their lawsuit, but then asked the jury for $1 million.

This is not the first time Speckhart's alternative therapies have been questioned. Several years ago, he was placed on probation by the state Board of Medicine for some of his techniques. He was allowed to continue practicing, and his probation was renewed in 1995.

The two-week trial revolved around Speckhart's role in his patient's decision to reject chemotherapy, a standard drug treatment for cancer.

While the trial touched on the validity of homeopathy, it focused on broader questions about the doctor-patient relationship: What is a doctor's duty in guiding a patient's choice of treatment? Where is the line between a doctor's influence and a patient's ability to make his own choices?

Rizzi visited Speckhart in 1992, after he had a recurrence of Hodgkin's disease, a cancer of the lymphatic system. Rizzi had received chemotherapy for it in the 1980s, and signs of the disease disappeared.

He had a chance of another remission if he had undergone chemotherapy again, according to several doctors who testified. But Rizzi had suffered terribly during his chemotherapy in the 1980s, according to a letter he wrote. He came to Speckhart seeking an alternative.

Speckhart had been trained as an oncologist - a cancer doctor - but by the time Rizzi saw him, the doctor dealt mostly with homeopathy.

Homeopathy is an unorthodox branch of medicine that uses drugs derived from natural substances, prescribed in very small doses, to spur the body's natural defenses.

Chemotherapy, a tool frequently used by cancer doctors, is a drug treatment that destroys cancer cells.

While seeing Speckhart, Rizzi repeatedly ignored the advice of another oncologist that he get chemotherapy.

The lawyers for Rizzi's widow, Victoria, said the doctor took advantage of their fear, leading them to believe that homeopathy was as effective as chemotherapy. The doctor's credentials as an oncologist - a title still used on Speckhart's official documents - helped convince them that homeopathy was accepted by the medical community.

``What's important. . . is not what the doctor thinks he is. It's what the patient thinks he is,'' said Lisa P. O'Donnell, one of the Rizzi attorneys, during closing arguments Thursday. ``What did they think they were getting when they were making a life or death decision?''

Although Speckhart mentioned the need for chemotherapy at least one time, noting the advice in one place in Rizzi's chart, he didn't push it or explain the consequences of not using it, Victoria Rizzi's lawyers claimed. Rizzi would have taken chemotherapy had he understood the odds, they contended.

But in his closing remarks, Speckhart's lawyer, Robert W. Hardy, described Rizzi as a smart, independent man who understood the risks.

Hardy said his client tried to get Rizzi to pursue chemotherapy along with the alternative treatment, insisting that Rizzi continue seeing a traditional oncologist.

But Rizzi adamantly refused chemotherapy, Hardy said, pointing to notations in the the medical records of Rizzi's regular oncologist, who wrote many times that his patient resisted chemotherapy.

Even if Rizzi had suffered through six to 12 months of chemotherapy, his odds were uncertain - he may have had less than a few years left, Hardy said, using testimony given by the family's expert witnesses.

``He is a bright man, he is an intelligent man, he is an educated man. . . he didn't want the chemotherapy and he made the decision not to get it.'' Hardy said it was an issue of patient rights. ``People should have a right to choose what they want.''

Early in the trial, the Rizzi family called several cancer doctors to the stand, who ridiculed his methods and said his record-keeping was sloppy.

``Some of the opinions Dr. Speckhart held forth in that record are completely foreign to me,'' said Dr. James J. Stark, a Hampton Roads cancer specialist.

Speckhart's attorney read from a letter Rizzi wrote to state officials in late 1992, when the doctor faced trouble with the state Board of Medicine. In the letter, Rizzi supported the doctor. He described how sick chemotherapy had made him, blackening his veins and making his hair fall out.

Friday afternoon, both sides were claiming partial victory.

``We're certainly pleased. This is one of those cases that the point is more important than the money,'' said O'Donnell, one of Rizzi's lawyers.

But Hardy said the verdict was relatively low, given what the family asked for. ``I think what we're looking at is a sympathy verdict,'' he said. Hardy said Speckhart has not decided to whether to appeal. ILLUSTRATION: Photo

Dr. Vincent J. Speckhart treated a cancer patient with homeopathy,

not with chemotherapy.