The detention of Maia Kokhtashvili, a neurologist in the Akhmeta municipality of Georgia’s eastern Kakheti region, on allegations of issuing a false psychotropic drug prescription has drawn questions and discontent, as the local community and medical circles have expressed solidarity with the doctor amid suspicions that she may have been the victim of deliberate provocation.
The doctor, whose detention was reported on September 11, was granted GEL 50,000 (USD 19,000) bail by a Telavi court the next day and will be released after posting the sum, with her family members reporting that the money was crowdfunded within an hour. Critics suspect political targeting while raising alarms over what they see as the harmful effects of tightened prescription rules.
The Investigation Service of the Finance Ministry announced the detention of Kokhtashvili as part of a series of arrests in connection with “different criminal cases.” According to the agency, the doctor, “abusing her office, illegally prepared and issued a false prescription to a citizen to obtain a psychotropic substance.”
The investigation is underway under Article 268-2 of the Criminal Code, covering “issuing a forged prescription or other document for the purchase of a psychotropic or potent substance for the purpose of distribution, or its distribution.” The offense is punishable by a fine or imprisonment for a term of three to six years, with or without a one-year suspension from professional activities or holding office. However, in announcing the detention, the Investigation Service only mentioned imprisonment but not the fine as a potential penalty.
The video released by the Investigation Service mixes footage from different cases. One fragment shows a conversation between two people, one of whom is presumably Kokhtashvili, with her image blurred and her voice altered. Kokhtashvili is allegedly heard saying, “you visited me on the 24th [of August] … the 15th day will be Monday, the 7th [of September].”
The other person, apparently a man from whose side the video is being recorded, is then heard asking whether they should visit on the seventh [of September], to which the doctor replies, “Don’t come anymore; call me,” with the next scene showing her apparently saying, “I will give you my number; you call me, and I will prescribe.”
Allegations of Staged Provocation
The news of Kokhtashvili’s arrest drew widespread condemnation from the local community in Akhmeta, who questioned the allegations of wrongdoing against a doctor whom they describe as widely respected and empathetic. Colleagues from medical professional circles also expressed solidarity, warning of the precedent this could set and the potential to undermine trust between patients and doctors.
Alleging that an “agent provocateur” was deliberately sent to the doctor to manipulate her into committing an offense by taking advantage of her sense of compassion, some critics have attributed the arrest to the openly expressed government-critical views of her family members, including their participation in ongoing anti-government protests.
According to Gela Mtivlishvili, editor-in-chief of the Mtis Ambebi outlet, the alleged agent-provocateur who recorded the video while posing as a patient is an employee of the Kakheti department of the Finance Ministry’s Investigation Service.
Others have also raised concerns over what they say are excessively tightened prescription rules as part of the government’s crackdown on the abuse of psychotropic drugs. The new regulations have drawn criticism for adding new bureaucratic burdens on patients in need of treatment.
The doctor was quoted by the media as telling the court on September 12 that she “had to break the law” after a person approached her, telling her his bedridden grandmother in a remote village needed the medication. “He had paid the registration money, and I felt uneasy not to provide assistance,” Kokhtashvili was quoted as saying.
Human rights lawyers have expressed concerns about the possible use of an agent by public authorities to provoke an offense.
“If it is established that the person who visited the doctor was an agent of a state authority and had told her a fabricated story about a bedridden mother in order to induce the doctor to take a specific action, the issue of provoking a crime arises,” Tamta Mikeladze of Social Justice Center, a Georgian human rights group, said on September 12.
According to her, the standards set by the European Court of Human Rights (ECtHR), “the state may use covert investigative methods to uncover already existing criminal activity, but a state representative may not create a criminal intent themselves or provide a person with such a substantial inducement that the crime would not have occurred without it.”
Concerns on Stricter Prescription Rules
The new regulations that took effect in April impose limits on doctors when prescribing psychotropic medications, including a rule requiring prescriptions to be renewed once every 14 days, while patients need to show up in person or use a power of attorney to be given a prescription and be able to purchase the drug. The new rules also impose daily dosage limits.
In August, RFE/RL’s Georgian Service published an article documenting a bureaucratic burden caused by the new rules for patients suffering from conditions ranging from severe pain to stroke or seizures.
The available footage released by the financial authorities suggests that Kokhtashvili may have violated the regulation by promising to renew the prescription remotely. No money-related deal is depicted in the published footage.
“This regulation has no justification either from medical or humane perspectives,” Psychiatrist Eka Chkhonia was quoted by Medscriptum, a medicine-focused platform. Expressing support for Kokhtashvili, Chkhonia said the neurologist “made her decision based on best medical objectives, which cannot be considered a crime.”
According to Chkhonia, the procedures associated with the new rules have made life difficult for patients who are elderly, bedridden, or suffer from neurocognitive issues and dementia.
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