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Teaching Health Law: Health Law Teaching in Medical Schools: Balancing the Different Roles

Published online by Cambridge University Press:  01 January 2021

Extract

Thirty years ago when I, an attorney, took a tenure-track faculty position at an innovative, newly opened medical school, I was an oddity — truly, a stranger in a strange land. Today it is not uncommon for American medical schools to employ an attorney as a tenured or tenure-track member of its faculty. Over these last three decades, the educational roles and responsibilities of health law faculty who teach in law schools have become increasingly well defined, with numerous health law courses and textbooks now generally accepted as part of the typical law school curriculum. However, the roles and responsibilities of attorney faculty members who teach in medical schools remain less clearly defined and likely are more individualized to the particular medical schools in which they teach. This essay explores some of the challenges and the opportunities which are given to attorney faculty members who teach in medical schools.

Type
JLME Column
Copyright
Copyright © American Society of Law, Medicine and Ethics 2010

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References

Exodus 2: 2021.Google Scholar
I am purposely distinguishing in this essay between an attorney employed by a medical school as a faculty member versus one employed with the primary job description of legal counsel or advisor to the administration of the medical school or its sponsoring university. This essay is only concerned with the former role. In addition to awarding full-time academic appointments, medical schools may alternatively or additionally utilize adjunct faculty members with formal legal credentials.Google Scholar
Persad, G. C., Elder, L., and Sedig, L. et al., “The Current State of Medical School Education in Bioethics, Health Law, and Health Economics,” Journal of Law, Medicine & Ethics 36, no. 1 (2008): 8994; Olick, R. S., “It's Ethical, But Is It Legal? Teaching Ethics and Law in the Medical School Curriculum,” Anatomical Record (New Anat.) 265, no. 1 (2001): 5–9, at 6 (“In contrast to the historical trend toward a freestanding required course in ethics, legal issues have increasingly been subsumed within broader curricular offerings.”)CrossRefGoogle Scholar
Mueller, P. S., Segovis, C. M., and Litin, S. C. et al., “Current Status of Medical Grand Rounds in Departments at US Medical Schools,” Mayo Clinical Proceeding 81, no. 3 (2006): 313321; Kravet, S. J., Howell, E., and Wright, S. M., “Morbidity and Mortality Conference, Grand Rounds, and the ACGME's Core Competencies,” Journal of General Internal Medicine 21, no. 11 (2006): 1192–1194.CrossRefGoogle Scholar
Wikipedia, s.v., “The Lone Ranger,” available at <http://en.wikipedia.org/wiki/The_Lone_Ranger> (visited October 7, 2010).+(visited+October+7,+2010).>Google Scholar
The term “attorney faculty member” is used here instead of “health law professor,” because the latter term usually is interpreted to refer to individuals who are hired specifically to teach law to law students in law schools, whereas the former term may be applied more broadly. See also, regarding the role of law professors teaching health law in the law school context, e.g., Greely, H. T., “Some Thoughts on Academic Health Law,” Wake Forest Law Review 41, no. 2 (2006): 391410; Wadlington, W., “Some Reflections on Teaching Law and Medicine in Law School Since the 60's,” Health Matrix 14, no. 1 (2004): 231–236. Many graduate programs in public health and health policy also employ one or more attorneys as full-time faculty members. I distinguish attorney faculty members in those kinds of academic settings from attorney faculty in medical schools because the pedagogical challenges presented in these respective environments are in many dimensions distinct.Google Scholar
See Sanbar, S., ed., 7th ed., Legal Medicine (Philadelphia: Elsevier, 2007).Google Scholar
On the difference between positive and negative defensive medicine, see Gibson, J., “Doctrinal Feedback and (Unreasonable Care,” Virginia Law Review 94, no. 7 (2008): 16411714.Google Scholar
See Posner, R. A., How Judges Think (Cambridge: Harvard University Press, 2010).CrossRefGoogle Scholar
Eckles, R. E., Meslin, E. M., and Gaffney, M. et al., “Medical Ethics Education: Where Are We? Where Should We Be Going? A Review,” Academic Medicine 80, no. 12 (2005): 11431152.CrossRefGoogle Scholar
Association of American Medical Colleges, available at <www.aamc.org> (last visited October 7, 2010).+(last+visited+October+7,+2010).>Google Scholar
Accreditation Council for Graduate Medical Education, available at <www.acgme.org> (last visited October 7, 2010).+(last+visited+October+7,+2010).>Google Scholar
See Feuillet-Le Mintier, B., “Ethics Education in Medical Schools: The Role of Jurists,” Medicine & Law 19, no. 3 (2000): 403407; Blechner, B. B., Hager, C. L., and Williams, N. R., “The Jay Healey Technique: Teaching Law and Ethics to Medical and Dental Students,” American Journal of Law & Medicine 20, no. 4 (1994): 439–455. Although this essay has a United States focus, attorney faculty members also sometimes are involved in teaching medical ethics in medical schools elsewhere. See, e.g., Claudot, F., Alia, F., and Ducrocq, X. et al., “Teaching Ethics in Europe,” Journal of Medical Ethics 33, no. 8 (2007) 491–495, at 492 (regarding medical ethics education in Europe).Google Scholar
But see Persad, et al., supra note 3, at 93 (“Bioethics, health law, and health economics are distinct disciplines with their own knowledge bases and extensive scholarly publications.”) and compare to Scofield, G. R., “Speaking of Ethical Expertise…,” Kennedy Institute of Ethics Journal 18, no. 4 (2008): 369384 (disparaging the very idea of professional expertise in bioethics). Cf. DeVille, K., “Lawyers and Bioethics: Balancing Being Lawyers and Conferring with Medical Ethics Advisors,” Defense Counsel Journal 68, no. 4 (2001): 466–473. There are, of course, a number of attorney faculty members teaching in medical schools who, besides law degrees, have acquired significant additional, formal education in humanities disciplines.Google Scholar
Regarding this trichotomy conceptualization, see Gostin, L. O., Public Health Law: Power, Duty, Restraint, 2nd ed. (Berkeley: University of California Press, 2008).Google Scholar
See American Bar Association, Model Rules of Professional Conduct (1983, as amended).Google Scholar
In William Shakespeare's Twelfth Night, Act II, Scene V, the character Malvolio proclaims: “Be not afraid of greatness: Some are born great, some achieve greatness, and some have greatness thrust upon them.” In my own case, it certainly was not greatness that was thrust upon me, but great opportunities.Google Scholar
When I was a faculty member at Wright State University School of Medicine (now the Boonshoft School of Medicine), for many years I was assigned the role of non-physician small group teaching partner in a similar course, then-entitled Introduction to Patient Care (IPC).Google Scholar
Mertz, E., The Language of Law School: Learning to Think Like a Lawyer (New York: Oxford University Press, 2007).CrossRefGoogle Scholar
See generally Gunsalus, C. K. and Steven Beckett, J., “Playing Doctor, Playing Lawyer: Interdisciplinary Simulations,” Clinical Law Review 14, no. 2 (2007–2008): 439464.Google Scholar
Khanijou, S., “Rebalancing Healthcare Inequities: Language Service Reimbursement May Ensure Meaningful Access to Care for LEP Patients,” DePaul Journal of Healthcare Law 9, no. 3 (2005–2006): 855884; Watson, S. D., “Reforming Civil Rights with Systems Reform: Health Care Disparities, Translation Services, and Safe Harbors,” Washington & Lee Race & Ethnic Ancestry Law Journal 9 (2003): 13–34; Keers-Sanchez, A., “Mandatory Provision of Foreign Language Interpreters in Health Care Services,” Journal of Legal Medicine 24, no. 4 (2003): 557–578.Google Scholar
Florida State University, available at <http://med.fsu.edu/education/syllabiyear2009–2010/MedBehavIISyllabus2010.pdf> (access limited to FSA students and faculty only; syllabus on file with author).+(access+limited+to+FSA+students+and+faculty+only;+syllabus+on+file+with+author).>Google Scholar
See, e.g., MacCourt, D. and Bernstein, J., “Medical Error Reduction and Tort Reform Through Private, Contractually-Based Quality Medicine Societies,” American Journal of Law & Medicine 35, no. 4 (2009): 505–56; Wei, M., “Doctors, Apologies, and the Law: An Analysis and Critique of Apology Laws,” Journal of Health Law 40, no. 1 (2007): 107–159.CrossRefGoogle Scholar
See, e.g., Buceo, A. A., “A Friendly Approach to Reducing Medical Malpractice Litigation,” Michigan State University Journal of Law & Medicine 11, no. 2 (2007): 323336.Google Scholar
See, e.g., Gallagher, T. H., Bell, S. K., and Smith, K. M. et al., “Disclosing Harmful Medical Errors to Patients: Tackling Three Tough Cases,” Chest 136, no. 3 (2009): 897903.CrossRefGoogle Scholar
See Feuillet-LeMintier, , supra note 13, at 405.Google Scholar
Bateman, R. B., “Attorneys on Bioethics Committees: Unwelcome Menace or Valuable Asset?” Journal of Law & Health 9, no. 2 (1994–1995): 247272, at 261.Google Scholar
Maguire, A. L., Majumder, M. A., and Cheney, J. R., “The Ethics of Lawyer-Ethicists,” Journal of Law, Medicine & Ethics 33, no. 3 (2005): 603607, at 605.CrossRefGoogle Scholar
See DeVille, , supra note 14, at 467.Google Scholar
See Reed, D. A., Windish, D. M., and Levine, R. B. et al., “Do Fears of Malpractice Litigation Influence Teaching Behaviors?” Teaching and Learning in Medicine 20, no. 3 (2008): 205211 (illustrating the negative bias held by most physician faculty members regarding attorneys and the legal environment).CrossRefGoogle Scholar
Scott, C., “Why Law Pervades Medicine: An Essay on Ethics in Health Care,” Notre Dame Journal of Law, Ethics & Public Policy 14, no. 1 (2000): 245304, at 245.Google Scholar
See Kapp, M. B., Our Hands Are Tied: Legal Tensions and Medical Ethics (Westport, CT: Auburn House, 1998) (exploring the importance of physicians’ legal perceptions in shaping their practice behavior).Google Scholar
Gutkind, Lee, ed., Becoming a Doctor: From Student to Specialist, Doctor-Writers Share Their Experiences (New York: W.W. Norton & Company, 2010).Google Scholar
Cf. American Board of Legal Medicine, which requires an applicant for certification to have earned both a medical and a law degree, available at <www.ablminc.org/eligibility.htm> (visited October 8, 2010).+(visited+October+8,+2010).>Google Scholar
See Olick, , supra note 3, at 6.Google Scholar
According to Allen, Woody, “Eighty percent of success is showing up,” available at <http://www.quotationspage.com/Woody_Allen> (visited June 29, 2010).+(visited+June+29,+2010).>Google Scholar
Goldstein, E. A., Maestas, R. R., and Fryer-Edwards, K. et al., “Professionalism in Medical Education: An Institutional Challenge,” Academic Medicine 81, no. 10 (2006): 871876, at 871.CrossRefGoogle Scholar
See generally Peterson, M. R., At Personal Risk: Boundary Violations in Professional-Client Relationships (New York: W.W. Norton & Company, 1992).Google Scholar
See, e.g., Kapp, M. B., “Managed Care and Mandatory Movies,” JAMA 276, no. 13 (1996): 1023; Kapp, M. B., “Informed Consent to Defensive Medicine: Letting the Patient Decide,” Pharos 56, no. 2 (1993): 12–14; Kapp, M. B., “Withholding Pain Medication in the ED Because of Legal Fears - Bad Practice for a Bad Reason,” American Journal of Emergency Medicine 17, no. 2 (1999): 207–208 (all describing medical encounters experienced by this author and suggesting lessons for more humanistic medical practice).CrossRefGoogle Scholar
See Karnieli, O., Vu, T. R., and Holtman, M. C. et al., “Medical Students' Professionalism Narratives: A Window on the Informal and Hidden Curriculum,” Academic Medicine 85, no. 1 (2010): 124133; Balmer, D., Serwint, J. R., and Ruzek, S. B. et al., “Learning Behind the Scenes: Perceptions and Observations of Role Modeling in Pediatric Residents' Continuity Experience,” Ambulatory Pediatrics 7, no. 2 (2007): 176–181; Brainard, A. H. and Brislen, H. C., “Learning Professionalism: A View from the Trenches,” Academic Medicine 82, no. 11 (2007): 1010–1014.
Cf. Quaintance, J. L., Arnold, L., and Thompson, G. S., “What Students Learn About Professionalism from Faculty Stories: An ‘Appreciative Inquiry’ Approach,” Academic Medicine 85, no. 1 (2010): 118123.CrossRefGoogle Scholar
See Rose, G. L., Rukstalis, M. R., and Schuckit, M., “Informal Mentoring between Faculty and Medical Students,” Academic Medicine 80, no. 4 (2005): 344348.CrossRefGoogle Scholar
At Florida State University College of Medicine, I am offering an elective 2-week or 4-week course for Year 4 medical students entitled Special Topics in Medicine and Law, MEL-7500, available at <http://med.fsu.edu/education/syllabi/year2010–2011/2010–2011electives.pdf> (access limited to FSA students and faculty only; syllabus on file with author).+(access+limited+to+FSA+students+and+faculty+only;+syllabus+on+file+with+author).>Google Scholar
Farrow, F. L., “The Anti-Patient Psychology of Health Courts: Prescriptions from a Lawyer-Physician,” American Journal of Law & Medicine 36, no. 1 (2010): 188219, at 207–208 (internal citations omitted).CrossRefGoogle Scholar
See “Humanizing Legal Education Symposium,” Washburn Law Journal 47, no. 2 (2008).Google Scholar