Teaching Health Law

Journal of Law, Medicine and Ethics

Volumn 38, Issue 3, 2010, Pages 701-707

  Tyler, Elizabeth Tobin ^a  

^a ROGER WILLIAMS UNIVERSITY   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; EDUCATION; ETHICS; HEALTH DISPARITY; HUMAN; INTERDISCIPLINARY EDUCATION; LAWYER; LEGAL ASPECT; MEDICAL EDUCATION; METHODOLOGY; PATIENT ADVOCACY; PROBLEM SOLVING; SOCIAL JUSTICE; TEACHING; UNITED STATES;

EDUCATION, MEDICAL; HEALTH STATUS DISPARITIES; HUMANS; INTERDISCIPLINARY STUDIES; LAWYERS; PATIENT ADVOCACY; PROBLEM SOLVING; RHODE ISLAND; SOCIAL JUSTICE; TEACHING;

EID: 77957236076     PISSN: 10731105     EISSN: 1748720X     Source Type: Journal    
DOI: 10.1111/j.1748-720X.2010.00523.x     Document Type: Article

References (28)

1. March 2009, http://www.medical-legalpartnership.org/sites/default/files/page/2009%20MLP%20Site%20Survey%20Report.pdf, National Center for Medical-Legal Partnership, Medical-Legal Partnership Network Site Survey, last visited August 4, 2010
2. Zuckerman B, Sandel M, Lawton E, Morton S. " Medical-Legal Partnerships: Transforming Healthcare," The Lancet 2008, 372(no. 9650):1615-1617. For a description of the model, see
3. Zuckerman B. " Why Pediatricians Need Lawyers to Keep Children Healthy," Pediatrics 2004, 114(no. 1):224-228. at 224-225
4. There has also been a change in faculty since we began the joint course. Brown medical school faculty Dr. Alicia Monroe and Dr. Jay Baruch helped me to develop the course in 2003. After Dr. Monroe left Brown Medical School in 2008, Dr. Patricia Flanagan joined us as a teaching partner for the course
5. Tyler E Tobin. " Allies Not Adversaries: Teaching Collaboration to the Next Generation of Doctors and Lawyers to Address Social Inequality," Journal of Health Care Law & Policy 2009, 11(no. 2):249-294. For a more extensive discussion of our course, see
6. This is not to suggest that there were no models for joint medical-legal courses. There is a long history of bringing medical and law students together in the classroom. See, for example, B. J. Naitove, Comment, " Medicolegal Education and the Crisis in Interprofessional Relations," American Journal of Law & Medicine 8, no. 3 (1982): 293-320, at 304; D. B. Wilkins, " Redefining the " Professional" in Professional Ethics: An Interdisciplinary Approach to Teaching Professionalism," 58 (1995): 241-258. Nonetheless, the focus of our course on the role of law in the social determinants of health and medical-legal partnership was new. Thus, we found no ready syllabi to help guide us
7. Piscella K, Epstein R M. " So Much To Do, So Little Time: Care for the Socially Disadvantaged and the 15-minute Visit," Archives of Internal Medicine 2008, 168(no. 17):1843-1852. For discussion of the frustrations doctors face in trying to treat patients with complex medical and social problems, see
8. Tyler. http://www.josiahmacyfoundation.org, See, note 5, Part II. For more recent discussion of how medical education should address these issues more directly, see B. Walker and C. Moulton, " Medical Education in the 21st Century," 20, no. 3 (August 2009): 617-624 (commenting on a report by the Josiah Macy Foundation, 2009,, last visited August 11, 2010
9. Morton S. " Advancing the Integrated Practice of Preventive Law and Preventive Medicine," Preventive Law and Problem Solving: Lawyering for the Future 2009, Barton T. For a discussion of the relationship between preventive medicine and preventive law, see, in, Lake Mary, FL, Vandeplas Publishing
10. Charon R. " Narrative Medicine: A Model for Empathy, Reflection, Profession, and Trust," JAMA 2001, 286(no. 15):1897-1902. See, C. P. Gilkerson, " Poverty Law Narratives: The Critical Practice and Theory of Receiving and Translating Client Stories," 43 (1992): 861-945
11. By " ethics" I mean both how legal and medical practice are shaped and governed by professional ethical rules, and also the moral ethical issues that arise for lawyers and doctors in practice. The ideas and expertise of one of my co-teachers, Dr. Jay Baruch, an emergency room physician and director of the ethics curriculum at Brown medical school, has been critical to our integration of these types of ethical issues into the course
12. Connelly K D. " Elucidating the Elephant: Interdisciplinary Law School Classes," Washington University Journal of Law and Policy 2003, 11:11-61. For a helpful discussion of the need to teach interdisciplinary collaboration in legal education, see, J. Weinstein, " Coming of Age: Recognizing the Importance of Interdisciplinary Education in Law Practice," 74 (1999): 319-366
13. Morton L. " Teaching Creative Problem Solving: A Paradigmatic Approach," California Western Law Review 1998, 34:375-388. In developing my understanding of teaching problem-solving, I found Linda Morton's articles very instructive. See, L. Morton, " A New Approach to Health Care ADR: Training Law Students to be Problem Solvers in the Health Care Context," 21 (2005): 965-992
14. We focus our course and case simulations on issues of child health. Medical-legal teaching can just as easily be geared toward health law issues affecting adult populations, such as those with HIV/AIDS or cancer, or the elderly
15. http://www.communityaction.org/Poverty%20Simulation.aspx, One class involves using the Community Action Poverty Simulation created by the Missouri Association for Community Action in which students must spend a " month" role playing a poor family's attempt to make ends meet on a limited budget. Information about the simulation is, last visited August 5, 2010
16. Tames P. Commentary, " The Lawyer Is In: Why Some Doctors Are Prescribing Legal Remedies for Their Patients, and How the Legal Profession Can Support this Effort," Boston University Public International Law Journal 2003, 12:505-527. All of the classes raise issues of the differences in professional ethical obligations of doctors and lawyers. The most overt discussion of these differences arises in the context of mandatory reporting of child abuse and exploring different professional obligations regarding confidentiality. For a discussion of the kinds of professional ethical issues that arise in medical-legal partnership, see
17. For example, a survivor of domestic violence has shared her very personal story of the difficulties she found in both the health care and legal systems as she was deciding to leave her abuser and seeking custody of her children who were also abused
18. For an example of how we teach the class on substandard housing and lead poisoning, see Tyler, note 5, Part V
19. The students do not give legal advice. They help families and individuals with budget planning to see if they may be eligible for a budget plan through the utility company and/or inform them of the classifications under the regulations for protected status. Utility company representatives are on-site and the students help advocate for their " clients" with the company representative
20. Frank. " Heat or Eat: The Low Income Home Energy Assistance Program and Nutritional and Health Risks Among Children Less than 3 Years of Age," Pediatrics November 2006, 118(no. 5):1293-1302. See
21. As part of the training, we also discuss and practice client counseling. I am grateful to Bonnie Roswig, Senior Staff Attorney at the Medical-Legal Partnership Project at the Center for Children's Advocacy in Connecticut, for introducing me to the utility clinic as an effective experiential learning experience for law and medical students in advocating for low-income individuals and families
22. http://www.ripuc.org/rulesregs/commrules/termination.pdf, Under Rhode Island regulations, a family with a child under 24 months of age that can show a financial hardship may qualify for protected status and may not have their utilities shut-off during the moratorium period of November 1st through April 15th. Rhode Island Public Utilities Commission, (February 1, 2007),, last visited August 11, 2010
23. ? (California Newsreel and Vital Pictures, Inc. 2008). We show the first hour episode of the seven part series as part of our introduction to the social determinants of health
24. The role of the law in public health can be understood both for the importance of legal rules in shaping population health as a whole and for understanding " that a particular legal rule or policy that may appear to have a positive impact on one population may have a very different impact on another." W. Parmet, (Washington, D.C.: Georgetown University Press, 2009): at 54. We explore how particular legal rules (or the failure to enforce certain legal rules) on behalf of particular populations may lead to health disparities
25. Summary, Educating Lawyers: Preparation for the Legal Profession 2007, 3. http://www.carnegiefoundation.org/dynamic/publications/elibrary_pdf_632.pdf, Carnegie Foundation for the Advancement of Teaching, last visited August 5, 2010
26. Cooke M. " American Medical Education 100 Years After the Flexner Report," New England Journal of Medicine 2007, 355(no. 13):1339-1344. at 1341-1342
27. Gibson J M, Schwartz R L. " Physicians and Lawyers: Science, Art, and Conflict," American Journal of Law & Medicine Summer 1980, 6(no. 2):173-182. For a discussion of the difference in the ways that we teach doctors and lawyers to think and explore " truth," see, Jennifer Bard's column for this journal, " What We in Law Can Learn from Our Colleagues in Medicine about Teaching Students How to Practice Their Chosen Profession," 36, no. 4 (2008): 841-848, also provides an excellent comparison/contrast of how we educate lawyers and doctors
28. http://services.aamc.org/currdir/, See, Association of American Medical Colleges Curriculum Directory, last visited August 5, 2010