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Law and Medicine: Myths and Realities in the Medical School Classroom

Published online by Cambridge University Press:  29 April 2021

George J. Annas
George J. Annas*
Affiliation:
Harvard College; Harvard Law School; Harvard School of Public Health; Center for Law and Health Sciences, Boston University School of Law; Boston University School of Medicine
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Abstract

One way to increase cooperation between the professions of law and medicine is to teach law in medical schools in a way that emphasizes methods of approaching problems, and seeks to dispel the major myths that doctors have about the law. In this Article, Professor George Annas presents an outline of a core course in legal medicine “tailor-made” for inclusion in the medical (and, with appropriate modifications, dental) school curriculum.

Type
Articles
Information
American Journal of Law & Medicine , Volume 1 , Issue 2 , Fall 1975 , pp. 195 - 208
Copyright
Copyright © American Society of Law, Medicine and Ethics and Boston University 1975

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Footnotes

*

An initial draft of this article was prepared for the Institute on Human Values in Medicine's Southwest Regional Institute sponsored by the Society for Health and Human Values, Galveston, Texas, October 17-19, 1973. The author wishes to thank Professors John Robertson, Kenneth Wing, and Frances Miller for reviewing and commenting on that draft. George J. Annas, and the American Society of Law & Medicine, Inc. 1975.

References

1 Levin, Compulsion (1956) quoted by Curran, W. & Shapiro, E., Law, Medicine & Forensic Sciences (1970)Google Scholar at 35 (taken from the defense attorney's closing argument to the jury).

2 Curran, The Medical Witness: Availability, Willingness to Testify, and Some Comments on Medico-Legal Training of Physicians, reprinted in Curran, W. & Shapiro, E., Law, Medicine & Forensic Sciences (1970)Google Scholar at 18. See also Power, Interprofessional Education and Medicolegal Conflict As Seen from the Other Side, 40 Am. J. Med. Ed. 233 (1965)Google Scholar; Powers, Interprofessional Education and the Reduction of Medico-Legal Tensions, 17 J. Legal Ed. 167 (1965)Google Scholar; Borillo, & Ebaugh, , Medicolegal Liaison: A Need for Dialogue in the Criminal Law, 37 Colo. L. Rev. 169 (1965)Google Scholar; Cohn, , Medical Malpractice Litigation: A Plague on Both Your Houses, 52 A.B.A.J. 32 (1966)Google Scholar; Schroeder, , Medicolegal Education: Bridging the Chasm, Law-Med Letter, 51 (Aug. 1972)Google Scholar; Spies, , Weiss, & Campbell, , Teaching Law Students in the Medical Schools, 77 Surgery 793 (1975)Google Scholar.

3 Dunn, , Legal Medicine in American Law and Medical Schools: A Survey, 9 Col. College Pre-Med 4 (1970)Google Scholar; Hirsch, , Educational Opportunities in Forensic Medicine in Medical Schools, 65 Phi Delta Epsilon News 2 (Winter, 1973)Google Scholar.

4 See generally Curran, , Titles in the Medicolegal Field: A Proposal for Reform, 1 A.J.L.M. 1 (1975)Google Scholar.

5 A 1972 study of the Boston University Center for Law and Health Sciences, for example, found that many physicians were “ignorant of the law in the very important area relating to treatment of minors.” Fewer than 20% of a sample of physicians were able to define correctly the law as it related to treatment of a minor for sore throat, stomach cramps, or venereal disease. See Glantz, , Feldman, , Parker, & Weisbuch, , Medical Practice, Medical Education, and the Law, 49 J. Med. Ed. 899, 900 (1974)Google Scholar.

6 Chayet, oral presentation, First National Conference on the Medicolegal Aspects of Emergency Care, sponsored by the American Society of Law & Medicine, Inc., Washington, D.C., June, 1975.

7 Vt. Stat. Ann. Title 12 & 519(a)-(c).

8 Duff, & Campbell, , Moral and Ethical Dilemmas in the Special Care Nursery, 289 New Eng. J. Med. 891 (1973)CrossRefGoogle Scholar. For a legal analysis of this type of treatment decision see Robertson, , Involuntary Euthanasia of Defective Newborns: A Legal Analysis, 27 Stan. L. Rev. 213 (1975)CrossRefGoogle Scholar.

9 Conversation at a Symposium on “The Ethics of Newborn Intensive Care: The Decision-Making Process,” Massachusetts General Hospital, Feb. 26, 1974.

10 DHEW, Medical Malpractice: Report of The Secretary's Commission on Medical Malpractice, DHEW Publ. No. (OS) 73-88 (U.S. Gov. Print. Office, Stock #1700 00114) (1973) at 10 [hereinafter cited as “Medical Malpractice“].

11 Dietz, Baird, & Berul, The Medical Malpractice Legal System, Appendix, Medical Malpractice at 97. It is worth noting that the British experts asked by the Commission to summarize the reasons for Britain's relatively good experience in the malpractice field concluded their report by suggesting that more time be made available in the medical curriculum for law: “We also believe that more attention should be paid to the teaching of legal medicine both to undergraduates and to postgraduates. It is only by constant propaganda—by articles, lectures, conferences, and films on legal medicine—that [physicians and dentists] will be made fully aware and reminded of their medicolegal responsibilities. Before embarking upon their professional careers practitioners must [fully] appreciate their legal obligations to patients and their relationship with lawyers. We do not believe that sufficient instruction is given to practitioners on medicolegal matters. We are of the opinion that much more consideration should be given to legal medicine in medical and dental education than is at present the case.” Addison & Baylis, The Malpractice Problem in Great Britain, Appendix, Medical Malpractice at 854, 870.

12 Brook, & Stevenson, , Effectiveness of Patient Care in an Emergency Room, 283 New Eng. J. Med. 904 (1970)CrossRefGoogle Scholar; Brook, & Appel, , Quality-of-Care Assessment: Choosing a Method for Peer Review, 288 New Eng. J. Med. 1323, 1327 (1973)CrossRefGoogle Scholar.

13 Medical Malpractice, supra note 11 at 12.

14 Id.

15 See, e.g., Keeton, , Compensation for Medical Accidents, 121 U. Pa. L. Rev. 590 (1973)CrossRefGoogle Scholar.

16 See, e.g., Note, Medical Legal Screening Panels as an Alternative Approach to Malpractice Claims, 13 Wm. & Mary L. Rev. 695 (1972)Google Scholar.

17 See, e.g., Henderson, , Contractual Problems in the Enforcement of Agreements to Arbitrate Medical Malpractice, 58 VA. L. REV. 947 (1972)CrossRefGoogle Scholar.

18 Annas, , Medical Malpractice: Are the Doctors Right?, 10 Trial 59 (July, 1974)Google Scholar.

19 Annas, , Medical Remedies and Human Rights, 2 Human Rts. 151, 156-157 (1972)Google Scholar. and See Becker, , Geer, , Hughes, & Strauss, , Boys In White: Student Culture in Medical School (1961)Google Scholar; and Katz, , The Education of the Physician-Investigator, 98 Daedalus 485 (1969)Google Scholar.

20 This incident occurred at the Tufts Medical School in the spring of 1972. The other attorney was Professor Charles H. Baron of the Boston College Law School.

21 There are a number of potential problems, however. Law students, while generally fascinated with scientific and medical information, often complain that the legal analysis was too basic, and that the class discussions tended to be superficial. Non-law students also sometimes tend to view the hypotheticals presented by the law students in class discussions as too farfetched to be taken seriously. An affirmative position on interdisciplinary seminars is taken by Dr. Martin Norton in his Development of an Interdisciplinary Program of Instruction in Medicine and Law, 46 J. Med. Ed. 405 (1971)Google Scholar. As for the experiences of trained attorneys in medical school and trained physicians in law school, see Curran, , Cross-Professional Education in Law and Medicine: The Promise and the Conflict, 24 J. Legal Ed. 42 (1971)Google Scholar.

22 Some typical comments the author has heard from first and second year medical students concerning a course in medicolegal issues are: “I'll worry about it when I get my license;” “I don't think it's critical, but it's a lot more important than just plain ethics;” “I think we should study it because it's necessary to know to be able to function as a physician.” Students should, however, have some role in the development of any new medicolegal course, whether it is proposed as an elective or a requirement.