Curriculum

The following courses have recently been offered, or will be offered in the current academic year. Numbers in parentheses indicate which academic year(s) the courses were offered: 2007-08 courses are coded (8); 2008-09 courses are coded (9); and 2009-10 courses are coded (10).

COURSES
Bioethics and the Law (8,9,10)
Food and Drug Law (9,10)
Germs, Guns and Lead: Public Health Law and Policy (10)
Health Care Law (8)
Health Care Structure and Financing (10)
Medical Malpractice and Health Care Quality (8,9,10)
Mental Health Law (8,9,10)
Themes in Biomedicine (8,9)

SEMINARS
Aging and the Law (8,9,10)
Germs, Guns and Lead: Public Health Law and Policy (8,9)
Health Care for Children: Law, Economics, and Health Policy (10)
Law and Ethics in Medical Practice (8,9)
Law and Ethics of Human Subject Research (8,10)
Law of Health Care Organization and Finance (8)
Legal Careers and Life Satisfaction (8)
Mental Health, Juvenile Justice, and Family Law (9)
New Frontiers in Law and Psychiatry (8)
Psychiatry and Criminal Law (8,9,10)
Tobacco Policy (8)

CLINICS
Advocacy Clinic for the Elderly (8,9,10)
Mental Health Law Clinic (8,9,10)

SHORT COURSES
Genetics and the Law (8,9,10)
Health Care Structure and Financing (9)
Medical Care for Children: Law, Economics, and Health Policy (9)

COURSE DESCRIPTIONS

ADVOCACY CLINIC FOR THE ELDERLY This clinic trains students to provide legal services to older persons. Under the supervision of an attorney, students represent elderly clients in negotiations on a variety of legal matters, including administrative hearings, and court proceedings, including basic wills and powers of attorney, guardianships, consumer issues, Medicaid and Medicare benefits, nursing home regulation and quality of long-term care, elder abuse and neglect, and advance medical directives. Students develop practical skills by participating in client interviewing, counseling, and trial advocacy. Students may engage in policy analysis and advocacy work with partnering organizations including the Jefferson Area Board for Aging, the Legal Aid Justice Center, the Virginia Elder Rights Coalition, and the Senior Lawyers Division of the American Bar Association.

Aging and the Law This seminar will address significant legal and policy issues relating to health and financial needs of the elderly. Representative topics include ethical issues raised in representing elderly clients; financing of health care (Medicare and Medicaid) and the estate planning and legal questions that health care costs pose for elderly clients; guardianship and other mechanisms of surrogate decision-making; nursing home regulation, special housing needs for elderly individuals and the availability of assisted living facilities; elder abuse and neglect; end-of-life medical care (including physician-assisted suicide); employment discrimination; and income security (Social Security and employer-provided pensions). Dr. Evans will participate in the entire seminar, which will address medical issues as well as legal questions. Research fellows and resident physicians in Geriatrics in the Medical School may also participate on a regular basis, and will bring their special expertise and experience to class discussion of the legal issues. Other speakers may be invited to address selected topics, and class visits to a nursing home and an assisted living facility will be scheduled. Special times may require some scheduling flexibility. Class participation will be taken into account in grading.

Bioethics and the Law This course explores the intersection among medicine, technology, and the law. Topics include human reproduction and birth (including actions for wrongful birth, wrongful life, and wrongful conception), human genetics and the privacy and ownership of genetic information, death and dying, research involving human subjects, organ transplantation, and public health and bioterrorism.

FOOD AND DRUG LAW This course considers the Food and Drug Administration as a case study of an administrative agency that must combine law and science to regulate activities affecting public health and safety. The class covers issues such as regulation of cancer-causing substances in foods, the use of risk-assessment techniques in regulatory decision-making, the effects of FDA drug approval requirements on research and competition in the pharmaceutical industry, regulation of new medical technologies, and the ethics of drug testing.

GENETICS AND THE LAW This class explores legal issues that arise with new genetic technologies. We review the history of genetic research in the United States , with particular attention to the incorporation of hereditarian and eugenic concepts into the law, as well as the state and federal cases in which those concepts were challenged. The semester surveys genetic privacy and access to genetic information; the forensic use of genetic information; reproductive issues, including monitoring of genetic diseases and novel techniques of reproduction such as cloning; alteration and ownership of biologic forms; and genetic risks in the context of employment and insurance.

GERMS, GUNS AND LEAD: PUBLIC HEALTH Law and Policy This course explores the legitimacy, design and implementation of a variety of policies aiming to promote the public health and reduce the social burden of disease and injury. It highlights the challenge posed by public health’s population-based perspective to traditional individual-centered, autonomy-driven approaches to bioethics and constitutional law. Other themes center on conflicts between public health and public morality and the relationship between public health and social justice. Illustrative topics include mandatory immunization, screening and reporting of infectious diseases, prevention of lead poisoning, food safety, prevention of firearm injuries, airbags and seat belts, mandatory drug testing, syringe exchange programs, tobacco regulation, and restrictions on alcohol and tobacco advertising.

Health Care for Children: Law, Economics, and Health Policy The course will examine those issues which influence the health and wellbeing of children in our society. Elements in the health care and legal systems which are unique to children will be emphasized. The financing and organization of children’s health and social services will be reviewed. One important theme will be the significance of socioeconomic status and poverty levels on the welfare of children. Other topics will include parental duty to support and provide medical care, medical neglect, child abuse, decision making by and for minors about their health care, the terminally ill child and research on children. Discussion will attempt to define the milieu in which physicians and other children’s advocates must make decisions and how the legal system responds to the problems that arise. The course will be open to medical students and residents in addition to law students. The grade will be based on class participation and an open book examination. A research paper may be substituted for the examination by approval of the instructors.

HEALTH CARE LAW This course surveys the law applicable to health care delivery in the United States. Topics include: treating patients, industry structure, antitrust regulation, health insurance, organ transplantation, Medicare, Medicaid, and more.

HEALTH CARE STRUCTURE AND FINANCING This course provides an overview of the structure and financing of the American health care system. It will provide a broad overview of American law and regulation as it applies to these areas. Major topics include: access to and cost of health care in the U.S., health insurance and managed care, Medicare and Medicaid, the relationship amongst health care professionals and organizations, enforcement and compliance activities of the government, and the impact of liability on the health care system. It is intended that this one-credit course be a high level overview of the American health care system and the laws and regulations that shape it.

LAW AND ETHICS IN Medical Practice This interdisciplinary seminar addresses legal and ethical issues arising in the practice of medicine. During the first meetings of the seminar, the instructors orient the law students to the practice of medicine at the University, and to basic medical concepts pertinent to seminar topics. The following meetings bring together residents, fellows and faculty from the various departments at the Medical School, including Neurology, Medicine, and Family Practice, to explore such issues as informed consent and capacity to consent to or refuse treatment (including life-sustaining treatment), ethical and legal challenges arising in managed care, prevention and acknowledgment of medical errors, the purpose and role of evidenced-based medicine in contemporary medical practice, regulation of research, and end-of-life issues such as the definition and implications of persistent vegetative state and the definition of death. Efforts are also made to identify areas of divergence and convergence in professional norms in law and medicine. (Also offered as Law and Ethics in Neurology)

Law and Ethics of Human Subject Research This seminar, specifically designed to be interdisciplinary, is open to graduate students in bioethics, nursing, and public health sciences, law students, and medical school junior faculty and fellows. We will begin with a brief look at the origins of the current system for regulating human subjects research and the ethical and legal frameworks that have evolved to assist with that regulation. We will explore central issues like risk-benefit assessment, informed consent, confidentiality, diversity in subject populations and how subjects are recruited and retained. We will also look into concerns raised by international research such as recruitment of poor and underserved populations and equitable access to the results of the research. We will examine some of the issues raised by new technologies such as genomics and personalized medicine, stem cell research and genetic engineering, nanotechnology and synthetic biology. Finally, we will explore how the changing economics of research creates both conflicts of interest and potentially increased innovation.

Law of Health Care Organization and Finance This course will provide an overview of the structure and financing of the American health care system. It will provide a broad overview of American law and regulation as it applies to these areas. Major topics include: Access to and cost of health care in the U.S.; Health insurance and managed care; Medicare and Medicaid; The relationship amongst health care professionals and organizations; Enforcement and compliance activities of the government; and, The impact of liability on the health care system. It is intended that this course be a high level overview of the American health care system and the laws and regulations that shape it.

Legal Careers and Life Satisfaction This seminar explores the relationships between careers in law and life satisfaction. The large body of psychological research on the determinants of “happiness” that has emerged in the past decade will form the foundation of the seminar. From there, the course examines the empirical literature on attorneys’ job satisfaction and their reactions to job dissatisfaction (e.g., depression, alcoholism). The seminar aims to identify factors that promote or attenuate job satisfaction in particular, and life satisfaction more generally, among attorneys practicing law in various settings (e.g., large firm, small firm, in-house counsel, public interest). This is a research, rather than a clinical, seminar.

MEDICAL CARE FOR CHILDREN: LAW, ECONOMICS, AND HEALTH POLICY The short course includes students from both the medical and the law schools. It focuses on the framework for providing health care to children. Specific issues include the parental duty to support and provide medical care, medical neglect, child abuse, decision making by and for minors about their medical care, fetal alcohol syndrome, crack babies, the terminally ill child, the Virginia and Florida Neurologically Defective Infants Acts, public health laws such as vaccination and quarantine, and adoption of children with special medical needs.

MEDICAL MALPRACTICE AND HEALTH CARE QUALITY Medical malpractice litigation in this country is alternatively characterized as in crisis and the bane of conscientious health care providers or as an invaluable means to enhance the quality of health care and compensate individuals who received inadequate care. This course examines the regulation of health care quality in the United States through medical malpractice liability (including professional, institutional, and managed care liability), professional licensure, obligations flowing from the professional-patient relationship, and external and internal regulation of health care facilities (including accreditation, staff privileges, and peer review).

MENTAL HEALTH LAW Students address legal issues that pertain to the treatment of individuals with mental illness or mental retardation. The course explores the delivery of mental health services, the regulation of the mental health professions, and the relationship between society and people with mental disability. The course’s interdisciplinary approach includes periodic guest lecturers from the disciplines of psychiatry, psychology, social work, and social services, as well as presentations by relevant legal practitioners. Students are encouraged but not required to enroll in the Mental Health Law Clinic where they have an opportunity to apply the substantive law they learn in this class to cases they are handling. Likely topics include: the nature of psychiatric diagnoses and mental disorders; the right to treatment and community services; professional liability for malpractice; civil commitment; relationships between criminal and civil justice systems; benefits eligibility; protection against discrimination; and client competence and surrogate decision-making for incompetent clients.

MENTAL HEALTH LAW CLINIC This course is offered in conjunction with the Charlottesville-Albemarle Legal Aid Society. Students represent mentally ill or mentally disabled clients in negotiations, administrative hearings, and court proceedings (to the extent permitted by law) on a variety of legal matters, including: social security, medicaid, and disability benefits claims, disability discrimination claims, access to housing, advance directives for medical care, and access to mental health or rehabilitative services. Under the supervision of an attorney, students directly perform all of the lawyer functions associated with their cases, including client and witness interviews, factual development, legal research, preparation of pleadings, negotiation and courtroom advocacy.

Mental Health, Juvenile Justice, and Family Law This interdisciplinary seminar, offered by faculty of the Institute of Law, Psychiatry and Public Policy, examines the role of mental disorders and mental health professionals in juvenile justice and family law. Students include graduate students in psychology as well as law students. In addition to traditional seminar class sessions, the course includes the observation of live and videotaped forensic mental health evaluations conducted through the institute. Seminar sessions explore issues in juvenile forensic mental health (e.g., adjudicative competency, criminal responsibility, waiver to adult courts, juvenile sexual offending, school violence, and the prevalence of mental illness within juvenile justice system) and family law (e.g., child custody, termination of parental rights, child sexual abuse).

ORGAN DONATION: ALTRUISM OR RECIPROCITY? This short course addresses the growing gap between the need for kidneys, livers, and other organs for transplantation and the supply of available organs. Topics include the moral basis of organ donation, reasons for the low rate of donation, the current legal structure of organ procurement, and possible policy solutions. The course will be coordinated with the work of the Institute of Medicine Committee on Increasing the Rate of Organ Donation on which the instructor is serving.

New Frontiers in Law and Psychiatry

Psychiatry and Criminal Law This interdisciplinary seminar will examine how the criminal justice system addresses defendants and offenders with a mental disorder. Issues likely to be addressed include: adjudicative competency (e.g., competence to stand trial, competence to waive rights); criminal responsibility (e.g., the insanity defense, diminished capacity); sentencing and the death penalty; sex offenders; juvenile offenders; and mental health expert testimony. Guest lectures will be provided by mental health professionals and legal practitioners. In addition to traditional seminar class sessions, the course will include the observation and discussion of live and videotaped forensic mental health evaluations conducted by the Institute of Law, Psychiatry and Public Policy.

Themes in Biomedicine The issue of health care reform almost needs no introduction. For the last twenty years it has been a simmering national discussion involving every facet of the American (and international) economy and health care delivery system. With the 2008 presidential election and recent state forays into health care reform, the issue is once again at the center of national debate. We will start with an initial session that will provide foundation and background and focus on the upcoming Presidential election. Successive sessions will feature nationally-known speakers and panels including policymakers and others at the center of the debate both nationally and at the state level. Students will be provided background materials before each session and will be required to submit a one-page response paper after each session.

Tobacco Policy This seminar explores the unsolved puzzles of tobacco regulation. Used by 46 million people in the United States, tobacco is regarded as the underlying cause of more than 400,000 deaths every year. Although the prevalence of smoking has declined steadily since 1965, the initiation rate among teenagers remains stubbornly high (around 25%) and adult prevalence also seems to be flattening at around 20%. Class sessions will focus on several key issues in the ongoing debate about tobacco regulation, including the proper scope of smoking restrictions, the constitutionality of restrictions on advertising and marketing of tobacco products and the most sensible approach to regulating tobacco products, especially those that purport to be “safer” than ordinary tobacco products. Although tobacco control is a worldwide problem, the class will focus on U.S. tobacco policy, and will be grounded in a National Academy of Sciences/Institute of Medicine study on this subject chaired by Professor Bonnie. The IOM report was released in May 2007.

 

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