‘Patient-Centered Health Law and Ethics’ conference set for April 15

Wake Forest University School of Law will host a conference on “Patient-Centered Health Law and Ethics” on Thursday, April 15, in the Worrell Professional Center.

The conference, featuring Mark A. Hall, Wake Forest University law professor and director of the Center for Bioethics, Health and Society, and Lois Shepherd, director of the University of Virginia’s Center for Biomedical Ethics and Humanities, will involve participants from law and other academic fields including sociology, medicine, philosophy and religion.

Scholars from these different fields will share their perspectives on whether law and ethics should focus more on patients’ concerns than on the concerns of health care providers, insurers, or the government. Following the conference, the Wake Forest Law Review will report about the scholarly discussion, together with short essays submitted by the speakers.

The event is from noon to 6 p.m. in Room 1301. It is free and open to the public.

This inaugural conference of the Center for Bioethics, Health and Society is made possible by a generous gift from David Zacks (’64, JD ’67), a

partner at Kilpatrick Stockton in Atlanta, who represents both plaintiffs and defendants in complex litigation matters. He is a certified arbitrator and mediator with the American Health Lawyers Association and a founding member of the Georgia Academy of Mediators and Arbitrators. Zacks practices in the health care industry and represents both hospital and physician providers. He is also the co-founder of the American Cancer Society Patient Navigator Program and Past National Chair of the Board as well as the co-chair-elect of the Wake Forest University School of Law, Law Board of Visitors, among others.

Featured speakers are:

• Howard Brody, University of Texas Institute for Medical Humanities
• Larry Churchill, Vanderbilt University Center for Biomedical Ethics & Society
• Arthur Frank, author of “The Wounded Storyteller: Body, Illness, and Ethics”
• Mark A. Hall, Wake Forest University Center for Bioethics, Health and Society
• Nan Hunter, Georgetown University O’Neill Institute for National and Global
Health Law
• Sandra Johnson, St. Louis University, Tenet Endowed Chair in Health Law
and Ethics
• Joan Krause, University of North Carolina Schools of Law, Medicine, and
Public Health
• Carolyn McLeod, Department of Philosophy, University Western Ontario
• Ted Ruger, University of Pennsylvania Law School
• William Sage, University of Texas
• Carl Schneider, former member of the President’s Council on Bioethics
• John Scott, Robert Wood Johnson Medical School
• Lois Shepherd, University of Virginia’s Center for Biomedical Ethics and

The birth of both health law and bioethics as academic fields dates roughly to 1960. But the two fields have sharply contrasting intellectual histories – especially regarding their principal points of focus. Health law began as a physician-centered enterprise, focusing on the issues and perspectives that practicing doctors faced when they encountered the legal system. Only in the 1980s did health law shift to a broader public policy orientation, but even then it adopted an industry-centered perspective that attended mainly to the issues of importance to hospitals, insurers, and government institutions.

Bioethics, in contrast, began in very much a patient-centered mode. An animating purpose was to shift the focus of medical ethics from physicians’ concerns embodied in professional codes of conduct and to advance an agenda of patients’ rights. In recent years, though, bioethics’ traditional approach to patient-centeredness has been criticized as unduly preoccupied with patient autonomy, to the neglect of other patient-centered values and concerns, such as suffering, relationships, or trust.

“In health law, growing dissatisfaction with previous intellectual paradigms led us, along with Carl Schneider (University of Michigan), to convene a group of leading health law and other scholars four years ago to ‘Rethink Health Law,’ “ Hall said. “That group spent two days discussing: Does health law have a core set of concerns? What new paradigms can best help us reconceive health law? How can health law accommodate the special psychological, emotional, and moral aspects of its subject?”

“The conference prospectus we sent to participants at that time proposed a patient-centered focus to health law and suggested three under-developed approaches that contributors might pursue: patient-centered professionalism, patient-centered empiricism, and a relational perspective that places the patient at the center of a web of relationships,” Hall explained. “The articles and workshop discussions offered promising insights into the emerging concept of a patient-centered health law. Building on this initial effort, we believe it is now time to think more systematically and comprehensively about what patient-centeredness might mean, and the different approaches it might engender, both in health law and in bioethics.”

Emphasizing the patient’s centrality forces law and ethics to acknowledge and accommodate crucial features of the medical arena that differentiate it fundamentally from other social and economic arenas. Health care law and bioethics address the delivery of an extremely important, very expensive, and highly specialized professional service in situations of tremendous personal vulnerability, Hall said.

“These high stakes are what makes health care so expensive and its dilemmas so compelling. They are what drew most of us to the field. And they counsel us to attend more closely to the psychological realities of treatment encounters and the essential ingredients of medical practice and professionalism. Sometimes it matters fundamentally, even profoundly, that a legal matter involves physicians caring for patients, rather than providers servicing generic consumers. When this is so, general law becomes health care law, and ethics become medical ethics.”