Topics and Speakers for Health Law Courses
Topic: The Anatomy of Medical Error (Fall 2009)
Speakers:
David E. J. Bazzo, M.D., Clinical Professor of Family Medicine, Associate Director, UCSD PACE Program;
Paul A. Craig, J.D., R.N., Director of Risk Management, UCSD Medical Center; Stephen Hjelt, J.D., Administrative Law Judge, Office of Administrative Hearings, State of California;
Robin Samit, J.D., Director of Business Contracting, UC San Diego Health Sciences; David Balfour, J.D.; Jan Mulligan, J.D.;
William A. Norcross, M.D., Clinical Professor of Family Medicine, Director, UCSD PACE Program
Faculty Participant: Ed Dauer
Description of the Session:
Using elements of lecture, discussion, role-playing, and psychodrama the presenting faculty deconstruct the case of Libby Zion, the tragic and complicated story of an 18 year-old college freshman whose final five days in the Spring of 1984 have come to represent a landmark study of the complex interplay between individual, systems, cultural, interpersonal, and socioeconomic factors as they relate to patient care.
The faculty hopes for a very interactive educational experience and hope that all in attendance will experience a greater degree of empathy and understanding with all of the participants in this human drama, while providing no easy answers to the questions that will be uncovered.
While we do not limit ourselves to prescribed topic areas, this 3-hour session (with one break) will include, at a minimum, the following issues:
o Patient responsibilities in clinical outcomes
o Drug abuse and mental health issues
o Issues of supervision and “back-up” in medical education
o Sleep deprivation in medical education and clinical practice
o Work load and over-work in medical education and clinical practice
o Resident (and intern) work hour legislation
o Hand-offs and transitional care
o Pharmacokinetics issues and Polypharmacy
o Clinical heuristics and errors in diagnostic thinking
o The use of restraints: physical and chemical
o The challenge of diagnosing the uncommon or unexpected disease
o Challenges of human communication (the patient, family, and providers)
o Social and cultural influences on health care
o Response to call and physician responsibility
o Hospital responsibilities in patient care
o Systems issues in patient care
o Group discussion: After a quarter century, what do you think happened?
Topic: When the Doctor Says 'No': Physicians, Conscience Clauses, and the Law (Fall 2009)
Speaker: Mary Devereaux, PhD, UCSD Research Ethics Program; Adjunct, CWSL
Description of the Session:
What role should factors unrelated to individual patient health have on physician willingness to provide medical services? Conscience clause laws permit health care providers to "opt out" of providing medically indicated services that they find objectionable on religious or moral grounds. The obvious case is abortion, but conscience clauses may come into play in a variety of other circumstances: prescribing Viagra for patients engaging in unsafe sexual practices; providing birth control; removing life support in circumstances of medical futility.
This workshop will examine the philosophical arguments for and against conscience clauses. Participants will be assigned to small groups with the task of analyzing the complex ethical, medical and legal issues raised by appeals to physician conscience. Our aim will be to develop criteria adequate to distinguish between legitimate and illegitimate grounds for refusing to provide requested medical treatment.
Topic: Medicine, Research, and Ethics: Can we have it all? (Fall 2009)
Speaker: Michael Kalichman, Ph.D., Co-Founder of the Center for Ethics in Science and Technology
Faculty Participant: Ed Dauer, Dean Emeritus and Professor of Law, U. of Denver Sturm College of Law
Description of the Session:
Liability for medical errors is an area of healthcare law that has been praised, excoriated, vilified, studied, subjected to political initiatives, legislative interventions and constitutional challenges, and written about well and written about badly for years. Proposals for reform abound, and the temperature of the debate rises every time liability insurance prices swing upward, as with regularity they always do.
President Obama raised both the interest and the stakes when, in remarks to the American Medical Association and again in his recent address to the Congress, he bundled malpractice reform with comprehensive legislative initiatives in national healthcare reform, focusing on the malpractice system’s excessive costs and its failure to achieve much-needed improvements in healthcare quality and patient safety.
This workshop will explore the empirical and philosophical cases for and against contemporary malpractice liability law, and will outline the more frequently cited and most interesting alternatives. Participants in the workshop will also be challenged to develop, working in small groups under the guidance of the workshop leader, their own proposals and arguments for change (or not), and invited to present their ideas to other groups working on parallel ideas.
Topic: Safety Issues for Drugs and Biologics (Fall 2007)
Speakers: Bryan Liang, Associate Professor of Anesthesiology at UCSD School of Medicine and Co-Director of the San Diego Center for Patient Safety at UCSD School of Medicine; Lew Kontnik, Director of Brand Protection, Amgen Pharmaceuticals
Description of the Session:
As pharmaceutical and biologic products become a core tool in medical practice, the cost of these products increases the threat of illegal and unsafe activities. In this workshop Mr. Kontnik will discuss the startling reality of counterfeits in the medicine supply, and its global prevalence. He will also review the system that allows for such activities to occur, and some likely strategies and outcomes from recognition of this problem. Dr. Liang will explore the current science of biological drug manufacture, and policy efforts to allow abbreviated approval of biologic copies, known as "follow-on biologics." He will provide a review of drug approval of biologics here and in the EU, and offer his thoughts of an appropriate method of regulation of follow-on biologic products.
Topic: Current Issues in Medical Liability Reform (Fall 2007)
Speaker: Edward Dauer, Dean Emeritus and Professor of Law, U. of Denver Sturm College of Law
Description of the Session:
The medical injury liability system – better known as medical malpractice – is loved by almost no-one. Calls for reform arise with great regularity, typically whenever the liability insurance premium cycle comes around to higher prices and lower availability. This workshop begins with an overview of the evidence concerning how well – or poorly – medical liability works as a compensation process, an accountability process, and a patient safety process. A brief history of reform efforts to-date will also bring workshop participants up-to-date, and participants will work in small groups to develop their own ideas for reform, under the guidance of the instructor. The evening will conclude with the presentation and discussion of the groups’ ideas and a comparison with existing legislative proposals developed by reform advocates elsewhere.
Topic: Current Initiatives to Create State Health Insurance Plans
(Winter 2008)
Speaker: Susan Channick, Prof. of Law, California Western School of Law
Description of the Session:
This workshop will examine in depth the concept of state-led health insurance plans, looking primarily at both the Massachusetts “universal” health insurance plan and similar plan that has been proposed by Governor Schwarzenegger to provide health insurance for all Californians. Both of these plans utilize what is known as the “individual mandate” approach in order to ensure that all residents of the state have health insurance. These programs are modeled on the mandatory automobile insurance paradigm which requires all residents to obtain health insurance. Financing the program is the shared responsibility of all players including the insured, employers, the state and federal governments and, in the case of California, providers as well. In both states, low-incomes residents will be entitled to premium assistance.
Topic: Pharmaceuticals and the Internet (Winter 2008)
Speaker: Francine Haight, R.N., Founder, Ryan’s Cause (Reaching Youths Abusing Narcotics), & Board Member, Families Changing America
Faculty Participant: Bryan Liang
Topic: Emerging Concerns and Considerations Regarding Genetic Privacy (Winter 2008)
Speakers: Leonard Deftos, Professor of Medicine, UCSD School of Medicine;
Steve Smith, Dean of the California Western School of Law; Ted Friedmann, MD, Professor of Medicine, UCSD School of Medicine
Description of the Session:
Genetic information raises many legal and medical issues about privacy, discrimination, and insurability. These issue are being magnified by the continuing progress in genetic research, such as that supported by the Human Genome Project. This workshop will present and discuss varying view points on the topic. In particular, there seems to be substantial and surprisingly consistent support from medical, scientific, and legal bodies for allowing disclosure of genetic information to third parties under some circumstances.
Topic: Legal Considerations Associated with Use of Marijuana for Medical Purposes (Winter 2008)
Speakers: Marsha Cohen, Professor of Law, UC Hastings College of the Law;
Igor Grant, M.D., UC San Diego Department of Psychiatry,
Faculty Participant: Len Deftos
Description of the Session:
Federal law regulates drugs that are deemed subject to abuse under the Federal Controlled Substances Act (CSA), making some (like marijuana) unavailable even for use by prescription, and controlling the prescription use of others. Significant conflict has arisen in recent years over federal controlled substance policy and federal interpretation of its statutory authority in this area. These conflicts have given rise to litigation that has gone to the United States Supreme Court in disputes involving state "medical marijuana" laws and Oregon's "Death with Dignity" act. The health care practitioners who comprise the pain management community have clashed with the Drug Enforcement Administration, claiming its aggressive criminal prosecution of physicians and other health care professionals (as well as some patients) for their use of controlled substances criminalizes what might be poor professional judgment as if it were drug abuse and diversion. This workshop will provide the legal framework and an opportunity to examine these important public policy issues.
Topic: Health Insurance Reimbursement Structure and Procedures: Preventing Fraud and Abuse
Speaker: Paul Belton, Vice President of Corporate Compliance, Sharp Healthcare (Spring 2008)
Faculty Participant: Ed Dauer
Description of the Session:
This workshop examines the circumstances and dynamics that may lead to fraud and abuse in health insurance reimbursement, with a special emphasis on Medicare, as well as current efforts to remedy the situation. Specific topics include the insurance reimbursement processes, regulatory enforcement environment, the intent and impact of legislative and regulatory reform, signs of ethical collapse, and high-risk areas for hospital and health care providers.
Topic: Malpractice: Law, Politics and Healthcare Reform (Fall 2008)
Faculty Participant: Ed Dauer
Topic: Legal Thought and Medical Thought (Fall 2008)
Speaker: Michael Middleton
Faculty Participant: Ed Dauer
Topic: The Medical and Legal Environments of Medical Injury and Patient Safety: A Workshop and Dramatization. (Fall 2008)
Speaker: William A. Norcross, M.D., Clinical Professor of Family Medicine, Director, UCSD PACE program
Faculty Participant: Ed Dauer
Description of the Session:
The goal of this program is to improve the knowledge base in medicine of those legal professionals who deal with cases related to medicine and health care. The Anatomy of Malpractice shall provide insight into the complexities and uncertainties of medicine and surgery. We hope that legal professionals who attend this course will practice with greater accuracy, understanding and compassion. The curriculum will be case-based, practical, lively, and exciting. The case based approach will be interactive and problem based allowing the faculty to combine basic science and clinical medicine. We propose to use malpractice cases to introduce the participants to aspects of medical school including clinical evidence based medicine and surgery. The goal will be to provide judges and lawyers with a focused set of core medical knowledge that will help them improve their skills in the courtroom and/or the negotiating table.
Topic: The Ethics of Multiple Births - When is Enough Enough?(Winter 2009)
Speaker: Dr. Mark Pian
Faculty Participant: Susan Channick
Description of the Session:
Nadya Suleman, a single mother with six children, gave birth on January 27 to octuplets. This 3 hour workshop looks at the ethical, legal and social questions raised by the Suleman case. Issues include: Should professional or legal restrictions limit the number of embryos IVF doctors may implants? What are the limits and scope of patient choice, e.g., Nadya Suleman’t request to have eight embryos implanted? What medical and quality of life concerns do high multiple births raise? Did the fertility doctor’s conduct fall below the standard of care? And if so, can he lose his license? Should he? Lastly, what role, if any, should cost considerations play in thinking about the ethics of patient and physician conduct?
Topic: Legal Challenges in Hospital Administration
Speaker: Richard Liekweg, CEO UCSD Medical Center
Topic: Anatomy of a Public Health Initiative: Community Water Fluoridation
Speakers: Eleanor Nadler, RDH, MPH, Executive Director, San Diego Fluoridation Coalition; Marjorie Stocks, Fluoridation Consultant, California Dental Foundation; Laura Spiegel, Executive Director, First 5 San Diego;
Richard Ledford, Public Affairs Consultant
Topic: Effective Lobbying Techniques
Speaker: Jimmy Jackson, Vice President, Public Policy, BIOCOM
Topic: Addendum: The Role of the County in Health
Speaker: Leslie Bruce, JD, Course Instructor/Facilitator
Topic: Why I Got Involved
Speaker: Dr. Nick Yphantides, Chair, San Diego Childhood Obesity Initiative
Topic: Conflicts of Interest and Commitment: Investigator and Institutional Issues
Speakers: Leonard Deftos, MD, JD, LLM, Professor of Medicine, UCSD School of Medicine; Steven R. Smith, JD, Dean of California Western School of Law
Topics: Managed Care: Contracts among Payers, Providers, and Patients
The Impact of Federal Law: ERISA and Providers’ Fiduciary Duties
Regulation of Providers: Civil Liability, Licensure and Discipline
Disputes About Benefits: State and Federal Rules
Regulating Quality: Peer Review, Accreditation, Reporting
Speaker: Edward Dauer, Dean Emeritus & Professor of Law, U.of Denver Sturm College of Law
Topic: Managed Care
Speakers: Mark Johnson, David Kraus & Jody Root
Topic: The Conversion of Public Non-Profit Organizations
Speaker: Susan Channick, Prof. of Law, California Western School of Law
Topic: Regulating Drugs and Devices
Speaker: Robert Bohrer, Professor of Law, California Western School of Law
Topic: Peer Review and Credentialing
Speaker: Jacqueline Parthemore
Topic: Influenza Pandemics
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