Medlaw: At the Intersection of Law and Medicine
November 24, 2009
Growing at the Intersection of Law and Medicine
"It seems I've witnessed a million moments when minds have changed, when entrenched attitudes-including my own-have melted away. I can't count the moments when students have grappled with something new and grown from the encounter."
For Professor Susan B. Apel, leading Vermont Law School's Medlaw Seminar has been 10 years of continual change and re-creation. For two hours a week, students from VLS and Dartmouth Medical School work to understand complex issues at the intersection of medicine and law as they explore their own opinions and ethical positions. Issues center around new forms of family made possible by assisted reproductive technology.
"There are few precedents and little case law in most of these areas," says Apel, "so students are engaging each other at the level of core principles. These are the battles being fought around the nation-and the world-today, at the foundations of law."
"Every session has been transformative. Every class has had an ah-ha moment for me. This was the first time I had been forced to consider an argument that I had resisted in the past."
Lillian Kortlandt, 3L
Discussion and deliberation benefit from the small size of the seminar, which attracts around a dozen law students and half as many medical students. The two-credit course satisfies the law school's "perspectives" requirement, and, according to Apel, is also attractive because it offers "a different experience, with different players, outside of South Royalton.
" For the first-year med students, the seminar is truly an elective course. "We attract the students who are really interested in the subject matter. It's mostly word-of-mouth at the medical school."
The dynamic of the seminar is often based on small-group work, with three or four lawyers working in teams with at least one doctor. "There's very little lecturing," says Apel. "Instead, we ask the small groups to put themselves into the roles of juries, state legislators, judges, or policy-makers."
But don't imagine that this is a polite moot court. The complex issues generate a spectrum of opinion and the boundaries are fluid. "The discussions are exciting, but they're also discomforting," says Apel. "We disagree, then contradict ourselves, and even find ourselves switching places in arguments."
"Every session has been transformative," says Lillian Kortlandt, a third-year law student. "Every class has had an ah-ha moment for me. This was the first time I had been forced to consider an argument that I had resisted in the past."
These seminars, led jointly by Apel and Dr. Judy Stern, director of the Human Embryology and Andrology Center at Dartmouth Hitchcock Medical Center, deal with a range of assisted reproductive technologies, including surrogacy; egg, sperm, and embryo donation; and preimplantation genetic diagnosis. It was one of these issues-the rights of the biological parents-that caused Kortlandt to turn a corner.
"I had a gut reaction when the discussion turned to the point of view of biological parents. I realized that they had a large interest in these procedures. It was the first time I was able to step out of the legal realm and, hands on, see how families are affected by the law. I got a new perspective, and for that, the seminar has been, far and away, one of the best classes I've taken at law school."
For Apel, who also directs Vermont Law's General Practice Program, facilitating these new, more human perspectives is the real payoff. "When I designed the course," she says, "I wanted to find a place where doctors and lawyers could work together, someplace other than medical malpractice. Each profession is, in some ways, out there on its own: doctors want to understand outcomes and lawyers want to know what the law is. In a century, these issues will be old hat, but right now they're in their infancy. This seminar is meant to fill the need to collaborate in productive ways, ways that make sense to both professions and lead them forward."
And for Apel, the seminar also passes the parking-lot test.
"Some Wednesday evenings we have trouble getting out of the parking lot because of all the lively discussions that spill out of the classroom. For me, that makes this seminar a real joy to teach."