New center emphasizes collaboration between medicine and law

The Florida State University Center for Innovative Collaboration in Medicine & Law has been established to promote cooperation between two professions that often view each other warily.

Marshall Kapp

The center, a joint effort of Florida State's College of Medicine and College of Law, is based in the medical school. Marshall Kapp, previously the Garwin Distinguished Professor of Law and Medicine at the Southern Illinois University Schools of Law and Medicine, has been named its director.

"Its unique mission is collaboration starting at the student level, through the practitioner level, through the policy level — collaboration on behalf of the consumer, who's the doctor's patient and the lawyer's client," said Kapp, who is also a professor in the medical school's Department of Geriatrics, a courtesy professor in the law school and an affiliate of the Claude Pepper Institute at Florida State.

"Many law schools have health-law centers; many medical schools have medical humanities departments that touch upon legal issues. But I think both in terms of its potential educational program and projects it might do, this mission is unique for an academic enterprise."

Kapp, who has a law degree and a master's degree in public health,also is professor emeritus from Wright State University School of Medicine and for more than 20 years was on the adjunct faculty at the University of Dayton School of Law. He is current editor of the American College of Legal Medicine's Journal of Legal Medicine and serves on the editorial boards of several other major journals in health law. He has published and spoken extensively on topics in health law, medical ethics, and law and aging.

Kapp said the idea for the center arose from informal conversations among faculty members at the medical and law schools.

"One of the premises of the new center is that, yes, there's a certain innate distrust, and we're not going to make everybody love each other, but we're going to try to break down the barriers enough to at least identify the areas where we can work together," Kapp said.

Among the center's constituents, he said, will be policymakers, both public (such as legislators) and private (such as insurance companies).

"As an academic institution, we can present information and counsel without having our own agenda, other than wanting to benefit consumers — patients and clients," he said. "I think if we can establish that credibility, legislators will come to us. Whether we do briefings, programs or publications for the policymakers, they will see what we have to say on issues."

Among the many issues the center will address, he said, is end-of-life care.

"That issue is a good example of a situation where doctors' anxieties and apprehensions about the law and their own legal exposure influence how they treat patients," Kapp said. "So through this center, I want to identify those kinds of issues and ask: What are their apprehensions? Where do doctors get these legal fears? Are they justifiably worried, or is it a matter of misunderstanding and missing information? If that's the case, then one remedy is education. And to the extent that doctors are justifiably fearful, to the extent that the law actually does work at cross purposes with ethics and medicine, what can we recommend to policymakers to change the law?"

Perhaps the best-known fault line between medicine and law, Kapp noted, is the debate over medical malpractice.

"The two primary objectives of the current system are to compensate people who are, through no fault of their own, injured while receiving medical care, and to improve medical care, to deter bad practice," he said. "The question is: What's the best way to achieve those two objectives? Is it the current tort system, or is it some other system? You can't really talk a lot about collaboration between the two professions and ignore the liability concerns."

But the field of medicine and law is much broader than just the liability question, he said, and there is much for this new center to explore.

John Fogarty, dean of the College of Medicine, is enthusiastic about the possibilities.

"This new center provides Florida State University an incredible opportunity to truly build collaborative programs between our medical school and law school that should set the national model," Fogarty said. "Sharing faculty and resources and providing expertise and frameworks for looking at the difficult ethical, moral and health care-related concerns of our society should be a great benefit to our university and our state."

Donald Weidner, dean of the College of Law, is equally optimistic.

"We hope to help bridge the gap between the professions of law and medicine," he said, "to improve the health and justice systems for all our citizens."

By Ron Hartung