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University of Pennsylvania's Health Law Program Takes Advantage of Its Surroundings

By Erica Winter

Philadelphia is home to some of the nation's premier hospitals. It seems only right, therefore, that the University of Pennsylvania Law School offers a highly extensive interdisciplinary program in health law.

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The school's health law program is not based at a center, nor does it come with its own certificate of completion. Students do not have to apply to get into the program once they have been accepted by the law school. Instead, the health law program is a concerted effort on the part of the law school to acknowledge and draw on the law school's local assets and expand those relationships.

Over the past few years, the law school has been actively hiring professors who concentrate on health law, says Kristin Madison, Assistant Professor at Penn Law. The school is ''trying to take advantage of internal and external resources,'' Madison says.

Madison, who came to Penn four years ago, specializes in legal issues involving healthcare organizations. She explains that ''health law'' means different things to different people. For example, Madison teaches a class on the law of health care regulations, which looks at things such as healthcare fraud under both federal and state laws.

In addition, larger, more general areas of law touch on healthcare law, Madison explains, such as liability or antitrust law and questions of whether these areas of law change when applied to healthcare. Medical malpractice liability is rather well known; less known is the question of vicarious liability, such as whether a hospital is responsible for a doctor's actions. Anti-trust issues can be clear when dealing with corporations, but possibly less so when dealing with a group of nonprofit hospitals.

Penn Law brought in Assistant Professor Theodore Ruger last year from Washington University in St. Louis as another addition to its health law faculty. ''Health law'' can be ''the legal doctrines that in some way impact the core relationship of doctor and patient,'' he says, or the law which addresses that relationship indirectly, through insurers, hospitals, public health, or constitutional law issues.

The constitutional side included in ''health law'' is studied in-depth at Penn through bioethics, which involves questions of healthcare privacy, the right to die, and other constitutional issues in healthcare. Anita Allen-Castellitto, Henry R. Silverman Professor of Law, came to Penn four years ago and is a leading national expert on privacy law and bioethics.

The goal for students studying health law at Penn is to shape ''lawyers who are knowledgeable and sophisticated regarding legal issues in healthcare,'' says Allen-Castellitto. Towards this end, students learn about health law from the entire range of perspectives, including constitutional, financial, legislative, and ethical.

Within that framework, the diversity of the University of Pennsylvania's academic offerings are used to their fullest, whether they are contained within the law school or not.

The Bioethics Center, which is not part of the law school, is the heart of a master's degree in bioethics (MBE) that some law students pursue simultaneously with their law degrees. The MBE is a two-year program; law students can apply for it when they apply to the law school or apply while in their first year. If accepted, law students start taking MBE courses in their second year. This year, there are nine Penn Law students who are also studying for their MBEs, says Madison.

Law students studying bioethics can do clinical rotations in the Hospital of the University of Pennsylvania (HUP) or at Philadelphia's Children's Hospital. Second-year Penn Law student Holly Fernandez will take advantage of this resource next year when she does her rotation with HUP's Bioethics Committee, whose members respond to hospital physicians' medical ethics questions. Fernandez will ''shadow and learn,'' she says, from these ''philosophers with pagers.''

Also at Penn is the Wharton School of Business, which has a Health Care Systems Department. Penn Law students can receive a certificate in business and public policy from Wharton while in law school. This program, too, requires a separate application but can be completed concurrently with the J.D.

The law school facilitates this interdisciplinary atmosphere with the practical step of letting law students take four elective courses in other parts of the university. For the MBE, for example, those law students take one course per semester in bioethics during their second and third years, and can cross-count some of their law school classes towards the master's degree.

Students themselves embody the interdisciplinary spirit of the health program at Penn Law. Some students take time off from medical school or even from programs in veterinary medicine to study law and bioethics.

If they do not return to medial school or become veterinarians, graduates who focused on health law while at Penn usually go to work in large law firms, says Madison, and some to those firms' healthcare groups.

No matter where students work after graduation, they will encounter health law in their legal work, says Ruger. Healthcare issues ''permeate American social and economic life,'' he says. Through Penn's program, Ruger hopes that students will be ''leaders in addressing these pressing questions.''

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