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The Role of Evidence in Emergency Health Care Policy and Law: Rory Staunton and NYU Langone Medical Center - STIRS Student Case Study

Joel Teitelbaum, JD, LLM
Department of Health Policy, The George Washington University
Washington, District of Columbia
joelt@gwu.edu

Abstract:  The Langone Medical Center Student Case, which is based on real events, offers an opportunity to discuss health law and policy and the role of medical evidence in applying the former and formulating the latter.  It provides an example of the ways in which the use of evidence in emergency medical care can have life or death consequences, and then considers whether the use (or not) of evidence in the example is itself (a) evidence of wrongdoing in a legal sense and/or (b) evidence of the fact that policy should be changed at either the institutional or state level so that similar outcomes can be avoided in the future.  Depending on facilitator preference, the case can be structured as an Analysis case, a Directed case, a Discussion case, or a Role-Play case – or some combination of these – using the definitions provided by the National Center for Case Study Teaching in Science.

Use in Courses:  A nice thing about this case is that it allows students to contemplate and analyze the facts and consequences from multiple perspectives -- legal, medical, policy, and ethical.  In fact, one of the most interesting uses of this case is to model the plot device used in Akira Kurosawa’s famous movie “Rashomon,” a 1950 Japanese period drama which forces viewers to consider multiple characters’ portrayal of alternative, mutually contradictory versions of the same incident.  Through the eyes of four witnesses, the film treats viewers to widely differing accounts of a crime, and the accounts may or may not be influenced by the self-serving desires of the characters.  In the Langone Medical Center case, students could undertake multiple readings of the tragic facts at the core of the case, considering both the legality of what occurred and what (if any) changes to pursue from the four angles noted above.  The case can be easily adapted to be taught either as a whole or in parts.

The multi-dimensional nature of this case offers a great opportunity for students to explore, analyze, and integrate issues connecting law, policy, and medical care.  This case would also be of interest to students in pre-medical programs.  The case would probably be most effective for third or fourth year students.  

The case provides opportunities for students to work collaboratively in small groups and it could be used in capstone courses focusing on health law or public health policy.  It also provides ample opportunity for students in writing-intensive courses to enhance their analytical writing skills.

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Professor Teitelbaum developed this case study as an example for the STIRS Program.