Research Profile: Professor Mary Anne Bobinski
“Health care law focuses on the intersection of the legal system with the vast array of challenges and new developments found in modern medicine, from new reproductive technologies to developments in neuroscience”
For Professor Mary Anne Bobinski, the excitement of health law as a field of research stems from the fact that it “focuses on the intersection of the legal system with the vast array of challenges and new developments found in modern medicine, from new reproductive technologies to developments in neuroscience.” Working as an individual researcher and as a research team leader, Professor Bobinski’s research and scholarship in health law over the years has developed in two separate areas. Her early work focused on conflicts of interest in healthcare, examining specifically the different ways the health care financing system in the United States creates incentives that might not align with patient interests. The second, more recent area of work explores the intersection of law with emerging new developments in medicine and science, analyzing the legal system’s response to the changes and developing recommendations for new approaches.
Conflict of Interest in Healthcare
While we think of physicians as having a duty to serve patient interests, as Professor Bobinski’s research shows, financial aspects of the health care system can create conflicts, such as where physicians in a health maintenance organization might receive greater pay for providing less care to patients. Her scholarship pursued an analysis of these and other scenarios involving conflict of interest along a number of interconnected axes: whether and how the law recognizes such potential conflicts of interest; the physician’s legal obligation to patients from the potential conflict; and the response of patients to the protections established by the legal system. So, for example, if the physician has to disclose his or her conflict of interest to the patient, what can the patient actually do with that information?
Professor Bobinski’s research on financial conflicts of interest broadened too into analysis of other conflicts of interest in the physician-patient relationship, including provider-associated risks – the personal characteristics of the physician that represent a risk to the patient. The legal approach to this type of risk is sometimes controversial. For example, different jurisdictions have struggled with the appropriate response to the extremely low risks presented by physicians infected with HIV in some health care settings. Should these physicians have a duty to refrain from providing care for the patients or should the risk be disclosed to their patients?
Beyond HIV, Professor Bobinski also provided consideration of issues around drug and alcohol use by physicians and discussed conflicts of interest in the context of medical research, where, for example, patients can sometimes misunderstand the difference between treatment and research and courts have imposed duties on researchers to disclose their research interests to patients.
Professor Bobinski notes there are significant gaps in addressing conflicts of interest in the health care field because the available legal theories to address the issues so often focus on the special obligations of physicians to their patients. There are far fewer common law and statutory protections for the conflicts that arise from health care providers and organizations involved in health care system.
New Challenges to Healthcare Law
Professor Bobinski has also worked in areas ranging from public health to reproductive health law, where new developments have challenged existing legal approaches. Her work in these areas began with a study on the legal response to HIV in the late 1980s, when the level and source of legal protections available for people with HIV infection were unclear. Publishing a number of articles and book chapters and working with colleagues on a casebook on the legal challenges presented by HIV, Professor Bobinski’s work on HIV infection provided a base for her later scholarship on legal aspects of Hepatitis and bioterrorism.
More recently, advances in genetics have created new challenges in our approach to health care information, including whether and how information about one person’s genetic risks can or should be shared with other family members, while developments in reproductive technology have challenged traditional approaches to defining parenthood and families. Both have created fresh challenges for the legal system, which Professor Bobinski’s far-reaching analysis has helped to explore and elucidate.
Leading Research Teams
From 1989 to 2003, Professor Bobinski was a faculty member at the University of Houston’s Law Center, where she held a number of administrative roles including serving as Associate Director and then Director of the Health Law and Policy Institute, then the top-ranked health law program in the United States. The Institute received funding from Texas legislature to work on health policy issues. As Director, Professor Bobinski had the opportunity to lead the legislative research effort and a team consisting of four research professors and student research assistants.
The Institute worked on the research projects at the direction of the health related committees of the Texas legislature. The issues were very diverse – from developing legal responses to bioterrorism to questions about vaccination policies. Professor Bobinski notes that “the program was a great example of public support for involving university faculty and students in evidence-based policy development in a critically important area for government.” The Institute was also able to provide students with the opportunity to hold health policy internships with the legislature in Austin.
Research as the Law School’s Dean
After she joined UBC, Professor Bobinski has maintained her involvement in US-health law projects while beginning to work on Canadian health law and comparative health law topics. She has served as a board member and President of the American Society of Law Medicine and Ethics, published several articles, and continued as a co-author of one of the leading health law case books in the US, Health Care Law and Ethics.
Professor Bobinski’s scholarly work in Canada has focused on HIV and Canadian public health law. She has also enjoyed working with a former interdisciplinary graduate student on projects related to legal aspects of radiation oncology that have been published in peer-reviewed medical journals. She continued her policy consultation work in Canada, serving as a member of the Canadian Public Health Officer’s Ethics Advisory Committee (2010-12). Professor Bobinski continues to be a member of the advisory board for the National Core for Neuroethics at UBC.
With the completion of her term as Dean this summer, Professor Bobinski is looking forward to being able to focus more intensively on developing her Canadian health law scholarship in areas ranging from public health to neuroscience. During her upcoming leave, Professor Bobinski will also deepen and broader her base for comparative health law research and scholarship. Professor Bobinski will begin her leave as a visiting scholar at Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School. During the second part of her leave she will be a visiting scholar in Australia. Professor Bobinski reports that she is looking forward to returning to UBC’s rich and engaging scholarly environment at the conclusion of her leave.
Further Reading for You
From June 8-10, 2015, the Peter A. Allard School of Law was the site of a unique Junior Scholar Workshop on Human Rights. Among the Workshop’s aims was the goal of better incorporating non-Western perspectives in scholarly and activist discourses and research agendas about human rights.