Medical, law students team up to take on end-of-life issues

It could be a patient's nightmare: Doctors and lawyers in the same room, asking you personal questions about your impending death.

Or, it could be just the peace of mind you need.

Local law and medical students were together in a Sacramento classroom this week for an unprecedented joint learning experience that should help ease end-of-life ordeals for the rest of us.

"As baby boomers continue to age, we're going to see more of this kind of interaction," said Sarah Hendrickson, who will graduate in May from McGeorge School of Law.

Students from McGeorge have joined medical students at the University of California, Davis, for two class sessions to exchange ideas and concerns between the two disciplines on how to deal with the rights of patients facing death. Mainly, patients must decide who will convey their wishes when they no longer can do it themselves.

It's been an eye-opener for both sides.

"It's interesting to see the intersecting of health and law," said Hendrickson, 27, after the first session on Tuesday.

In the class, a mock interview by medical students with a 72-year-old cancer patient made Hendrickson pointedly ask whether the patient's competency should be questioned just because she seems to shun the doctor's treatment. "Who are we to force her to go through this?" she said outside the class.

It's the kind of discussion that law professor Ned Spurgeon had hoped would emerge when he came up with the idea of joint classes.

"There's room for improved understanding between doctors and lawyers generally," said Spurgeon, who teaches health law and elder law and policy at McGeorge. "The Terri Schiavo case brought this into sharper focus. Hopefully, this will mean better-educated doctors and lawyers with respect to enabling patients to have their surrogates make better decisions."

The idea of law and medical students coming together to learn has been done in other parts of the country but never in this region, Spurgeon said. The two-class sessions end today for the 40 law students who joined 90 third-year medical students on the Sacramento campus of the medical school.

Training together for the same goal seems logical, said Dr. Michael Wilkes, a medical professor at UC Davis. "It's ridiculous to train all these people in a silo," he said.

In one of the classrooms, an actress portrayed Mrs. Jamison, a 72-year-old leukemia patient who visits her doctor to hear crucial news. Jamison knows she probably has five years to live, but treatments are failing and indications are not good.

As students look on, her doctor, Irina Krivoshto, 25, a third-year medical student, broaches the topic of end-of-life issues, such as when doctors should stop treating her and what kind of measures would she want them to take.

"I don't want to die," Jamison said when she hears the death reference.

"No, no," Krivoshto said, trying to soften the message. "This is in case something happens in the future."

Jamison squinted, looking skeptical and uneasy.

Both law and medical students weighed in on how to ease the patient's anxiety.

More honesty, perhaps? Substitute terms like "death" with less alarming ones?

Krivoshto pressed on, focusing on getting Jamison to promise to discuss her wishes with family members.

"I'm going to think about it," Jamison said, pointing a finger at Krivoshto.

When Jamison returns to the classroom, wearily sinking into her chair, it's two years later and death is near.

"I'm sick of being sick," she said to her doctor, Dan Sobel, 32. Sobel suggests a blood transfusion, which will energize her, but not cure her or even extend her life.

"I don't want to be stuck with any needles," Jamison said, shaking her head.

Medical students coach Sobel on how to make a better sell to convince Jamison. Maybe her competency is clouded?

Hendrickson raises her point about questioning the competency of patients who disagree with doctors, which prompts a laugh.

Krivoshto, who plans to go into internal medicine, said the joint class broadened her understanding. "We are so medical-cultured, and it is so great to get a different perspective, she said.

Next year, Spurgeon plans a similar session. The topic: health care reform.

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