Academic Director Interview: LLM in Health Law

Roxanne Mykitiuk has had a very successful career in the health law field, focusing on disability and the regulation of reproductive and genetic technologies. She also happens to serve as the Director of the Part-time Professional LLM in Health Law at OsgoodePD. 

We sat down to discuss her thoughts, experiences, and perceptions of both the LLM and the greater health law field. 

Roxanne Mykitiuk
Academic Director of Osgoode’s LLM in Health Law

Given how diverse our student body can be in the LLM, how would you advise those who are thinking about undertaking the LLM in Health Law? What kinds of questions should they be asking themselves?

One of the things they should ask is why they want to pursue the LLM. Is it a question of accreditation? I tend to think about the degree as something that students are pursuing because there is a thirst for knowledge. It’s also a way of learning concepts, ideas, and ways of understanding that might not be familiar otherwise – especially to those who are coming from outside law! 

In the early 2000s, [cohorts were composed of] lawyers [who] were interested in switching their areas of practice into health law. They were interested in getting a more detailed understanding of health law doctrine and practice.

The makeup of the LLM class now has radically shifted to 1/3 lawyers and 2/3 health care professionals across a broad range of health care professions. I think that the quality of the class and the nature of the class dynamics is far superior now. 

Students are bringing a broad range of perspectives and knowledge to the issues we are examining in this program, and sharing them with each other. It is like looking through a kaleidoscope, twisting it in a variety of ways, and bringing a multiplicity of perspectives to the understanding of the same phenomenon. Students who want to think in this way are best situated for this program. 

Rather than [just focusing on] the technicalities of the law – which we certainly do in a number of the courses – [this program is attractive to those] who want to challenge themselves to think in both an interdisciplinary and policy-informed way.

You’ve remarked that we have a very strong cohort, which is excellent. Can you expand on this for me and share something of your experience with these students or in the classroom? 

What I’m really enjoying is their interaction with each other. They’re coming from a diverse set of professional backgrounds. 

[There are] several high-level administrators and specialist physicians – including chiefs of staff – and a couple of professors of nursing with interesting research agendas of their own. We [also] have someone who works in a women’s health clinic who has really interesting on-the-ground experiences of intimate and vulnerable patient [interactions] that she’s able to [draw] into the theoretical and conceptual conversations that we’re having. We have individuals with a variety of regulatory experience. Then, there are the lawyers who have experience practicing in the disability and medical malpractice context who can apply conceptually what we’ve been talking about to their everyday practice. 

The class is filled with intelligent, thoughtful, accomplished individuals who have different disciplinary knowledge and experiences and who are able to speak to each other in a way in which their different perspectives inform the other. All of this happens in a very generous, non-adversarial way. That’s what’s great about this program – there’s a [feeling of] respect and an attempt to educate each other.

I also bring guest speakers into the class who are experts in the field and provide additional perspectives, some of which may be novel to students. For example, David Lepofsky, retired General Counsel and Chair of the AODA Alliance, who has been blind for most of his life, challenged students’ views and thinking about disability rights. 

A number of students – in particular health care professionals – [have] referred to the impact that David’s interaction [made] on the development of their thinking about disability rights and the need to include a disability rights lens into their practice and health policy.

I also had another speaker, Dr. Jeff Nisker, who is a preeminent physician, scientist, and bioethicist [visit]. In the late ‘80’s, early ‘90’s he worked at the cutting edge of repro-genetic technology and was able to talk about that with the class. 

However, his experience with the use of the technology made him question its development, ethically, and he began to think about the broader ethical and public policy implications. He actually gave back his research funding, closed his lab, and began a PhD in bioethics and became very involved in issues of public engagement about the use of genetic technologies.

He was able to talk to the class about both the science – including current cutting edge science – as well as the ethical and public policy questions we should ask about the use of that science and its technological developments. 

It’s very interesting for the class to engage with an eminent scientist physician. In the course, I’m trying to provoke different ways of thinking about how we should generate regulations in this area, which is very difficult. Whose perspectives count and what do we need to know?

Can you talk more about those challenges?

Part of it is trying to get the class to understand the kind of knowledge that scientists produce, the way that science and technology [apply] knowledge, and how the scientific method validates truth. Scientific progress is valued and encouraged within our society but moves at a very, very fast pace. But then there’s the idea that it messes with the social order of things, the natural order of things, the religious order of things – all of which create risks of all kinds.  

We don’t know what is going to be produced and what is going to happen. In science, we want to discover, innovate, and progress – the thought is that more technology and more science is a good thing. But law – law generally, including common law – relies on precedent and order to set limits, tell us how to regulate, and [how to] move forward. The two don’t necessarily mesh all that well. Law doesn’t always take its cue of the truth or facts from science. What science considers to be an embryo, law doesn’t. You can’t rely on scientific definitions of facts and truths for legal facts and truths.  

When you’re dealing with two different groups of professionals, you end up with a culture clash. Part of the challenge is getting the two to talk together to see where the clash is so we can get on the same page and begin to think about how we may go about regulating. [It’s about getting] science to see that there are risks that individuals and society deem worth considering, and also [about] getting law to see that precedent doesn’t apply in [every] case. 

What aspirations do you have for the LLM in Health Law?

I’d love to bring in some international professors. There are no international borders to health, as we’ve seen with Covid. 

Health is a universal good, though despite WHO statements and definitions, It’s not universally defined and certainly not universally protected. Health, health care, and health care professionals in various jurisdictions around the world are regulated in different ways.

Many of the same issues arise, but the norms and regulations are different – at times with cross-border or jurisdiction shopping implications. It’s interesting and enlightening to understand how different jurisdictions regulate. 

I think it would be great to bring in those with different backgrounds on both the student and instructor level. Then, we might have a better opportunity to develop more robust understandings of health law issues and even be timelier in our response to global issues. [One such example was] a course that came up pretty quickly on pandemic law. While this course didn’t have an international dimension to it in terms of instructors or students, the speed with which it was introduced into the curriculum demonstrates the nimbleness of the program to be able to respond to pressing health care crises.  

Do you have a favourite memory or experience you can share from your time at OsgoodePD?

There are two things that I love. One of them is when I read students’ reflection papers and there are personal experiences or epiphanies that are embedded in the papers. You can tell when students have really thought hard about an issue using the materials and perspectives of the course and when something in the course has actually changed their minds. They’ve thought long and hard and been exposed to an idea that’s made them see something in a new way they hadn’t thought of before. That’s very gratifying.  

Then, I really like the collegiality that goes on in the classroom. There’s this tremendous sense of goodwill among the students towards each other. It’s not competitive. They pull together, work together, and are friendly and kind to each other. There’s friendship, respect, and collegiality that exists amongst them. As professionals in their respective fields, the students may not be experts on the subject matter we are considering, but many of them will have encountered related issues.  Sharing their experiences and insights contributes enormously to the learning in the class.