Where health and the law meet

A unique faculty position provides pharmacy students with amazing learning opportunities.

Students enrolled in the pharmacy program at the University of Alberta have a unique advantage when it comes to health care and the law-learning about health law and ethics directly from a lawyer.

Ubaka Ogbogu (LLM '05), assistant professor in the faculties of law and pharmacy and pharmaceutical sciences and Katz Research Fellow in Health Law and Science Policy, is possibly the first-if not the only-cross-appointment in these two disciplines in Canada.

Ogbogu, who came to the U of A in 2002 for a master's degree after practising law in Nigeria, has been with the Health Law Institute since 2005 and has held the cross-appointment since 2011.

Ogbogu views his dual role as a tremendous opportunity to "build a connection between law and pharmacy."

"It's a unique position that was created to explore the intersections of these two faculties, and it's a responsibility I take very seriously," he says. "I see the position as an opportunity to learn what pharmacists do and to communicate to them what lawyers do and what lawyers bring to the table. Learning about what pharmacists do also informs my research and allows me to examine the policy implications of what health-care professionals do in Canada."

Ogbogu has immersed himself in the role, becoming involved in the culture of the faculty and attending student events. In fact, the popular professor recently found himself hosting the "Pharmily Feud" contest as part of the Alberta Pharmacy Students' Association fundraiser, Mr. Pharmacy.

Ogbogu says the reaction from students in his class has been outstanding.

"There's something about the learning culture in the faculty that I quite like. Pharmacy students are motivated by learning the subject matter," he says. "You are only as good as your students make you. The response I get from students is so great; they make it easy to teach."

His impact on the Faculty of Pharmacy and Pharmaceutical Sciences has been remarkable, according to James Kehrer, dean and professor.

"Pharmacy law is a critical component of the safe and legal practice of the profession of pharmacy, and is part of the licensure examination. In the past, pharmacy law was taught by pharmacists with some guest lectures from law faculty members," says Kehrer. "Having a joint position with the Faculty of Law provides our faculty with a true expert in health-care law. This, in turn, provides our students with unique and in-depth perspectives on legal issues that pharmacists face. Dr. Ogbogu is a highly accomplished legal scholar in health law, and we are fortunate to have him as a joint appointment with the Faculty of Law."

Ogbogu has also undertaken collaborative research projects. He is currently working on a research paper with clinical assistant professor Candace Necyk (BSc Pharm '08, MSc '13) on "Alberta pharmacists and their practices in relation to natural health products." The study, which involved more than 400 pharmacists, is slated for publication before the end of the summer.

"It's been wonderful to work with faculty members on projects and research at the intersection of pharmacy and law," says Ogbogu. "It's led to collaborating on a grant with colleagues from the University of Western Ontario and the University of Waterloo on issues surrounding pharmacy practice and the law"

While Ogbogu is known on campus for his work in health law and ethics, he's often asked to give guest lectures or provide comment in the media about a wide variety of issues. Though he often uses his media interviews and social media to engage with people in discussions, he feels speaking with people in person is just as important.

Ogbogu often participates in community events such as philosophers' cafes on a variety of topics and speaks to high-school students. This public engagement gives Ogbogu plenty to draw from to share with his classes.

Recently, Ogbogu has been speaking out about myths related to vaccinations. "It's important to educate the public-one issue that brings us together as a country is health care and how we want it to be delivered."

Ogbogu has a book due out before the end of 2016, titled Vaccination and the Law in Ontario 1800-1920, which he describes as "a historical examination of vaccination policy and debates in the 19th century."

"I am writing the book to show that vaccination is not a new issue. It's been here for a long time, but the nature of the debate has not changed," he says. "People have been fighting vaccinations since they were invented, even in the face of serious infectious diseases."

"Vaccination is not just a health-care issue, it's also a political matter. The book attempts to show what has worked and what hasn't over time, and what arguments about vaccination resonate."

Vaccination myths and what pharmacists can do

As Alberta's most accessible health-care professionals, pharmacists have a role to play in educating people about vaccinations. Ogbogu shares in his own words what he sees as some of the myths surrounding vaccinations and what pharmacists can do to help counter these myths with facts.

Myth #1: Everybody knows why they need to be vaccinated.

Some people don't understand why they have to get vaccinated. There's so much confidence in the fact that you should know that this is good for you, but I think there are many people out there who are suspicious of vaccinations. Vaccines work, we know it. But it is not as intuitive to people as we think it is. Many people who are alive today don't know about many infectious diseases. Why is that? Because vaccines work. It's ironic. We don't know diseases because vaccines have worked to eliminate diseases, but because we don't know diseases, we don't know how important it is to take steps to prevent them. Health-care professionals need to watch for this overconfidence. They need to not assume that people know.

Myth #2: Anti-vaccination opposition and hesitancy

There are people who are opposed to vaccinations and then there are people who are hesitant for all kinds of reasons, including misinformation about vaccines, poor understanding of why they are necessary, fear of vaccinations, overprotectiveness of children and lack of access to health care. Language barriers, especially in immigrant communities, can also pose problems with accessing vaccinations. (Ogbogu is currently considering doing a project that translates information about vaccinations into different languages.)

Myth #3: Talking to people about vaccination equals action.

Just talking to people doesn't mean they will do anything about it. Those who are opposed often become entrenched in their views. Studies have shown education is not always effective. One area we need to look at is whether we need a coherent health policy to address vaccine refusal or hesitancy. I'm supportive of compulsory or mandatory vaccination for recommended childhood vaccines, but I won't recommend punishing parents who don't comply. Rather, I think mandatory vaccination laws will help create a culture of compliance. We are a law-abiding society and if you say vaccination is compulsory, people might protest, but over time it will become something they see as the right thing to do. It may also lead them to ask questions about why it is a legal requirement. The notion that education will solve everything doesn't take into account that those who oppose vaccination have a stronger voice in the community and they are often preying on fear. They have a powerful message.

Celebrities often promote anti-vaccination messages-and they seem to be winning the fight. However, it's important to keep in mind that it's not an entirely dismal situation. We are, as a whole, a fairly well-vaccinated population, but we can do better. For example, children in southern Alberta are under-vaccinated.

Myth #4: Health-care workers should have the option to get the flu vaccine.

When it comes to health-care workers, I support mandatory flu vaccination. Health-care workers should take reasonable precautions on the job to protect patients. Health-care workers provide an essential service that goes above and beyond what the rest of us do. Most work with persons who are vulnerable to the flu and other infectious diseases.

No health-care professional would argue about the precautions necessary in dealing with a quarantined patient. I would compare vaccinations to wearing a hazmat suit that protects vulnerable patients from infection. However, I don't think non-compliance should result in losing one's job; there should be some accommodation if a health care worker holds serious reservations to the flu vaccination. Perhaps unvaccinated workers can be redeployed elsewhere during outbreaks.

What can pharmacists do to help battle the myths?

1. Be an advocate.

We need a provincial policy that makes sense. Pharmacists can get involved in advocacy.

I'd love to see pharmacy students and pharmacists engage more in advocacy and policy around this issue. We need to mobilize the collective. I think pharmacists have a very powerful voice in the province and nationally, and I think governments will listen. Pharmacists are trusted professionals, by both policy-makers and members of the public.

2. Make vaccination a routine part of health-care counselling.

Make patients who come to see you understand the need for vaccinations, how it can be done, and so on. Have regular conversations with patients.