Laura Roberts Receives Prestigious MacLean Ethics Award

Psychiatrist Laura Roberts, M.D., M.A., educator and ethicist, has been a pioneer in expanding the scope of ethical inquiry to incorporate the hopes, fears, and expectations of patients in vulnerable populations receiving psychiatric care. Last month she was honored for her work when she received the 2015 MacLean Center Prize in Clinical Ethics and Health Outcomes during the 27th Annual Dorothy J. MacLean Fellows Conference on ethics in medicine at the University of Chicago Law School.

Roberts is the chair of the Department of Psychiatry and Behavioral Sciences at Stanford University School of Medicine. The MacLean Center helped to pioneer the formal study of clinical medical ethics in the early 1980s.

In a statement announcing the $50,000 prize, Mark Siegler, M.D., director of the MacLean Center and the Lindy Bergman Distinguished Service Professor of Medicine and Surgery there, noted that Roberts was one of the first graduates of the MacLean Center’s Clinical Ethics Fellowship training program. “Throughout her distinguished career as an academic leader, Dr. Roberts has applied her knowledge of clinical ethics to improve patient care, medical education, and the practice of American psychiatry,” he said.

Roberts has dedicated much of her career to studying vulnerable and special populations, particularly those who have serious disability and life-threatening diseases and who experience societal and economic adversity. Her work has led to advances in understanding the ethical aspects of physical and mental illness research, societal implications for genetic innovation, the role of stigma in health disparities, the impact of medical student and physician health issues, and optimal approaches to fostering professionalism in medicine.

“This year’s MacLean Prize is so special for its focus on vulnerable populations,” Roberts said in acceptance of the MacLean Center Award. “The prize honors these individuals who teach us about medicine, and about life, as they face great sorrow and injustices with courage and generosity.”

Roberts has also pioneered the introduction of empirical research on ethical questions in research and clinical care. “Bioethics is a rich field that brings together scholarship from many disciplines to reflect on important human questions,” she told Psychiatric News. “Some of these questions cannot be resolved, however, except through empirical inquiry.

“An example would be whether people with serious mental illness are able to understand risks associated with research, whether they make research participation decisions in a manner that is similar to physically ill people, or whether mentally ill individuals can discern how clinical care and clinical research differ in their aims,” she said. “Conceptual analysis helps to enrich our understanding of why such considerations are ethically important, but rigorously derived empirical data are needed to answer such questions. These data, moreover, can help inform public policy and professional practices so that our work is more respectful of the true strengths and more attentive to the potential vulnerabilities of people to whom we are accountable in our work.”

Roberts has also helped to advance the teaching of ethics to medical students and trainees and as a part of lifelong medical education. “I am heartened by the ideals and aspirations of our early career colleagues and by their clear understanding that every reflection, decision, and action has ethical meaning,” she said.

Roberts has been active in APA around subjects related to ethics and education and is a past chair of an ad hoc work group that started the development of a resource document to educate psychiatrists about APA’s Principles of Medical Ethics With Annotations Especially Applicable to Psychiatry. That work group is now chaired by Rebecca Brendel, M.D., J.D. (Psychiatric News, November 20).

Roberts believes the study of ethics and the practice of psychiatry go hand in hand. In a chapter she wrote recently for a forthcoming book on ethics, Roberts wrote: “Psychiatry, more than any other field of medicine, concerns itself with studying and strengthening the capacities that make us distinctly human and that allow us to attach, learn, love, reason, feel, live with one another, and make choices. Separately and together, the fields of ethics and psychiatry examine human meaning, intention, and consequences, and both are concerned with the expanse and limits of the self in the world. Thus by their natures, ethics and psychiatry are overlapping fields of inquiry.” ■