Dr. Jay Katz, a psychoanalyst and Yale Law School professor whose
analysis of the conflicting interests and motivations of doctors and
patients made him a leading authority on medical ethics, died of heart
failure Monday in New Haven, Conn. He was 86. Katz was best
known for his 1984 book "The Silent World of Doctor and Patient," which
examined the complex factors that shape the physician-patient
relationship and hinder the medical decision-making process. . . .
Katz was a forceful advocate for patients involved in medical research. In
the early 1970s, he was a member of a national panel that investigated
the Tuskegee syphilis experiment, in which researchers from the U.S.
Public Health Service withheld treatment from 400 rural Alabama black
men in order to observe the progress of the disease. Some men were
allowed to die during the 40-year study, which ended in 1972 at the
urging of the panel.
Katz said the Tuskegee subjects had been
"exploited, manipulated and deceived. They were treated not as human
subjects but as objects of research." . . . .
In 1993, he was named to a
presidential commission that documented the exploitation of research
subjects in post-World War II studies on the effects of radiation. "There is
persistent confusion between research and [clinical] practice and the
obfuscation of the two," Katz told The Times in 1994. "You cannot use
people -- or you should not use people -- as means for others' ends and
for ends that might ultimately even be good."
He urged doctors
and patients to share the responsibility of making medical decisions by
talking honestly to each other about the uncertainties of treatment,
their expectations and the role each party must play, a radical idea
given the long tradition of physician paternalism and patient
"As a doctor steeped in the law, Jay Katz
illuminated better than anyone has before or since, the complex of
medical, legal and ethical choices that haunt the silent world of
doctor and patient," Harold Hongju Koh, the dean of Yale Law School,
said in a statement last week.
Katz, who was the school's first
professor of law, science and medicine, made major contributions in a
number of areas, including family law and reproductive technology. He
spoke sternly against a change in federal regulations in 1996 that
allowed investigators in some medical studies to enroll patients who
are unable to give their consent because of a head injury or other
life-threatening condition. Katz said the change violated the Nuremberg
Code, developed after the Nuremberg trials of Nazi doctors after World
War II, which said that nothing should be done to a human being without
his or her approval. He also was a vocal opponent of
scientists' use of data from experiments that Nazi doctors conducted on
concentration camp prisoners during Hitler's reign.
issues resonated particularly profoundly for Katz, who was born Oct.
20, 1922, in Zwickau, Germany, and witnessed Hitler's rise to power. He
endured intense harassment by teachers and classmates as the only
Jewish student in a school for the gifted. His father, a prominent
businessman, was arrested by the Gestapo. . . . One
by one, Katz's family, including his father, escaped Germany. In 1940,
he arrived in the U.S., soon to be joined by the rest of his family. He
graduated from the University of Vermont in 1944 and became a U.S.
citizen in 1945. He earned his medical degree at Harvard University in
1949. . . .
At his retirement in 1993, he was the Elizabeth K. Dollard professor of law, medicine and psychiatry.