In Memoriam

In Memoriam: George Annas

Over more than 50 years of scholarship, he was an incisive commentator on several important seismic shifts in health law, including several landmark “right to die” cases that upheld a patient’s right to withdraw from medical treatment, whether that patient is competent or not. “There was not just intellectual integrity to his work, but a fierce sense of justice driving what he was saying,” said Nicole Huberfeld, Edward R. Utley Professor of Health Law at BU School of Law and School of Public Health.  “It really bears underscoring that George is one of the founders of the field of health law. That is not an overstatement.”

Annas was often labeled as a bioethicist but bristled at the description, preferring, instead, the simpler and more accurate “health lawyer” to explain his life’s work. For much of his career, he was squarely focused on protecting the rights of people in situations when they had the least agency. He was a passionate advocate for the rights of hospital patients to refuse treatment, including Cathy Shine, a woman treated against her will whose case established an adult’s right to decline medical treatment, even in a life-threatening situation. After Shine’s death, her family established an endowed lecture at BUSPH in her name dedicated to patient rights and advocacy.

In a message to the SPH community, Dean ad interim Michael Stein said that beyond his academic achievements, “Professor Annas was revered for his unwavering commitment to patient rights and human dignity. His teachings and writings have left an indelible mark on countless students, colleagues, advocates, and practitioners worldwide.”

With his SPH colleagues, Annas also wrote scathing articles in support of detained prisoners who were force fed against their will, and excoriated doctors whose actions he believed violated the principles of their Hippocratic Oath. “He knew that people who weren’t in power needed to be protected from people in power,” said Leonard Glantz, emeritus professor of health law, a frequent Annas co-author and one of his closest friends.

Over nearly six decades, Annas wrote powerfully about the important role for both the medical and legal professions in safeguarding the dignity of patients. It was fitting that his own passing, in an intensive care room at Massachusetts General Hospital, was as respectful of his wishes as he would have hoped, said Glantz. “There were no tubes, there were no defibrillators, there was no pounding on his chest. There were no futile attempts to bring him back.” This patient- and family-centered medical treatment in his final, most vulnerable hours was perhaps the ultimate measure of his lasting effect on the doctor-patient relationship.

Annas was born in St. Cloud, Minnesota and graduated magna cum laude from Harvard College in 1967 with a degree in economics. During his senior year and for several years after, he took a series of summer jobs as an economist at the U.S. Economic Development Administration, a bureau of the U.S. Department of Commerce, and flirted with becoming a full-time economist. He soon circled back to furthering his study in the areas that would come to define his lifelong career: law and public health.

He graduated Harvard Law School in 1970 and then clerked for Justice John V. Spalding of the Massachusetts Supreme Judicial Court for a year while deciding on his future path. He returned to Harvard to become one of the first Joseph P. Kennedy Foundation Fellows in Medical Ethics and used the stipend from that fellowship to enroll in classes at the Harvard School of Public Health. He graduated with an MPH in 1972; as he later recounted, he was one of the first lawyers at Harvard to be awarded the MPH, a degree previously reserved for physicians.

After a year teaching legal writing and health law at Boston College Law School, Annas moved across the city to Boston University School of Law in 1973 and became the director of the School’s Center for Law and Health Sciences. While at the center, he began working on his seminal book, The Rights of Hospital Patients: The Basic ACLU Guide to a Hospital Patient’s Rights, first published in 1975. It was written for a lay audience, with little legal or scientific jargon, and would become a foundational text for decades. It led to Annas’ being described repeatedly—and accurately, according to peers—as “the father of patient rights.” He eventually wrote or edited more than 20 books and nearly 400 articles on bioethics, health law, and human rights.

Annas was a prolific writer, with numerous contributions to the New England Journal of Medicine, the American Journal of Public Health, the Journal of the American Medical Association, the Hastings Center Report, and dozens of others. He and SPH colleagues co-authored Public Health Law, the textbook used by many health law instructors. Yet he never wrote just for the sake of writing, Huberfeld said. “The end goal was to try to make health better for people in the US and globally. There was always a sense of purpose, driven by centering the patient.”

He strongly believed that doctors were a critical component in the patient-hospital dynamic and began teaching classes to medical students at Boston University Medical School (now the Chobanian & Avedisian School of Medicine) in 1974. Demand for the classes was unexpectedly strong, and Glantz joined Annas in exposing medical students to the broad and varied world of health beyond the hospital. “They were really smart kids. That’s how they got into medical school,” said Glantz. “Unfortunately, they sacrificed the rest of their education in order to do that. They knew everything about biochemistry and cellular anatomy and stuff like that, but they knew nothing about history. They knew nothing about politics. And this was an opportunity for them to go to college.”

Most of all, they were unaware of the complex web of sociological reasons for why people get sick, now commonly described as the social determinants of health. Two years later, the medical school’s Department of Socio-Medical Sciences and Community Medicine launched a part-time evening program leading to a Master of Public Health. That modest program blossomed into the Boston University School of Public Health, where Annas taught health law and bioethics for more than 40 years.

Despite his formidable intellect, Annas was an unassuming presence on campus, Glantz said, “just a regular guy” who taught in jeans and comfortable sweaters and loved Star Trek and telling jokes. He took teaching seriously as an integral part of his work at both SPH and LAW; just last fall, he joined SPH colleagues in teaching a section of Health Systems, Law, and Policy, one of the four core courses of the MPH curriculum.

“He enjoyed every part of it,” Huberfeld said. “He enjoyed being a teacher and interacting with students and guiding them. He enjoyed learning and researching and writing. He had insatiable curiosity, but he also always kept front and center that the work of health law and public health is about people. It’s about patients. It’s about people who are vulnerable.”

Throughout his long career, Annas wrote and lectured extensively on various aspects of human rights, including the privacy and liberty rights of individuals in all phases of life. This central tenet would become an academic pillar of the Center for Health Law, Ethics and Human Rights (CLER) at BUSPH, which he directed for many years.

In his unflagging advocacy for those without control, colleagues noted that Annas served as an ethical beacon in CLER and beyond. “He set the tone for the department, because he was not just a leader on the organizational chart,” Glantz said. “He was a moral leader. He was a man with real values, values he cared about. And those values had to do, again, with the disempowered—how do you protect them, or empower them?”

Heidi Kummer (SPH’04), is an anesthesiologist and emergency care physician who studied health law and bioethics under Annas en route to her MPH. After her own unnerving medical scare, and with Annas as a mentor and friend, she pivoted to a second career as a noted advocate for patients. “The world lost a brilliant mind, a gifted teacher and a truly wonderful human being,” said Kummer, who was the first SPH alum to deliver a Shine Lecture. “His guidance has been invaluable, his impact immeasurable and his loss unfathomable.”

In 2009, Annas was one of the first BU faculty members to be named a William Fairfield Warren Distinguished Professor at Boston University, an endowed chair bestowed in honor of BU’s first president that commends senior faculty members who remain actively involved in research, scholarship, teaching, and the University’s civic life.

Alianna Higgins, a PhD candidate in epidemiology at SPH, wrote in a public remembrance that she still carries the lessons learned in Annas’ Health and Human Rights class into her work as an epidemiologist. “If there is one thing Prof. Annas taught me, it was overwhelming hope in the face of adversity. It is knowing that we can and will continue to protect human rights, even if it feels bleak right now. He will be so deeply missed at BUSPH and far beyond.”

During his career, Annas helped write or was signatory to many amicus briefs to the United States Supreme Court. In 1989, with his longtime colleagues Glantz and Wendy Mariner, he co-authored a then-controversial brief for Webster v. Reproductive Health Services, a Missouri case that prohibited the use of public facilities, employees, or funds to provide abortion-related services. Annas later said it was one of the first briefs specifically argued from a bioethics standpoint.

Despite his legendary distaste for meetings, which he joked about on many occasions, he served in several regulatory roles, including as vice chair of the Massachusetts Board of Registration in Medicine, chair of the Massachusetts Health Facilities Appeals Board, and chair of the Massachusetts Organ Transplant Task Force.

Annas explored stand-up comedy later in his career. It was a natural progression for someone whose lectures were peppered with humor, the occasional levity acting as a counterbalance to the often gravely serious topics of his talks. For example, Annas and colleagues from CLER, including the late Michael Grodin, argued for better worldwide adherence to principles put forth in both the Nuremberg Code and the Universal Declaration of Human Rights to avoid the horrors of the past. In 1996, he co-founded Global Lawyers and Physicians, which aimed to merge medical ethics with human rights for physicians and health lawyers so both groups could work together for life, health, social justice, and equality.

“I came to see human rights as a much more useful, comfortable, and effective framework for my work than medical ethics or health law,” Annas told interviewer Judith Swazey of the Acadia Institute in 1997. “It sounds overly idealistic on one level, but we take it quite seriously. It’s a grandiose idea that doctors and lawyers can actually work together transnationally to promote human rights and health. What that means is that it doesn’t matter what country they’re from; that the professions can transcend governments and their laws…to try to help people.”

His wife of 55 years, Mary Roche Annas, passed away in the fall of 2024.  They lived in the same house in Newton together for more than 50 years, where they raised their two children, Catherine and David.

This tribute was originally published by the Boston University School of Public Health.