McAllaster leaves legacy as transformative clinician, social justice warrior, and policy advocate for people with HIV and AIDS
Colin W. Brown Clinical Professor of Law Carolyn McAllaster retired June 30 after 31 years on the faculty, leaving a lasting legacy at Duke Law through her leadership of the Health Justice Clinic and the HIV/AIDS Policy Clinic and having helped build a policy framework and infrastructure to benefit people living with HIV and AIDS across the South.
Committed to social justice throughout a career that began in private practice, she impressed on all of her students the importance of empathy and compassion in the practice of law. “Carolyn has been a tireless champion for persons who historically haven’t had a powerful advocate, and she has inspired multiple generations of Duke Law students to do the same,” says Dr. John Bartlett, an early clinical collaborator at Duke University Medical Center.
No less significant is her impact on the Law School’s clinical program. The AIDS Legal Project (now the Health Justice Clinic) was one of the first legal clinics in the country focused on the legal needs of clients with HIV and AIDS when she started it in 1996, reviving clinical education at Duke Law, which now has 11 clinics.
“We have some of the strongest clinics of any law school and that is largely due to the example that Carolyn set,” says Kerry Abrams, the James B. Duke and Benjamin N. Duke Dean of the School of Law and professor of law. “It is clear to me that she’s as responsible as anyone for the strength of the clinical program and the Law School’s commitment to service, particularly to those who are marginalized and stigmatized by our society.”
“The quietest radical you’ll ever meet”
McAllaster, who hails from Gouverneur, New York, near the Canadian border, entered the University of North Carolina at Chapel Hill for its four-year program in nursing but switched her interest to law as a more flexible career that would still allow her to help people. About a third of her classmates at UNC Law School were women.
“We were at the beginning of the wave of women coming to law school,” McAllaster recalls. “Roe v. Wade had just been decided, and I remember Ruth Bader Ginsburg as a litigator fighting sex discrimination cases. It was an exciting time to be a woman, but we were rare when we got out.”
After graduating with her JD in 1976 she began a practice representing plaintiffs in civil cases and defendants in criminal cases. In 1978, she co-founded the North Carolina Association of Women Attorneys, becoming its first president.
“She was always very attuned to women not being treated as they should in the legal profession,” says longtime colleague and friend Jane Wettach, the William B. McGuire Clinical Professor of Law and director of the Children's Law Clinic, who served as association president in 1987. “She has always been attuned to people being discriminated against, to creating inclusive environments, and trying to make sure that race, religion and other factors did not impede people from being recognized.
“She is the quietest radical you’ll ever meet.”
As a trial attorney, McAllaster was a member of the legal team in a civil trial representing victims of the Nov. 3, 1979, Greensboro Massacre, in which five self-identified Communists were killed by members of the Ku Klux Klan and neo-Nazis during an anti-Klan demonstration. State and federal criminal trials had already resulted in acquittals.
“It was an unpopular cause at the time, even within the progressive community,” McAllaster told Duke Law Magazine in 2017. “There was incredibly strong bias against the demonstrators because they were Communists. People said to me, ‘You’re going to hurt your reputation, this will be bad for your career.’”
“That didn't bother her,” says Wettach, who lived next door to McAllaster at the time. “In fact, she embraced it. What happened to them was wrong and she was going to try to make it right.”
McAllaster helped obtain civil judgments for negligence against the city of Greensboro, several members of the Klan, and other parties. The litigation took five years, ending in 1985, and exacted “a pound of flesh,” she says, but it also helped her develop the skills to make a career change into teaching. She juggled adjunct positions at four different law schools until 1995, when she began teaching pre-trial and trial practice at Duke Law full-time.
By then McAllaster’s brother Joseph, a gregarious Boston restaurateur to whom she was very close, had been diagnosed with HIV. He died at 38, on June 18, 1993.
“Joseph’s death was tragic and heart-wrenching for her,” says Wettach. “But it changed her life. It gave a focus to the whole rest of her career, and she has honored him throughout.”
Revitalizing the Duke Legal Clinics
McAllaster’s first step: volunteering to write wills and powers of attorney at Blevins House, a group home in Durham for people dying of AIDS. The need was great, and law students were keen to help, so in 1993 McAllaster launched the volunteer AIDS Wills Project at Duke Law, working closely with clinicians and social workers at hospitals throughout the Triangle to identify patients in need of assistance. Thirty-five students showed up at her first training session.
Bartlett, now Professor of Medicine, Global Health and Nursing and a leader in the university’s Center for AIDS Research and Global Health Institute, says McAllaster and her students served many clients who were estranged from their families, but whose same-sex partners lacked rights to visit and make end-of-life decisions.
“Carolyn was able to get health care powers of attorney set up and this was critically important to gay couples because otherwise decisions about health would default to the family,” he says.
Trish Bartlett, a licensed clinical social worker at Duke Health, recalls how McAllaster and her students gained the trust of wary patients who had been stigmatized by their illness: “The students spent so much time on the cases that pretty soon the word got out and [patients] started calling them, ‘my lawyers.’ It gave them some element of control over their lives, and sometimes I think they actually lived longer because they didn’t feel hopeless anymore.”
As other legal needs emerged, concerning such issues as guardianship, benefits, and employment discrimination, McAllaster began laying the groundwork for a formal clinic. Professor John S. Bradway had established one of the first law school-connected Legal Aid clinics in the country at Duke in 1931, but though it was resurgent elsewhere and strongly supported by the American Bar Association, clinical education had long been dormant at the Law School.
Wettach, who then taught legal writing, noted a level of entrenched opposition to clinics among some members of the governing faculty. "Carolyn had the job not only of convincing the faculty of the value of clinical legal education, but of the acceptability of an in-house clinic dedicated to serving people with HIV and AIDS," Wettach says. "This took diplomacy, persuasiveness, and, above all, perseverance.
"I think it would have been easier to start a clinic representing a more sympathetic group than people with HIV and AIDS, who were stigmatized," she adds, "but Carolyn was drawn to that population because of her brother and also because she wanted to show the world that these were human beings who were just as entitled to legal services as anyone."
For her part, McAllaster recalls that opposition was countered by strong support from some faculty colleagues and administrators, including Katharine Bartlett, the A. Kenneth Pye Professor of Law who was then senior associate dean, and then-dean Pamela Gann ’73. Gann approved the clinic proposal as long as McAllaster could find a way to fund it, which she did, cultivating donors and submitting grant proposals while teaching a full course load. The AIDS Legal Project launched in January 1996 with full enrollment and a waiting list, led by McAllaster as director and Wettach as supervising attorney. For the next six years, it was the Law School’s only in-house clinic, offering students insights into the health care system, health insurance, and the experience of navigating serious illness for indigent and marginalized people, as well as practical skills training in the law relating to HIV and AIDS.
“There is nothing more humbling than drafting a will for a person who literally owns nothing,” says Eli Mazur ’02, a partner at YKVN in Ho Chi Minh City, Vietnam. “However, I learned that the law can help people prepare for the inevitable and have a semblance of order in their lives when, in truth, their lives are filled with nothing but chaos.
“For Professor McAllaster, the most important thing that a lawyer could give to an impoverished and dying client was an opportunity to enjoy a moment of dignity in the face of otherwise unnoticed death.”
For Lei Mei ’05, helping to win Social Security disability benefits for an indigent client was “the moment I started to feel like a lawyer.” Mei, a patent attorney and founder of Mei & Mark in Washington, D.C., says McAllaster’s lessons went beyond legal skills. “More importantly, she taught compassionate empathy toward those who need legal help but otherwise cannot afford it. That really stuck with me and I treasure it so much.”
Shifting to policy advocacy
Duke Law's clinical program expanded and gained dedicated space while Kate Bartlett served as dean from 2000 to 2007 and was further bolstered during the tenure of her successor, David F. Levi, now the Levi Family Professor of Law and Judicial Studies and director of the Bolch Judicial Institute, who made clinic funding part of the Law School's budget.
In 2011, McAllaster launched a second clinic that engaged students in policy development surrounding HIV and AIDS. She was encouraged to do so by Harvard Law School Clinical Professor Robert Greenwald, a longtime colleague, who had established a policy center at Harvard and was working on numerous policy initiatives in the South, which has the nation’s highest rates of new HIV infection and fatalities, especially among minorities.
“When you are committed to equity work, there’s no place more important than the Deep South,” Greenwald says. “So after a number of years, I approached Carolyn and said, ‘You need to get into this space.’”
The HIV/AIDS Policy Clinic initially focused on North Carolina but was later selected by the Ford Foundation to lead the Southern HIV/AIDS Strategy Initiative (SASI), a coalition of HIV/AIDS advocates and researchers based in the Duke Global Health Institute and developing research-based policy and strategy recommendations aimed at securing federal resources. McAllaster served as program director until her retirement.
“Direct legal service work is critically important, but you can also help to address inequities through systemic policy reforms, and that is something that Carolyn just excelled at,” Greenwald says.
“She is a great facilitator and a great strategist. She has the capacity to talk about complex law and policy issues in a way that demystifies them and makes them accessible, and as a result Carolyn has been able to build strong and diverse coalitions of advocates, who working together have made a significant difference in addressing the critical needs of people living with and at risk for HIV in the South.”
Kathie Hiers, chief executive officer of AIDS Alabama, says SASI’s research and McAllaster’s outreach have brought national attention to the HIV epidemic in the South and rural areas and given HIV/AIDS advocates a voice in high-level policy discussions. Hiers credits McAllaster with helping pass the Housing Opportunities for Persons with AIDS Modernization Act of 2016, which directed more federal Housing and Urban Development funds toward the South, and securing $44 million for the three-year Care and Prevention in the United States (CAPUS) demonstration project, with most of the money going to Southern states.
“With Carolyn came the research team at Duke, which has just been phenomenal,” says Hiers. “Duke brings with it a certain amount of credibility and then you add to that Carolyn’s personality. She’s succinct and clear. People listen when she talks. She’s been fabulous in facilitating meetings for us with important people. And she always makes sure that we have a diverse table and that people living with the disease have a lot of input.”
McAllaster’s input was vital to shaping North Carolina’s response to HIV/AIDS, says Evelyn Foust, head of the state Division of Public Health’s Communicable Disease branch. McAllaster’s efforts early in the epidemic helped eliminate the waiting list for the state’s HIV medication assistance program. Getting people access to care and a consistent supply of medication is critical to eradicating the virus because today’s medications reduce the viral load to where it is undetectable and cannot be transmitted, Foust says.
“If people access care they can become virally suppressed and live long, healthy lives. Carolyn’s advocacy at the state and, eventually, the national level made all the difference.”
In recent years SASI research has focused on stigma, which remains a stubborn barrier to care for people with HIV, especially in rural areas, says Clinical Professor Allison Rice, director of the Health Justice Clinic, who has worked with McAllaster since 2002. “People will travel to a big medical center from three hours away because they do not want to be seen walking into the health department or HIV clinic in their community. People lose their jobs, people are shunned, people are thrown out of their church.”
In 2017, McAllaster and Rice helped draft new state control measures, regulations that long criminalized certain behaviors by people with HIV in an attempt to reduce transmissions. The new regulations, which went into effect the next year, removed stigmatizing language, and reflect scientific advances in HIV treatment.
“In so many ways, Carolyn is responsible for one of the most progressive laws in the South and one of the most forward-thinking in the country,” says Lee Storrow, executive director of the North Carolina AIDS Action Network (NCAAN), which McAllaster and Rice helped found in 2010.
To honor her work, NCAAN, which named her its 2018 Advocate of the Year, has created the Carolyn McAllaster Scholarship, which will send one person each year to AIDSWatch, the nation’s largest HIV/AIDS advocacy event. That scholarship is partially underwritten by a $75,000 grant to NCAAN made in McAllaster’s honor by the Elton John AIDS Foundation. She also received the ABA’s 2014 Alexander D. Forger Award for Sustained Excellence in the Provision of HIV Legal Services and Advocacy and the North Carolina Justice Center’s 2018 Defender of Justice Award. In June 2019 she was awarded the Order of the Long Leaf Pine, one of North Carolina’s highest honors, for extraordinary service to the state.
Leaving a lasting impact on students
Following McAllaster’s retirement, the HIV/AIDS Policy Clinic and Health Justice Clinic at Duke Law are being consolidated under Rice’s leadership, and the Southern AIDS Coalition, where McAllaster remains a board member, is overseeing SASI’s research initiatives.
“I feel very lucky to have been able to do work that I really felt strongly about and believed in,” says McAllaster, who has also taught a seminar on transgender issues for the past two years. “Duke has been a remarkable place to do the work. I’ve had five deans, every one of them supportive.
“I wasn’t happy with the circumstance that led to me getting involved in this issue but I’ve always been happy doing the work. And I still love it.”
McAllaster is especially proud of the attention and resources SASI’s work has drawn to the HIV epidemic in the South. She is equally proud of the lasting effect their clinic work had on many of her students.
“The clinic is the first time that most of them have worked with individual clients and seeing the impact of their work is powerful for them,” she says. “I hope there’s been a ripple effect, not only in terms of compassion for clients but also an understanding of people living with HIV and the stigma that surrounds the illness. I hope, in a small way, I’ve helped create a more tolerant world through the students who have gone through the HIV work here.”
Scott Skinner-Thompson ’08, a professor at the University of Colorado Law School, says McAllaster has served as an important mentor in his academic career. His scholarship and teaching focuses on constitutional law, civil rights, and privacy law, particularly LGBTQ and HIV issues.
“She really models what it means to be a social justice lawyer,” he says. “In the clinic and her doctrinal classes, she’s emphasized not only how to make concrete changes for individual clients but also to think more broadly about the structures that impede health benefits, disability benefits, and lived equality for those individuals.”
Mei has continued his pro bono work representing clients in Washington, D.C.’s HIV and immigrant communities. He says the experience also influenced the way he approaches his work as a patent litigator.
“We typically represent smaller companies against big companies, and I always remind myself, ‘If I don’t do well our client may have to close the doors and people will lose their jobs,’” he says. “So the same compassion and empathy that I treasure so much from my clinical days continues on in my work life.”
At McAllaster’s retirement party in April, Mei, a steadfast financial supporter of her clinic, surprised her with the announcement of a major gift to launch a scholarship fund in her name. Thanks to his gift and those of other alumni, colleagues, and admirers of McAllaster in the North Carolina community, the Carolyn McAllaster Law Scholarship Fund will provide financial aid for generations of future Duke law students, ensuring that her legacy – and her brother’s – continues for years to come.
“It’s been my greatest honor to do the work that I have done on behalf of people living with HIV in memory of Joseph,” McAllaster says, displaying a ring he bought her during the final months of his life and which never leaves her hand.
“My brother was a great communicator and he shared everything that was going on with his disease, so he was a real teacher. It would have been really fun to do this with him – but he’s been with me every day in the work.”