James Stabler, J.D. Timothy Wahlin, J.D. Kevin Braun, J.D. Beth Giebel Mandel, J.D.
THE EVOLVING ROLE OF PUBLIC HEALTH LAW IN CONTAINING INFECTIOUS DISEASE Anne Murphy, J.D. Chief...
Transcript of THE EVOLVING ROLE OF PUBLIC HEALTH LAW IN CONTAINING INFECTIOUS DISEASE Anne Murphy, J.D. Chief...
THE EVOLVING ROLE OF PUBLIC HEALTH LAW
IN CONTAININGINFECTIOUS DISEASE
Anne Murphy, J.D.
Chief Legal Counsel
Illinois Department of Public Health
"The findings and conclusions in this presentation have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy.”
THE RECENT EMERGENCE OF INFECTIOUS DISEASES HAS INCREASED THE DEMAND FOR EFFECTIVE LEGAL TOOLS
Bioterrorism preparedness Zoonotic-borne diseases Global spread of highly contagious
diseases New diseases or disease strains
RESULTING RENAISSANCE IN U.S. PUBLIC HEALTH LAW: REASSESSMENT OF TRADITIONAL PUBLIC HEALTH LEGAL AUTHORITIES
Isolation and quarantine Property takings Reporting of, access to medical information Enforced treatment
RESULTING RENAISSANCE IN U.S. PUBLIC HEALTH LAW: IDENTIFICATION OF EMERGENT LEGAL ISSUES
Medical privacy, especially as to electronic and syndromic capabilities
Animal control and containment Application of public health powers in a
bioterrorist event
Interface of federal/state /local powers (geographic jurisdictions)
Interface of public health, law enforcement, emergency response, agricultural and environmental regulatory powers (substantive jurisdictions)
Assessment of police powers under current civil liberties standards
RESULTING RENAISSANCE IN U.S. PUBLIC HEALTH LAW: NEED FOR PROACTIVE, WELL INFORMED LEGAL COUNSEL FOR PUBLIC HEALTH AUTHORITIES
Assess extent of current legal authority Identify gaps in law and work to develop
new legal authorities Provide counsel to clients in application of
authorities Interface with counsel from other
jurisdictions
PUBLIC HEALTH LAW INFRASTRUCTURE NEEDED
CDC has taken leadership role at national levelAnnual Public Health Law ConferenceFacilitation of Public Health Law
AssociationForensic epidemiology initiative
Sponsorship of Model State Public Health Emergency Powers Act, academic analyses
Public Health Law Program (website, resources, educational programs, daily public health law news)
In many states and local jurisdictions, comparable efforts are underway
Opportunity to further advance public health law, through continued infrastructure development International public health law Legal product and services development
For lawyers and for scientistsAssure scientific basis for legal powers
and conclusionsBreak down barriers to achieve
interdisciplinary approaches
FOUR COMMON THEMES IN EMERGING PUBLIC HEALTH CHALLENGES1.1. Traditional public health laws do not always fit Traditional public health laws do not always fit
new problemsnew problems
2.2. Must continuously balance individual rights Must continuously balance individual rights with effective protection of public’s healthwith effective protection of public’s health
3.3. Legal approaches must be interdisciplinary and Legal approaches must be interdisciplinary and coordinated coordinated
4.4. Must be proactive planning for interdisciplinary Must be proactive planning for interdisciplinary legal preparedness legal preparedness
1. Traditional public health laws do not always fit
Existing laws Vague Silent regarding bioterrorism,
mass outbreaks, zoonotic illness Outdated under current civil liberties
principles New laws and regulations often needed
2. Must continuously balance individual rights with effective protection of public’s health
Informed consent Medical privacy and confidentiality Restrictions of movement, invasions of person
3. Imperative that legal approaches be interdisciplinary and coordinated
Substantive areas Legal Legislative Judiciary Academic Law Enforcement Science/medicine
Emergency managementAgricultureFood, drugs and dairyHealth care facilities and professionals
Advocates for civil rights
4. Must be proactive planning for interdisciplinary legal preparedness
Bioterrorism in Illinois TOPOFF Legal Team Public Health Emergency Powers
Legal Team; HB 5164 Forensic epidemiology Isolation and quarantine working
groups
SPECIFIC AREAS OF PUBLIC HEALTH LAW NEEDING CONTINUED FOCUS
Jurisdiction – who’s in charge Isolation and quarantine Reporting/release of medical information Licensure/certification issues Emergency management issues Informed consent Injury compensation/liability Extraordinary powers
Isolation and quarantineNotice Initial detention, post deprivation rightsRight to counselClear and convincing evidence, least
restrictive means; must be tied to particular circumstances, scientific basis
Application to groups
Reporting/release of medical informationRelease of information to
media/publicProvider reporting to public healthPublic health/law enforcement
exchange of informationHIPAA issues, confusion
Licensure/certification issuesScope of practice limits for
professionalsOut of state professionalsUse of unlicensed personnelEmergency hospital privileges
Informed consentEmergencies (i.e., SNS distribution)Vaccinations, experimental treatment
Injury compensation/liability
Extraordinary powersClosure of facilities, control/destruction
of propertyDisposition of human remainsMandated testing, examination,
treatment, monitoring
A CHALLENGE TO THE INFECTIOUS DISEASE SCIENTIFIC COMMUNITY
Public health law is a tool for your use: You have ownership in this
Satisfaction of public health legal standards requires a sound clinical/scientific basis: You have ownership in this
For clinicians affiliated with providers and payers, For clinicians affiliated with providers and payers, discuss with counsel disaster privileges, privacy discuss with counsel disaster privileges, privacy issues, informed consent, liability issuesissues, informed consent, liability issues
For clinicians affiliated with public health, discuss For clinicians affiliated with public health, discuss with counsel isolation and quarantine protocols, with counsel isolation and quarantine protocols, plans for EIDs, disaster plans, confidentiality plans for EIDs, disaster plans, confidentiality issuesissues