What is Public Health Legal Preparedness?

Abstract

Legal preparedness has gained recognition as a critical component of comprehensive public health preparedness for public health emergencies triggered by infectious disease outbreaks, natural disasters, chemical and radiologic disasters, terrorism and other causes. Public health practitioners and their colleagues in other disciplines can prepare for and respond to such an event effectively only if law is used along with other tools. The same is true for more conventional health threats. At first glance, public health legal preparedness may appear to be only a matter of having the right laws on the books. On closer examination, however, it is as complex as the field of public health practice itself. Public health legal preparedness has at least four core elements: laws (statutes, ordinances, regulations, and implementing measures); the competencies of those who make, implement, and interpret the laws; information critical to those multidisciplinary practitioners; and coordination across sectors and jurisdictions. The process of improving public health legal preparedness has begun in earnest with respect to potentially massive public health emergencies. Elected officials, public health, legal, and law enforcement practitioners, and national security organizations have contributed to initial benchmarks for the core elements. A few gaps in legal preparedness have been identified in the context of exercises, actual public health emergencies, and through more general assessments of public health preparedness conducted by CDC and the Department of Justice. While a strong beginning has been made, this work is incomplete. Redoubled effort is needed to define practical, measurable benchmarks or standards of legal preparedness, to identify and correct shortcomings, and to review findings from regular exercises and actual public health emergencies. There is great value in having this work move forward on two converging tracks, one defined by states and localities acting on their own initiative and the other shaped by the federal government as informed by state and local experience. The TOPOFF and Dark Winter exercises exemplify the grounded, case-based approach that teaches practical lessons about benchmarks, gaps, and steps to improve public health's legal preparedness. It goes without saying that action on both tracks should be taken by collaboratives whose membership includes representatives of the many different communities integral to the design and application of laws that affect the health of the public and the effectiveness of the public health system itself. Consistent with the concept of a public health or population health system with which we began this paper, participants in both tracks should include representatives of non-governmental bodies--community-based organizations, non-profit organizations active in disaster preparedness and response, and others. This paper presents a conceptual and analytic framework those groups may apply, one that is sufficiently broad to serve as an integrating schema across sectors...

The power of detention in the management of non-compliance with tuberculosis treatment: A survey of Irish practitioners and analysis of potential legal liability

“…42 An attempt to justify the deprivation of liberty on the grounds of necessity, which had succeeded in the House of Lords, was rejected. The ECtHR held that the doctrine of necessity afforded insufficient procedural safeguards to protect against arbitrary deprivations of liberty, and thus violated Article 5 (1). Formalized procedures for dealing with such patients were introduced in England and Wales in response to that decision.…”

“…Whilst awareness of the importance of public health legal preparedness has grown since the anthrax attacks in the USA and the outbreak of severe acute respiratory syndrome in 2003, there has been relatively little study of the practical use of public health detention in recent times. 1 In Ireland, a power to detain and isolate individuals who are 'a probable source of infection' is provided under Section 38 of the Health Act 1947 (as amended). [2][3][4] The power may only be applied where it is impracticable to isolate the individual in their home.…”

Legal Preparedness: The Modernization of State, National, and International Public Health Law

“…This enables more effective identification of public-health authority held by government entities, initiation of efforts to improve, organize and standardize state public health laws to address both ancient and modern public health concerns, and ensures that the application of public health laws adequately balance critical human rights and due process concerns with state public health protection demands [34]. For example, a state may undertake an examination of whether current laws inhibit effective distribution of medications and health-professional licensure in times of emergency, or whether current regulations pertaining to quarantine and isolation afford sufficient protection of individual liberty rights [35].…”

Animal Health Policy Principles for Highly Pathogenic Avian Influenza: Shared Experience from China and Canada

“…Legal preparedness is a critical component of comprehensive emerging infectious disease (EID) management (Moulton et al., 2003). International laws are not capable of imposing local and national level actions necessary to interfere with the exchange of pathogens between people and animals (Gostin, 2006).…”