BIOGRAPHICAL INFORMATIONBrowne C. LewisLeon and Gloria Plevin Professor of LawDirector, Center for Health Law & PolicyCleveland-Marshall College of LawCleveland State University

PURPOSE OF THE SLIDES These slides are to be used in

conjunction with the teaching module. The professor should modify them as

appropriate to conform with his or her teaching objectives.

USING LAW TO PROTECT THE PUBLIC’S HEALTH

APPROPRIATE COURSES This information contained in the unit is

appropriate for use in a survey public health course or seminar and a survey public health law course or seminar.

This information may also be appropriate for use in a survey health law course.

UNIT OBJECTIVES The purpose of this unit is two-fold. The first objective is to provide law

students with an overview of the role that law plays in keeping the population healthy.

The second objective is to give law students the opportunity to apply the knowledge that they have acquired to a “real world” situation.

To make the project more effective the students should be divided into public health law departments at the beginning of the course.

POSSIBLE USE BY PROFESSORS Professors should use the information

contained in this module at the beginning of the course to help the student gain an understanding of the type of work in which public health lawyers engage.

The project should be used after the professor introduces the students to emergency management plans. The professor should modify the project to reflect the type of disasters that are appropriate to the region.

WHAT IS PUBLIC HEALTH?

LAWRENCE GOSTIN, DIRECTOR, CENTER FOR LAW AND THE PUBLIC’S HEALTH

“Public health law is primarily concerned with the government’s powers and duties to assure conditions under which populations will be as healthy as possible; it might reasonably be considered the body of law that creates a citizen’s “right” to exist in a healthy environment.”

PUBLIC HEALTH “is what we, as a society, do collectively

to assure the conditions for people to be healthy.”

Institute of Medicine, The Future of Public Health 19 (1988)

ROLE OF PUBLIC HEALTH DEPT.

EXAMPLE

PROBLEM-BABIES ARE DYING WHILE SLEEPING WITH THEIR PARENTS

RISK FACTORS Suffocation associated with co-

sleeping. Suffocation due to infants being

trapped or wedged between the mattress and another object.

Suffocation due to airway constriction when a baby is face down on a waterbed.

Strangulation in rails or openings on beds that allow a baby’s body to pass through while entrapping the head.

PREVENTIVE STRATEGY-SAFE SLEEP EDUCATION

ASSURE WIDESPREAD ADOPTION Training parents Billboard campaigns Video campaigns

WHAT IS THE ROLE OF THE PUBLIC HEALTH DEPARTMENT?

MAIN GOALS OF A PUBLIC HEALTH DEPARTMENT UNDERSTAND POTENTIAL THREATS TO

PUBLIC HEALTH IDENTIFY A POLICY FOR ELIMINATING OR

REDUCING THE THREAT IMPLEMENT THE POLICY EVALUATE THE POLICY’S OUTCOMES

WHAT IS PUBLIC HEALTH LAW?

THE LAW DEFINES THE JURISDICTION OF PUBLC

HEALTH OFFICIALS AND SPECIFIES THE MANNER IN WHICH THEY MAY EXERCISE THEIR AUTHORITY.

PUBLIC HEALTH LAW Is the study of legal powers and duties

of the state to assure the conditions for people to be healthy and the limitations on the power of the state to constrain the autonomy, privacy, liberty, proprietary, or other legally protected interests of individuals for the protection or promotion of community health.

Gostin, Public Health Law: Power, Duty, Restraint 4 (2000).

POLICE POWER “….the state may invest local bodies

called into existence for purposes of local administration with authority in some appropriate way to safeguard the public health and public safety.” Jacobson v. Commonwealth of Massachusetts, 197 U.S. 11 (1905)(upholding a law mandating small pox vaccinations)

CONSTITUTIONAL LIMITS ON PUBLIC HEALTH INTERVENTIONS Must be necessary to prevent an

avoidable threat to the public health Must be a reasonable relationship

between the intervention and the achievement of a legitimate public health goal

The human burden caused by the intervention must be proportionate to the expected benefit

LIMITS CONT. The intervention must not pose a health

risk to the public

Gostin, Public Health Law: Power, Duty, Restraint 68-69 (2000).

SOME THINGS NEGATIVELY IMPACTING THE PUBLIC’S HEALTH

DISASTERS

NATURAL DISASTERS (EARTHQUAKES, FIRES, FLOODS, HURRICANES, TORNADOS)

MAN MADE DISASTERS (BOMBINGS, BIOTERRORISM)

PUBLIC HEALTH RESPONSES

DISEASES (COMMUNICABLE AND INFECTIOUS)

PUBLIC HEALTH RESPONSES Mandatory HPV vaccinations for girls

and boys Screening for HIV in pregnant women

and newborn babies Mandatory isolation and quarantine to

prevent the spread of communicable diseases

POSSIBLE LEGAL CHALLENGES Medical Battery-the right to be free of

offensive touching (vaccinations) First Amendment-religious objections

(vaccinations) Lack of informed consent (vaccinations) Fourth amendment illegal search and

seizure (HIV screening)

POSSIBLE LEGAL CHALLENGES CONT. Violation of the right to privacy (HIV

screening) Equal protection (HIV screening) 14th Amendment deprivation of liberty

without due process (quarantine)

ANTISOCIAL BEHAVIOR (BULLYING, MASS SHOOTINGS, SCHOOL SHOOTINGS)

PUBLIC HEALTH RESPONSES Banning the sale of guns in high crime

areas Banning guns from public buildings Mandatory reporting of bullying by

school personnel Anti-cyberbullying laws

POSSIBLE LEGAL CHALLENGES Second Amendment (gun bans) First Amendment (anti-bullying)

LIFE STYLE CHOICES (OBESITY, PRESCRIPTION DRUG ABUSE, SMOKING)

PUBLIC HEALTH RESPONSES Banning trans fat in restaurants Requiring schools to report students’

BMIs Banning tobacco ads Prohibiting tobacco use in public

buildings

POSSIBLE LEGAL CHALLENGES 5th Amendment Takings (trans fat ban) State Preemption (trans fat ban) Right to Privacy (BMI reporting) 14th Amendment Equal Protection (BMI

reporting) First Amendment (banning tobacco ads) Federal Preemption (banning tobacco

ads)

CLASS PROJECTEmergency Management Plan

PROJECT Your students are members of the city’s

public health department. The National Weather Service has predicted that a natural disaster will hit your city in approximately 72 hours. Have the students prepare an emergency management plan.

HAVE THE STUDENTS GATHER THE FOLLOWING INFORMATION ABOUT YOUR CITY Population size % of people under 18 and over 65 % of people classified as disabled % of people receiving public benefits % of people who work downtown % of people who have private transportation % of people who are incarcerated or

institutionalized Location of most of the population Number of hospitals, police precincts, fire

departments, long-term care facilities, airports, banks, bridges and schools

INFORMATION GATHERING CONTINUED Type of public transportation available Distance of nearest major city Major highways in and out of the city Traffic patterns

QUESTIONS TO ANSWER ABOUT WHAT WILL HAPPEN PRIOR TO THE EVENT

Will there be mandatory evacuation, voluntary evacuation or no evacuation?

How will the public be informed about the evacuation plan?

What will happen to people who cannot be evacuated?

How will the evacuation plan be enforced?

QUESTIONS CONT. What steps will be taken to mitigate the

loss of life and to reduce property damage?

How will people without private transportation be evacuated?

QUESTIONS TO ANSWER ABOUT WHAT WILL HAPPEN DURING THE EVENT

How will people who are not successfully evacuated will be protected?

How will the city leaders communicate with the public during the event?

How will necessary utilities be maintained during the event?

QUESTIONS TO ANSWER ABOUT WHAT WILL HAPPEN AFTER THE EVENT

How will the victims be located and taken care of after the event?

How will the government prevent looting and other crimes after the event?

How will the city leaders communicate with the public after the event?

How will the government assess the damage after the event?

POST PROJECT Have the students meet as a group to

discuss and critique the emergency preparedness plan they create.

Compare the plan the students create to the one that actually exists in your city.

Have the director of your local health department evaluate and give feedback to the students on the plan they create.

NOTE-Additional scenarios are included in the teaching module.