Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM,...

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Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences Library System University of Pittsburgh [email protected]

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Page 1: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Ethical and Legal Aspects of Disaster Response: Legal PreparednessAugust, 2012

Barbara L Folb, MM, MLS, MPHPublic Health InformationistHealth Sciences Library SystemUniversity of [email protected]

Page 2: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Agenda

• Definitions, background, class reading• Core elements of legal preparedness (Moulton

2003)– Associated information resources

Page 3: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Objectives

• Describe the legal structure supporting disaster planning and response.

• Recognize the interaction of ethics and law in disasters.

• Plan a search for legal information.• Describe how key historical events such as

9/11, SARS and pandemics have shaped present approaches to disaster law.

Page 4: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Limitations

• You will not be a legal researcher at the end of the class.

• Librarians without law degrees can’t give legal advice. No practicing law without a license.!

Page 5: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

How often do you receive requests for legal information from library patrons?

A. FrequentlyB. OccasionallyC. SeldomD. Never

Page 6: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Does your workplace have a manual or guide for emergencies/ disasters that includes legal information?

A. YesB. NoC. Not sure

Page 7: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Public health emergency preparedness definition

“…public health emergency preparedness (PHEP) is the capability of the public health and health care systems, communities, and individuals, to prevent, protect against, quickly respond to, and recover from health emergencies, particularly those whose scale, timing, or unpredictability threatens to overwhelm routine capabilities. “

(Nelson 2007)

Page 8: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Public Health Legal Preparedness

…a subset of public health preparedness and can be defined as attainment by a public health system (…of a community, a state, the nation, the world community) of legal benchmarks essential to the preparedness of the system.

(Moulton 2003)

Page 9: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Disasters, Emergencies

• Definitions situational• Good legal definition will clarify conditions

that trigger actions

Page 10: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Pre-class reading

• Moulton, A. D., Gottfried, R. N., Goodman, R. A., Murphy, A. M., & Rawson, R. D. (2003). What is public health legal preparedness? The Journal of Law, Medicine & Ethics : A Journal of the American Society of Law, Medicine & Ethics, 31(4), 672-683. Retrieved from http://hdl.handle.net/2027.42/71834

Page 11: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Is legal preparedness information available?

A surprising finding is how rare such information resources [legal preparedness] are. With some exceptions, there appear to be few, if any, published manuals on public health emergency law for government and hospital attorneys, “bench books” for judges to brief themselves on evidentiary standards for public health search warrants and quarantine orders, or databases of extant state and municipal public health emergency statutes and regulations.

(Moulton, 2003, pg 674)

Page 12: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Class Reading Question 1• Moulton names four core elements of public health

legal preparedness. Which of the following is NOT one?

A. CompetenciesB. Cross-jurisdictional, cross-sectoral coordinationC. EthicsD. InformationE. Laws

Page 13: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Question 1 Answer• Moulton names four core elements of public health

legal preparedness. Which of the following is NOT one?

C. Ethics

Page 14: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Ethics, Legal Authority Foundational to Preparedness

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Ethics, Health Law and Disasters

Goal: Balance the rights of individuals with the needs of societyChallenge: No uniform belief about where the balance should be set

• Individual liberty– Due process protections

• Constitutional property rights – protects against unreasonable

search and seizure– Just compensation

• Protect community from disease– Quarantine, isolation laws

• Community safety– Seizure of private property

posing a danger– Use of property

Page 16: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

PUBLIC HEALTH LEGAL PREPAREDNESS : CORE ELEMENTS

Page 17: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

CORE ELEMENT: LAWS

Page 18: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Class Reading Question 2According to Moulton, which of the following are

considered law?A. Executive orders from president or governorB. Judicial rulingsC. Memorandum of understanding between hospitals and public health

agenciesD. Mutual aid agreements between statesE. RegulationsF. StatutesG. All of the above (A-F)H. Only A, B, E, and FI. Only C and D

Page 19: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Class Reading Question 2 Answer According to Moulton, which of the following are

considered law?A. Executive orders from president or governorB. Judicial rulingsC. Memorandum of understanding between hospitals and public health

agenciesD. Mutual aid agreements between statesE. RegulationsF. StatutesG. All of the above (A-F)

Page 20: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Building blocks of law

• Constitutions• Statutes• Regulations = Rules• Common law = court rulings

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Federalism

• Under the U.S. Constitution and Bill of Rights, states have sovereignty over matters not specifically delegated to Congress or to the President or to the federal judiciary.

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State “Police Power”

• Power to assure the health & safety of the population– Regulation of persons– Regulation of businesses, organizations, and

professionals– Prevention, mitigation of dangers and nuisances

• State may delegate powers to local government

Page 23: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

U.S. Constitution: “Limited” federal powers

• Tax and spend

• General welfare

• Regulating commerce

Article 1, section 8

The Congress shall retain Power

To lay and collect Taxes, Duties, Imposts and Excises,

to pay the Debts and provide for the common Defence and general Welfare of the United States; …

To regulate Commerce with foreign Nations, and among the several States, and with the Indian Tribes

Page 24: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

How might federal power to regulate interstate commerce affect health?

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Example: State Sovereignty, Notifiable Diseases

Page 26: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Assessing public health law – 1988

State public health laws are in many cases seriously outdated. Statements of public health agency authority, responsibility, and organizational structure are inadequate to deal with contemporary problems. Procedural safeguards protecting individual rights are frequently weak or absent.

(IOM, 1988)

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Public Health Pre Anthrax Attacks

• Low state and local laboratory capacity• Low access to computers, Internet• Low coordination with other agencies• Public health agencies unsure of their role• General public confused about public health’s

role• Workforce not training for terrorism response

(Gursky 2012)

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Prep Law Development spurred by anthrax attacks•Anthrax key event, changed federal law, spending on public health, health care preparedness

Page 29: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

State Law Changes• Model State Emergency Health Powers Act

– Drafted at request of the CDC– Used to evaluate existing state law– State adoption of portions of the law varied

• Majority of states adopted some elements • Most common changes:

– Defining of “public health emergency”– Public health emergency reporting– Isolation and quarantine– Immunity for state, private actors

Page 30: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Federal Law Changes

• Document:– Timeline, Major Disaster Events and Law

Developments, 1950- 2010 (in Moodle)

Page 31: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Key Health Preparedness Laws

• Public Health Security and Bioterrorism Preparedness and Response Act of 2002 (June 2002)

• Homeland Security Presidential Directive 8 (12/17/2003)

• Homeland Security Presidential Directive 10 (4/28/2004)

• Project Bioshield Act of 2004 (July 2004)http://www.hsdl.org/?collection/stratpol

Page 32: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Impact of Federal Laws

http://healthyamericans.org/states/?stateid=PA#section=2,year=2012,code=undefined

Page 33: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

International Law

• WHO International Health Regulations, 2nd ed. 2005– http://www.who.int/ihr/en/index.html

• Reduce risk of the international spread of disease

• Minimize impact on trade and travel

Page 34: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Current issues in preparedness law • Are quarantine, isolation laws an unneeded

violation of personal rights? (Hodge 2012)• Laws allow multiple states of emergency to be

declared for a single event. Does this create overlap in authorities, confusion? (Hodge 2012)

• Is the legal workforce prepared to provide legal advice in real time? (Hodge 2012)

Page 35: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Current issues continued

• No uniform liability protection for all responders, creates inconsistencies. (Hodge 2012)

• Are state professional scope of practice laws flexible enough to address surge capacity for emergency vaccine administration? (O’Connor 2011)

• How do we measure legal preparedness?

Page 36: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

CORE ELEMENT: COMPETENCIES

Page 37: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Competencies

• Know what the applicable law is and can access it.

• Apply the law correctly in a given situation.• Different job responsibilities require different

– Skills– Levels of proficiency

Page 38: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

(Jacobson 2012)

“Most local public health and emergency management professionals relied on what they perceived the legal environment to be rather than on an adequate understanding of the objective legal requirements.”

Page 39: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Sources of Competency Standards

• Journal articles (Gebbie 2008; Hodge 2008)– Hodge 2008 – table of competency sources

• National Public Health Performance Standards– http://www.cdc.gov/nphpsp/– State, local standards

• CDC: Public Health Preparedness Capabilities: National Standards for State and Local Planning– http://www.cdc.gov/phpr/capabilities/index.htm

Page 40: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Training to support competency (1)

• CDC Public Health Law Program– http://www.cdc.gov/phlp/publications/type/resources.html

• CPHP Education Resource Guides– http://preparedness.asph.org/perlc/resourcereports.cfm

• NACCHO. Public Health and the Law: An Emergency Preparedness Training Kit– http://www.naccho.org/topics/emergency/PHPL/

Page 41: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Training to support competency (2)

• TRAIN, state, academic online learning management systems– TRAIN

• https://www.train.org/DesktopShell.aspx

– TRAMS• http://trams.jhsph.edu/trams/

• Table top exercises, live training

Page 42: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

CORE ELEMENT: COORDINATION

Page 43: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Coordination is Multidirectional

• Vertical – layers of government, local to international

• Horizontal – between disciplines, organizations – Public health, health care, emergency

management, law enforcement, courts, etc.• May be facilitated or hindered by laws

Page 44: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Legal Issues in Coordination

• All parties must know the law– For their organization and others responding

• Who is in charge, can to what, situational– Ex: TB , A. Speaker case (Fidler 2007)

Page 45: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

CORE ELEMENT: INFORMATION

Page 46: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Reading Question 3

• According to Moulton, which of the following is true about information sources supporting legal preparedness?

A. They are plentifulB. They are scarceC. There are enough of them, but they are hard

to find

Page 47: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Reading Question 3 Answer

• According to Moulton, which of the following is true about information sources supporting legal preparedness?

B. They are scarce

Page 48: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Information Needs

• Repositories of public health law– Databases of state law

• Current awareness of new law• Law “best practices”• Law practice guidelines

– Manuals for attorneys– Bench books for judges

(Moulton, 2003)

Page 49: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Repositories

• Likely hosts– Government agencies– Public health, health law research, advocacy,

training centers– Other professional interest groups in health and

law• Example: Homeland Security Digital Library: Policy &

Strategy• http://www.hsdl.org/?collection/stratpol

Page 50: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Evaluating Law Repositories• Are they complete?

– Statutes, regulations, court cases, executive orders all apply

• Are they in the right form for the purpose at hand?

• Are they up to date?• Who is their audience?

Page 51: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Which of the Following Areas Would Be Important to Include in a Resource Guide for Multijurisdictional

Collaboration? Moderate to High Interest

Page 53: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

NLM DIMRC

http://disaster.nlm.nih.gov/

Page 54: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Identifying government law repositories

• Look for agencies that regulate disaster response, or must comply with the law – Federal, state, and local

• EX: DHHS, Assistant Secretary for Preparedness and Response (ASPR),– http://www.phe.gov/preparedness/legal/Pages/d

efault.aspx • Consult a law librarian, law library websites

Page 55: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Non-governmental law repositories

• Locating law research, training, assistance centers – Who’s publishing?– CDC Public Health Law Program

• http://www.cdc.gov/phlp/technicalassistance/index.html

– Who’s funded? (RWJF, Kellogg, CDC PHLP etc)– Search public health, public health law conference

proceedings– Check Network for Public Health Law

http://www.networkforphl.org/

Page 56: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Michigan Public Health Code

http://www.networkforphl.org/_asset/smw6h3/Summary-CD-Action-General-MI-FINAL.pdf

Page 57: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Associations with Law Resources

• NACCHO. Public Health and the Law: An Emergency Preparedness Training Kit– http://www.naccho.org/topics/emergency/PHPL/

• ASTHO (Association of State and Territorial Health Officers)– www.astho.org/

• AHLA (American Health Lawyers Association)– www.healthlawyers.org/

Page 58: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Federal Law, Regulations

http://www.gpo.gov/fdsys/

Page 59: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Help Finding Federal Law

• Forte, E. J., Hartnett, C. J., & Sevetson, A. (2011). Fundamentals of government information: Mining, finding, evaluating, and using government resources. New York: Neal-Schuman Publishers. – Sections on law, regulation, courts very useful

• Law librarian colleagues• Law school – legal research classes• AALL – American Association of Law Libraries

– http://www.aallnet.org/

Page 60: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

List of State Law Websites

• Justia• Example: Pennsylvania websites

– http://www.justia.com/us-states/pennsylvania/

Page 61: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Model State Emergency Health Powers Act (MSEHPA)

• Links to the model law, check list– http://www.publichealthlaw.net/ModelLaws/MSEH

PA.php – http://www.cphp.pitt.edu/upcphp/benchbook.pdf

• Summary matrix, state decisions as of August 1, 2011. – http://www.networkforphl.org/_asset/80p3y7/MS

EHPA-States-Table-06142012.pdf

Page 62: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Legal Indicators Project

• Database of full text of public health preparedness state laws from 12 states, searchable by keyword– http://www.phasys.pitt.edu/research/prototypes.

html • Video with Elizabeth Ferrell Bjerke, JD, co-

investigator on the project– http://media.hsls.pitt.edu/media/BjerkeInterview

1-bf0712/interview.html

Page 63: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Current Awareness-Proposed legislation, regulations

• Organizational Compilations– CDC Public Health Law News

• http://www.cdc.gov/phlp/news/current.html

– AHA Emergency Readiness• http://www.aha.org/advocacy-issues/emergreadiness/i

ndex.shtml

• GPO Fdsys– Federal Register– Congressional Bills

Page 64: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Toolkits

http://www.apctoolkits.com/isolationandquarantine/

Page 65: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Best Practices

“Best practices guidelines typically are based on information derived from practical experience and outcomes that is evaluated through a systematic methodology.”

(Rees 2008)

Page 66: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Best Practices Sources

• Public health emergency exercises• Applied research• Lessons learned• Benchmarking projects

Page 67: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Best Practices Examples• CDC, ASTHO

– Social Distancing Law Assessment Project• http://www.cdc.gov/phlp/publications/social_distancing.html

– ASTHO Useful Practices • http://www.astho.org/Programs/Preparedness/States-of-Prepared

ness/Useful-Practices/

• AHLA– Lessons Learned from the Gulf Coast Hurricanes. 2007

• http://www.healthlawyers.org/hlresources/PI/InfoSeries/Documents/Lessons Learned.pdf

Page 68: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Practice Guidelines for Legal Professionals

• Benchbooks• Locating them: Internet

search for public health bench books

• Guides for attorneys– American Health Law

Association– Public Health Law

Associationhttp://www.cphp.pitt.edu/upcphp/benchbook.pdf

Page 69: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Key Journals

• American Journal of Public Health (PMC 2 yr)• Biosecurity and Bioterrorism: Biodefense Strategy,

Practice and Science (PMC 1 yr)• Disaster Medicine and Public Health Preparedness• Journal of Law, Medicine and Ethics• Law Review journals (various titles)

Page 70: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Exercise

• You are working on a multi-organizational team developing a local pandemic influenza response plan. – List at least 3 legal resources you would consider

consulting for this project, and why

Page 71: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

PubMed for Legal Preparedness

• Disaster-Related MeSH– http://sis.nlm.nih.gov/dimrc/mesh_disaster.html

• Legal MeSH– Jurisprudence http://

www.ncbi.nlm.nih.gov/mesh/68007603 and appropriate narrower terms– Legislation and jurisprudence http

://www.ncbi.nlm.nih.gov/mesh/81000331 subheading

• Ex: "Disaster Planning/legislation and jurisprudence"[Mesh]

Page 72: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Should you include law terms?

• How inclusive must you be?– Law is so fundamental to public health it may be

mentioned in an article not indexed for law terms• Ex: Weiss 2007 search terms

– hurricane and health– Law component determined by examining the

article

Page 73: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

FINAL QUIZ!

Page 74: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Under the US system of law, what level of government has the most public health

authority?

A. FederalB. StateC. LocalD. Federal and state

are equal

Page 75: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Under the US system of law, what level of government has the most public health

authority? (answer)

B. State

Page 76: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Which of these statements is most true about emergency public health law and ethics?

A. They are in complete agreement.B. The laws attempt to balance the ethically derived

rights of individuals and the community .C. Laws change but ethics do not.D. Laws define ethics clearly enough to remove

doubt about the ethics of public health decisions.

Page 77: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Which of these statements is most true about emergency public health law and ethics? (answer)

B. The laws attempt to balance the ethically derived rights of individuals and the community .

Page 78: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Disaster planners can benefit more from reading the original text of a law than from reading a summary

from their legal counsel on their question.

A. TrueB. False

Page 79: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Disaster planners can benefit more from reading the original text of a law than from reading a summary from their legal counsel on their question. (answer)

B. False

Page 80: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

For After Class

• Other classes in the Disaster Information Specialist Certificate series• http://www.mlanet.org/education/dis/

• Archived, upcoming classes • Moodle: Access to related documents, Internet links

Page 81: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Acknowledgements

• University of Pittsburgh– Elizabeth Ferrell Bjerke,

JD– Tina Hershey, JD– Kurt Holliday– Jared Galvan– Hasan Guclu, PhD– Margaret Potter, JD

• MLA– Debra Cavanaugh

• NLM– Siobhan Champ-Blackwell– Cindy Love

• CDC Public Health Law Program– Matthew Penn, JD, MLIS

Page 82: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

This project is funded by the National Library of Medicine under contract HHS-N-276-2010-00782-P.

Page 83: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

References• Centers for Disease Control and Prevention (CDC). (2011). Summary of

notifiable diseases: United states, 2009. MMWR.Morbidity and Mortality Weekly Report, 58(53), 1-100. Retrieved from http://www.cdc.gov/mmwr/PDF/wk/mm5853.pdf

• Committee on Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations. Institute of Medicine. (2012). In Hanfling D., Altevogt B. M., Viswanathan K. and Gostin L. O. (Eds.), Crisis standards of care: A systems framework for catastrophic disaster response. Washington, DC: National Academies Press.

• Federal Emergency Management Agency (FEMA). (2012). CERT liability guide: A risk management overview for local CERT programs. Retrieved July 21, 2012, from http://www.citizencorps.gov/cert/downloads/pdf/CERT_Liability_Guide.pdf

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References 2• Fidler, D. P., Gostin, L. O., & Markel, H. (2007, Winter; 2012/5). Through the

quarantine looking glass: Drug-resistant tuberculosis and public health governance, law, and ethics.3 Journal of Law, Medicine and Ethics 35(4), 616-28.

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(2008). Assessing competencies for public health emergency legal preparedness. Journal of Law, Medicine and Ethics, 36(SUPPL. 1), 28-35.

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References 4• Moulton, A. D., Gottfried, R. N., Goodman, R. A., Murphy, A. M., & Rawson, R. D.

(2003). What is public health legal preparedness? The Journal of Law, Medicine & Ethics : A Journal of the American Society of Law, Medicine & Ethics, 31(4), 672-683. Retrieved from http://hdl.handle.net/2027.42/71834

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References 5• Rees, C. M., O'Brien, D., Briss, P. A., Miles, J., Namkung, P., & Libbey, P. M. (2008).

Assessing information and best practices for public health emergency legal preparedness. The Journal of Law, Medicine & Ethics, 36, 42-46. doi: 10.1111/j.1748-720X.2008.00259.x

• Weiss, R. I., McKie, K. L., & Goodman, R. A. (2007). The law and emergencies: Surveillance for public health-related legal issues during hurricanes katrina and rita./American Journal of Public Health, //97 Suppl 1/, S73-81. doi: 10.2105/AJPH.2006.104240

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Image Credits 1• Anthrax Reward Poster

– http://en.wikipedia.org/wiki/File:Anthraxreward.jpg • Legal, Ethical Foundations of Crisis Standards of Care

– Reprinted with permission from Crisis standards of care: A systems framework for catastrophic disaster response., 2012 by the National Academy of Sciences, Courtesy of the National Academies Press, Washington, D.C.

• Public Health Officers ( 2 images)– CDC. Public Health Image Library

• Scale of Justice– http://commons.wikimedia.org/wiki/File:Balance_justice.png

• US Capital – http://commons.wikimedia.org/wiki/File:US_Capital_Building.jpg

Page 89: Ethical and Legal Aspects of Disaster Response: Legal Preparedness August, 2012 Barbara L Folb, MM, MLS, MPH Public Health Informationist Health Sciences.

Image Credits 2• US Supreme Court

– http://commons.wikimedia.org/wiki/File:Supreme_Court_US_2009.jpg • White House

– http://commons.wikimedia.org/wiki/File:WhSouthLawn.JPEG • U.S. Constitution

– http://www.archives.gov/exhibits/charters/charters_downloads.html • You Can’t Take it With You

– http://commons.wikimedia.org/wiki/File:You_can%27t_take_it_with_you_-_NARA_-_518155.jpg