gene w. matthews, j.d. cdc foundation 50 hurt plaza, suite 765 atlanta, ga 30303 (404) 373-1276...

Gene W. Matthews, J.D.CDC Foundation

50 Hurt Plaza, Suite 765

Atlanta, GA 30303

(404) 373-1276

[email protected]

Institute of Public Health

Law

INSTITUTE of PUBLIC HEALTH LAW

Historical Role of Attorneys and 21st Century Public Health

Practice


ABA Center for Continuing Legal Education Understanding the Role of Public Health in Your Practice

August 10, 2005

Historical Context

• 100 years ago, lawyers were integral to the practice of public health at the community level

• Example, Teddy Roosevelt and Long Island polio quarantine of 1890’s

• Example, in 1905 a Chicago lawyer founded the Rotary Club:

--Purchased a horse for the doctor --Built the first public restroom

in Chicago


HISTORICAL CONTEXT

1950’s : Two Ships Passed in the Night!

Salk Polio Vaccine – 1955 (END IN U.S. OF COMMUNITY-WIDE PUBLIC HEALTH CONTROL MEASURES—300 years!)

Brown v. Board of Education 1954(BEGINNING OF MODERN EVOLUTION OF PROCEDURAL

PROTECTIONS OF INDIVIDUAL LIBERTIES AGAINST GOVERNMENT ACTION)


“A renaissance is now taking place in public health law”

(…and just in time!)


Natural Events

21st Century Emerging Infections

Mad Cow Disease

West Nile Virus

SARS

Monkey Pox

Avian Flu

Marburg Disease??

Cascade of

Comm

unications

Challenges

INSTITUE of PUBLIC HEALTH LAW

Population Density

21st Century: Travel Time vs. Population Density

Travel Time


Human Events 21st Century Asymmetrical Terrorism

Bioterrorism Events Anthrax attacks of 2001

Smallpox vaccinations of 2003Ricin events in 2003-2004

“Conventional” Weapon EventsAirliner hijackings of 9/11/2001Madrid subway attacks of 2004London transit attacks of 2005

Chemical & Nuclear ThreatsChemical weapon concerns-(Sarin gas in Tokyo subway)“Suitcase bomb” & “dirty bomb” scenarios

Comm

unications

Cascade


Question: “Why should I care?”

“In an outbreak situation, the private

sector cannot afford for government to

fail!”

Governments are facing multi-level budget deficits-federal, state, & local

In an outbreak, government is going to need the help of the private sector

Answer:


Law/Policy Change in Public Health Emergency


THE GREEN ZONE“normal time”

“Emergency”THE RED ZONE

(Culture temporarilyChanges)

Immediate Aftermath

Moment of Law & Policy Change

Immediate Aftermath


…and…“THE BLAME GAME”

may begin!

(Selective Amnesia Returns)

30,000 “voluntary” quarantines over 3 months

27 formal quarantine orders…and..

1 appeal (withdrawn)

MORE SOCIAL

COHESION

Toronto experienced a temporary shift increasing social cohesion

Compliance with quarantine directives was substantial

One example of how a culture temporarily changes

The Toronto Example of the RED ZONE—2003 SARS

NOT DIVISIVENESS

& PANIC


A “Tipping Point” for SARS Leadership in TorontoA “Tipping Point” for SARS Leadership in Toronto

On the day that the large medicalOn the day that the large medical

convention cancelled in Toronto,convention cancelled in Toronto,

the the centercenter of leadership of leadership shiftedshifted::

A A HealthHealth Problem for An Problem for An EconomicEconomic Problem Problem

GovernmentGovernment Leaders for Leaders for BusinessBusiness

LeadersLeaders

To SolveTo Solve To Solve To Solve


BECAME

Initial Lessons

Lessons from Toronto are readily understandable and are transferable to other settings.

The Biggest Lesson: The “Balance of Governance” is significantly (if only temporarily) altered during an emergency.

Business and Public Health need to build bridges with each other before a crisis.


The Green Zone: Normal Times


Government

IndividualsBusiness

Normally, there is distance between these entitiesbecause of different goals, agendas, & strategies

The RED ZONE: An Emergency


Government

IndividualsBusiness

Relationships are altered during anemergency—we need to plan for it…now.

Persons are more likely to

follow quarantine orders

Employees get their informationthrough their employers

Businesses engage & lead

in economic recovery plans

An Example of One Window of Change:Rapid National Legal/Policy Changes

That Followed 9/11/01

Department of Homeland Security created

BT Infrastructure Block Grants to states

USA PATRIOT Act Enacted

Select Agent Rule for control of BT pathogens

Model State Emergency Health Powers Act Drafted

Airline Recovery Legislation Enacted


Law/Policy Change in Public Health Emergency


THE GREEN ZONE“normal time”

“Emergency”THE RED ZONE

(Culture temporarilyChanges)

Immediate Aftermath


Immediate Aftermath


…and…“THE BLAME GAME”

may begin!

(Selective Amnesia Returns)

What can we do to plan for moments of legal and policy change?

Start linking businesses, governments, & civic leaders

about this agenda

Use civic groups, trade associations, academic centers &

preparedness forums to address these obvious issues.

Examine legal concerns: sick leave policies, liability

limitation, compensation, insurance coverages, Good

Samaritan Laws, etc.

Recognize that the “normal”, risk-averse decision-making

does not always work in the Red Zone


Rediscover leadership role of community lawyers in public health

Remember the model of 100 years ago

Lawyers are also interested in community public health issues beyond emergency preparedness

Policy reform is instinctive to lawyers

A Reminder for the 21st Century


Gene W. Matthews, J.D.CDC Foundation

50 Hurt Plaza, Suite 765

Atlanta, GA 30303

(404) 373-1276

[email protected]

Institute of Public Health

Law


"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.”

gene w. matthews, j.d. cdc foundation 50 hurt plaza, suite 765 atlanta, ga 30303 (404) 373-1276...

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