gene w. matthews, j.d. cdc foundation 50 hurt plaza, suite 765 atlanta, ga 30303 (404) 373-1276...
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Gene W. Matthews, J.D.CDC Foundation
50 Hurt Plaza, Suite 765
Atlanta, GA 30303
(404) 373-1276
MatthewsPHLaw@aol.com
Institute of Public Health
Law
INSTITUTE of PUBLIC HEALTH LAW
Historical Role of Attorneys and 21st Century Public Health
Practice
INSTITUTE of PUBLIC HEALTH LAW
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
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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)
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“A renaissance is now taking place in public health law”
(…and just in time!)
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Natural Events
21st Century Emerging Infections
Mad Cow Disease
West Nile Virus
SARS
Monkey Pox
Avian Flu
Marburg Disease??
Cascade of
Comm
unications
Challenges
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Population Density
21st Century: Travel Time vs. Population Density
Travel Time
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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
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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:
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Law/Policy Change in Public Health Emergency
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THE GREEN ZONE“normal time”
“Emergency”THE RED ZONE
(Culture temporarilyChanges)
Immediate Aftermath
Moment of Law & Policy Change
Immediate Aftermath
Moment of Law & Policy Change
…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
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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
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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.
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The Green Zone: Normal Times
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Government
IndividualsBusiness
Normally, there is distance between these entitiesbecause of different goals, agendas, & strategies
The RED ZONE: An Emergency
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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
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Law/Policy Change in Public Health Emergency
INSTITUTE of PUBLIC HEALTH LAW
THE GREEN ZONE“normal time”
“Emergency”THE RED ZONE
(Culture temporarilyChanges)
Immediate Aftermath
Moment of Law & Policy Change
Immediate Aftermath
Moment of Law & Policy Change
…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
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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
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Gene W. Matthews, J.D.CDC Foundation
50 Hurt Plaza, Suite 765
Atlanta, GA 30303
(404) 373-1276
MatthewsPHLaw@aol.com
Institute of Public Health
Law
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.”
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