Transcript Emerging Infectious Diseases and the Law

Emerging Infectious
Diseases and the Law
Edward P. Richards, J.D., M.P.H.
Professor of Law
Executive Director
Center for Public Health Law
University of Missouri Kansas City
http://plague.law.umkc.edu/cphl
Center for Public Health
Law
• Mission
– The Center for Public Health Law is a research center
based at the University of Missouri Kansas City School
of Law. It is an interdisciplinary and inter-institutional
Center with the goal of furthering research and
service in public health law.
• Personnel
– Executive Director - Edward P. Richards, J.D., M.P.H.
– Director for Medicine and Epidemiology - Katharine C.
Rathbun, M.D., M.P.H.
– Director for Ethics - Jerry Menikoff, J.D., M.D.
• Host Institution
– University of Missouri Kansas City School of Law
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What Motivates Modern
Public Health?
• Social Justice
– Health People 2010
• Integrated Delivery System
– NIH Future of Public Health Study
• “Our Patients”
– Unnamed State Health Director
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Parens Patriae
• "Parens patriae," literally "parent of
the country,”... It is the principle that
the state must care for those who
cannot take care of themselves, such
as minors who lack proper care and
custody from their parents.
– Blacks Law Dictionary
• The King as Father
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Modern Parens Patriae
Powers
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Child Welfare
Indigent Care
Wellness Programs
Mental Health Care
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Why do Lawyers and Law
Professors Like Parens Patriae?
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Helping the Downtrodden
Empowering the Individual
Distrust of the State
Lots of Money in Suing for Individuals
Not Much Money in Representing the
State
• No Money or Private Practice in
Public Health Law
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What is the Alternative?
Police Power
• Right of Societal Self-Defense
• Right of the State to Protect
Itself
• Right of the State to Protect Its
Citizens
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History
• From English Common Law
• Core of Colonial Government
• Key Power Reserved to the
States
• The Key Public Health Law
Doctrine until the 1980s
• Still the Doctrine Used by the
Courts
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Police Power v. Parens
Patriae
• The state has a legitimate interest
under its parens patriae powers in
providing care to its citizens who are
unable because of emotional
disorders to care for themselves; the
state also has authority under its
police power to protect the
community from the dangerous
tendencies of some who are mentally
ill.
– Addington v. Texas, 441 U.S. 418 (1979)
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Why the Paradigm
Matters
• Parens Patriae
– The Individual Is First
– Society is just the Sum of the
Individuals
• Police Power
– Ecological Model
– Society is a Complex Organism
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Practical Differences
• Parens Patriae
– Driven by Individual Medical Needs
– Individual Lives Trump Statistical Lives
– Protect Yourself From Disease
• Police Power
– Driven by Community Protection
– Stresses Statistical Lives
– Protect Others From Disease
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Emerging Infectious
Diseases
• Demand Surveillance
• Case Finding
• Swift Action in the Face of
Uncertainty
• Protect Individuals Against their Will
• Must Sometimes Sacrifice Individual
Rights to Societal Protection
• Same Issues in Bioterrorism
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EID Control Depends on
the Police Power
How do We Restore the
Police Power to Public
Health?
Rethinking Public Health
Services
• Train Public Health Professionals in
Public Health Law
• Train Public Health Professionals in
Traditional Public Health
– Food and Water Sanitation
– Infectious Disease Control
– Vermin, Animal Control, and other
Nuisance
• Separate Acute Medical Services
from Core Public Health
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