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GeneW Matthews J D CDCFoundation50HurtPlaza Suite765Atlanta GA30303 404 373 1276MatthewsPHLaw InstituteofPublicHealthLaw INSTITUTEofPUBLICHEALTHLAW HistoricalRoleofAttorneysand21stCenturyPublicHealthPractice INSTITUTEofPUBLICHEALTHLAW ABACenterforContinuingLegalEducationUnderstandingtheRoleofPublicHealthinYourPracticeAugust10 2005 HistoricalContext 100yearsago lawyerswereintegraltothepracticeofpublichealthatthecommunitylevelExample TeddyRooseveltandLongIslandpolioquarantineof1890 sExample in1905aChicagolawyerfoundedtheRotaryClub Purchasedahorseforthedoctor BuiltthefirstpublicrestroominChicago INSTITUTEofPUBLICHEALTHLAW HISTORICALCONTEXT1950 s TwoShipsPassedintheNight SalkPolioVaccine 1955 ENDINU S OFCOMMUNITY WIDEPUBLICHEALTHCONTROLMEASURES 300years Brownv BoardofEducation1954 BEGINNINGOFMODERNEVOLUTIONOFPROCEDURALPROTECTIONSOFINDIVIDUALLIBERTIESAGAINSTGOVERNMENTACTION INSTITUTEofPUBLICHEALTHLAW Arenaissanceisnowtakingplaceinpublichealthlaw andjustintime INSTITUTEofPUBLICHEALTHLAW NaturalEvents 21stCenturyEmergingInfectionsMadCowDisease WestNileVirus SARS MonkeyPox AvianFlu MarburgDisease CascadeofCommunicationsChallenges INSTITUEofPUBLICHEALTHLAW PopulationDensity 21stCentury TravelTimevs PopulationDensity TravelTime INSTITUEofPUBLICHEALTHLAW HumanEvents 21stCenturyAsymmetricalTerrorismBioterrorismEventsAnthraxattacksof2001Smallpoxvaccinationsof2003Ricineventsin2003 2004 Conventional WeaponEventsAirlinerhijackingsof9 11 2001Madridsubwayattacksof2004Londontransitattacksof2005Chemical NuclearThreatsChemicalweaponconcerns SaringasinTokyosubway Suitcasebomb dirtybomb scenarios CommunicationsCascade INSTITUEofPUBLICHEALTHLAW Question WhyshouldIcare Inanoutbreaksituation theprivatesectorcannotaffordforgovernmenttofail Governmentsarefacingmulti levelbudgetdeficits federal state localInanoutbreak governmentisgoingtoneedthehelpoftheprivatesector Answer INSTITUTEofPUBLICHEALTHLAW Law PolicyChangeinPublicHealthEmergency INSTITUTEofPUBLICHEALTHLAW THEGREENZONE normaltime Emergency THEREDZONE CulturetemporarilyChanges ImmediateAftermathMomentofLaw PolicyChange and THEBLAMEGAME maybegin SelectiveAmnesiaReturns 30 000 voluntary quarantinesover3months27formalquarantineorders and 1appeal withdrawn MORESOCIALCOHESIONTorontoexperiencedatemporaryshiftincreasingsocialcohesionCompliancewithquarantinedirectiveswassubstantialOneexampleofhowaculturetemporarilychanges TheTorontoExampleoftheREDZONE 2003SARS NOTDIVISIVENESS PANIC INSTITUTEofPUBLICHEALTHLAW A TippingPoint forSARSLeadershipinToronto OnthedaythatthelargemedicalconventioncancelledinToronto thecenterofleadershipshifted AHealthProblemforAnEconomicProblemGovernmentLeadersforBusinessLeadersToSolveToSolve INSTITUTEofPUBLICHEALTHLAW BECAME InitialLessons LessonsfromTorontoarereadilyunderstandableandaretransferabletoothersettings TheBiggestLesson The BalanceofGovernance issignificantly ifonlytemporarily alteredduringanemergency BusinessandPublicHealthneedtobuildbridgeswitheachotherbeforeacrisis INSTITUTEofPUBLICHEALTHLAW TheGreenZone NormalTimes INSTITUTEofPUBLICHEALTHLAW Normally thereisdistancebetweentheseentitiesbecauseofdifferentgoals agendas strategies TheREDZONE AnEmergency INSTITUTEofPUBLICHEALTHLAW Relationshipsarealteredduringanemergency weneedtoplanforit now Personsaremorelikelytofollowquarantineorders Employeesgettheirinformationthroughtheiremployers Businessesengage leadineconomicrecoveryplans AnExampleofOneWindowofChange RapidNationalLegal PolicyChangesThatFollowed9 11 01 DepartmentofHomelandSecuritycreatedBTInfrastructureBlockGrantstostatesUSAPATRIOTActEnactedSelectAgentRuleforcontrolofBTpathogensModelStateEmergencyHealthPowersActDraftedAirlineRecoveryLegislationEnacted INSTITUTEofPUBLICHEALTHLAW Law PolicyChangeinPublicHealthEmergency INSTITUTEofPUBLICHEALTHLAW THEGREENZONE normaltime Emergency THEREDZONE CulturetemporarilyChanges ImmediateAftermathMomentofLaw PolicyChange and THEBLAMEGAME maybegin SelectiveAmnesiaReturns Whatcanwedotoplanformomentsoflegalandpolicychange Startlinkingbusinesses governments civicleadersaboutthisagendaUsecivicgroups tradeassociations academiccenters preparednessforumstoaddresstheseobviousissues Examinelegalconcerns sickleavepolicies liabilitylimitation compensation insurancecoverages GoodSamaritanLaws etc Recognizethatthe normal risk aversedecision makingdoesnotalwaysworkintheRedZone INSTITUTEofPUBLICHEALTHLAW RediscoverleadershiproleofcommunitylawyersinpublichealthRememberthemodelof100yearsagoLawyersarealsointerestedincommunitypublichealthissuesbeyondemergencypreparednessPolicyreformisinstinctivetolawyers AReminderforthe21stCentury INSTITUTEofPUBLICHEALTHLAW GeneW Matthews J D CDCFoundation50HurtPlaza Suite765Atlanta GA30303 404 373 1276M
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