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APHA Scientific Session and Event Listing

Recorded presentation

Patricia Sweeney, JD, MPH, RN, Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, 3109 Forbes Ave. Suite 210, Pittsburgh, PA 15260, 412.383.2231, psweeney@pitt.edu and Michael P. Allswede, DO, Department of Emergency Medicine, University of Pittsburgh School of Medicine, 271 Quantum 1 Building, 2 Hot Metal Street, Pittsburgh, PA 15213.

Early detection of a public health emergency hinges upon the ability of private medical practitioners and hospitals to link with public health authorities and rapidly communicate with federal authorities. These linkages however were constructed to detect disease risks of an earlier century. Today, pathogens can travel the globe in less than 24 hours. In addition, contemporary civil societies highly regard the privacy of personal matters and proprietary business dealings and therefore have taken significant steps to legally protect such matters. Consequently, in the context of modern trade, travel and jurisprudence, does our current legal infrastructure enable the detection and communication of the earliest warning signs? To disclose the scope of laws regulating communication between clinical medicine, public health and law enforcement, and to discern their affect upon a timely response to a potential public health emergency, a retrospective study was conducted which analyzed 13 incidents of natural or intentional outbreaks of illness that occurred in the US over the past two decades. For each incident, applicable state and federal statutes and ethical concerns were characterized as either supporting or limiting the interagency or inter-domain communications needed for detection and management of the outbreak. All 50 state public health codes were analyzed to identify the legal framework for forensic epidemiology investigations. The analysis uncovered myriad and often incongruous laws underlying the actions taken by these domains. Specific gaps and conflicts were identified and a series of legal strategies to improve and facilitate interdisciplinary communication in time of crisis were developed.

Learning Objectives:

• At the conclusion of the session the participant will be able to
• 1. Discuss the legal and ethical principles and statutes supporting the communication of personally identifiable, proprietary or confidential information between clinical medicine, public health, and law enforcement.
• 2. Define the legal and ethical principles and statutes which limit communication of personally identifiable, proprietary or confidential information between clinical medicine, public health, and law enforcement.
• 3. Describe the impact that opposing laws have upon the communication behaviors of practitioners in each of these domains as related to rapid detection of potential incidents of bioterrorism or infectious disease.
• 4. Articulate three legislative changes that, based upon assessed public health risk, would strengthen the legal infrastructure and support appropriately limited yet progressively comprehensive communication between clinical medicine, public health, and law enforcement.

Keywords: Public Health Legislation, Health Law

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation