Legal Dimensions of Large Scale Response
The goal of this sub-project is to identify substantive issues, beyond those usually considered in public health emergencies that impact, favorably or unfavorably, on the response to large-scale casualty scenarios in metropolitan areas of the United States.
LaSER’s project personnel include physicians, attorneys, and physician-attorneys. Through this multidisciplinary team LaSER is developing a broad analyses of legal issues pertinent to large-scale emergency readiness, and proposals to remove barriers to efficient and effective response that are posed by conflicts or gaps in law and regulation across jurisdictions. Our interest is in determining the laws that exist to help or hinder a large-scale emergency response, the authority to use or suspend such laws, and the interaction of public health, medical and emergency management laws at different levels of government as well as case law.
After developing an exhaustive list of potential legal issues that impact upon public health and medical response during an emergency, we began with identification and analysis of laws pertaining to triage and emergency management; mass evacuation, prophylaxis and quarantine; special populations, confidentiality; malpractice and liability; use of buildings; financial issues; federal disaster law; discrimination against those exposed; and power to declare emergency. The research is intended to focus in great detail on a few of these topics, in an effort to make a novel and real contribution to the understanding of these issues.
Current Efforts
Article: "Public health requires legal role in evacuation"
This paper discusses the pertinent historical facts, the medical and public health concerns during an evacuation, and the legal basis for ordering and managing an evacuation. It delineated concerns and problems in the legal, emergency management, and public health systems in the implementation of evacuations, identifies critical issues and suggests remedies. The paper will advocate for the design and administration of emergency large-scale evacuation plans that protect public health and promote effective medical response.
Legal Manuscripts: "Public health requires legal role in evacuation"
This manuscript continues to outline the current Federal, state and local framework for preparing and implementing large scale evacuations. In particular, it focus on: (1) the absence of an affirmative duty under the Federal constitution on Federal, state and local government to effectively prepare for universal evacuations; (2) the failure of Federal, state and local statutes and regulations to require planners to anticipate the public health aspects of universal evacuations; and (3) the lack of Federal requirements – either constitutional or statutory – to provide for the needs of venerable populations in universal evacuations. This paper include more technical legal arguments than the first paper and advocates for the adoption of regulations to impose clear and measurable requirement on planners to create universal evacuation plans that provide for the public health needs of vulnerable populations.
"Legal Obstacles to Health Care for Children Who Are Separated from their Parents During a Disaster
Here the team switch its attention to pediatric health in large scale disasters. The paper identifies obstacles in the current legal regime (statutes in combination with case law) that present obstacles to medical personnel providing emergency care to children who are separated from a parent or guardian. These include limitations on exceptions to parental consent rules which would prevent health providers in large scale disasters from treating medical conditions of children whose parents are not available to provide consent if such conditions are not imminently life threatening. These limitations prevent treatment of chronic conditions that may grow substantially worse if left untreated, treatment to prevent the onset of illness and treatment to alleviate pain. Additionally, the existence of clinics in schools may remove them from the application of the Good Samaritan rule thereby discouraging emergency care by volunteer medical professionals.