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Hospitals Drop the Ball on Physician Oversight (HRG Publication #1873), Public Citizen, 27 May 2009
Psychiatric emergency qualifies for EMTALA - Moses v. Providence Hospital and Medical Centers, Inc., No. 07-2111 (6th Cir. 04/06/2009)- damages were murder by released patient, court also found that EMTALA did not provide for private remedy against the physician.
CRS - Closing the Guantanamo Detention Center: Legal Issues.
January 22, 2009
Project on National Security Reform, Forging a New Shield, November 2008. A sweeping review of the current national security system and recommendations for reform.
Review of Detention Policy Options, January 22, 2009.
Ensuring Lawful Interrogations, January 22, 2009. Replacing: Interpretation of the Geneva Conventions Common Article 3 as Applied to a Program of Detention and Interrogation Operated by the Central Intelligence Agency, Executive Order 13440, July 20, 2007
Happy New Year!
FEMA - National Incident Management System, December 2008
Homeland Security - National Response Framework, January 2008
PHS officers can be sued under Bivens - Castaneda v. United States, 546 F.3d 682 (9th Cir. 2008) - This is an excellent discussion of the interplay between FTCA actions for negligence and Bivens actions for intentional acts. A INS detainee with an obvious serious medical condition was denied care until he had untreatable cancer. He sued under Bivens, rather than the FTCA, and the Public Health Service argued that the FTCA was the sole remedy. The Court disagreed and allowed the Bivens claim.
MMWR, Recommendations for Partner Services Programs for HIV Infection, Syphilis, Gonorrhea, and Chlamydial Infection. The CDC finally recommends a uniform approach to STIs, including HIV.
MMWR, Subpopulation Estimates from the HIV Incidence Surveillance System — United States, 2006 September 12, 2008 / Vol. 57 / No. 36. - Critical data on the prevelance of HIV produced from the new HIV reporting data.
Hurricane and Disaster Preparation Guide
Left Behind Black America: A Neglected Priority in the Global AIDS Epidemic, Black AIDS Institute, August 2008 - original link: http://www.blackaids.org/image_uploads/article_575/08_left_behind.pdf
Office of the Director of National Intelligence, Office of General Counsel – “Intelligence Community Legal Reference Book” (2007) - An extremely handy desk reference with excerpts from key statutes and guidelines.
Bioterrorism Lecture for Public Administration Students
Review of the DOJ opinion opposing Congressional revision of the state secrets act - April, 2008.
"The War Powers Resolution: After Thirty-Four Years," updated March 10, 2008.
Nuremburg Trials - Trial of the Major War Criminals before the International Military Tribunal
The Downer Cow Case - Humane Society v. Secretary of Agriculture
CRS - "Instances of Use of United States Armed Forces Abroad, 1798-2007," updated January 14, 2008.
CRS - "The Emergency Alert System (EAS) and All-Hazard Warnings," updated January 28, 2008
Joint Advisory Committee on Communications Capabilities of Emergency Medical and Public Health Care Facilities - Report to Congress
"Homeland Security: Roles and Missions for United States Northern Command," January 28, 2008.
Court dismisses most Katrina levee breach claims against the Army Corps of Engineers - 30 Jan 2008
"Data Mining and Homeland Security: An Overview," updated December 5, 2007
New Jersey passes opt-out HIV testing law for pregnant women - 2007.
Fusion Centers: issues and options for Congress, by Todd Masse and others, Congressional Research Service, July 6, 2007. Report on how intelligence networks set up to share information on terrorism have drifted into conventional law enforcement, and the effect that has on civil liberties.
Mayfield v. United States (D. Or. Sep. 26, 2007) - Oregon Federal District Court strikes Patriot Act provisions adopting the signficant purpose test for warrants under FISA, which allows warrantless searches when the primary purpose of the search is collecting criminal evidence, rather than collecting evidence of national security threats.
“The 2007 XDR-TB Incident: A Breakdown at the Intersection of Homeland Security and Public Health.”
Mass Shootings at Virginia Tech April 16, 2007, which addresses, among other things, the adequacy of mental health laws and emergency preparedness at the school.
Wilkie v. Robbins, 127 S.Ct. 2588 (2007) - Court rejects RICO and other novel claims against the government - interesting discussion of exhaustion of administrative remedies.
CRS: "Clinical Trials Reporting and Publication," updated July 12, 2007.
Preparing for Pandemic Influenza: The Hospital and Community Perspective, Stephen V. Cantrill, MD, Associate Director, Department of Emergency Medicine, Denver Health Medical Center, 2007 Great Lakes Homeland Security Training Conference & Expo. (These slides are an excellent review of preparations a community can take for pandemic flu preparation.)
Military Health: DOD's Vaccine Healthcare Centers Network. GAO-07-787R, June 29.
Florida Supreme Court Benchbook on Quarantine and Isolation
The 2007 Great Lakes Homeland Security Training Conference & Exposition
Cicin-Sain, Biliana, R.W. Knecht, N. Foster, Trends and Future Challenges for U.S. National Ocean and Coastal Policy, Silver Spring, MD, National Oceanic and Atmospheric Administration, National Ocean Service, Special Projects Office, 1999.
Chapter on Coastal Populations
Radiation Event Medical Management - HHS
"Legal Support to Military Operations," Joint Publication JP 1-04, March 1, 2007 - "Military lawyers were true combat multipliers in Iraq," said General David H. Petraeus, who is now U.S. commander in Iraq. "I tried to get all the lawyers we could get our hands on -- and then sought more."
Supplement - Volume 55, No. Supplement, December 22, 2006
60 Years of Public Health Science at CDC - In 2006, CDC celebrates its 60th anniversary. From the agency's relatively humble beginnings in 1946 as a malaria-control agency through its rapid growth in mission and expansion of staff and public health partnerships by 2006, science has been the foundation for everything CDC does. Public health science comprises numerous disciplines that, combined, are more than simply the addition of their parts. This synergy is public health's unique scientific strength. This supplemental issue of MMWR celebrates CDC's scientific strength and diversity by describing the public health contributions of 11 disciplines. It begins with the fundamental, cross-cutting disciplines of laboratory sciences and epidemiology, then focuses on disciplines new to public health, yet essential to CDC's success. Although this supplement only partially illustrates the variety of disciplines contributing to public health, the 11 articles provide a flavor of public health's scientific diversity and strength. They highlight contributions of many disciplines to each of CDC's health protection goals and emphasize how synthesizing scientific information is essential to impact health and maximize scientific investments.
Seattle King County WWW site - lots of useful info and forms.
CDC finally recommends routine HIV testing!
CDC History of Tuberculosis Control (large PDF)
New York City Pandemic Flu Plan - July 2006
Protection of National Security Information, CRS, June 30, 2006
A framework for an Australian Influenza Pandemic Plan: (Communicable Diseases Intelligence Technical Report Series No 4) Endorsed by the Communicable Diseases Network Australia New Zealand Published by Commonwealth Department of Health and Aged Care June 1999
Homeland Security plan for bird flu pandemic - this is a plan to plan, not an operational document. It raises good questions and has a excellent collection of references and legal authorities.
8 Feb 2006
Does the state owe compensation when property is destroyed to protect the public in a disaster? - Surocco v. Geary, 3 Cal. 69, 1853 WL 639, 58 Am.Dec. 385 (Cal. Jan Term 1853)
Human Tuberculosis Caused by Mycobacterium bovis --- New York City, 2001--2004, MMWR, June 24, 2005 / 54(24);605-608 - TB from unpasteurized milk
Testimony before the Presidential Advisory Council on HIV/AIDS
Congress may preempt state medical use marijuana laws - Gonzales v. Raich, No. 03-1454 (U.S. 06/06/2005)
Emergency Preparedness, Response, & Recovery Checklist. The American Health Lawyers Association (AHLA) has posted a new emergency preparedness checklist. The checklist is designed to help identify key legal and operational issues arising in a public health crisis, terrorist threat, environmental disaster, or other emergency situation.
Century Fund Report Calls for National Public Health Standards on Bioterrorism Preparedness
Supreme Court Establishes the Reach of the Commerce Clause - Gibbons v. Ogden, 22 U.S. 1 (1824)
It is ironic that the FDA is being criticized, in the same week, for being too hasty in approving Vioxx and not hasty enough in approving new techniques to make flu vaccine. The FDA represents a classic public policy choice: you can either have drugs approved quickly or carefully. No amount of fiddling with the law can change this because the only way to get good date on low level risks, which is the problem with Vioxx and antidepressants in children, is that you have to look at a lot of people taking the drug for a long time. Smart physicians do not prescribe new drugs for several years after they hit the market, unless they have real benefits and no alternatives because of this. Had Vioxx only been prescribed for the relatively small number of patients for which it gave relief and who could not take other drugs because of the side effects, the cardiovascular risk would have still been a problem, but the befit of using the drug would have weighed against it.
Short-circuiting flu vaccine approval is very dangerous for two reasons. First, you give flu vaccine to a lot people in a very short time, giving no chance to find risks until everyone has taken it. Second, if you spook the public, even with fears of risks that do not exist, then you undermine the entire vaccination effort for all diseases. Better to be conservative with vaccine approval than feed the lawyer and anti-vaccination nut driven hysteria over vaccine injuries.
Syndromic Surveillance: Reports from a National Conference, 2003
Flu shortage information page updated:
Ironically, the Washington State Nurses Association filed suit just before the shortage was announced to block a hospital plan to require manditory immunizations for the nursing staff. This highlights an ironic problem in the midst of the hysteria over access to flu vaccine: many health care worker who should be vaccinated for their own and their patient's protection have historically refused the flu and other vaccinations.
Emergency Rules for vaccine allocation page (Oregon) updated
Michigan passes a law protecting manufacturers and sellers of food against obesity related lawsuits.
Administrative law provides for emergency rules which go into effect at once. Oregon used this power to ration flu vaccine. This page collects the relevant law, rules, and the plan - Oregon emergency rule limiting access to flu vaccine.
Shepard v. Hill, 151 Mass. 540, 24 N.E. 1025 (Mass. 1890) - Classic case on standards for whether a business is a nusiance.
Boom v. City of Utica, 2 Barb. 104 (N.Y.Sup.Gen.Term, 1848) - Court finds that a person who is infected with a communicable disease is not a nuisance and has to be regulated through other police powers.
Com. v. Pear, Com. v. Jacobson, 67 L.R.A. 935, 183 Mass. 242, 66 N.E. 719 (Mass. 1903)
Materials on the history of Medicare
Kentucky AG Opinion 04-ORD-143, August 24, 2004, In re: The Kentucky Enquirer/Covington Police Department, Open Records Decision, The question presented in this appeal is whether the Covington Police Department properly relied on KRS 61.878(1)(a) and the Health Insurance Portability and Accountability Act of 1996 in partially denying The Kentucky Enquirer’s requests for specifically identified accident and incident reports generated by that public agency. For the reasons that follow, we find that the department’s partial denial of these requests was procedurally deficient and substantively incorrect.
Beta version 1.0 - Public Health Law Map / Graphic Map / Printing Version
Expert Witness Malpractice - Update
The Supreme Court provides broad new protections to health plans in Aetna Health Inc. v. Davila, No. 02-1845 (U.S. 2004) - click here for more detailed information and the case.
Council of State and Territorial Epidemiologists (CSTE) releases the report: Public Health Practice vs. Research: A Report for Public Health Practitioners Including Cases and Guidance for Making Distinctions. A copy of the report is currently available online in Adobe Acrobat format at CSTE's website at http://www.cste.org.
The WHO releases proposed revisions to the Current International Health Regulations.
The "Domestic WMD Incident Management Legal Deskbook," published by the Defense Threat Reduction Agency (DTRA) - this is a mirror site that also fixes some of the broken links on the DOD site.
Terrorism Insurance: Implementation of the Terrorist Risk Insurance Act of 2002. GAO-04-307 , April 28, 2004 - Terrorism Insurance: Effects of the Terrorism Risk Insurance Act of 2002, by Richard J. Hillman, GAO-04-720T, April 28
Emerging Infectious Diseases: Asian SARS Outbreak Challenged International and National Responses. GAO-04-564 , April 28, 2004
SARS and Public Health in Ontario , Interim Report of the SARS Commission (Canada), April 15, 2004
Lessons from the Anthrax Attacks: Implications for U.S. Bioterrorism Preparedness by David Heyman, CSIS, under contract to the Defense Threat Reduction Agency, April 2002 (2 MB PDF file), as redacted by the DOD and releasedon March 15, 2004)
Radiological Dispersal Devices: Select
Issues in Consequence Management,
CRS Report for Congress,
Order Code RS21766,
March 10, 2004
(Thanks to the Federation of American Scientists)
CDC releases primer on food borne illness
Top Officials (TOPOFF) Exercise Series: TOPOFF 2 - After Action Summary Report For Public Release, December 19, 2003 PDF TOPOFF 2000 US Army MARS Emergency Operations Information Page
Tobacco Settlement: States' Allocations of Fiscal Year 2003 and Expected Fiscal Year 2004 Payments. GAO-04-518, March 19. - (it is not going to health and anti-smoking efforts.)
FEMA - Emergency Response to Terrorism Job Aid - Feb 2003 - Released Feb 2004
ANALYSIS - How much should we worry about ricin in the Senate Office Building?
On 2 Jan 04 traces of ricin were found in a white power in a letter sent to Senator Frist at the Senate Office Building. By the next day the building was closed and mail had been disrupted to the House as well. A little over years ago, the Senate Office Building was closed for many weeks when it was the target of a letter laced with anthrax.
First, how dangerous is ricin? Ricin is a natural toxin found in the seeds of the castor bean plant, a common garden ornamental. (Ricin info) As little as a milligram of ricin can kill, if it is injected into the body, as was done in the 1978 murder of a Bulgarian journalist. Yet a milligram is quite a lot compared to la ethal dose of anthrax spores. If it is distributed as a trace in some white power such as artificial coffee creamer, it would only be dangerous to someone who ate most of the power. Since the tests used for screening potential bioterrorism agents are very sensitive, they have many false positives, and this may yet turn out to be a hoax. Or it may be ricin, but nothing more than the scrapings of a castor bean seed. Enough to show positive, but no real threat.
The real threat is the disruption caused by the letter. The anthrax letters disrupted government functions, mail delivery on a wide area, frightened millions of people, and cost billions of dollars. Some of these costs were due to an overreaction to a real risk, but they convinced the public and the congress that any area exposed to even tiny amounts of anthrax must be closed and disinfected, inch by inch. (Since we had not measured background levels of anthrax spores before the attack, there was no way to know if some of them were from horse hair stuffing in antique sofas and chairs - a known source of anthrax.)
After the anthrax letter, police departments in all major cities were inundated with "white power" calls. Some cities saw hundreds of these over a few months, draining police resources and disrupting the businesses that were targeted. (Los Angles started sending trained officers to the scene with a microscope, which allowed them to rule out the most common substances used.) Police departments still respond to these threats, as they must, and can expect to have a new round of them after this ricin attack. All of these have been hoaxes, but they have very effectively gummed up the works of government.
How much disruption can we stand? Have the terrorists and pranksters won? We must decide on a correct level of response based on the threat these "white powder" attacks really pose. If we do not, then we will not be able to deal with a real attack. If there was a serious attack with a bioterrorism agent such as anthrax, we could not afford to disinfect every inch of a city, nor could we be promise that there would be no risks to the citizenry. People might die, but many more would die if unreasonable fears lead to panic. We are stoking those fears when we overreact to minor threats.
HHS announces the regulations for the smallpox compensation program.
QUARANTINE AND ISOLATION:
LESSONS LEARNED FROM SARS, A Report to the Centers for Disease Control and
Prevention, Institute for Bioethics,
Health Policy and Law
University of Louisville School of Medicine. Original Link
CDC posts draft of SARS response plan
Maryland Attorney General's Opinion on compensation for public workers who are injured by the smallpox vaccine. This is good analysis of the federal vaccination compensation law and how it fits with one state's worker's compensation laws.
CDC releases guidelines on prevention of HIV transmission for health care providers taking care of persons with HIV: Incorporating HIV Prevention into the Medical Care of Persons Living with HIV. These are a great step forward in that they recognize the value of reporting HIV, tracing the contacts of persons with HIV, and warning those contacts that they are at risk of contracting HIV. Unfortunately, many state health departments still do not do named reporting, contact tracing, and partner notification for HIV.
CDC reports that millions are bitten by dogs each year and that nearly 1,000,000 require medical treatment - Nonfatal Dog Bite–Related Injuries Treated in Hospital Emergency Departments — United States, 2001
30 June 2003
Yet another call for whizbang technology for public health, with no discussion of the underlying infrastructure problems due to budget cuts and increasing demands for basic services. While the technology would be useful, it always comes at the expense of the other activities and staffing.
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