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Law, medicine and public health: The case of Ebola
Public Health Reports (2015)
  • James G Hodge, JD, LLM
  • Lawrence O. Gostin, JD, LLD (Hon.), Georgetown University
  • Dan Hanfling, MD, Inova Health System
  • John L Hick, MD, Hennepin County Medical Center
Abstract
The Ebola crisis overseas has come ashore to the United States, resulting in a series of effective public health responses and some high-visibility errors. Although the U.S. has had only one imported case from West Africa as of October 27, 2014, several missteps in handling the case in Dallas, Texas, led to the release of an Ebola patient after initial presentation to a hospital emergency room, potential exposures of dozens of people, and the subsequent infection of two nurses.1 One of the nurses with symptoms was permitted to fly on commercial airliners, placing hundreds of additional Americans at some risk of infection, albeit minimal.2 Media coverage of the domestic “Ebola outbreak”3 has fueled public concerns and the naming of America's first “Ebola Czar,” Ron Klain.4 The nation's preparedness capabilities are under question.1

Dr. Georges Benjamin, Executive Director of the American Public Health Association, suggests that “[a] strong, well-developed and adequately funded public health system is the key to containing Ebola.”5 However, years of funding cuts, loss of personnel, and political apathy have stripped the public health system to its core even as expenditures for health care have risen exponentially.1 U.S. public health agencies must rely on the frontline efforts of doctors, nurses, and other health workers equipped with sufficient legal authority and knowledge to control emerging health threats such as Ebola and protect the public's health. The stakes are high in the face of an infectious condition for which there is no approved vaccine or reliable treatment, and the fatality rate ranges from 30% to 70% globally.6

In this column, two public health lawyers and two emergency medicine physicians who served together on the Institute of Medicine Crisis Standards of Care Committee from 2009 to 20127 share guidance on controversial topics at the intersection of law, medicine, and preparedness for Ebola, including (1) the willingness among health workers and entities to handle patients suspected or known to be infected; (2) novel treatments and administration of experimental drugs; (3) implementation of isolation, quarantine, and other social-distancing measures in medical settings; and (4) prospective liabilities of health workers or entities for medical errors or omissions in the handling or treatment of Ebola cases.
Keywords
  • Ebola,
  • public health preparedness,
  • legal
Disciplines
Publication Date
March, 2015
DOI
https://dx.doi.org/10.1177%2F003335491513000210
Citation Information
James G Hodge, Lawrence O. Gostin, Dan Hanfling and John L Hick. "Law, medicine and public health: The case of Ebola" Public Health Reports Vol. 130 Iss. 2 (2015) p. 167 - 170
Available at: http://works.bepress.com/dan_hanfling/90/