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EPID 618: PUBLIC HEALTH LAW

EPID 618 Rene S. Cabral-Daniels, JD, MPH

Public Health Law
Semester course; 3 lecture hours. 3 credits. Provides the student with the structure of the legal system and statutes and regulations governing state and local health departments. This course examines the federal public health laws, medical malpractice, privacy and confidentiality issues, mental health laws, abortion and sterilization, patients rights, emergency medical care law, human experimentation, rights of the terminally ill, AIDS law, occupational and environmental health law, and health planning and reimbursement law.
Summer semester

COURSE TIME/ROOM: Tuesdays 1:00 - 2:55 P.M. and Thursdays 1:00 – 2:55 P.M.

Room ? ___ Grant House

CREDITS: 3 credit hours

INSTRUCTOR: Rene S. Cabral-Daniels, JD, MPH

Virginia Department of Health

Office of Health Policy and Planning

109 Governor Street

Richmond, VA 23219

(804) 864.7425; FAX 864.7440

Email: Rene.CabralDaniels@vdh.virginia.gov

COURSE DESCRIPTION:

This course explores how law can both promote and impede the public’s health. It describes the legal concepts that underlie the public health system and frame public health policy. The course focuses on the legal foundations of the federal, state, and local public health care laws to gain a better understanding of governmental policies in providing for the collective health of its citizenry. It explains and clarifies the role of law in public health practice, administration, and enforcement. Lectures and readings will cover the basics of the development and implementation of federal and Virginia law (covering relevant statutes and regulations for public health on a federal, state, and local basis) and describe the policy-making role for the Virginia Department of Health.

COURSE OBJECTIVES:

1). Acquaint the student with the fundamental principles and processes of the legal system as they relate to the federal public health care system;

2). Acquaint public health workers with the legal duties and responsibilities associated with the typical functions they perform;

3). Acquaint the student with the rights and obligations imposed by the Bill of Rights on both private citizens and public health workers so as to appreciate the basic legal rights and duties of the relevant stakeholders in the system;

4). Acquaint students with the manner in which laws, regulations and public policy in the public health arena are developed and adopted;

5). Enable students to perform legal research on significant public health legal issues.

6). Develop a vocabulary of public health and legal terms in order to facilitate communications between public health and legal professionals; and

7). Develop in students public speaking & technical writing proficiency.

MPH PROGRAM MISSION STATEMENT

The Mission of the Medical College of Virginia/Virginia Commonwealth University MPH Program is to promote, preserve and restore health. This Mission is accomplished by training students to be effective practitioners of the skills, knowledge and attitudes needed to effectively conduct public health needs assessment of populations; program planning and evaluation and other research to address identified needs, and work with communities to generally enhance the protection and promotion of health.

The MPH Program emphasizes community services for under served populations by working closely with local counties, municipalities, and state agencies, as well as with service organizations, to identify community needs, educational and service opportunities for program students and graduates. The Program directly advances the University Mission and the School of Medicine Mission.

Americans With Disabilities Act Statement

Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990 require Virginia Commonwealth University to provide an ‘academic adjustment’ and/or a ‘reasonable accommodation’ to any individual who advises us of a physical or mental disability. If you have a physical or mental limitation that requires an academic adjustment or accommodation, please arrange a meeting with me at your earliest convenience. Additionally, if our course work requires you to work in a lab environment, you should advise the instructor or department chairperson of any concerns you may have regarding safety issues related to your limitations(s).”

For further information contact:

VCU Services for Students with Disabilities

Coordinator: Cheryl Chesney-Walker (clchesneywal@vcu.edu)

Campus location: VMI Building, 1000 E. Marshall Street, Room 301

Mailing address: PO Box 980124, Richmond, Virginia 23298-0214

Voice: 804-828-9782 | TTY: 804-828-4608 | FAX: 804-828-4609

Web: www.vcuhealth.org/vp/dss

All students are expected to comply with the VCU Honor Code. Detailed information about the Honor Code can be found at http://www.has.vcu.edu/psy/psy795/honcode.htm.

TEXT: PUBLIC HEALTH LAW; Power, Duty, Restraint;

Lawrence O. Gostin; U. Cal. Press; 2000; ISBN 0-520-22648-8

COURSE OUTLINE

Week Of:

05\24\05 Overview of Public Health Law; Course Roadmap; Chap. 1 Sample Case Brief, Loving v. Virginia, Legal Writing
05\31 Public Health in the Constitutional Design; Chapter 2
06\7 Constitutional Limits on the Exercise of Public Health Chap. 3 Powers; Safeguarding Individual Rights & Responsibilities; Suggested Topic for Term Paper Due June 7
06\14 Public health Regulation; Chap. 4 Trade-offs; Public Good & Private Rights
06\21 Public Health information; Chap. 5
06\28 Health, Communication, & Behavior; Chap. 6 Freedom of Expression
07\5 Mid-Term Examination July 7, 2005
07\12 Immunization, Testing, & Screening; Chap. 7 Student Presentations TERM PAPERS DUE
07\19 Restrictions of the Person: Autonomy, Liberty, Chap. 8 & Bodily Integrity Student Presentations
07\26 Administrative Law & Economic Regulation; Chap. 9
08\02 Tort Law & the Public’s Health Chap. 10 Indirect Regulation Part III - The Future of Public Health Chap. 11 Student Presentations
08\8 Final Exam

COURSE OUTLINE - Expanded

Lecture Week 1 Chapter 1: Overview of Public Health Law; Course road map; A theory and definition of public health law; Distinctions between public health law and health care law; Five essential characteristics of public health law; Role & responsibilities of governments in the United States; Interplay between coercion and individual rights in public health law. Legal writing will also be covered.

Lecture Week 2 Chapter 2: Public Health in the Constitutional Design; the U.S. Legal System; U.S. Constitution; Federal statutes; State constitutions and statutes; Federalism and the Tenth Amendment; Separation of Powers doctrine; Commerce Clause & doctrine of preemption; the Police Power & the doctrine of parens patriae; Sovereign immunity-federal and state. Powers of local government and Dillon’s Rule.

Lecture Week 3 Chapter 3: Constitutional Limits on the Exercise of Public Health Powers; Safeguarding Individual Rights & Responsibilities; Due Process and Equal Protection of the law; Standards of judicial review-rational basis v. strict scrutiny; Protections against undue interference with personal liberty and conduct

Lecture Week 4Chapter 4: Public health Regulation; Trade-offs; Public Good & Private Rights

Justification for public health regulation (risk to others, self, & protection of incompetents);Understanding of risk; relative risk; Economic issues; Personal burdens of public health regulations; Fairness and equity issues; Concept of the Least Restrictive Alternative.

Lecture Week 5 Chapter 5 Public Health information; Gathering and analysis of information as core public health function; Public health surveillance (history, specific diseases); Reportable disease regulations; Partner notification; Limits to confidentiality of personal health information; Regulation of human subject research (IRBs, etc.); Ethical issues; Recent developments in federal adoption of medical privacy rules.

Lecture Week 6 Chapter 6: Health, Communication, & Behavior;. The First Amendment - Freedom of speech & the press; Health and safety disclosure requirements; Restrictions on commercial speech; advertising of tobacco and pharmaceuticals; governmentally subsidized speech and the “unconstitutional conditions” doctrine. TERM PAPERS DUE

Lecture Week 7 Mid-Term Examination

Lecture Week 8 Chapter 7: Immunization, Testing, & Screening; Control of communicable disease; compulsory immunization & examination; Americans with Disabilities Act issues; The 4th Amendment and Freedom from Unreasonable Search & Seizure; Warrant Requirements; Standards for & Exceptions to Warrant Requirements; Workplace genetic testing issues; Involuntary testing for drugs of abuse; Virginia Practices & Procedures; See; Camara; Marshall v. Barlow’s; Mosher Steel V. Teague.

Student Presentations

Lecture Week 9Chapter 8: Restrictions of the Person: Autonomy, Liberty, & Bodily Integrity

Law of quarantine; compulsory hospitalization and detention; Refusal of treatment; Assisted suicide; Criminal law and knowing exposure to infectious disease; the Law of AIDS; Control of Mental Illness; Civil Commitment of the mentally ill and sex offenders; the rights of the mentally ill; Emergency Commitments.

Student Presentations

Lecture Week 10Chapter 9: Public Health Law, Economic Regulation, & Administrative Law: Federal Administrative Procedures Act, 5 USC 553, et seq.: Promulgation of Regulations: Adjudication of Case Decisions: the Federal Register and Code of Regulations; NPRM Process; Participation in Regulatory Proceedings; Litigation of Validity of Regulations; Litigation of Administrative Case Decisions; Standards of Review; Virginia Administrative Process Act; the Virginia Register; Promulgation of Virginia Regulations.

Lecture Week 11 Chapter 10 Tort Law & the Public’s Health; Indirect Regulation.

The common law; Negligence (duty, breach of duty, causation, damages); Product Liability, Strict Liability; Nuisance; Law and Equity Courts; The tobacco, asbestos, Bendectin, firearms, and breast implant litigation. Frye, Daubert, Kumho. Chapter 11: Part III - The Future of Public Health

Student Presentations

Final Exam

GRADING:

First Exam 25%

Final Exam 35%

Term Paper 25%

Class Presentation 10%

Class participation & attendance 5 %

The term paper is to be: on a public health legal issue agreed upon by the student and professor.

handed in by July 12, 2005 8 to 10 pages in length, exclusive of appendices & References

Appendices not to exceed five pages

Organized as follows:

Cover page

Table of Contents

Summary or overview [1 page maximum]

Text of paper

Endnote citations (using standard Bluebook legal citation format)

Appendices, if appropriate & necessary

typed; double spaced; with pages numbered

Other Readings & References:

Science on Trial, The Clash of Medical Evidence & the Law in the Breast Implant Case; Marcia Angell, M.D.;W. W. Norton & Co.; New York; 1996
Breaking the Vicious Cycle; Toward Effective Risk Regulation; Stephen Breyer; Harvard University Press; 1993
Public Health Law Manual; F. P. Grad; 2nd Edn.; APHA; (1990).
Judging Science; Scientific Knowledge & the Federal Courts; Foster, K.R. & Huber, P.W.; MIT Press; 1999.

Some legal web sites:

Lexis at VCU: http://www.library.vcu.edu/resources.html

Web site of the Health law Section, Virginia State Bar: http://www.vsb.org/sections/hl/

American Bar Ass’n LawLink: http://www.abanet.org/lawlink/home.html

Virginia: Code: http://leg1.state.va.us/000/src.htm

Administrative Code http://leg1.state.va.us/000/srr.htm

Courts: http://www.courts.state.va.us/

Other:

FindLaw http://www.findlaw.com/casecode/

Federalist Soc. http://www.fed_soc.org/

Print Journals

Journal of Law, Medicine & Ethics