Discuss the Difference Between a “Declaration of a State of Emergency” & a “Declaration of a Public Health Emergency


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What is the purpose of the new International Health Regulations


I. Short Answers:

The State’s police power gives public health officers authority to take certain actions regarding persons who have serious infectious diseases and pose a danger to the public health. List 4 of these actions:




4. _________________________________________________________________________


What are reporting laws and why are they important to public health protection? What public health activity do they support?




List three examples of reporting laws:





What is the purpose of the new International Health Regulations, how do they differ from the previous regulations and why are they important today?




Discuss the difference between a “declaration of a state of emergency” and a “declaration of a public health emergency.” Give an example of each.




What is the holding in the case of Jacobson v. Massachusetts, 197 US 11 (1905) and why is it a landmark case in public health law?




II. Circle the key principle of law applicable to or invoked in the specific situation.

1. A novel, highly contagious influenza has been identified in the United States and is spreading quickly. The mortality rate is very disturbing. The Secretary of Health and Human services has signed a declaration mobilizing the Public Health Service Corps, suspending some Medicare and Medicaid requirements and providing emergency approvals for the use of unapproved or experimental drugs. The Secretary has declared what:

a. A public health emergency

b. A state of emergency

c. An outbreak


2. The South Carolina Supreme Court held that state statutory laws limiting smoking did not prevent local governments from implementing ordinances banning smoking in restaurants and bars. This ruling involved the principle of:

a. Free speech

b. Preemption

c. Public health emergency


3. State health inspectors conduct a routine inspection of a hospital and find regulatory violations. The department imposes a $10,000 fine. The hospital corrects the violations and pays the fine. This is an example of which of the following remedies:

a. Civil sanction

b. Injunction

c. Criminal sanction


4. The state Department of Health and Environmental Control works closely with the federal Environmental Protection Agency to enforce the Clean Air Act in South Carolina. This is an example of:

a. Tort

b. Federalism

c. Stare decisis


5. Upon receiving a complaint, state health inspectors investigate and find an industrial plant is discharging untreated waste into a river. The inspectors file a petition in court asking the court to order the plant to stop immediately. The inspectors are seeking what?

a. Civil sanctions

b. Injunction

c. Criminal sanctions


6. A doctor diagnoses a patient with H1N1 influenza and, as required by law, reports the case to the health department. This is an example of which of the following activities:

a. Surveillance

b. Quarantine

c. Least Restrictive Alternative


7. Which of the following is NOT an element of a crime?

a. Mens rea

b. Actus reus

c. Posse comitatus


8. A patient has active tuberculosis and much difficulty complying with his treatment regimen. The public health officer explains that if the patient does not comply, he will petition the court for an Isolation Order. The patient agrees to take his medications in accordance with a set schedule under the supervision of a public health nurse, and therefore, the public health officer decides not seek an Isolation Order at this time. What principle is the public health officer applying in making that decision?

a. Precedent

b. Least restrictive alternative

c. Legal immunity


9.A federal district court judge (trial judge) has heard a case and must issue a ruling. The facts of the case are identical or very similar to past decisions issued by the US Supreme Court. Although he disagrees with those holdings, he is bound by the prior decisions. Which one of these principles does this situation NOT involve?

a. Precedent

b. Stare decisis

c. Ex parte communications


10. During the 2003 SARS epidemic, Toronto health officials asked certain health care workers who had been exposed to SARS but showed no signs of infection to agree voluntarily to work in certain hospital units while wearing personal protective equipment. These workers participated in what:

a. Isolation

b. Working quarantine

c. Cordon sanitaire


11. This U.S. Supreme Court case affirmed the legality of public health reporting laws. The court found the individual’s concern for privacy did not outweigh the need for reporting such information to the State in order to protect the public health. The Court also held that the State must use reasonable measures to protect and keep the information secure.

a. Ferguson v. City of Charleston

b. Jacobsen v. Massachusetts

c. Whalen v. Roe


12. CDC has exercised these powers to prevent the spread of communicable diseases by banning the importation into the United States of African rodents (2003, monkeypox), civet cats (2004, SARS) and birds from Southeast Asia (2004, avian influenza).

a. Federal quarantine

b. Human rights

c. Interstate commerce


13. Under the authority of this provision in the US Constitution, the federal government oversees such health-related activities as the licensing and regulation of drugs, biologic products and medical devices.

a. Federal quarantine

b. Congress’ power to tax and spend

c. Interstate commerce clause


14. The private health care sector focuses upon the health of individuals. The public health sector focuses upon the health of whom?

a. Only those who waive their constitutional rights

b. Only those who can afford to pay for care

c. Populations


15. Throughout its history, the State of South Carolina has enacted many laws to protect the public health. Its authority to enact and enforce these laws is derived from what?

a. International health regulations

b. Federal statutes

c. Police Power


16. Literally a “sanitary cord” which, by tradition, is placed by health authorities around an infected area to control, restrict or prohibit the movement of persons and articles into or out of a location where a contagious disease exists.

a. Interstate commerce

b. Cordon sanitaire

c. Shelter in place


17. A modern concept to decrease the level of personal exposure in a community by asking individuals to remain in their homes, schools or work locations while a chemical, radiologic or biologic threat exists. This sometimes is referred to as a “snow day.”

a. Interstate commerce

b. Cordon sanitaire

c. Shelter in place


III.  Who was Mary Mallon? What name did the press create for her? What principles of pubic health law were relevant to her experience? How would they be applied differently today? Discuss the balance of power between public health protection and individual rights.




IV. How can law become a barrier to public health goals? Give an example.




Bonus Question:

Why is it important for public health officers and private health care administrators to study public health law?




Matching Terms for Part I

A. the residual power held by the states to enact legislation and regulations to protect the public health, welfare and morals and to promote the common good

B. a written agreement between countries, the obligations of which are binding under international law

C. a court order requiring an actor to stop a defined activity that may be prohibited by law or to follow certain prescribed actions to comply with applicable law

D. the body of law created by administrative agencies through rules, regulations, orders and procedures designed to further legislatively enacted policy goals

E. the first ten amendments to the U.S. Constitution

F. the legal effect that results when a superior governmental unit blocks an inferior governmental unit from regulating a particular area. The rationale of this is to provide national uniformity in certain areas.

G. law that generally prohibits the use of the military for law enforcement purposes

H. a view that an intrusion by a regulatory authority into an individual liberty should be limited and reasonable

I. the allocation of responsibility to demonstrate that a matter alleged in a court is factually true and to the level of confidence in the allegation required in that particular setting (includes preponderance of evidence, clear and convincing evidence and beyond a reasonable doubt)

J. the system of government in the United States that is based on the concept of dual sovereignty between the states and the federal government

K. the process of carrying on a lawsuit or the lawsuit itself

L. judge made law that is modified case by case over generations

M. the rules that regulate the relationships among sovereign states and other actors, such as international organizations and individuals, in the international system

N. fundamental protection provided by a clause in the U.S. Constitution, or comparable clause in a state constitution, that requires government officials and their agents to follow fair and even-handed procedures when enforcing laws

O. fundamental protection provided by a clause of the U.S. Constitution that ensures that a law’s overall effect on an individual’s fundamental rights, such as the right to procreate and the right to marry, is justified or justifiable

P. the separation, for the period of communicability, of known infected persons in such places and under such conditions as to prevent or limit the transmission of the infectious agent

Q. the restriction of the activities of healthy persons who have been exposed to a communicable disease, during its period of communicability, to prevent disease transmission during the incubation period if infection should occur

R. in constitutional law, the government’s actual or effective acquisition of private property either by ousting the owner and claiming title or by destroying the property or severely impairing its utility

S. a civil wrong in which the victim suffers injury to his or her person or damage to his or her property as a result of intentional, negligent, or abnormally dangerous conduct of the injuring party

T. established as an exercise of the state’s police power, these systems are designed for the reporting of diseases and conditions of public health interest by health-care professionals and laboratories to public health agencies in order to detect, track and address the incidence and prevalence of disease in the population

U. an agreement between two or more parties creating obligations that are enforceable or otherwise recognisable at law

V. court produced bodies of legal opinions that guide the application of the law

W. a state legislative provision or action allocating a measure of autonomy to ensure to a local government, conditional on its acceptance of terms

X. the failure to do something that a reasonable person, guided by the considerations that normally regulate human affairs, would do, or the doing of something that a reasonable person would not do

Y. a statutorily structured process by which persons with qualifying conditions are legally confined within a designated facility either because they pose a danger to themselves or to protect the safety of others

Z. rules that are subject to the enforcement power of a government entity. It includes the structures, norms and rules that a society uses to resolve disputes, govern itself, and order relations between members of society

AA. an activity that unreasonably interferes with the public’s use and enjoyment of a public place or that harms the health, safety, and welfare of the community

BB. official source for federal regulations implementing U.S. congressional statutes

CC. a legal doctrine requiring that past judicial decisions generally guide courts in deciding identical, similar or analogous issues

DD. the necessity, based on the Fourth Amendment of the US Constitution, for law enforcement officials to obtain a warrant to search private property

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