Book Review

Law in Public Health Practice

N Engl J Med 2007; 356:2436-2437June 7, 2007

Article

Law in Public Health Practice
Second edition. Edited by Richard A. Goodman, Richard E. Hoffman, Wilfredo Lopez, Gene W. Matthews, Mark A. Rothstein, and Karen L. Foster. 570 pp. New York, Oxford University Press, 2007. $59.95. ISBN: 978-0-19-530148-9

Once upon a time there was a great body of law with vast dormant powers. That law, the police power in public health, has been quietly used by administrators and policymakers alike as a tool for protecting the public health with little fanfare and great humility, starting with the Supreme Court case of Jacobsen v. Massachusetts in 1905. By the late 20th century, a well-established ethos of public health practice did not recognize the inextricable link between the law and the administration of public health that has served so many vulnerable populations in the United States and worldwide. Yet the overarching importance of the law of public health needs no new authority to bolster its force — it is a power that during emergencies or in time of quarantine can overtake a host of civil liberties and traditional patterns of interstate commerce on a state, federal, international, or even municipal level.

The new collection of thoughtful essays in Law in Public Health Practice provides a clear, focused snapshot of the state of the art in public health law for practitioners in the first decade of the 21st century. The very dense text reflects the wisdom of several leaders in health law in New York City, including Wilfredo Lopez, general counsel for health at the New York City Department of Health, and Frank P. Grad of Columbia University, author of the prestigious book Public Health Law Manual, now in its third edition (Washington, DC: American Public Health Association, 2004). The editors of the book also had the courage to embrace new frontiers in public health law, such as the International Health Regulations developed by the World Health Organization (WHO). The stellar team of legal minds and medical practitioners assembled to summarize the current thinking in public health law pursue their illusive task as one might attempt to catch a wave on the sand — in the past several years, following the events of September 11, 2001, and the aftermath of natural disasters such as Hurricane Katrina, certain areas of public health law have come to the fore, including civilian protection against bioterrorism and emergency preparedness. As noted in the first chapters, the major achievements of public health in the 20th century included the conquest of lethal communicable diseases, the control of smoking and the use of tobacco, and improvements in motor-vehicle safety. In the 21st century, the focus shifts to the use of the law as the superstructure in a variety of settings, with regulation and litigation the weapons in the practitioner's arsenal.

One consequence of expanded popular awareness of public health law, following recent pandemics and environmental emergencies, is the need to redefine the roles of states, municipalities, and nations under the principles of federalism. In this sense, the editors of the book have erred on the side of caution by allowing the repetition of major themes regarding federalism in several essays.

The outstanding chapter by David P. Fidler and Martin S. Cetron, “International Considerations,” makes a pathbreaking effort to “remedy the neglect of international considerations in the analysis of U.S. public health law,” acknowledging the growing influence of globalization and international law. Departing from recent history, when, as Fidler and Cetron write, “international health diplomacy lost its grounding in U.S. self-interest,” the new International Health Regulations put forward by the WHO embrace the incorporation of human rights principles, acknowledging the need “to balance effective responses to disease risks” with respect for fundamental individual freedoms. The regulations are mindful of restrictions on trade in the General Agreement on Tariffs and Trade that are intended to protect human health and of the U.S. obligation to prevent the exportation of public health threats.

The collective efforts of the editors and authors of this book give renewed vigor to the proposition that around the world, across cultures, and in every generation, public health law is a vibrant requisite of survival — not only for individuals but for all civilization.

Ilise L. Feitshans, J.D., Sc.M.
International Health Law Programs, Digital 2000 Productions, Stafford, TX 77477
ilise@prodigy.net