Current Legal and Ethical Controversies in American Health Care

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Presentation transcript:

Current Legal and Ethical Controversies in American Health Care Government Power to Protect and Promote the Public Health

Instructors Marshall B. Kapp, J.D., M.P.H. Leslie Beitsch, M.D., J.D. FSU College of Medicine

Distinguish Policy/Ethical v. Legal Questions Policy/Ethical Questions What’s a good idea? What should we do? Legal Questions What duty does govt. have to act? What power or authority does govt. have if it chooses to act? What are the limits on govt. power?

Govt. Duty to Act? Nothing in U.S. Constitution Federal, state, or local governments may voluntarily take on responsibilities. Therefore, the main inquiries are about govt. authority/power and limits.

Discussion Cases Ban on sale of large soft drinks in restaurants? Different from restrictions on tobacco sale? Use in public places? Different from restrictions on firearms sales and use? Different from restrictions on drug sales and use? Alcohol?

Government Power to Act Federal govt. (Enumerated Powers) Regulate interstate and foreign commerce Taxing and spending power Eminent domain power

State and local govts. Police power to protect and promote the general health, safety, welfare, and morals of the community. 10th Amendment. Parens patriae power to protect those who cannot protect themselves. 10th Amendment. Eminent domain

Limits on Government Power 14th Amendment Due Process Life Liberty Property/Economic rights Equal Protection Freedom of speech—1st Amendment Freedom of religion—1st Amendment Eminent Domain-Just Compensation

Balancing Act: Govt Power v. Limits Rational relationship test—A legitimate reason and rational relationship between means and ends Strict scrutiny test—A compelling reason and a necessary relationship between means and ends Intermediate scrutiny test

More Examples Children’s vaccinations Adult vaccinations Health care providers Citizens Travel restrictions Social mixing restrictions Isolation and Quarantine Other initiatives?