1. Potemkin Plans: What are the ethical duties of planners asked to give false assurances? Edward P. Richards, JD MPH Program in Law, Science and Public Health LSU School of Law http://biotech.law.lsu.edu

2. Potemkin Village After Grigori Aleksandrovich Potemkin, who had elaborate fake villages constructed for Catherine the Great's tours of the Ukraine and the Crimea. After Grigori Aleksandrovich Potemkin, who had elaborate fake villages constructed for Catherine the Great's tours of the Ukraine and the Crimea. (Possibly just a good story, which I assumed, but this is what the dictionary says.) (Possibly just a good story, which I assumed, but this is what the dictionary says.)

3. Potemkin Plans Elaborate plans for public health emergency preparedness that cannot be carried out because of lack of staff, resources, political will, or competence, or any combination of the above. Elaborate plans for public health emergency preparedness that cannot be carried out because of lack of staff, resources, political will, or competence, or any combination of the above.

4. Is This a New Problem? Enemy of the People, Ibsen (1882) Enemy of the People, Ibsen (1882) Should be required reading in public health Should be required reading in public health Unsupportable plans are nothing new to government, or to public health Unsupportable plans are nothing new to government, or to public health Emergency preparedness is nothing new Emergency preparedness is nothing new

5. What is New: 9/11 Emergency preparedness becomes a national security issue Emergency preparedness becomes a national security issue National security means federal command and control National security means federal command and control The militarization of emergency response The militarization of emergency response Federal push down requiring elaborate plans on every crisis de jure, with federal programmatic funding depending on the right answers in the plan Federal push down requiring elaborate plans on every crisis de jure, with federal programmatic funding depending on the right answers in the plan

6. What Do These Plans Say? The plans have to address all the federal target issues and have to say that the state and localities are prepared to carry out the functions The plans have to address all the federal target issues and have to say that the state and localities are prepared to carry out the functions State legislators do the same to their own state and local governments State legislators do the same to their own state and local governments

7. What is the Structural Problem? National is the wrong level for emergency response National is the wrong level for emergency response All state and local public health, police, and other first responders are already committed about 110% All state and local public health, police, and other first responders are already committed about 110% There have been net cuts in most programs as emergency response has been added There have been net cuts in most programs as emergency response has been added Existing problems like crime and disease control do not go away during disasters Existing problems like crime and disease control do not go away during disasters

8. Why Does It Matter? It does not work It does not work We can argue about this, but it is the minor point We can argue about this, but it is the minor point It distorts risk communication and leaves communities at greater risk It distorts risk communication and leaves communities at greater risk

9. Katrina Examples The core problem is not fighting mother nature The core problem is not fighting mother nature If all the emergency prep had worked, not much would have changed If all the emergency prep had worked, not much would have changed What has changed? What has changed? We have lots more plans We have lots more plans They do not change anything about the risk They do not change anything about the risk They convince people that it is OK to go back and do the same thing They convince people that it is OK to go back and do the same thing

10. Where Does this Leave the Experts in the Agency? You know this will not work You know this will not work Do you speak up? Do you speak up? What happens if you do? What happens if you do? What is the long term impact on agencies and policy? What is the long term impact on agencies and policy? Is this like Vaclav Havel's work on being a write in the Communist block? Is this like Vaclav Havel's work on being a write in the Communist block? Should this be the #1 public health law ethics issue? Should this be the #1 public health law ethics issue?

11. Should we have mechanisms to let people speak out? Most state whistleblower laws do not work Most state whistleblower laws do not work What about hot lines like we use for fraud and abuse? What about hot lines like we use for fraud and abuse?