Our nation is on the cusp of momentous changes to the laws, policies, and procedures that shape governmental and private institutional power to protect the public’s health. The 2024 election, the Covid-19 pandemic, the reversal of longstanding precedents by the Supreme Court, and the collapse of deference to mainstream scientific consensus have created a legal and political environment suffused with uncertainty and distrust. Our polity is deeply divided on questions of what we owe each other as members of a shared society and what role government should play in creating the conditions required for people to be healthy. Public trust in science and public health plummeted in the aftermath of the pandemic. Important levers for reform will soon be in the hands of officials who have lobbed threats at public health leaders and peddled scientific disinformation on topics ranging from HIV transmission and vaccine safety to the cure-all effects of nutritional supplements.
In this time of rapid evolution, we offer a thoroughly updated and revised fourth edition of our book, Public Health Law and Ethics: Power, Duty, Restraint.
The first edition of this book, published in 2000, began with a modest question: why offer a book on public health law? So much has changed in the intervening quarter century. Interest in public health law has exploded. Simultaneously, public health ethics has become more firmly established as a field distinct from clinical bioethics. The science and practice of public health have reemerged from the shadows of high-technology, high-cost medicine. Growing ranks of public health law and ethics experts are pioneering innovative new strategies. A host of exciting new initiatives are under way to connect and support practitioners, advance research, and drive rigorous analysis of law as a tool for the public’s health. The “legal determinants of health” have been an important problem for public health law and practice. The science of social epidemiology—in its infancy when the first edition was published—is informing wide-ranging discussion of the devastating effects of subordination and resulting health disparities on our society.
The fourth edition defines the fields of public health law and ethics for a new generation. We articulate the scope and limits of governmental powers and duties to protect the public’s health. We critique the role of the courts in striking down democratically enacted laws. We delineate disputes between the federal government and state, local, territorial, and tribal authorities. We assess the pros and cons of swift executive action versus legislative reform. We build a case for why social justice must be prioritized as a core value of public health ethics and we defend this approach against accusations that it politicizes science. Our work is informed by careful analysis of public health legislation, regulations, judicial opinions, and scholarly research from multiple disciplines.
We cover today’s most pressing health issues, including chronic diseases, opioid overdoses, outbreaks of vaccine-preventable infectious diseases, gun violence, mental health, disability rights, sexual and reproductive health, and the benefits of racial and gender justice for public health. Our ideas are illustrated by concrete examples and real-world debates.
This foundational book offers a conceptual framework for ensuring public health interventions are based on sound scientific evidence and consistent with ethical values. These issues are now more critical than ever.
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