ABA Health eSource
 December 2007 Volume 4 Number 4

Chair's Column: Public Health
by Andrew J. Demetriou, Fulbright & Jaworski LLP, Los Angeles, CA

Andrew J. DemetriouFor most of us, issues of public health are remote from our professional interests. The lawyers who deal with public health primarily work for government agencies that are charged with a range of issues, including infection control and reporting, food safety, sanitation, health education programs and disease prevention. Except for the occasional interaction between the provider community and public health authorities in dealing with prevention of the spread of infectious disease, lawyers who do not practice in the public health field are not likely to encounter or appreciate the myriad of complex considerations that come into play in trying to ensure a level of public health that our society almost takes for granted. Nonetheless, the issues of public health affect all of us and I thought it would be important for you to understand what our Section is doing to engage the public health community and make our members more aware of the programs and needs of the public health system.

Under the leadership of our former Chair, Tony Patterson, our Section began a dialogue with the United States Centers for Disease Control in Atlanta. We have cooperated with programs of the CDC Public Health Law group on Public Health Policy Summits on issues such as pandemic preparedness, emergency care, and for 2008, obesity as a public health issue. The issues surrounding obesity are inordinately complex, starting with the fact that obesity itself is not typically regarded as a disease, and yet it is associated with conditions, such as Type II diabetes, COPD and other disorders of the heart and circulatory system, which in the aggregate consume as much as 50% of national healthcare expenditures. The range of matters that affect and influence obesity in our population range from agricultural subsidies to encourage corn production, transportation policies that discourage pedestrian travel, food processing techniques used to preserve and lower the cost of food products, school nutrition programs, federal food assistance grants and, inevitably, personal choice in the foods we choose to eat. As a member of the Planning Committee, I will be responsible for recommending potential authors and speakers to contribute to the Summit and I would appreciate knowing if any of you have interest in participation on this project.

Our positive engagement with the CDC's legal staff led to our decision to form the Public Health & Policy Interest Group, which now boasts over 150 members and is Chaired by Montrece Ransom of the CDC. This group has been a productive contributor to our publications and educational programs. In addition, our work with the CDC has resulted in our sponsorship of a Recommendation and Report on emergency preparedness that was approved by the ABA House of Delegates this past August in San Francisco.

We are presently working with the CDC on the issue of "Expedited Partner Therapy," or EPT. We are developing a recommendation and report for the ABA House of Delegates that will advocate laws that will authorize physicians to provide specified medications to patients with certain sexually transmitted infectious diseases to be made available to the patient's partner, without the necessity for an additional physician visit, in an effort to control the spread of the disease. Certain states authorize this practice, but in many others the law is unclear or even prohibits a physician from providing medications in the absence of contact between the physician and the recipient of the drugs. There are significant issues involving privacy, liability and professional standards raised by EPT, and we look forward to working with groups that have interests in these areas to forge a workable plan that will address a serious public health issue.

Our interest in public health issues is not limited to the United States. Under Paul DeMuro's leadership, we have established a relationship with the World Health Organization, which plays an important role in coordinating international response to potential pandemic situations. The WHO is grappling with very difficult problems around reporting of outbreaks by countries, travel restrictions, and the availability of medicines and infection control personnel to an affected area. Often political concerns and governmental priorities clash with medical and science-based public health response modes to an outbreak of infectious disease. Dr. Paul Gully of the WHO addressed a group of us at our Spring Council in Berlin this last May, and imparted a deeper appreciation of the ongoing work of the WHO in promoting global public health and developing tools to contain the transnational spread of contagion. These issues also enjoy a priority with the International Bar Association Committee on Health, for which Paul serves as our liaison.

I hope this column has helped familiarize you with our Section's work on public health matters. If you have additional interest in these topics contact Montrece or other leaders of the Public Health & Policy Interest Group.

I want to remind you that our annual Emerging Issues in Healthcare Conference is around the corner, February 20-22, 2008 in San Diego. Our Planning Committee has assembled a great program, all of our Interest Groups will be meeting and presenting lectures and this is a great forum for you to get to know fellow practitioners in a pleasant setting. I promise that the weather will be outstanding and there will be lots of activities to enjoy outside of the meetings. Please make plans to join us in San Diego!