This article summarizes public health legal issues that need to be considered in preparing for and responding to nuclear detonation. Laws at the federal, state, territorial, local, tribal, and community levels can have a significant impact on the response to an emergency involving a nuclear detonation and the allocation of scarce resources for affected populations. An understanding of the breadth of these laws, the application of federal, state, and local law, and how each may change in an emergency, is critical to an effective response. Laws can vary from 1 geographic area to the next and may vary in an emergency, affording waivers or other extraordinary actions under federal, state, or local emergency powers. Public health legal requirements that are commonly of concern and should be examined for flexibility, reciprocity, and emergency exceptions include liability protections for providers; licensing and credentialing of providers; consent and privacy protections for patients; occupational safety and employment protections for providers; procedures for obtaining and distributing medical countermeasures and supplies; property use, condemnation, and protection; restrictions on movement of individuals in an emergency area; law enforcement; and reimbursement for care.
(Disaster Med Public Health Preparedness. 2011;5:S65-S72)
(Received September 20 2010)
(Accepted January 20 2011)
(Corrected March 25 2011)
Correspondence: Address correspondence and reprint requests to Susan E. Sherman, Office of the General Counsel, US Department of Health and Human Services, 200 Independence Ave SW, Room 7A22, Washington, DC 20201 (e-mail: Susan.Sherman@hhs.gov).
Author Affiliation: Ms Sherman is with the Office of the General Counsel, US Department of Health and Human Services.
The US Department of Health and Human Services (DHHS) provided funding to support this publication and convene the authors. The contents of the articles represent the personal views of the individual authors and do not necessarily express the opinion or policy of DHHS or its components. No statement in the articles should be construed as an official position of DHHS or its components.