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With lessons learned from COVID-19, a world-leading expert on pandemic preparedness proposes a pragmatic plan urgently needed for the future of global health security. The COVID-19 pandemic revealed how unprepared the world was for such an event, as even the most sophisticated public health systems failed to cope. We must have far more investment and preparation, along with better detection, warning, and coordination within and across national boundaries. In an age of global pandemics, no country can achieve public health on its own. Health security planning is paramount. Lawrence O. Gostin has spent three decades designing resilient health systems and governance that take account of our interconnected world, as a close advisor to the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), and many public health agencies globally. Global Health Security addresses the borderless dangers societies now face, including infectious diseases and bioterrorism, and examines the political, environmental, and socioeconomic factors exacerbating these threats. Weak governance, ineffective health systems, and lack of preparedness are key sources of risk, and all of them came to the fore during the COVID-19 crisis, even-sometimes especially-in wealthy countries like the United States. But the solution is not just to improve national health policy, which can only react after the threat is realized at home. Gostin further proposes robust international institutions, tools for effective cross-border risk communication and action, and research programs targeting the global dimension of public health. Creating these systems will require not only sustained financial investment but also shared values of cooperation, collective responsibility, and equity. Gostin has witnessed the triumph of these values in national and international forums and has a clear plan to tackle the challenges ahead. Global Health Security therefore offers pragmatic solutions that address the failures of the recent past, while looking toward what we know is coming. Nothing could be more important to the future health of nations.
Now revised and expanded to cover today's most pressing health threats, "Public Health Law and Ethics "probes the legal and ethical issues at the heart of public health through an incisive selection of government reports, scholarly articles, and relevant court cases. Companion to the internationally acclaimed text "Public Health Law: Power, Duty, Restraint, "this reader can also be used as a stand-alone resource for students, practitioners, scholars, and teachers. It encompasses global issues that have changed the shape of public health in recent years including anthrax, SARS, pandemic flu, biosecurity, emergency preparedness, and the transition from infectious to chronic diseases caused by lifestyle changes in eating and physical activity. In addition to covering these new arenas, it includes discussion of classic legal and ethical tensions inherent to public health practice, such as how best to balance the police power of the state with individual autonomy.
The international community has made great progress in improving global health. But staggering health inequalities between rich and poor still remain, raising fundamental questions of social justice. In a book that systematically defines the burgeoning field of global health law, Lawrence Gostin drives home the need for effective global governance for health and offers a blueprint for reform, based on the principle that the opportunity to live a healthy life is a basic human right. Gostin shows how critical it is for institutions and international agreements to focus not only on illness but also on the essential conditions that enable people to stay healthy throughout their lifespan: nutrition, clean water, mosquito control, and tobacco reduction. Policies that shape agriculture, trade, and the environment have long-term impacts on health, and Gostin proposes major reforms of global health institutions and governments to ensure better coordination, more transparency, and accountability. He illustrates the power of global health law with case studies on AIDS, influenza, tobacco, and health worker migration. Today's pressing health needs worldwide are a problem not only for the medical profession but also for all concerned citizens. Designed with the beginning student, advanced researcher, and informed public in mind, Global Health Law" will be a foundational resource for teaching, advocacy, and public discourse in global health.
"Biosecurity" comprehensively analyzes the dramatic transformations
that are reshaping how the international community addresses
biological weapons and infectious diseases.
Lawrence O. Gostin's seminal Public Health Law is widely acclaimed as the definitive statement on public health law at the turn of the twenty-first century. In this bold third edition, Gostin is joined by Lindsay F. Wiley to analyze major health threats of our time such as chronic diseases, emerging infectious diseases, antimicrobial resistance, bioterrorism, natural disasters, opiod overdose, and gun violence. The authors draw on constitutional law, administrative law, local government law, and tort law to develop their conception of law as a tool for protecting the public's health. The book creates an intellectual framework for modern public health law and supports that framework with illustrations of the scientific, political, and ethical issues involved. In proposing innovative solutions for the future of the public's health, Gostin and Wiley's essential study provides a blueprint for public and political debates to come. New issues covered in this edition: corporate personhood rights raised in response to regulations of tobacco, food and beverages, alcohol, firearms, prescription drugs, and marijuana; local government authority to protect the public's health; deregulation and harm reduction as modes of public health law intervention; taxation, spending, and alteration of the socioeconomic environment as modes of public health law intervention; access to health care as a strategy for protecting the public's health; taxation, spending, licensing, zoning, and shared-use strategies for chronic disease prevention; the public health law perspective on violence and injury prevention; and health justice as a framework for reducing health disparities and protecting the public's health.
Human rights are essential to global health, yet rising threats in an increasingly divided world are challenging the progressive evolution of health-related human rights. It is necessary to empower a new generation of scholars, advocates, and practitioners to sustain the global commitment to universal rights in public health. Looking to the next generation to face the struggles ahead, this book provides a detailed understanding of the evolving relationship between global health and human rights, laying a human rights foundation for the advancement of transformative health policies, programs, and practices. International human rights law has been repeatedly shown to advance health and wellbeing - empowering communities and fostering accountability for realizing the highest attainable standard of health. This book provides a compelling examination of international human rights as essential for advancing public health. It demonstrates how human rights strengthens human autonomy and dignity, while placing clear responsibilities on government to safeguard the public's health and safety. Bringing together leading academics in the field of health and human rights, this volume: (1) explains the norms and principles that define the field, (2) examines the methods and tools for implementing human rights to promote health, (3) applies essential human rights to leading public health threats, and (4) analyzes rising human rights challenges in a rapidly globalizing world. This foundational text shows why interdisciplinary scholarship and action are essential for health-related human rights, placing human rights at the center of public health and securing a future of global health with justice.
In this collection of essays, Lawrence O. Gostin, an internationally recognized scholar of AIDS law and policy, confronts the most pressing and controversial issues surrounding AIDS in America and around the world. He shows how HIV/AIDS affects the entire population - infected and uninfected - by influencing our social norms, our economy, and our country's role as a world leader. Now in the third decade of this pandemic, the nation and the world still fail to respond to the needs of persons living with HIV/AIDS and continue to tolerate injustice in their treatment, Gostin argues. AIDS, both in the United States and globally, deeply affects poor and marginalized populations, and many U.S. policies are based on conservative moral values rather than public health and social justice concerns. Gostin tackles the hard social, legal, political, and ethical issues of the HIV/AIDS pandemic: privacy and discrimination, travel and immigration, clinical trials and drug pricing, exclusion of HIV-infected health care workers, testing and treatment of pregnant women and infants, and needle-exchange programs. This book provides an inside account of AIDS policy debates together with incisive commentary. It is indispensable reading for advocates, scholars, health professionals, lawyers, and the concerned public.
..". glimpses of intriguing changes in social arrangements and cultural understandings in relation to surrogacy. Disturbing motherhood indeed." New Scientist "Larry Gostin has put together the definitive collection of essays on one of the most perplexing and titillating topics in contemporary medical ethics. This book includes contributions from some of the leading scholars on the legal, ethical, and social aspects of surrogacy, as well as several critical perspectives on the famous Baby M case must reading for understanding the surrogate motherhood controversy." Robert M. Veatch "Highly recommended... " Choice ..". a valuable resource for those concerned with an exceedingly difficult ethical, legal, and political problem." Ethics "There is a wealth of information here on the current status questionis in the United States, and anyone involved in the surrogacy debate, in the U.S. or otherwise, will find working through this material very worthwhile." Canadian Philosophical Review ..". an excellent sample of some of the best and most varied thinking so far on the numerous conceptual, moral, social, and policy questions raised by contract motherhood." The Journal of Clinical Ethics"
This innovative casebook explores and integrates the legal and policy aspects of health care financing/delivery, and of public health. In a readily teachable format, the casebook delivers a critical analysis of the design and governance of the American health care and public health systems. The casebook provides comprehensive coverage of the organization, financing, and delivery of the individual health care and population/public health systems. It also explores the deep interconnections between these two systems and the critical role of the Affordable Care Act in shaping future legal oversight. The book thus challenges students to think about how the legal doctrine governing both systems has developed over time, and how it should evolve going forward. It represents the most up-to-date and systematic coverage of the health system in the new era of the Affordable Care Act and does so in a highly accessible and engaging pedagogic style.
Catastrophic disasters occurring in 2011 in the United States and worldwide-from the tornado in Joplin, Missouri, to the earthquake and tsunami in Japan, to the earthquake in New Zealand-have demonstrated that even prepared communities can be overwhelmed. In 2009, at the height of the influenza A (H1N1) pandemic, the Assistant Secretary for Preparedness and Response at the Department of Health and Human Services, along with the Department of Veterans Affairs and the National Highway Traffic Safety Administration, asked the Institute of Medicine (IOM) to convene a committee of experts to develop national guidance for use by state and local public health officials and health-sector agencies and institutions in establishing and implementing standards of care that should apply in disaster situations-both naturally occurring and man-made-under conditions of scarce resources. Building on the work of phase one (which is described in IOM's 2009 letter report, Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations), the committee developed detailed templates enumerating the functions and tasks of the key stakeholder groups involved in crisis standards of care (CSC) planning, implementation, and public engagement-state and local governments, emergency medical services (EMS), hospitals and acute care facilities, and out-of-hospital and alternate care systems. Crisis Standards of Care provides a framework for a systems approach to the development and implementation of CSC plans, and addresses the legal issues and the ethical, palliative care, and mental health issues that agencies and organizations at each level of a disaster response should address. Please note: this report is not intended to be a detailed guide to emergency preparedness or disaster response. What is described in this report is an extrapolation of existing incident management practices and principles. Crisis Standards of Care is a seven-volume set: Volume 1 provides an overview; Volume 2 pertains to state and local governments; Volume 3 pertains to emergency medical services; Volume 4 pertains to hospitals and acute care facilities; Volume 5 pertains to out-of-hospital care and alternate care systems; Volume 6 contains a public engagement toolkit; and Volume 7 contains appendixes with additional resources. Table of Contents Front Matter Volume 1--Introduction and CSC Framework Volume 2--State and Local Government Volume 3--EMS Volume 4--Hospital Volume 5--Alternate Care Systems Volume 6--Public Engagement Volume 7--Appendixes
Gene transfer research is a rapidly advancing field that involves the introduction of a genetic sequence into a human subject for research or diagnostic purposes. Clinical gene transfer trials are subject to regulation by the U.S. Food and Drug Administration (FDA) at the federal level and to oversight by institutional review boards (IRBs) and institutional biosafety committees (IBCs) at the local level before human subjects can be enrolled. In addition, at present all researchers and institutions funded by the National Institutes of Health (NIH) are required by NIH guidelines to submit human gene transfer protocols for advisory review by the NIH Recombinant DNA Advisory Committee (RAC). Some protocols are then selected for individual review and public discussion. Oversight and Review of Clinical Gene Transfer Protocols provides an assessment of the state of existing gene transfer science and the current regulatory and policy context under which research is investigated. This report assesses whether the current oversight of individual gene transfer protocols by the RAC continues to be necessary and offers recommendations concerning the criteria the NIH should employ to determine whether individual protocols should receive public review. The focus of this report is on the standards the RAC and NIH should use in exercising its oversight function. Oversight and Review of Clinical Gene Transfer Protocols will assist not only the RAC, but also research institutions and the general public with respect to utilizing and improving existing oversight processes. Table of Contents Front Matter Summary 1 Introduction 2 Gene Transfer Research: The Evolution of the Clinical Science 3 Oversight of Gene Transfer Research 4 Evolution of Oversight of Emerging Clinical Research Appendix A: Data Sources and Methods Appendix B: Historical and Policy Timelines for Recombinant DNA Technology Appendix C: Committee Biographies
The adulteration and fraudulent manufacture of medicines is an old problem, vastly aggravated by modern manufacturing and trade. In the last decade, impotent antimicrobial drugs have compromised the treatment of many deadly diseases in poor countries. More recently, negligent production at a Massachusetts compounding pharmacy sickened hundreds of Americans. While the national drugs regulatory authority (hereafter, the regulatory authority) is responsible for the safety of a country's drug supply, no single country can entirely guarantee this today. The once common use of the term counterfeit to describe any drug that is not what it claims to be is at the heart of the argument. In a narrow, legal sense a counterfeit drug is one that infringes on a registered trademark. The lay meaning is much broader, including any drug made with intentional deceit. Some generic drug companies and civil society groups object to calling bad medicines counterfeit, seeing it as the deliberate conflation of public health and intellectual property concerns. Countering the Problem of Falsified and Substandard Drugs accepts the narrow meaning of counterfeit, and, because the nuances of trademark infringement must be dealt with by courts, case by case, the report does not discuss the problem of counterfeit medicines.
The influenza pandemic caused by the 2009 H1N1 virus underscores the immediate and critical need to prepare for a public health emergency in which thousands, tens of thousands, or even hundreds of thousands of people suddenly seek and require medical care in communities across the United States. "Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations" draws from a broad spectrum of expertise--including state and local public health, emergency medicine and response, primary care, nursing, palliative care, ethics, the law, behavioral health, and risk communication--to offer guidance toward establishing standards of care that should apply to disaster situations, both naturally occurring and man-made, under conditions in which resources are scarce. This book explores two case studies that illustrate the application of the guidance and principles laid out in the report. One scenario focuses on a gradual-onset pandemic flu. The other scenario focuses on an earthquake and the particular issues that would arise during a no-notice event. Outlining current concepts and offering guidance, this book will prove an asset to state and local public health officials, health care facilities, and professionals in the development of systematic and comprehensive policies and protocols for standards of care in disasters when resources are scarce. In addition, the extensive operations section of the book provides guidance to clinicians, health care institutions, and state and local public health officials for how crisis standards of care should be implemented in a disaster situation.
In the past 30 years, the population of prisoners in the United States has expanded almost 5-fold, correctional facilities are increasingly overcrowded, and more of the country's disadvantaged populations—racial minorities, women, people with mental illness, and people with communicable diseases such as HIV/AIDS, hepatitis C, and tuberculosis—are under correctional supervision. Because prisoners face restrictions on liberty and autonomy, have limited privacy, and often receive inadequate health care, they require specific protections when involved in research, particularly in today's correctional settings. Given these issues, the Department of Health and Human Services' Office for Human Research Protections commissioned the Institute of Medicine to review the ethical considerations regarding research involving prisoners. The resulting analysis contained in this book, Ethical Considerations for Research Involving Prisoners, emphasizes five broad actions to provide prisoners involved in research with critically important protections: * expand the definition of "prisoner"; * ensure universally and consistently applied standards of protection; * shift from a category-based to a risk-benefit approach to research review; * update the ethical framework to include collaborative responsibility; and * enhance systematic oversight of research involving prisoners.
Advancing the Human Right to Health offers a prospective on the global response to one of the greatest moral, legal, and public health challenges of the 21st century - achieving the human right to health as enshrined in the Universal Declaration of Human Rights (UDHR) and other legal instruments. Featuring writings by global thought-leaders in the world of health human rights, the book brings clarity to many of the complex clinical, ethical, economic, legal, and socio-cultural questions raised by injury, disease, and deeper determinants of health, such as poverty. Much more than a primer on the right to health, this book features an examination of profound inequalities in health, which have resulted in millions of people condemned to unnecessary suffering and hastened deaths. In so doing, it provides a thoughtful account of the right to health's parameters, strategies on ways in which to achieve it, and discussion of why it is so essential in a 21st century context. Country-specific case studies provide context for analysing the right to health and assessing whether, and to what extent, this right has influenced critical decision-making that makes a difference in people's lives. Thematic chapters also look at the specific challenges involved in translating the right to health into action. Advancing the Human Right to Health highlights the urgency to build upon the progress made in securing the right to health for all, offering a timely reminder that all stakeholders must redouble their efforts to advance the human right to health.
Since public health seeks to protect the health of populations, it inevitably confronts a range of ethical challenges having to do primarily with the friction between individual freedoms and what might be perceived as governmental paternalism. This volume brings together twenty-five articles by leading thinkers in the field, writing on topics that concern both classic and novel problems. They open up new terrain in each area, including tobacco and drug control, infectious disease, environmental and occupational health, the effect of new genetics on the publics health, and the impact of social inequalities on patterns of morbidity and mortality. The volume editors offer a context for discussion with introductory essays for each of the books five sections.
This volume brings together two important contemporary social movements: human rights and disability rights. It analyses the global struggle to realize equality, dignity, and comprehensive human and civil rights for persons with intellectual disabilities. In 20 chapters, contributors from a range of disciplines address the latest international developments in the field. These include international human rights standards and other sources of legal protection, nondiscrimination laws and the economics of equality, preventative technology, remediation and habilitation, and lifestyle chices and autonomy. The volume specifically considers the human rights of persons with intellectual disabilities from an international perspective. It identifies recent internatinal advances in their human rights and public policy positions, in addition to making recommendations for further advances at both the national and international levels.
Historically, the fields of public health and human rights have remained largely separate. The AIDS pandemic, however, made it clear that a complex relationship exists between the two fields. Women and children have proven to be extremely vulnerable to infection with HIV due to their inability to protect themselves in intimate relationships, their sexual exploitation, and their lack of economic and educational alternatives. On the other hand, coercive government policies aimed at controlling the AIDS pandemic often infringe on the rights of individuals known or suspected of having AIDS, and decrease the effectiveness of public health measures. Protecting and promoting human rights is becoming one of the key means of preserving the health of individuals and populations. A penetrating analysis of the close relationship between public health and human rights, this book makes a compelling case for synergy between the two fields. Using the AIDS pandemic as a lens, the authors demonstrate that human health cannot be maintained without respect for the dignity and rights of persons, and that human rights cannot be deemed adequate and comprehensive without ensuring the health of individuals and populations. In the course of their analysis, Gostin and Lazzarini tackle some of the most vexing issues of our time, including the universality of human rights and the counter-claims of cultural relativity. Taking a cue from environmental impact assessments, they propose a human rights impact assessment for examining health policies. Such a tool will be invaluable for evaluating real-world public health problems and is bound to become essential for teaching human rights in schools of public health, medicine, government, and law. The volume critically examines such issues as HIV testing, screening, partner notification, isolation, quarantine, and criminalization of persons with HIV/AIDS, all within the framework of international human rights law. The authors evaluate the public health effects of a wide range of AIDS policies in developed as well as developing countries. The role of women in society receives special emphasis. Finally, the book presents three case histories that are important in the HIV/AIDS pandemic: discrimination and the transmission of HIV and tuberculosis in an occupational health care setting; breast feeding in the least developed countries; and confidentiality and the right of sexual partners to know of potential exposure to HIV. The cases challenge readers with some of the complex questions facing policy-makers, scientists, and public health professionals, and exemplify a method for analysing these problems from a human rights perspective. Gostin and Lazzarini have written a book that will be a valuable addition to the libraries of public health teachers and practitioners, legal scholars, bioethicists, policy makers, and public rights activists.
Public Health Law and Ethics: A Reader, 3rd Edition probes the legal and ethical issues at the heart of public health through an incisive selection of judicial opinions, scholarly articles, and government reports. Crafted to be accessible to students while thorough enough for use by practitioners, policy makers, scholars, and teachers alike, the reader can be used as a stand-alone resource or alongside the internationally acclaimed Public Health Law: Power, Duty, Restraint, 3rd Edition. This updated edition reader includes new discussions of today's most pressing health threats, such as chronic diseases, emerging infectious diseases, antimicrobial resistance, biosecurity, opioid overdose, gun violence, and health disparities.
Institutions matter for the advancement of human rights in global health. Given the dramatic development of human rights under international law and the parallel proliferation of global institutions for public health, there arises an imperative to understand the implementation of human rights through global health governance. This volume examines the evolving relationship between human rights, global governance, and public health, studying an expansive set of health challenges through a multi-sectoral array of global organizations. To analyze the structural determinants of rights-based governance, the organizations in this volume include those international bureaucracies that implement human rights in ways that influence public health in a globalizing world. This volume brings together leading health and human rights scholars and practitioners from academia, non-governmental organizations, and the United Nations system. They explore the foundations of human rights as a normative framework for global health governance, the mandate of the World Health Organization to pursue a human rights-based approach to health, the role of inter-governmental organizations across a range of health-related human rights, the influence of rights-based economic governance on public health, and the focus on global health among institutions of human rights governance. Contributing chapters each map the distinct human rights efforts within a specific institution of global governance for health. Through the comparative institutional analysis in this volume, the contributing authors examine institutional dynamics to operationalize human rights in organizational policies, programs, and practices and assess institutional factors that facilitate or inhibit human rights mainstreaming for global health advancement.
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