Legal Advisors:
Information for Radiation Emergencies
General Comments
- Legal issues for medical planning and response to a mass casualty radiation incident will vary with
- Nature, severity, cause, and location of the radiation incident
- Agency through which the responder is operating and its own rules and regulations
- Professional capacity of the responder
- Training and certification of the responder
- Normal scope of practice of the responder
- "Normal" or "altered standard of care" (e.g. Crisis) existing during the response where the responder is working
- Activity performed or not performed
- Medical practice, standards of care, and liability issues are complex and each practitioner should consult with experts in his/her venue and organization to obtain the best and most current advice.
- Inclusion of references on this page does not constitute official US government or HHS endorsement.
- Selected Federal Legal Authorities Pertinent to Public Health
Emergencies(HHS/CDC)
- Emergency Preparedness(HHS/CDC)
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Assessment of State and Local Laws Regarding Management of Persons During Radiation Incidents
- Public Health Preparedness: Examination of Legal Language Authorizing Responses to Incidents Involving Contamination with Radioactive Material (PDF - 670 KB) (HHS/CDC/RSB and CDC/ATSDR; CDC/Office for State, Tribal, Local and Territorial Support; Legal Preparendess Project: collaboration between CDC and NACCHO), May 2014)
- Designed to answer 2 questions: Do states and select jurisdictions...
- "Possess the authority to decontaminate persons contaminated with radioactive material?"
- "Have the authority to restrict the movement of persons contaminated with radioactive material? (e.g. quarantine)?"
- Goals
- "Identify and categorize the current landscape of laws that may be available to decontaminate and restrict personal movement of persons contaminated or potentially contaminated with radioactivity"
- "Foster collaboration among stakeholders to enhance preparedness and response"
- Conducted a legal assessment of all fifty states, New York City, Los Angeles, and Washington, D.C.
- Text, maps and tables show comparisons among these jurisdictions
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Emergency Declaration Authorities Across all States and DC
- Links to legal authorizations for each of the 50 states and DC (The Network for Public Health Law)
- Table provides state statutory and regulatory authorities for emergency declarations in all 50 U.S. states and the District of Columbia including
- Emergency declarations, public health emergency declarations, and other types of declarations that may relate to the public's health.
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HIPAA Issues
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International Documents about Ethics in Disasters
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References
- Crisis Standards of Care: Ten Years of Successes and Challenges: Proceedings of a Workshop (2020), (NASEM, 2020)
- See Chapter 3: "Ethical and Legal Considerations"
- The 2020 NASEM monograph updates the NASEM Crisis Standards of Care monographs from 2009-2013 listed on the REMM standards of care page
- Emergency Ethics, Public Health Preparedness and Response, Eds. Bruce Jennings et al. Oxford, 2016.
- Cho KW, Cantone MC, Kurihara-Saio C, Le Guen B, Martinez N, Oughton D, Schneider T, Toohey R, ZöLzer F; Authors on behalf of ICRP. ICRP Publication 138: Ethical Foundations of the System of Radiological Protection. Ann ICRP. 2018 Feb;47(1):1-65. [PubMed Citation]
- Parmet WE, Sinha MS. Covid-19 - The Law and Limits of Quarantine. N Engl J Med. 2020;382(15):e28. [PubMed Citation]
- Although this article is about Covid-19, some issues it addresses could apply in a large radiation incident.
- Chu VS, Emergency Response: Civil Liability of Volunteer Health Professionals (PDF - 144 KB) (Congressional Research Service, 7-5700, R40176, January 2011)
- New York State Public Health Legal Manual: A Guide for Judges, Attorneys and Public Health Professionals, Editor-in-Chief: Michael Colodner (PDF - 650 KB) (New York State Bar Association in Collaboration with NY State Unified Court System, State of NY Department of Health, NY City Department of Health and Mental Hygiene, 2011)
- Sherman, SE. Legal Considerations in a Nuclear Detonation. Disaster Med Public Health Prep. 2011 Mar;5 Suppl 1:S65-72. [PubMed Citation] Full Text (PDF - 87 KB)
- Hodge JG, Courtney B. Assessing the Legal Standard of Care in Public Health Emergencies, JAMA 2010; 303(4):361-362. [PubMed Citation]
- Anderson ED, Hodge JG. Emergency Legal Preparedness Among Select US Local Governments. Disaster Med Public Health Preparedness 2009;3(Suppl 2):S176-S184. [PubMed Citation]
- Hoffman S, Goodman RA, Stier D. Law, Liability, and Public Health Emergencies. Disaster Med Public Health Preparedness 2009;3:1-9. [PubMed Citation]
- Crisis Standards of Care
- Hodge JG, Garcia AM, Anderson E, Kaufman T. Emergency Legal Preparedness for Hospitals and Health Care Personnel. Disaster Med Public Health Preparedness 2009;3(Suppl 1)S37-S44. [PubMed Citation]
- Barnett DJ, Taylor HA, Hodge JG, Links J. Resource Allocation on the Frontlines of Public Health Preparedness and Response: Report of a Summit on Legal and Ethical Issues. Public Health Reports 2009;124:295-124. [PubMed Citation]
- Hodge JG, Anderson ED. Principles and Practice of Legal Triage During Public Health Emergencies. 64 NYU Annual Survey of American Law, 249 (2008-2009).
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