Gostin L O, Burris S, Lazzarini Z
Georgetown University Law Center, USA.
Columbia Law Rev. 1999 Jan;99(1):59-128.
Law plays crucial roles in the field of public health, from defining the power and jurisdiction of health agencies, to influencing the social norms that shape individual behavior. Despite its importance, public health law has been neglected. Over a decade ago, the Institute of Medicine issued a report lamenting the state of public health administration, generally, and calling, in particular, for a revision of public health statutes. The Article examines the current state of public health law. To help create the conditions in which people can be healthy, public health law must reflect an understanding of how public health agencies work to promote health, as well as the political and social contexts in which these agencies operate. The authors first discuss three prevailing ways in which the determinants of health are conceptualized, and the political and social problems each model tends to create for public health efforts. The analysis then turns to the core functions of public health, emphasizing how law furthers public health work. The Article reports the results of a fifty-state survey of communicable disease control law, revealing that few states have systematically reformed their laws to reflect contemporary medical and legal developments. The Article concludes with specific guidelines for law reform.
法律在公共卫生领域发挥着至关重要的作用，从界定卫生机构的权力和管辖权，到影响塑造个人行为的社会规范。尽管其重要性，但公共卫生法一直被忽视。十多年前，医学研究所发布了一份报告，对公共卫生管理的总体状况表示遗憾，并特别呼吁修订公共卫生法规。本文探讨了公共卫生法的现状。为了帮助创造人们能够保持健康的条件，公共卫生法必须反映对公共卫生机构如何促进健康的理解，以及这些机构运作的政治和社会背景。作者首先讨论了三种流行的健康决定因素概念化方式，以及每种模式往往给公共卫生工作带来的政治和社会问题。然后分析转向公共卫生的核心职能，强调法律如何促进公共卫生工作。本文报告了对五十个州传染病控制法的调查结果，表明很少有州系统地改革其法律以反映当代医学和法律的发展。本文最后给出了法律改革的具体指导方针。
