Public Health Law: Power, Duty, Restraint (review)

In his book Public Health Law: Power, Duty, Restraint Lawrence O. Gostin offers a comprehensive look at the enactment and implementation of public health regulations. The author argues that the issue of public health law is significantly different from "other intellectual activities at the intersection of law and medicine" (p. xxii) because of the role that the government must play to advance public health, the scopes and constraints of the individual state's authority, the role of the parties ancillary to the government within the public health system, the needs of the overall population, the level of civic participation in different communities, the value imposed on preventive care, and the equitable delivery of health care. The book is presented in four sections.

Conceptual Foundations of Public Health Law.

The author argues that though theoretically intended to safeguard the health and safety of all, public health regulations benefit the group that is at risk of injury and disease the most. Government exercises the power to compel individuals and businesses to promote common good through the use of reporting requirements, mandatory testing and screening, environmental standards, industrial regulation, and isolation and quarantine. Problems arise when overreaching health regulations unduly curb individuals' rights in the name of communal good. Coercion can lead to distrust of or alienation of individuals from the medical and public health personnel and result in less participation in testing, counseling, and treatment sessions.

Law and the Public's Health.

Gostin reviews the historical transformation of the public health regulations with related interpretation and implementation of the laws for the greater good. By presenting numerous high profile cases and regulations Gostin explained the strengths and shortcomings witnessed so far in the name of public health. Through the formation of entities such as the Occupational Safety and Health Administration (OSHA), the federal government has sought to achieve balance in self-regulatory mechanisms and legal liability policies.

Public Health and Civil Liberties in Conflict.

Epidemiology, biostatistics, and public health surveillance, and their dissemination for the welfare of the community, all require steps to protect individuals' privacy. Gostin presents case studies on physician and community resistance to notification laws, especially regarding HIV and diabetes surveillance.

The Future of the Public's Health.

Gostin demonstrates the impact of leadership, politics, and money on public health policies. For example, he presents the regulatory hurdles faced in the areas of obesity and chronic disease.

Conclusion.

The book "Public Health Law: Power, Duty, Restraint," in its second edition is one of the thirteen books published by the joint collaboration between the Milbank Memorial Fund and the University of California Press. It is an essential tool to be used by providers, administrators, and policymakers alike. General audience readers who are willing to learn more about the intricacies of law that influences the health care delivery in the public system can also benefit from the book. I recommend the book without reservations.