What is a Public Health 'Emergency'?

Abstract

This article examines the appropriate scope of public health emergency declarations. Using Massachusetts Governor Deval Patrick’s declaration of the opioid-addiction crisis as a public health emergency, the paper explores the appropriate parameters of such declarations and the emergency powers that follow from them. We do not debate the public health significance of opioid addiction in the Commonwealth, nor the specific measures ordered pursuant to Patrick’s declaration. We do question using public health emergency powers beyond the traditional arenas of infectious disease outbreaks, natural disasters, and acts of bioterrorism into new territories, such as injuries and chronic disease.

State laws provide governors and their top health officers with considerable latitude in declaring public health emergencies. But the powers available upon such declarations are extraordinary and should be wielded with care. The article identifies three key criteria to guide the issuance of an emergency declaration: “the situation is exigent, the anticipated or potential harm is calamitous, and the harm cannot be avoided through ordinary procedures.” In the absence of these criteria, the invocation of such emergencies may raise heightened concerns — for instance, if ensuing orders involve serious infringements on individual and private business rights — and could result in a loss of public trust in health officials and legitimacy in public health laws.

Keywords: public health, emergency powers, quarantine