The Paradox of Public Health Policy Making in an Epidemic
Public health policy operates in a democratic paradox. The police power exists to protect individuals from harms they cannot themselves fend off, but every restriction of individual freedom in the name of public health runs against constitutionally protected individual rights. Public health officials are damned if they do, damned if they don’t.
“Opening the Schoolhouse Door to the AIDS Virus: Policy Making, Politics, and Personality in a Queens County Courtroom, 1985-86”
19 University of Pennsylvania Journal of Law and Social Change (forthcoming)
Draft downloadable via SSRN.
But policy makers can take steps to avoid litigation by partnering with the public in contentious public health decisions. District 27 Community School Board v. Board of Education and events leading to the lawsuit exemplify the democratic paradox. A largely overlooked case, District 27 is one of the most important early AIDS cases. It was the first to consider the disease in depth. The case established the dearth of evidence that AIDS could be transmitted casually. And District 27 signaled that AIDS did not demand and law did not permit discrimination. This article dusts off District 27 for its thirtieth anniversary and uses New York City’s policy-making process as a case study for public health policy making in an epidemic. It suggests ways lawyers and policy makers can balance secrecy and transparency against democratic ideals, as well as how valuing the public and allowing public input enhances policy decisions.
Image from the cover of the New York Post (August 29, 1985).