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10 - Legislative Authorities and Regulatory Issues

from PART II - OPERATIONAL ISSUES

Published online by Cambridge University Press:  05 August 2011

Kristi L. Koenig
Affiliation:
University of California, Irvine
Carl H. Schultz
Affiliation:
University of California, Irvine
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Summary

OVERVIEW OF THE PROBLEM

Catastrophic disasters disrupt the health and medical system. Medical infrastructure (e.g., hospitals, clinics, doctors' offices, laboratories, pharmacies, and medical suppliers) may suffer physical damage, or lose electrical power or communications capabilities such as Internet and computer services. A disaster creates new requirements for medical care when large numbers of people suffer from serious injuries or infectious diseases or are exposed to chemical, radiological, or biological contamination. As demonstrated by the 2004 Indian Ocean tsunami and the 2005 Hurricane Katrina in the U.S., a disaster can generate evacuees in the hundreds of thousands that are separated from their regular medical care network (e.g., doctors, nurses, prescription medications, and medical records), yet continue to require baseline health and medical needs.

Catastrophic disasters also challenge the legal basis of the medical system. Compliance with some legal requirements becomes impossible and practitioners must be aware of current standards and legal mandates that exist in the disaster environment. For example, in the United States, federal rules require clinicians to perform a medical screening examination and stabilize any patient who arrives on hospital grounds requesting medical care. How does this regulation apply when there is a physical plant disruption such as a hospital flood or fire, or chemical or radiological contamination of the building? Another example is that virtually all sovereign governments ensure the competence of medical professionals by issuing licenses to those authorized to practice medicine within its borders – yet in a disaster, medical volunteers will cross state or national boundaries to treat disaster victims.

Type
Chapter
Information
Koenig and Schultz's Disaster Medicine
Comprehensive Principles and Practices
, pp. 151 - 164
Publisher: Cambridge University Press
Print publication year: 2009

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References

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This doctrine of sovereign immunity, which originates from English common law during the feudal period, premised on the maxim that the “King could do no wrong” persists as a basic principle of sovereignty. See 74 Fordham L. Rev. 2927, April 2006. The Federal Tort Claims Act, 28 USC § 1346(b), provides limited exception to the doctrine of sovereign immunity only under certain circumstances.
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A “Table Top” is so named because it does not try to recreate an emergency event by simulating the event and actually deploying response resources (ambulances, helicopters, doctors, nurses, and so forth), rather a scenario is presented to participants representing their organizations. These participants – perhaps while sitting around a table – think through and describe how they would respond to an event and interact with other organizations.

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