Bedbugs are tiny, wingless insects which feed on mammal blood and leave behind painful, itchy sores. Although they can live in other settings, they are most commonly found in warm, dark places inhabited by humans, like beds. After being absent in the United States for over 60 years, thanks to powerful pesticides, bed bugs (Cimex lectularius), have returned in force and are present in every state and nearly every city. For reasons not entirely understood, bed bugs have developed resistance to traditional pesticides such as Permethrin and are therefore difficult to control. Although commonly believed to be associated with dirty housekeeping and associated with substandard housing, bed bugs are equally likely to be present in five-star hotels as they are in homeless shelters.

Public health law courses typically focus a good deal of attention on two related topics: the duty of government agencies to control the spread of communicable diseases and their use of the police power to do so. While governments sometimes take forceful actions in responding to disease outbreaks, they can also act to prevent their occurrence. Indeed, one of the great triumphs of public health in the 20th century was the development of vaccines and their widespread use, which seemed on course to relegate many formerly crippling or deadly diseases to the history books. Particular success occurred with vaccinations against childhood diseases such as polio, smallpox, and measles, outbreaks of which once routinely closed schoolrooms, playgrounds, and community swimming pools. By the last quarter of the century, completion of an elaborate schedule of immunizations was not merely the standard in pediatric practice but an official requirement for school enrollment. As a result, the range of communicable diseases that had once terrified parents had become threats to be feared only in memory.

Courses on bioethics and the law traditionally have focused their coverage on ethical issues arising from individual patients’ encounters with the medical care system, but the course also provides an excellent opportunity to expose students to ethical issues arising at the intersection of medical care and public health. The following materials were assembled for use near the end of a semester-long law school course in Bioethics & Law. I taught the course relying heavily on problems contained in Barry R. Furrow et al., Bioethics: Health Care Law and Ethics, 7th ed. (2013), which was the primary text for the course.

In law school we often focus on the importance of carefully crafting statutory and regulatory language. Textual ambiguities or sloppiness can significantly impair the efficacy of laws and regulations. Just as important as meticulous drafting, however, is the government’s ability to enforce its rules. In the absence of adequate enforcement resources, the government’s regulatory initiatives may well fail. The ability to promote public welfare depends as much on regulatory compliance as it does on the text of the regulations themselves.

The information contained in this teaching module and the accompanying PowerPoint slides is appropriate for use in a survey public health law course or seminar. The purpose of this lesson is two-fold. The first objective is to provide law students with an overview of the authority public health agencies have to set and enforce policies necessary to keep the population healthy. The second objective is to inform law students about the legal constraints courts have placed upon the actions of those agencies. The module ends with a project designed to give law students the opportunity to apply the law to a “real world” situation.

These teaching materials explore the specific powers of governments to implement control measures in response to communicable disease, in two different contexts:

• The first context concerns global pandemic diseases. Relevant legal authority includes international law, World Health Organization governance and the International Health Regulations, and regulatory authority of nations.

• The second context is centered on U.S. law and concerns control measures for drug-resistant disease, using tuberculosis as an example. In both contexts, international and domestic, the point is to understand legal authority to address public health emergencies.