Table 3.

Dissonant views on legal preparedness environment—PH vs. EM officials (summary and illustrative quotes)

Divergent views on	PH respondents	EM respondents
Legal authority	‘[There are] too many cannots in the law, we are not as protected as we could be with stronger laws …’	‘… there is plenty of authority, we will provide care and worry about legal questions later …’
	‘The authority for quarantine is clear, authority for who enforces is the problem …’	‘We do what we have to do [to save lives] and ask for forgiveness later …’
Flexibility in interpretation of laws and need for guidance	‘… [there is] no official legal opinion, but many inconsistent attorneys’ opinions’	‘… everything is based on laws, but laws can be put on hold to get it done, get people to safety whatever it takes …’
	‘… people want guidance … things would otherwise go wayside …’	‘… it is not a legal issue; decisions should be based on the number of lives saved …’
	‘… attorneys would not put anything in writing, but written makes it standard of care; … if not mandated, people won't do it …’	‘… can go outside the legal apparatus to get what's needed …’
		‘… people have in their mind what they want to do, and then look for the legal section to support what they want to do, which may not be right. But if you really use the laws that we already have, then we are pretty well covered'.
Liability vs. ethical concerns	‘… some may care, but we would not risk livelihood to help …’	‘… who cares about legal authority credentials in emergencies?’
	‘… liability is the key legal question; [if they are afraid] they may do the wrong thing at the wrong time, MDs may not show up for work without liability coverage …’	‘… there are standard of care issues, so we need liability protection for reduced standards [in emergencies] to salvage as many people as possible; [you may be] open to liability, but more will die if [you] uphold protocols …’
		‘… triage raises ethical questions with legal implications, because standards set base for legal action if standards are not met …’
Task-specific vs. all-hazards approach	‘… there is comfort in routine, [because] we are not sure about emergency rules …’	‘… preparing for disaster … is just a scaling-up of routine operations’
	‘… [there was a] shift of resources for planning for the big events, but routine preparedness needs to be ready all the time …’	‘… a community that is prepared for emergencies is prepared for anything …’