In a recent issue of the AJPH,1 Reverby responds, in part, to medical reports from the US Public Health Service Syphilis Study at Tuskegee, about which it was noted: “The primary activity of these agents is observing, a passive act rather than a dynamic one.”2(p257) Reverby makes the cogent, but often unheeded, comment that, “When public health officials do something legal but improper, we label it misfeasance,” and adds that, “Public health students and practitioners should be required to . . . consider what similar practices might look like today . . . as we continually struggle to prevent them in the present.”1(p14)
In these regards, it seems important and timely to draw attention to antilobbying law, which demands passivity by making it a crime to use federal funds directly or indirectly to pay for any personal service, advertisement, printed matter, or other device intended to influence a member of Congress, a jurisdiction, or an official of any government to favor or oppose, by vote or otherwise, any legislation, ratification, policy, or appropriation unless specifically requested by Congress, or if it is done to support positions of the current administration.3,4
We cite here just two of numerous examples influenced by current antilobbying law that may adversely affect general public health. First, 16 states have either secondary seat belt laws or none even though implementation of primary seat belt laws has been conclusively demonstrated to save lives.5,6 Second, legal bans against research on gun violence may be contributing to the increasing major public health problem of homicide by firearms.7
Dynamic action results from unfettered advocacy to achieve optimal health through rational decisions based on the totality of scientific evidence. This cascade must remain independent of legislative or bureaucratic influences. Nonetheless, antilobbying law restricts public health to the passive provision of educational information. Ironically, legislative bodies may benefit from more dynamic communication that includes scientific considerations directly relevant to the health of the general public.
Public health officials who follow the letter of antilobbying law must passively observe and quietly record the continuing harm to the public whom they have a sworn duty to protect. In considering what practices of the past might look like today, strict obedience to antilobbying law raises the specter that those who ignore history are doomed to repeat it and abdicate the “continual struggle” against misfeasance so aptly noted by Reverby.1
REFERENCES
- 1.Reverby SM. Historical misfeasance: immorality to justice in public health. Am J Public Health. 2017;107(1):14–15. doi: 10.2105/AJPH.2016.303554. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Watson MS. The rhetoric of dehumanization: an analysis of medical reports of the Tuskegee Syphilis Project. In: Reverby SM, editor. Tuskegee’s Truths: Rethinking the Tuskegee Syphilis Study. Chapel Hill, NC, and London, UK: University of North Carolina Press; 2000. pp. 251–265. [Google Scholar]
- 3.Levine RS, Rust GS, Pisu M et al. Increased Black–White disparities in mortality after the introduction of lifesaving innovations: a possible consequence of US federal laws. Am J Public Health. 2010;100(11):2176–2184. doi: 10.2105/AJPH.2009.170795. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.NCI ethics. Lobbying activities. National Cancer Institute, Ethics Office. 2011. Available at: https://ccrod.cancer.gov/confluence/display/NCIE/Lobbying+Activities. Accessed December 29, 2016.
- 5.The Guide to Community Preventive Services. Motor-vehicle related injury prevention. Available at: https://www.thecommunityguide.org/sites/default/files/assets/What-Works-Motor-Vehicle-factsheet-and-insert.pdf. Accessed December 29, 2016.
- 6.Governors Highway Safety Association. Seat belts. Available at: http://www.ghsa.org/state-laws/issues/seat%20belts. Accessed January 2, 2017.
- 7.Johnson SR. Could funding gun violence research help prevent another Orlando? Mod Healthc. 2016;46(25):10–11. [PubMed] [Google Scholar]