Last summer I had the honor of succeeding Mark Rothstein as editor of the Law and Ethics section of AJPH. During his distinguished tenure, the section published numerous path-breaking articles that demonstrated the influence of law and the importance of ethics to population health.
For much of the 20th century, researchers tended to neglect law’s influence on public health. Although public health practitioners understood that law was vital to their work, there was a paucity of rigorous studies that looked at how law affects population health. That has changed. The articles published in this section vividly reveal that researchers in both law and public health, many working in interdisciplinary teams, now read their mandate broadly to include examination of the multiple, complex pathways through which law affects population health and structures health inequities. Building on the research on social determinants, this new public health law research makes clear that to appreciate law’s impact on health, we need to extend our gaze beyond traditional public health laws, such as quarantine or vaccine mandates, to ask how environmental, housing, drug, and immigration laws, to name just a few, influence the health of differently situated populations. Likewise, although statutes and regulations that relate to health are critically important, so too are judicial opinions, legal doctrines, and modes of law enforcement (so-called law on the streets), which can also affect the health of individuals and communities. Accordingly, to understand the law’s relationship to health we should consider not only regulatory and statutory law but also the pronouncements of appellate courts and the practices of police, immigration agents, and other law enforcement agencies.
Researchers today use a wide range of interdisciplinary quantitative and qualitative methodologies to study law’s impact on public health. Hence, the section welcomes articles that employ the empirical tools of legal epidemiology, including policy surveillance studies and health impact studies as well doctrinal legal scholarship and normative analyses of laws pertaining to population health and health inequities.
The normative tradition in legal scholarship ties together the section’s two disciplines: law and ethics. Like public health law, public health ethics has blossomed in the past two decades, moving beyond autonomy-focused bioethics to incorporate a range of perspectives (such as human rights, feminism, critical race, and disability theory). As Mark Rothstein explained in his 2015 AJPH article “The Moral Challenge of Ebola” (http://bit.ly/33v8EwQ), ethical analysis becomes especially vital in the face of new public health challenges, as we are confronting now with the COVID-19 outbreak.
This past year has proven to be an exciting yet also sobering time to begin serving as editor of the Law and Ethics section. The articles we publish demonstrate the maturation of public health law and ethics and their tremendous potential to advance population health and reduce health inequities. Yet, as many of the articles published this past year have documented, laws can also undermine health and violate fundamental ethical norms. The articles we have published about migration, reproductive justice, gun violence and preemption, to offer just a few examples, underscore that threat and remind us that law is a form of power that can be used for good or ill. It is the mission of the section to continue publishing rigorous research and astute legal and ethical commentaries that demonstrate and call out that danger, while also pointing to how law can be used to advance health and diminish inequities.
7 Years Ago
E-Cigarettes and Smoking Cessation
Smokers (and particularly those who tried unsuccessfully to quit) are especially interested in using e-cigarettes. Those trying to quit smoking and younger smokers were most interested in alternative tobacco products, but use of these products was not associated with having made a successful quit attempt. This result calls into question whether these products aid cessation (as some claim) and whether the pattern of use is consistent with harm reduction (when one would expect use by inveterate smokers, not those interested in quitting). . . . Explicit or implied claims that alternative tobacco products are smoking cessation aids should be prohibited in the absence of a body of scientific evidence showing such an effect.
From AJPH, May 2013, p. 929
10 Years Ago
Public Health Concerns about the Rise of the e-Cigarette
The ENDS [Electronic Nicotine Delivery Systems] tested so far have demonstrated poor quality control; toxic contaminants, albeit at low levels; misrepresentation of the nicotine delivered; and insufficient evidence of overall public health benefit. Ongoing, rigorous safety testing is needed, including determining real-world use patterns and further laboratory testing across device constructions to determine actual systemic nicotine delivery and exposure to harmful constituents. We recognize a manufacturer’s desire to market their product and advocates who say ENDS are logically safer than cigarettes. However, to allow their unregulated sale on presumption is not protecting public health. ENDS should be removed from the market and permitted back only if and when it has been demonstrated that they are safe . . . [and] that their benefits outweigh their harms to overall public health.
From AJPH, December 2010, pp. 2341-2342
Biography
