29 April 2009

Compelling Health Care Workers during a pandemic?

From, I think, the Iowa Law Review and Seton Hall University School of Law:

Beyond the Call of Duty: Compelling Health Care Professionals to Work During an Influenza Pandemic
In anticipation of pandemics and other mass disasters, several states have enacted little-known laws that authorize government officials to order health care professionals to work during declared public health emergencies, even when doing so would pose life-threatening risks. Health care professionals who violate these orders could face substantial penalties, ranging from license revocations to fines and imprisonment. The penalties would apply even to individuals whose jobs do not normally involve clinical responsibilities, as well as to health care professionals who are retired or taking time off from work to care for their families.
Yikes.  I was not aware of these laws -- wonder if my state has one?  That'll be real popular.

I wonder if this could backfire.  Health professionals tend to be pretty altruistic and public-spirited, especially in times of crisis.  I would expect that the response from workers would be pretty positive.  But if the state were to start forcing people to work, then that public coercion would probably reduce the motivation for doctors and nurses to volunteer.  Which could be a sort of catch-22, since the state would probably only invoke this power if the response from health care providers was inadequate in the first place.

I'd actually be interested in reading that entire article.  Looks like only the abstract's available on line.


  1. This exists at the national level as well - the "Medical Draft." It's handled by the Selective Service System.


  2. yikes! didn't know about that...and here I am volunteering to serve in the public health corps this summer!

  3. The whole article is currently available on the Iowa Law Review's website. It's from the Nov. 2008 issue:

  4. Surprising, although less so when you consider the amount of police power given to many public health departments, especially in times of crisis.

  5. Yeesh! I better find out if similar laws are in Canada!

  6. During the SARS outbreak in Canada, Toronto was hit pretty hard. The Toronto medics were ostracized by many in the local community. A friend of mine was refused access to child care for his child, because he was a paramedic. He was also refused service in restaurants and other places of business.

    This was not limited to EMS, but it is kind of difficult to hide the fact that you are in uniform, when you are stopping to buy food during your shift. The big ambulance is another clue.

    If the masses are behaving as masses, by refusing services to health care workers, will this conscription also apply to services for health care workers, such as child care?

  7. During the SARS outbreak, nurses were coerced into working - by their union. They were told if they didn't work, they would lose all seniority within the union and at their employment.

    And more health care workers died of SARS than any other group: All transmitted after treating patients. The second largest group of fatalities? Health care workers' family members

  8. We were just talking about this at work the other day. One of the docs brought it up, actually. Seems our admin is playing ostrich and not worrying about it. Now I wonder if their lack of concern is because they know that the gov't will trump any of their requirements to work.

    Are there similar laws for cops? I know of many nurse-cop couples, (what's with that, anyway) how would it work for them if both are compelled to work?


  9. The only situation where doctors and other health care workers can be expected to perform beyond their normal call of duty is where they and their families are fully supported for doing so.

    By this I mean that, in a pandemic, health care workers at the coalface should have optional accommodation in hospital, childcare offered for their children and adequate compensation for doing their job in a riskier environment than usual.

    If, on the other hand, society is ostracizing health care workers and, say, nurses or paramedics cannot get childcare places for their kids because of what they do, well, society should be kindly reminded that health care workers have families too and loyalty to family should come before loyalty to society or country.

  10. The Selective service System has also been ordered to be prepared to draft health care workers in many fields (not just doctors and nurses):



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