The Law Reform (Epidemic Preparedness) Bill--a proper response to the pandemic threat?

The ethical frameworks for public health practice are not as clearly articulated as those used in clinical medicine. This poses problems when Medical Officers of Health are required to exercise coercive powers over individuals in the context of communicable disease control. Proposed legislation exacerbates this problem. The Law Reform (Epidemic Preparedness) Bill, recently introduced into Parliament, extends coercive powers but does not provide legal protection for individuals subject to such powers. A framework exists to critique the legitimacy of coercive public health powers and includes the principles of necessity, effectiveness, proportionality, and fairness. The fairness principle is under threat in the draft Bill, which fails to provide "due process" procedures to protect the rights of individuals. Experience in managing the SARS epidemic suggests that coercive powers alone will not enhance the response to public health crises. Respect for individual rights, a positive relationship between government and the community, and the scope for review of decisions are more consistent with modern public health practice and are likely to lead to improved outcomes. In our view, the Bill should be amended to include legal protection for individuals before it is passed into law.