Public Health Advocacy in the Courts

The aim of the article is to argue that there is need for public health advocates to make use of the judiciary branch, as opposed to the executive and legislative branches of local and federal governments, as a tool for public health advocacy. Another goal of the article is to articulate strategies for accomplishing the first aim and to describe landmark cases related to the power of the judiciary in the arena of public health.

The judiciary branch can play an important role in public health when this branch of government is called upon to settle a disputed issue by interpreting laws. An example is Jacobsen v. Massachusetts, a case from 1905 in which the U.S. Supreme Court upheld the compulsory smallpox vaccination law. In a related case, the U.S. Supreme Court upheld the right of a federal regulatory body to require airbags in cars, a standard which had been challenged by automakers.

A second area where the judiciary can influence public health is through product liability law, such as in upholding or rejecting cases brought against tobacco companies or gun manufacturers. Such cases can also be brought as class-action lawsuits. A special area of the law related to public health is “problem-solving courts” which are courts that specialize in trying to address the underlying causes of crimes, such as drunk driving or drug buying, by mandating treatment programs for offenders.

Strategies for influencing outcomes of public health-related cases include the use of public health experts as expert witnesses, or through “friend of the court” briefs. These briefs are used as opportunities for experts in a field to weigh in on important aspects of a case, and they can be influential upon outcomes of court cases. Public interest groups can also offer educational sessions related to particular areas of the law and thus, influence the judiciary, for example the National Judicial Institute on Domestic Violence offered a judicial education seminar on domestic violence. Lastly, since all federal judges are appointed by the president, advocacy organizations can lobby for or against the nomination of judges who may or may not support their cause. And, community monitoring of cases may influence outcomes, although this link has not been well established. Organizations such as Mothers Against Drunk Driving send representatives to observe and take notes during trials of drunk drivers, on the assumption that judges may pass harsher sentences when they know the community is invested in the outcome.

Although the authors recommend all these strategies for advancing the agendas of public health professionals, many public health professionals and organizations do not have the resources to spend on such intensive efforts. Therefore, more public health professionals need legal training, and partnerships between legal experts and public health professionals must be advanced.