Public Health Law & Military Medical Assets : Legal Issues in Federalizing National Guard Personnel

Background. Public health actions may involve military medical professionals supporting legally-mandated public health efforts, particularly in emergencies and disasters. Issue. The power of military medical professionals to enforce public health mandates is dictated by the specific laws under which they act. If National Guard members are federalized through activation under Title 10 of the US Code, they are prohibited from engaging in law enforcement activities under the federal Posse Comitatus Act. Yet if they are activated under Title 32, they are under state control and hence are able to engage in law enforcement efforts, which may include public health functions. This legal subtlety may delay effective public health responses to emergencies and disasters. Discussion. Efforts to address this legal conflict must take into account the law and policy implicated in public health activities and emergency and disaster response. Understanding the basis of the conflict, the relevant public health tools, such as quarantine and compulsory vaccination, and legal liability issues are imperative to drive appropriate reform in these most highly time and resource sensitive situations. Conclusion. Through assessments of legal conflicts and public health activities, clarification of law can result to allow effective use of military medical assets in emergency and disaster response. In particular, redrafting of the Posse Comitatus Act taking into account public health functions of military first responders would be a positive step in ensuring that effective emergency and disaster response is driven by substantive resource capacity rather than legal nuance