Criticized, Fired, Sued, or Prosecuted: Hindsight and Public Health Accountability

Abstract

The charges filed by Michigan prosecutors against state public health officials related to the Legionnaires’ disease outbreak in Flint raise difficult questions about accountability and responsibility for public health officials. Judging by the facts as alleged in the criminal charges, the circumstances in the Michigan case appear to be extreme and not representative of the usual ways that public health officials make difficult decisions with the public’s interest at heart. Accountability is vital, but those concerned with good public health leadership must distinguish between reasonable decisions made in good faith that nevertheless turn out to be incorrect and unreasonable actions that harm public health and deserve accountability. Several viable options exist to achieve accountability when things go wrong and public health decision-making leads to harm.

Keywords: Flint, public health, accountability, government officials, governance, crisis, health, water, environment

JEL Classification: I18, K32, K10, K14