Potemkin Plans: What are the
ethical duties of planners
asked to give
false assurances?
Edward P. Richards, JD MPH
Program in Law, Science and Public Health
LSU School of Law
http://biotech.law.lsu.edu
Potemkin Village
After Grigori Aleksandrovich Potemkin,
who had elaborate fake villages
constructed for Catherine the Great's tours
of the Ukraine and the Crimea.
 (Possibly just a good story, which I
assumed, but this is what the dictionary
says.)

Potemkin Plans

Elaborate plans for public health
emergency preparedness that cannot be
carried out because of lack of staff,
resources, political will, or competence, or
any combination of the above.
Is This a New Problem?

Enemy of the People, Ibsen (1882)

Should be required reading in public health
Unsupportable plans are nothing new to
government, or to public health
 Emergency preparedness is nothing new

What is New: 9/11
Emergency preparedness becomes a
national security issue
 National security means federal command
and control
 The militarization of emergency response
 Federal push down requiring elaborate
plans on every crisis de jure, with federal
programmatic funding depending on the
right answers in the plan

What Do These Plans Say?
The plans have to address all the federal
target issues and have to say that the
state and localities are prepared to carry
out the functions
 State legislators do the same to their own
state and local governments

What is the Structural Problem?
National is the wrong level for emergency
response
 All state and local public health, police,
and other first responders are already
committed about 110%

There have been net cuts in most programs
as emergency response has been added
 Existing problems like crime and disease
control do not go away during disasters

Why Does It Matter?

It does not work


We can argue about this, but it is the minor
point
It distorts risk communication and leaves
communities at greater risk
Katrina Examples

The core problem is not fighting mother nature





If all the emergency prep had worked, not much
would have changed
What has changed?
We have lots more plans
They do not change anything about the risk
They convince people that it is OK to go back
and do the same thing
Where Does this Leave the Experts
in the Agency?

You know this will not work
Do you speak up?
 What happens if you do?

What is the long term impact on agencies
and policy?
 Is this like Vaclav Havel's work on being a
write in the Communist block?
 Should this be the #1 public health law
ethics issue?

Should we have mechanisms to let
people speak out?
Most state whistleblower laws do not work
 What about hot lines like we use for fraud
and abuse?
