Authors

Amy L. Fairchild, PhD, MPH Assistant Director for Academic and Scholarly Activities Center for History and Ethics of Public Health

James Colgrove, PhD, MPH Associate Research Scientist Mailman School of Public Health

Marian Moser Jones, MPH Center for the History and Ethics of Public Health

Irwin Redlener, MD Director National Center for Disaster Preparedness

In consultation with Ronald Bayer, PhD Associate Director Center for the History and Ethics of Public Health

Acknowledgements

We thank David Berman for his helpful review and comments. We also extend our thankful appreciation to Lawrence Gostin and the Center for Law and the Public's Health for providing legal research. James Colgrove's work was supported by the Greenwall Foundation Faculty Scholars in Bioethics Program.

We would also like to thank the following for their support:

Operation Assist www.childrenshealthfund.org

Shay Gines Office Manager National Center for Disaster Preparedness

Wilmer Alvarez Associate Director National Center for Disaster Preparedness

Table of Contents

Executive Summary...... 1

Overview and Context ...... 5

The Law and its Limits ...... 9

Ethical Issues Related to Mandatory Evacuation...... 11

Policy Implications: Providing and Deciding for...... 21

Recommendations...... 25

References ...... 27

Executive Summary

hen Hurricane Katrina made landfall W in August 2005, between 70,000 and • What are the limits of liability and 100,000 residents of New Orleans immunity for those calling for and either did not or could not comply with the executing the evacuation? order that had been issued to evacuate. The events surrounding Katrina raised critical The authority of the state to issue an legal and ethical questions about the use of order for a mandatory evacuation is granted mandatory evacuation orders. These include under the police powers of states to guard two of primary consideration: the health, welfare, and safety of their populations. There is little doubt that • What are the legal and moral governments have ample authority to order foundations of mandatory evacuation and enforce mandatory evacuation orders. orders given the fact that a failure to In almost every state, statutes enable police leave one’s home poses a threat powers to be exercised during natural primarily to those who stay behind, and disasters and emergencies. Where the generally do not endanger the safety of authority is vested differs among states, others through their actions? however; in some states it is granted to the governor while in others both the governor • When can those overseeing an and local officials may do so. evacuation invoke their own safety as a rationale for not assisting those who We discuss four key ethical issues that refused to obey the order? must be confronted when considering whether to issue an order of mandatory • To what extent and in what evacuation: circumstances should limited resources be used to evacuate those who do not The costs of precautionary follow orders when these resources can #1action in the face of uncertainty. also be used to execute the evacuation order? Mandatory evacuation orders impose costs on governments, business, individuals, and • What level of coercive authority ought to not-for-profit and educational organizations, be applied to those who do not comply? and these costs may argue against an invocation of such an order. An order of

1 evacuation may also damage the credibility raises some of the same ethical issues as of public officials, which is essential to quarantine such as when should an order be securing public trust and cooperation, if the given and how should it be enforced. But in hurricane (or other forecast disaster) fails to sharp contrast to the confinement of people strike. Evacuations also pose special risks to with an infectious disease, which is the ill and disabled. designed to protect third parties from harm, those who defy an evacuation primarily The duty to provide for place themselves at risk. Nevertheless, the #2 people. government bears an obligation not only to provide for the public in emergency situations, but also to decide for them. An ethical axiom holds that “ought implies Moreover, the government must reconcile can”—that is, ordering people to evacuate the need to provide for those who evacuate, implies an assumption that they have the and to determine to what extent they must means to comply. Therefore, any order of dedicate resources to those who stay behind, mandatory evacuation imposes an ethical either voluntarily or out of personal limitation duty on the government to provide the such as handicap. material conditions necessary for citizens to carry out the order. In the states and The acceptability of territories vulnerable to hurricanes, laws #4 compulsory measures. require that a variety of services be provided once the order has been issued. In many There exists a broad consensus that the use states, however, language specifying the of physical force to remove people from an obligations of the states is exceedingly area where an evacuation has been ordered general. Further, what obligation does the is unacceptable. However, emergency state have after an evacuation to return officials are justified in using a variety of those who have been evacuated to their coercive or quasi-coercive means to homes? Issues of liability and immunity convince people to comply. These include underlay the entire process from evacuation levying fines or holding people civilly liable to the rights of those who are left behind. for the costs of their rescue.

Paternalism and the preemption The implications of these legal and #3 of individual choice ethical dimensions on public policies are wide ranging. In the face of uncertainty, As a compulsory measure instituted by the officials must always have the option to government to guard the health and safety recommend rather than impose evacuation. of the population, mandatory evacuation In order to have any meaning, a mandatory

2 order of evacuation requires officials to the government to demonstrate clearly the engage in vigorous, deliberate efforts to need to know and intervene with such persuade reluctant citizens to leave: the vulnerable populations and then restrict the compulsory nature of the order must be use of sensitive data to emergency made clear and enforced. As one legal evacuation purposes only. scholar has argued, the law, in fulfilling its tutelary functions, acknowledges a kind of paternalism—that is, the realization that “the teacher knows something the students do not.” The challenge of how to handle the evacuation of minors in an emergency situation requires further analysis. Among the states and territories vulnerable to hurricanes, only Puerto Rico’s emergency management statutes provides for the forceful separation of families. Child abuse law in the U.S. grants the state the capacity to remove children from the custody of their parents. But in the history of civil defense evacuations, the challenge of reuniting families rather than separating them has been the priority. Providing assistance requires knowledge of the needs and whereabouts of the most vulnerable. The creation of registries of populations with special needs, like the elderly and physically and mentally disabled, brings into sharp focus the tension between surveillance as an essential strategy for identifying individuals at risk and the claims of privacy. To the extent that states may legitimately order and use some degree of coercion to compel compliance, authorities may similarly compel registration. The privacy-limiting features of such compulsory registration, however, require

3

4

Overview and Context

n Friday, August 26, 2005, the himself initiated such a call to warn officials ON ational Weather Service warned about the severity of a storm.3,4 that a Category 4 hurricane was bearing The morning of Sunday, August 28, toward the Gulf Coast region. At 5:00 p.m., Katrina was elevated to a Category 5 with Hurricane Katrina 56 hours from landfall, hurricane. 5 In response, Mayor Nagin—for

Louisiana Governor Kathleen Blanco the first time in the history of New Orleans— declared a state of emergency. By the next put into place plans that had been made in morning, Blanco began urging the consultation with the governor the night evacuation of New Orleans, which, though before and ordered a mandatory evacuation. protected by levees, rests nine feet below This order was issued 19 hours before the sea level.1 New Orleans Mayor Ray Nagin storm hit.6,7,8,9,10 Mississippi and Alabama followed on Blanco’s heels, issuing a quickly followed suit, issuing mandatory voluntary evacuation order late Saturday evacuation orders at 10:00 a.m. and 1:00 afternoon.2 That evening, Max Mayfield, the p.m., respectively.11,12 head of the National Hurricane Warning When Katrina made landfall on

Center, placed calls to Governor Kathleen Monday, August 29, Louisiana had

Blanco and Mayor Nagin. He advised them evacuated over 90 percent of residents who that the approaching Hurricane Katrina were threatened by the storm. Governor represented conditions such as he had Blanco, reflecting on the evacuation effort, never before seen in his 36 years of described it as a “stunning success.” 13 professional experience. “Preparations to Nagin, likewise, heralded the effort. “Our protect life and property should be rushed to region had one of the most successful mass completion,” he urged. “This has to be taken evacuations in the history of the United seriously.” Only once before had Mayfield States.”14 Some 70,000 to 100,000

5 individuals, however, either could not or issued mandatory orders of evacuation soon would not comply with the order to enough and provided citizens adequate evacuate.15,16 The city’s levies broke on information and assistance to escape from

August 29, causing widespread flooding. By the path of the storm.21 State and local the next day, the police were receiving a officials were given extraordinary warnings request for help every 25 seconds, recording and yet, said Virginia Republican Thomas

900 calls in a 6 hour period.17 By the next Davis, “no action [was] taken.”22 Former day, the police were receiving a request for FEMA Director Michael Brown called the city help every 25 seconds, recording 900 calls and state’s failure to evacuate “the tipping in a 6 hour period.18 Local, state, and federal point for all the other things that either went efforts proved insufficient to cope with the wrong or were exacerbated.”23 scale of the emerging disaster, and In February 2006, the U.S. House vituperative accusations of incompetence select committee presented the results of its and misjudgment roiled all levels of inquiry, concluding that a mandatory government. evacuation order, issued earlier, would have

Most of the post-Katrina analysis saved lives and mitigated the morbidity and has focused on logistical issues related to suffering that resulted from the hurricane effectively implementing wide-scale and subsequent flooding.24 It was evacuations.19,20 In the political aftermath of particularly critical of Mayor Nagin’s the storm, the U.S. House of “decision to enforce that order,” once made,

Representatives created a Select Bipartisan “by ‘asking’ people who had not evacuated

Committee to Investigate the Preparation for to go to checkpoints for bus service.”25 But and Response to Hurricane Katrina. The while the report noted the lack of “a clear committee interviewed the highest ranking and consistent definition of mandatory officials in Louisiana, Alabama, Mississippi, evacuation,” it gave little guidance as to and the Federal Emergency Management what mandatory orders should entail, noting

Agency (FEMA). Central to the controversy only that the term “implies that individuals do was whether state and local officials had not have a choice, that the government will

6 not be able to protect them and provide September, 2005, underscoring the ethical relief if they remain, and it generally conveys issues that they raise. We focus on the a higher level of urgency.”26 contested meaning of compulsory orders of

As the events surrounding Katrina evacuation, which are sometimes taken to suggest, insufficient attention has been mean the duty of the government to provide given to critical legal and ethical dimensions for people and, in other instances, to mean of mandatory evacuation. When and under the prerogative of the government to decide what conditions of severe threat should for people. In carefully differentiating the officials order citizens to leave their homes? different impulses motivating evacuation, we

What are the legal and moral foundations of can clarify the affirmative duties of the mandatory evacuation orders given the fact government and the acceptability of that a failure to leave one’s home poses a coercion in emergency situations. While this threat primarily to those who stay behind analysis focuses on the response to despite official warnings? What level of hurricanes, it has specific relevance for any coercive authority ought to be applied to disaster situation involving advance warning, those who resist? Should penalties be which can include floods, wildfires, sought in such cases? What duties of mudslides, or a terrorist attack. rescue, if any, do public officials bear for those who resist orders of evacuation?

When there are orders of evacuation, what obligations does the government have to provide effective means to leave safely?

In this paper we address the ethical and policy challenges of mandatory evacuation orders. We begin with an overview of the legal basis for such orders.

We then analyze decisions made in preparation for Katrina in August and

7 8

The Law and its Limits

he authority to issue an order for Corps of engineers also erected a stronger T mandatory evacuation is granted under system of dikes around the lake after the the police powers of states to guard the 1928 flood). These repeated evacuations health, welfare, safety, and morals of their demonstrated a pattern of repeated populations. In the early to mid-twentieth mandatory evacuation of a particular area century, the Red Cross ordered evacuations only after a lethal hurricane had hit. under its de facto authority as a federally During World War II, when chartered disaster relief organization, but it technological advances began to make it is not clear that it was legally vested with possible to more accurately predict police powers.27 The oldest available news hurricanes and it became imperative to report of mandatory state-directed hurricane protect vital coastal airbases, mass evacuation dates to 1933, from Florida’s evacuations became part of a systematic Lake Okeechobee.28 The year before, a government response to disaster.31,32,33 In massive hurricane had hit Palm Beach with 1950, in the context of the Cold War and the winds of 140 miles an hour then blew the Korean conflict, the Federal Civil Defense waters of Lake Okeechobee, Florida’s Act mandated the creation of a national civil biggest lake, into an adjoining towns of defense organization for protection against mostly black migrant laborers, flooding the enemy attack, declaring that “this town and causing as many as 2,400 to responsibility for civil defense shall be drown. As the Weather Bureau had vested primarily in the several States and predicted that the storm would miss Florida, their political subdivisions.” Under the act, nobody had been evacuated; dikes around federal funds were directed toward the the lake, not designed to handle storm construction of emergency shelters and surges, had given way.29 When hurricanes hospitals, and civil defense administrators again hit the East coast of Florida a year were hired for states and municipalities.34 later, evacuation plans were quickly put into Numerous states also passed state civil motion for remaining residents of the Lake defense acts, which became the template Okeechobee areas.30 Periodically, over the for later emergency management statutes next 19 years, this region would be (in some cases a legal template that has evacuated whenever hurricanes threatened been revised surprisingly little).35 While the to pass over the lake (although the Army Federal Civil Defense Act was not directed

9 to natural disasters, in practice state and provides that “The governor may local civil defense administrators and recommend the evacuation of all or part of volunteers began serving as local the population from a stricken or threatened coordinators in hurricanes and civil defense area in the state if the governor considers equipment and shelters were repeatedly the action necessary for the preservation of used to cope with such emergencies.36,37,38 life or other disaster mitigation, response, or Throughout the 1960s, officials in recovery.”43 various locales continued to rely on Most of the state statutory schemes, voluntary evacuations and used different however, grant the governor authority to degrees of persuasion to try to move people declare an emergency. Further, most of the out of harm’s way. Reliance on voluntary states also allow the exercise of emergency measures continued even after catastrophes or disaster authority by a local like hurricane Betsy, which struck New government.”44 This is true for the states and Orleans and caused the levies to break in territories that have been struck by a 1965.39,40 It is not until the 1970s and hurricane, which include Alabama, 1980s—ironically, during a period of rights- Connecticut, Delaware, Florida, Georgia, based political activism and profound Hawaii, Louisiana, Maine, Maryland, distrust of government—that states began to Massachusetts, Mississippi, New Jersey, favor mandatory evacuation orders, New York, North Carolina, Rhode Island, sometimes accompanied by the threat of South Carolina, Texas, Virginia, and Puerto force or other forms of coercion.41 Rico. Typical is the language of Louisiana, There is little doubt that which grants the governor power to “Direct governments have ample authority to order and compel the evacuation of all or part of and enforce mandatory evacuation orders. the population from any stricken or The U.S. Court of Appeals for the First threatened area within the state if he deems Circuit has noted that “Almost every state in this action necessary for the preservation of the United States has adopted statutes life or other disaster mitigation, response, or providing for the exercise of police powers in recovery.”45 the event of an emergency or disaster (such In some instances, authority is as fire, flood, tornado, or hurricane).”42 In granted to both governors and municipal some states, power to order evacuations officials. Louisiana’s statute, in addition to rests with local authorities rather than the designating authority to the governor, also governor. Emergency statutes in explicitly authorizes municipalities to order Massachusetts, New York, and New Jersey, evacuations.46 The legislation specifies that however, do not specifically grant their a mayor or chief executive of a municipality governors power to evacuate residents in must then covey this order to parish the case of an emergency. Texas only presidents, but offers no guidance regarding

8 communication between chief executives primary authority in the disaster at the same and the governor or vice versa, save to time the Federal government becomes indicate that it is the governor who is involved.51 ultimately responsible for the public safety in Case law provides a second emergency situations. In Mississippi, unequivocal basis for taking forceful actions evacuation is “Subject to the order of the in response to an emergency.52 Although chief executive of the county or municipality mandatory orders of evacuation have yet to or the Governor.”47 In Delaware, Florida,48 be challenged, U.S. Courts have upheld the Georgia, Hawaii, Maine, and Mississippi, authority of the government to force the however, the Governor is only empowered evacuation of distressed vessels in life to declare a state of emergency when he or threatening emergencies.53 she determines that the situation exceeds In the instance of the evacuation of the capabilities of local authorities.49 A lack a sinking ship, a Federal appeals court of clear lines of command, without a doubt, disagreed with the vessel’s owner, who complicated the response to Katrina in argued that the Coast Guard, as an agent of Louisiana and, later, Rita in Texas.50 the government, had “exceeded its authority Federal law does little to clear this by compelling the boat’s captain to leave it confusion. The Disaster Relief Act against his will.” While “we do not accept Amendments of 1974, commonly known as [that the] Coast Guard [has] carte blanche the Stafford Act, gave the federal authority to engage in forcible evacuations in government authority to assist state and less than life-threatening emergencies,” the local governments with disaster court wrote, “the body of case law preparedness and relief, but specified that developed under the ‘emergency aid’ federal disaster assistance be contingent on exception to the Fourth Amendment’s a request by the governor of a state, based warrant requirement both lends support for upon “a finding that the disaster is of such evacuation authority and cabins it. That severity and magnitude that effective exception requires an objectively reasonable response is beyond the capabilities of the belief by safety officers that a true state and the effective response is beyond emergency exists and there is an immediate the capabilities of the state and local need for assistance or aid.”54 governments and that federal assistance is Courts, likewise, have upheld the necessary.” This provision also mandates right of governments to enforce curfew in the that, as a condition of receiving federal wake of disasters. In three states vulnerable assistance, the governor must “direct to hurricanes—Delaware, Maryland, and execution of the State’s emergency plan,”— New York—emergency management which typically includes evacuation statutes explicitly grant the governor measures—thus reemphasizing the state as authority to issue a curfew, although such

9 statutes do not provide the sole source for be sufficient to counter the grave dangers such authority. The courts have generally presented.”59 The court considered the viewed curfew cases in light of “whether the rights of citizens to travel, to visit friends, executive’s actions were taken in good faith clients, and relatives at night, but ruled that it and whether there is some factual basis for was “substantially outweighed by the the decision that the restrictions imposed public’s right to be safe in their homes were necessary to maintain order”55 and during the hours of darkness, and to be safe whether they were “reasonably necessary to from injury from continued dangerous prevent widespread lawlessness.”56 conditions on St. Croix.”60 The Virgin Islands’ territorial governor, for example, issued a curfew after a hurricane had knocked out power and telephone service in St. Croix and led to the escape of the island’s prison population.57 Thus, the district court ruled that “Current conditions on the islands still justify the nocturnal curfew. Electrical power is not yet restored—power lines are still down on the roads. Crews are working 24 hours a day to restore electrical power. The problems of law enforcement during hours of complete darkness and still present. The lack of telephone service on St. Croix makes summoning help nearly impossible during night time hours. The imposition of a nocturnal curfew not only allows work crews to work unimpeded overnight, but protects them as they restore service on the island.”58 Curfews also seek to ensure the safety of citizens: “the residents of the Virgin Islands are protected during the night from those who might take advantage of the emergency situation to cause injury to persons or property.” Thus, “while the curfew is a drastic measure, the court can not say that a less restrictive measure would

10

Ethical Issues Related to Mandatory Evacuation

hile the law is important to recognize economic costs on governments, W in defining the parameters of businesses, and voluntary acceptable practice, the requirements of law organizations.61,62,63 Public officials in must be distinguished from what ethics Louisiana, which has no provisions for deficit might demand or preclude. It is one of the spending, stressed these costs in the functions of ethical discussion and review to aftermath of Katrina. Mandatory evacuations provide a standard against which to judge cost state and local governments millions of current practice and legal dollars in overtime pay to requirements. Here we The requirements police and emergency officials. outline what we considered of law must be Privately funded relief to be the four critical issues: distinguished from organizations such as the Red the costs and risks what ethics might Cross, as well as local and associated with demand or preclude. state emergency agencies, precautionary action in the spend millions of dollars in face of uncertainty, the duty to provide care, setting up and running shelters for evacuees. the acceptability of paternalism, and the Transportation departments spend extra appropriate use of coercion. money on overtime turning highways into one-way evacuation routes, suspending toll The costs of precautionary action in the collection for more efficient evacuation, and face of uncertainty. addressing traffic accidents that can result from clogged highways during evacuation. One of the primary ethical and Police use up overtime in trying to enforce policy challenges related to the use of mandatory evacuations.64 Costs may be precautionary measures such as an order of exacerbated by the problem of “shadow mandatory evacuation is that actions taken evacuation,” in which people who are not in preemptively to reduce harm can danger nonetheless hit the roadways themselves cause harm. Mandatory because of misunderstanding or a sense of evacuation orders may impose costs on vulnerability, and contribute to traffic delays. governments and individuals that may argue About half of the two million people who against their invocation. evacuated from Florida in anticipation of Most obviously, mandatory 1999 hurricane Floyd, for example, were evacuation orders entail enormous determined to be shadow evacuees.65

11 In addition to burdening public decision-making in the face of uncertainty: “it coffers, mandatory evacuation imposes all goes back to money and resources.”72 costs on individuals. These include loss of time at work and extra expenditures in gasoline and lodging for evacuees, as well as danger to the property which they must temporarily abandon.66 In 1980, officials in Galveston, Texas ordered an evacuation of the city when Hurricane Allen menaced the city. But Allen missed Galveston, and New Orleans, La, August 31, 2005 -- Stranded residents in Jefferson Parish numerous homeowners returned to find out Photo by Win Henderson that their homes had been looted.67 Some of the costs to both In the case of Katrina, governments and individuals are not Representative Gene Taylor, a Mississippi calculable in strictly monetary terms. For Democrat, sought to impress on his individuals, such costs may include hours colleagues that they, like him, could afford to spent on roadways, stays at uncomfortable “waste a little money buying fuel needlessly shelters with little or no privacy, and burdens or food needlessly.” But if they would “try to on family members and friends with whom think the way an average Joe is thinking they stay. An order of evacuation may also back home” they would need to remember damage the credibility of public officials, that “it’s the end of the month” and people which is essential to securing public trust are “on a fixed income.” Decisions have to and cooperation, if the hurricane (or other 73 be made on the weekend and the “Social forecast disaster) fails to strike. Indeed, Security check doesn’t come until although it was focused on terrorism rather Thursday.”68 It was for similar reasons that than hurricanes, a study by the National many in New Orleans refused to evacuate in Center for Disaster Preparedness found that anticipation of the region’s next hurricane, one third to nearly half of people polled at Rita. Said one Algiers resident, “I don’t have three different intervals in 2004 and 2005 money to run. I don’t have no car, so where cited lack of confidence in officials issuing am I going to run to?”69 People may also feel orders as representing a reason not to 74 a need to stay in area to take advantage of evacuate immediately. Louisiana Governor clean-up employment immediately after a Kathleen Blanco, testifying before the House storm.70 Some employers threaten to dock select committee on the response to the pay of workers who evacuate, thrusting Hurricane Katrina, thus explained, “Put your them an untenable position of weighing their four kids in the car, you’re sitting in the traffic, lives against their jobs.71 One official and they’re screaming. And nothing succinctly summarized the difficulty of happens, and you go home and you say, ‘I’m not doing this again, this is crazy.’”75

12 New Orleans Mayor Ray Nagin underscored healthy, will likely have one or more this point. A rash mandatory evacuation prescription medications to take and may order issued by one of the city’s parish feel disoriented if sent to a shelter without presidents the prior year, he argued, “had friends or family present. the effect of lowering public confidence on exactly when they would listen to a public The duty to provide for people. official as far as ordering a mandatory evacuation.”76,77 An ethical axiom holds that “ought Evacuations pose special risks to implies can”—that is, ordering people to the ill and disabled. In the case of hospital evacuate implies an assumption that they populations, the question raised during have the means to comply. Therefore, any Katrina was “whether they were harming order of mandatory evacuation imposes a them more by moving them or not.”78 duty on the government to provide the Mississippi officials, for example, did not material conditions necessary for citizens to order mandatory evacuation for areas on carry out the order. Congressional higher ground that had a “large number of Representative Christopher Shays (R-CT) medical facilities” and thus “the potential risk stressed this point when he criticized public to patients.”79 In prior hurricanes, sick and officials for their lateness in imposing an elderly people have been moved from order of mandatory evacuation: “the point of hospitals and nursing homes to facilities as making it mandatory, was that then there’s a many as 100 miles away, only to suffer whole host of assistance that your cardiac deaths presumably community gets. They don’t due to the shock of transit In the case of hospital have to just get in their cars or the stress of the populations, the question and drive off. They are situation.80 Since the 1970s, raised during Katrina given special assistance.”82 as Florida has become one was “whether they were In the states and of the nation’s most popular harming them more by territories vulnerable to retirement destinations, moving them or not.” hurricanes, issuance of an evacuation from this order of evacuation hurricane-prone state has entailed massive generally requires those states to provide a mobilizations of elderly residents from variety of services. In Alabama, for example, retirement homes and nursing homes. For officials become responsible for providing for these populations, evacuation to an transportation, food, clothing, housing, and unfamiliar and uncomfortable place such as medical care. Likewise, Connecticut’s a shelter set up in a school gymnasium by emergency management act stipulates that the Red Cross is not trivial.81 An elderly officials may “take such steps as are person, even if physically and mentally necessary for the receipt and care of such

13 evacuees.”83,84 In some states and territories, Hurricane Georges in 1999, for example, though—including Georgia, Louisiana, Louisiana officials were surprised by the Maine, New Jersey, the Carolinas, Texas, number of people with special needs who Virginia, Puerto Rico, and even Florida, needed help evacuating. “I don’t think any of which boasts perhaps the most us had any idea as to the magnitude of the comprehensive emergency management problem…and how serious it was,” statute—language specifying the obligations commented the emergency management of the states is exceedingly general. Notably, director for Jefferson Parish.91 On a national these obligations are imposed whether or level, a 2005 Marist poll commissioned by not an order of mandatory evacuation has the National Center for Disaster been issued. Florida’s governor, for example, Preparedness found that between 25 and 30 has a general mandate to provide shelter percent of the population felt they would be and relief.85 In many states these unable to evacuate in the event of a terror obligations are contingent on the governor’s attack without some assistance.92 declaring a state of emergency. All of the One way to track such people is law in states vulnerable to hurricanes views through a registry or database maintained at such measures as a means of “reduce[ing] the state level. In Florida, for example, a the vulnerability of the people”86 or the “care registry of those with physical, mental, and and welfare of the people.”87,88 sensory disabilities is populated with data The Federal Stafford act from a number of social In many states also authorizes the welfare agencies—the obligations are President to provide Department of Children and contingent on the “temporary housing” free of Family Services, the governor’s declaring a charge for twelve months Department of Health, the state of emergency. but only after the governor Agency for Health Care of a state has declared a major disaster and Administration, the Department of Labor and requested federal assistance.89 Employment Security, and Department of The duty to provide for people is an Elderly Affairs—and updated annually. especially critical one for sick and elderly Surveillance efforts have, since the 1970s, populations, whose needs may include raised profound confidentiality concerns, prescription medications and other life- particularly when they involve medical sustaining interventions that must be made information that individuals might view as available in the days following evacuation.90 being intimate or potentially stigmatizing.93 A critical element of meeting this duty is The legitimacy of sharing public health data knowing well in advance of a rapidly has been the subject of particularly intense approaching disaster who will require debate.94 Nevertheless, a special Texas task additional assistance. In preparing for force to the Governor recommended

14 creating a registry of the elderly, individuals emergency responders during rescue with physical or mental disabilities and their operations and the fair distribution of scarce caregivers, the homeless, and people personnel resources illustrate that without transportation.95 It did not specify individuals who elect to defy evacuation whether the state should follow in the path of orders place not only themselves in Florida,96 where such registration is jeopardy.100 In 1987, for example, a Florida populated with data from a number of social Mayor said, after having issued a mandatory welfare agencies and updated annually and order of evacuation, “I don’t want to be allows citizens the option of preauthorizing callous, but if someone wants to be that emergency response personnel to enter foolish (to ignore evacuation), we have to be their homes during search and rescue concerned with taking care of people who do operations, or New York, which maintains a want to get out… I’m not going to lose a voluntary registry.97 police or fireman because somebody wouldn’t leave.”101,102,103,104 Paternalism and the preemption of Although it would be consonant with individual choice about risk. a broader history of justifying action that compels or prohibits individual behavior by As a compulsory measure instituted framing it in terms of harm to others, as in by the government to guard the health and the instances of smoking and motorcycle safety of the population, mandatory helmet laws,105,106 suggesting that risk to evacuation raises some of others is the central ethical the same ethical issues as Mandatory evacuation issue represents a quarantine. But in sharp raises some of the disingenuous sleight of contrast to the confinement same ethical issues as hand. The central and of people with an infectious quarantine. perhaps most vexing disease, which is designed question that mandatory to protect third parties from harm, those who evacuation raises is whether such orders defy an evacuation primarily place are unacceptably paternalistic, substituting themselves at risk. Likewise, while the the judgment of government officials for that primary purpose of curfew is to ensure the of the affected individuals. Some safety of hurricane response personnel and paternalistic public health measures are to prevent misconduct like looting, it also widely accepted. Regulations on serves to protect a population against its occupational and environmental exposures, own potentially bad judgment in venturing for example, express the belief that society out after dark.98 99 should not let people expose themselves to This is not to say that there is no hazards, even though they might “choose” to potential risk to third parties; the safety of do so.107

15 Governor Blanco and most officials am I going to do?”114 It has long been familiar with the threat of hurricanes, accepted in law and policy that the state believed that there would always be some may overrule parental choice when the people who feel that “they were tougher than welfare of children is endangered.115 Puerto the storm.”108,109,110 Without shifting attention Rico’s emergency management statute, for away from the 80 percent of the Louisiana example, provides for evacuation of population reliant on public transportation “minors…against the will of their parents, and could not have evacuated without guardians, custodians or tutors.”116 Yet in assitance,111 the House’s Select Bipartisan practice there is no evidence of children Committee also found that those who had forcibly having been removed from their the capacity to leave yet chose to remain parents’ custody during an evacuation. behind “must share some of the blame.”112 The view that the government bore an obligation not only to provide for the public, but also to decide for them in emergency situations, did not appear in its final report. During the hearings, however, Representative Shays and others made this argument quite explicitly. Said Shays, “if your argument to us is, you know, we’re brave, we’re tough, so we’re going to stay.… New Orleans, La., September 2, 2005 -- [t]hat’s the whole point of making it Evacuees wait in lines for evacuation. Photo: Michael Rieger mandatory. You don’t have an option. You’re going.”113 For such critics, it was The acceptability of compulsory unconscionable to have the power to compel measures. people to leave and not use it. The final report of the House Bipartisan Select It is a widely accepted tenet of Committee, however, failed to explore what public health ethics that voluntary measures Shays might have required and offered no are preferable to compulsory ones.117 alternative to persuasion. Persuading rather than forcing people to The issue of paternalism takes on a comply with health-preserving procedures is somewhat different cast in considering the also consistent with the country’s liberal case of minor children whose parents may democratic values. Louisiana Governor place them at risk by defying evacuation Kathleen Blanco gave voice to this view orders. When hurricane Hugo threatened when she argued that that forcing people out South Carolina in 1989, one teenager told of their homes at “gunpoint” was unjustified, reporters, “My parents are staying, so what unnecessary, and impractical.118,119 “[I]n the

16 United States of America,” said Blanco, “you statute qualify as misdemeanors.129 But in don’t go out and force people. You urge practice, there are questions as to whether people.”120 This position is consonant with people should be arrested for failure to the recent history of responses to hurricanes, evacuate.130,131,132 And, indeed, arrests have in which mandatory orders were issued with typically been limited to instances in which little intention to enforce them.121 A Florida people are found on the beaches after the official has argued that “’mandatory supposed completion of a mandatory evacuation’ is a misnomer: Officials can’t evacuation or on the streets in violation of a force anyone to leave.”122 Some view this curfew. 133,134 Terry Ebert, director of the stance in terms of respecting individual New Orleans homeland security office, in choice, others in terms of expressing the testimony before the House Select inability of the government to provide further Bipartisan Committee, explained that “non- assistance once a hurricane hits,123 and still lethal verbal persuasion was the way we others of relieving states of responsibility managed trying to regain control over some and liability for those who choose to of those problems.”135 remain.124,125,126 Yet other officials have There exists a broad spectrum of expressed worries that enforcing mandatory options lying between the two extremes of evacuation orders makes the government “urging” and “forcing at gunpoint.”136 One liable for damage that might occur to private preferred tactic in the realm of non-lethal property.127 Nagin, for verbal persuasion been to example, was reportedly Only seven of the states make contact with concerned that a vulnerable to hurricanes individuals either through mandatory evacuation do the emergency “reverse 911” calls order would leave the city management statues (warning individuals about liable for lost revenue.128 explicitly limit liability for the urgent need to leave Indeed, in only seven of the injury, death, or property the area). Such calls states vulnerable to damage. should also be made to hurricanes do the emergency management residents who are requested not to evacuate statues explicitly limit liability for injury, death, an area to minimize the problem of shadow or property damage that may result as a evacuation, in which people who are not in consequence of evacuation or sheltering. danger nonetheless hit the roadways, But despite these very different because of misunderstanding or a sense of perspectives on the risks of ordering vulnerability. In more urgent situations, fire mandatory evacuation, there exists a broad or law enforcement personnel have been consensus that the use of force is sent door to door.137,138,139 In highly unwarranted. Most states, for example, populated urban areas where such specify that violations of the emergency intervention would be infeasible, they could,

17 at least, be sent neighborhood to ignore a disaster warning and then must be neighborhood with loudspeakers. For rescued civilly liable for the costs.148 example, the President of one of Louisiana’s Even following a hurricane, when low-lying Parishes called for a mandatory there is a clear and present danger to evacuation on Saturday morning before the citizens remaining in a disaster zone, storm. On Sunday, sheriff’s deputies went officials have shown a strong preference for door to door to warn any remaining lesser forms of coercion. For example, a residents of the need to evacuate and to little over a week following hurricane Katrina identify those who required further doctors in coastal Louisiana reported assistance. In this way they were able to several cases of a vibro vulnificus, an illness evacuate up to 98 percent of the parish and much like cholera.149,150,151 A spokesperson avert all but three deaths.140 But while such for the federal Centers for Disease Control strategies have typically proved to be and Prevention (CDC) confirmed the cases, effective, they have been criticized by some stating, “It could be life-threatening.”152 In as representing an inappropriate use of response, Mayor Nagin issued a sharply scarce resources in an emergency worded order to city police and federal law situation.141 enforcement officials, commanding them to Although not search houses in all areas necessarily less resource Local police have often of the city, flooded or not, intensive, various types of asked those who and “to compel the burdens or penalties have refuse to evacuate for evacuation of all also been placed on those contact information for persons…regardless of who refuse to leave. Local next of kin, in part to whether such persons are police have often asked impress on them the on private property or do those who refuse to gravity of the risk they not want to leave.”153,154 evacuate for contact were assuming. “Individuals are at risk of information for next of kin, dying,” stressed the city’s in part to impress on them the gravity of the police superintendent, “There’s nothing risk they were assuming.142,143,144,145,146 more important than the preservation of Some legal scholars have recommended human life.”155 It was in this context that this as a more practicable and effective use Nagin declared a state of martial law and of police powers.147 Other tactics intended ordered the city to be emptied. both to convince people to evacuate and to A day later, officials from the EPA reduce the burdens on the public resources and CDC confirmed the waterborne hazard. if they continue to refuse include levying Levels of e-coli and lead were 10 times substantial financial penalties. North higher than was deemed safe.156,157 Indeed, Carolina, for example, holds persons who bacteria levels were so high that they

18 exceeded the limits of EPA testing estimated to number as many as 10,000, as equipment.158 The CDC and state and local people losing their grip on reality.”166 officials confirmed four deaths in Mayor Nagin, therefore, stated his neighboring states from Vibro commitment to using force to evacuate vulnificus.159,160,161 CDC Director Julie anyone remaining in the city. State officials, Gerberding warned, “For the evacuees who however, determined that state troopers and haven’t left the city yet, you must do so.”162 National Guard units were unlikely to assist Local health officials were unable to assist in with any forced evacuations. One official the effort for, according to Gerberding, “the with the Louisiana Office of Homeland entire public health staff in New Orleans is Security and Emergency Preparedness gone.”163 commented, “We personally will not force anyone out of their homes.” Another was less adamant, noting only that Nagin would first have to request the assistance of state law enforcement officers and troops and at that point it would be left to the state’s discretion: “We are not required by law to provide military troops to force people to

Washington, DC, August 30, 2006 – leave their homes.”167 Even some local Photo by Bill Koplitz officials refused to abide by the order. In many instances, knowledge of the Jefferson Parish President insisted that it danger and the order to evacuate were was voluntary for his constituents: insufficient to persuade people to leave. “Somehow this has gotten transferred to Said a restaurant manager, “They keep Jefferson Parish and it just ain’t so. I don’t talking about the threat of disease, but how have the resources to pull people out of their many people have gotten sick so far? I’m 168 164 homes.” not buying it.” Post-storm evacuation Where it could be enforced, the task orders, particularly in neighborhoods that thus fell to the beleaguered city police force. were free from flood waters, raised some The first stage of the forced evacuation residential suspicions. “It has overtones of involved confiscation of all firearms. “Only ethnic cleansing,” said one resident who law enforcement are allowed to have could see no other reason for having to weapons,” said the police superintendent.169 leave what seemed like a safe area. “New Orleans,” noted local reporters, “has “They’re calling us a pocket of resistance,” turned into an armed camp, patrolled by he continued, but “We’re calling ourselves a 165 thousands of local, state, and federal law pocket of civilization.” A London enforcement officers, as well as National correspondent reported that “The authorities Guard troops and active-duty soldiers.”170 were quick to characterize the diehards,

19 Before resorting to employing what New Orleans homeland security office, in the police superintendent described as “the testimony before a House Bipartisan Select minimum amount of necessary Committee investigating the preparation for force,”171 ,172officers concentrated next on and response to Katrina, said that “non- encouraging individuals to leave lethal verbal persuasion was the way we voluntarily.173 In one working-class area of managed trying to regain control over some the French Quarter, police officers of those problems.”179 Nagin, too, while accomplished this task by refusing to leave expressing a heightened interest in ensuring the home of two healthy men with adequate compliance, saw the strategy as largely supplies until they agreed to accompany rhetorical. “We did the legal research and them.174 In another instance, police forcibly found out that it’s very difficult for you to go entered a home and found a man who had into someone’s home and force them to failed to evacuate while they were in pursuit leave,” he told House members. “So we of a suspect. The man reportedly stated decided to instead try to convince as many calmly, “You’re going to have to kill me to people as possible.”180 get me out of this house.” After an hour’s negotiation, with the help of a psychologist who was part of the emergency response team, they counted the man as a voluntary evacuee. He, however, was insistent: “If I had a choice, yeah, I would have rode it out.”175 Emergency response personnel, however, remained certain that he would come to realize that he had made the correct decision.176 Another apparently successful tactic was to inform reluctant evacuees that health officials would be dousing the area with “toxic” spray to control mosquitoes.177 Any individuals who wished to challenge the forced evacuations were required to do so in Baton Rouge, “where the federal judges from the Eastern District of Louisiana, based in New Orleans, have relocated.”178 In the end, there was no documented use of physical force to compel evacuations. Terry Ebert, director of the

20

Policy Implications: Providing and Deciding for

n the face of uncertainty, officials must Requiring the least Ia lways have the option to recommend restrictive/intrusive alternative that can rather than impose evacuation. And, clearly, effectively maximize evacuation represents any evacuation recommendation must be a means to impose limits on government invoked with great care. A precautionary interventions consistent with the traditions of ethic181,182,183 that would have us take bold privacy, freedom of association, and liberty. action regardless of the cost to the The standard, which is grounded in the government and private citizens could pose principle of proportionality, requires that the unacceptable risks to the elderly, the least invasive interventions that may help to disabled, infirm, and those in low lying areas achieve the desired objective are utilized or citizens who might be trapped on the first. Face-to-face encounters with officials highways in an sweeping as opposed to conveying mandatory evacuation orders, targeted evacuation.184,185,186,187 In order to where feasible, are typically sufficient to have any meaning, a mandatory order of convey the urgency of the situation. At the evacuation requires officials to engage in very least, when situations are urgent, vigorous, deliberate efforts to persuade disaster response personnel can be sent reluctant citizens to leave: the compulsory neighborhood to neighborhood with nature of the order must be made clear and loudspeakers.189 enforced. As one legal scholar has argued, If such direct communication fails to the law, in fulfilling its tutelary functions, reduce substantially the proportion of the acknowledges a kind of paternalism—that is, population who refuses to leave, the realization that “the teacher knows requirements involving next of kin something the students do not.” Thus, “the declarations or conveying information about law is more than debate. It is coercion.”188 personal liability for rescue efforts represent Paternalism and compulsion are ethically acceptable measures that require justified in the instance of evacuation in the no physical force. It is not ethically face of disaster because not everyone has permissible to hold citizens liable for the equal access to media, sufficient knowledge, costs of their rescue unless they have been or adequate experience or resources to fully informed of the consequences of their enable them to make sound decisions actions. Just as states cannot be relieved of regarding evacuation. The use of physical the responsibility of making every force, however, is of limited utility. reasonable effort to rescue people in the

21 midst or aftermath of a hurricane or other people in emergency situations rather than calamitous event, they cannot be relieved of deciding for them. There is little question the responsibility to inform them fully of the that, in the face of a mandatory evacuation, practical limits of those efforts and the the government bears specific potential catastrophic consequences of the responsibilities. Because not all citizens failure to comply. How and under what have the financial resources necessary to circumstances penalties might be imposed evacuate, states should provide certain key would require weighing the complex factors resources, namely, means of egress to that figure into decision-making in the anyone who wants or needs transportation context of a crisis.190,191 and shelter equipped with sufficient food, The challenge of how to handle the water, and security personnel. In turn, the evacuation of minors in an emergency States should provide return from flight situation requires further analysis. As noted under circumstances where evacuation is above, among the states and territories compulsorily. The principle of justice vulnerable to hurricanes, only Puerto Rico’s requires that the benefits and burdens of emergency management statutes provides public health action be fairly distributed, thus for the forceful separation of families. Child precluding the additional burdening of abuse law in the U.S. grants the state the already socially vulnerable populations. capacity to remove children from the Officials should, then, extend the same kind custody of their parents. But in the history of of material resources to anyone who civil defense evacuations, the challenge of requests them even during voluntary reuniting families rather than separating evacuations. them has been the priority. Health Providing assistance requires professionals and officials with special knowledge of the needs and whereabouts of expertise in the law and the limits of the most vulnerable. The creation of coercion as it applies to children must be registries of populations with special needs, brought together to decide in advance of a like the elderly and physically and mentally hurricane how officials will approach the disabled, brings into sharp focus the tension problem of evacuating minors against the between surveillance as an essential will of their parents. They should explore strategy for identifying individuals at risk and alternatives to the use of outright the claims of privacy. To the extent that compulsion. What steps, both punitive and states may legitimately order and use some persuasive, might be taken to pressure degree of coercion to compel compliance, parents with children to evacuate? authorities may similarly compel registration. In practice, regardless of powers Such an effort carries an obligation to they are allowed by law, officials have ensure that databases are as complete and placed greater emphasis on providing for accurate as possible regardless of whether

22 registration is voluntary of mandatory and orders. Yet, noted the House Select regardless of whether special needs Bipartisan Committee report, “no one populations are defined narrowly, as in requested that the state or federal Florida, or broadly, as Texas has government provide resources to recommended. The privacy-limiting features supplement those of the parish to implement of such compulsory registration, however, more complete evacuation.”198 FEMA require the government to demonstrate officials, however, strenuously distanced clearly the need to know and intervene with themselves from the position that if local such vulnerable populations and then resources were insufficient then the federal restrict the use of sensitive data to “government needed to assist people to emergency evacuation purposes only. evacuate.”199 For Michael Brown, federal Hurricanes prior to Katrina have responsibility represented “a horrible path to consistently underscored the lack of go down.”200 Justice, however, would adequate shelter space in many regions, demand that if local and state officials are Louisiana in particular.192,193,194 Identifying or unable to extend the necessarily assistance, building appropriate shelters is primarily a then this burden must be borne by the logistical issue. But sheltering raises federal government. Swift and equitable humanitarian and ethical issues as well. The distribution of material resources and case of public health quarantines—where coordination of relief efforts, in turn, requires ethical and legal analyses have stressed the explicit government authority to issue orders importance of providing those confined with of evacuation.201 a “safe and habitable environment” that The Stafford Act broadly authorizes includes provisions for living and basic the president to direct any federal agency to comfort such as food, water, clothing, utilize its resources to support State and bathing, and health care—195,196 provides a local disaster assistance efforts, and to framework for determining acceptable “prescribe such rules and regulations as standards for sheltering evacuees from may be necessary and proper to carry out hurricanes. any of the provisions” of the Act. It also Who, then, is responsible for specifically authorizes federal agencies to providing and maintaining vital resources? perform “any emergency work or services After 1999’s Hurricane Georges, one New essential to save lives and to protect and Orleans official said that “The bottom line is preserve property, public health and safety, the city doesn’t have enough buses and including…search and rescue, emergency vehicles to get everybody out.”197 In medical care, emergency mass care, anticipation of Katrina, Jefferson Parish emergency shelter, and provisions of food, President said that he lacked the necessary water, medicine, and other essential needs, resources to enforce mandatory evacuation including movement of supplies or persons”

23 (emphasis supplied.) The federal government must be willing to use this discretionary power in cases of massive mandatory evacuation.202

24

Recommendations

Concluding its report on the response to There must be some mechanism for Katrina, the House select committee report ensuring that residents are aware that a stressed, “This extraordinary storm required mandatory order of evacuation has been extraordinary measures.”203 Making clear issued. These can include: the obligations of government will help to take emergency responses out of the realm √ Making contact with individuals through of the extraordinary, creating both a set of “reverse 911” calls warning individuals expectations regarding the degree to which about either the urgent need to leave government is required to provide for people the area or the imperative to resist and specific but limited measures that it evacuating an area to minimize the must take when deciding for them. However, problem of shadow evacuation. the committee stops short of reconciling the many disconnects between state and federal √ Sending vehicles with loudspeakers evacuation planning and response and through neighborhoods to make clarifying when an evacuation order should announcements. be called, whom it covers, the extent to which it can be enforced, the liabilities for ƒ The means for compliance must be those who fail to evacuate, and the burden available, such as information about of return following an evacuation. These evacuation routes, public issues are far from trivial and failure to transportation, and shelter; provide carefully debated, codified providing gasoline along evacuation resolutions can undermine even the best routes; providing shelter for pets; evacuation plans. taking steps to accommodate increased traffic on highways; and States, and where applicable special assistance for those who #1 local jurisdictions, should review cannot evacuate without help. emergency management statutes with an eye to clearly and explicitly define options that may be available to implement in a mandatory evacuation.

25 Mandatory evacuation The legal and ethical should not entail physical aspects of evacuation must #2 #4 force, but officials should be be addressed not only at required to use a variety of non-physical the state but also at the federal level. means of enforcing the order. We recommend a national dialogue led by a Mechanisms to enforce evacuation should federally assembled task force comprising begin with the least intrusive, least resource- leaders from FEMA, the National Guard, the intensive alternatives and proceed to more military, state and local law enforcement, forceful, more costly methods as the emergency response personnel; the urgency of the situation demands. These American Red Cross; medical professionals; include: and ethicists and policy analysts. Such a dialogue should consider the following: √ Sending fire or law enforcement personnel door to door. √ Review of the implications, limitations, and obligations imposed by the federal √ Requiring those who refuse to evacuate Stafford Act to complete next of kin forms. √ The responsibly of states with respect to √ Levying financial penalties or holding involuntary evacuation of minors or those who fail to evacuate liable for the other dependents against the wishes of costs of their rescue. their parents or guardians.

States should create √ The ethical and legal obligations of key #3 registries of those in need employees to stay and provide services of special assistance when evacuating. in the face of a mandatory evacuation including but not limited to police and The privacy-limiting features of such fire personnel, emergency medical registration require the government to service providers, hospital-based restrict the use of sensitive data to medical providers and staff, and bus emergency evacuation purposes only. drivers.

√ The obligation to ensure sufficient public sector resources and funds as needed for persons with limited resources to comply with mandatory evacuation orders.

26

References

17 1 Joby Warrick, Spencer S. Hsu, and Anne Hull, Warrick, Hsu, and Hull, "Blanco Releases "Blanco Releases Katrina Records; La. Governor Katrina Records." 18 Seeks to 'Set the Record Straight' Ibid. 19 " Washington Post, December 4 2005. “A Failure of Initiative: Final Report of the 2 Gordon Russell, "Nagin Gets Mixed Reviews; Select Bipartisan Committee to Investigate the Evacuation Plans, Superdome Use Criticized," Preparation for and Response to Hurricane Times-Picayune, October 23 2005. Katrina,” Washington D.C., U.S. Government 3 Rogers, House Hearings, December 14, 2005. Printing Office, February 15, 2006. 20 See also testimony of Nagin. Governor’s Task Force on Evacuation, 4 Rogers, House Hearings, December 14, 2005. Transportation, and Logistics, Final Report to the 5 Harold Rogers (R-KY), House Bipartisan Governor, Austin, Texas, February 14, 2006. 21 Select Committee Hearings, December 14, 2005. Thomas Davis (R-Virginia), House Bipartisan 6 Julia Malone, "Mass Evacuation of New Select Committee Hearings, December 14, 2005. 22 Orleans Called 'Success'; Feds at Fault for Slow Ibid. 23 Rescue Efforts, La. Governor Tells House Bruce Alpert, "Ex-FEMA Chief Pins Blame on Committee," Atlanta Journal-Constitution, La.; Late Evacuation Order Lead to Mess, He December 15 2005. Tells Congress," Times-Picayune, September 28 7 Spencer S. Hsu, "Blanco Criticizes Levees, 2005. 24 Hails Evacuation Efforts," Washington Post, “Final Report of the Select Bipartisan December 15 2005. Committee,” p. 103. 25 8 Russell, "Nagin Gets Mixed Reviews; “A Failure of Initiative: Final Report of the Evacuation Plans, Superdome Use Criticized." Select Bipartisan Committee to Investigate the 9 Harold Rogers (R-KY), House Bipartisan Preparation for and Response to Hurricane Select Committee Hearings, December 14, 2005. Katrina,” p. 111. 26 10 Ray Nagin (Mayor, New Orleans), House Ibid., p. 108. 27 Bipartisan Select Committee Hearings, "Florida East Coast Spared by Hurricane :13 December 14, 2005. Dead, 300 Hurt, Millions Damage 11 In Mississippi, mandatory evacuation in Cuba," Chicago Daily Tribune, Sep 29 decisions are made by local officials. Brent Warr 1935. 28 (Mayor, Gulfport, Mississippi), House Bipartisan “Seas and Winds Lash Florida,” New York Select Committee Hearings, December 7, 2005. Times, Sep 4, 1933. p. 3 29 Congressional Quarterly. http://web.lexis- Kerry Emanuel, Divine Wind, the History and nexis.com. Science of Hurricanes, New York, Oxford 12 Anne Ryals (Director, Baldwin County University Press, 2005, pp. 118-121. Also see Emergency Management Agency), House “Storm Toll Staggers :Florida Dead Set at 2300; Bipartisan Select Committee Hearings, Search for Bodies Continues Amid Wreckage- December 7, 2005, November 9, 2005. Strewn Cities and Towns; Governor Directs Congressional Quarterly. http://web.lexis- Work of Clearing Roads and Linking Wires,” nexis.com. Los Angeles Times, Sep 25, 1928., p. 1 , Deaths 13 Malone, "Mass Evacuation of New Orleans In Florida Said To Total 2,300 :More Emergency Called 'Success'." Supplies Rushed Into Stricken Everglades Area. 14 Kathleen Blanco (Governor, Louisiana) and Lake Control Is Urgent, The Washington Post, Ray Nagin (Mayor, New Orleans), House Sep 25, 1928. Zora Neale Hurston, Their Eyes Bipartisan Select Committee Hearings, Were Watching God. 30 December 14, 2005. “Storm Razes Florida Homes :Hurricane And 15 Ibid. Cyclones Beset Resort Land,” Chicago Daily 16 House Bipartisan Select Committee Report, p. Tribune, Sep 29, 1929. (2 pp.). 111.

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31 “Planes Evacuated in Threat of Hurricane,” 41 Bill Curry, “Mainland Girds For Storm Today: Washington Post, September 22, 1941, By Lieut. South Florida Bracing for First Hurricane in 14 Comdr. A.R. Fields, “Military Planes Being Years,” The Washington Post, Sep 3, 1979. Flown Out Of Storm Area :Navy Fliers Find 42 Thames Shipyard & Repair Co. v United Hurricane Contains Core Within Core, USN, The States 350 F3d 247 (2003). Washington Post, Sep 15, 1947; “Navy Shifts 43 , "Title 4. Executive Branch, Subtitle B. Law 450 Aircraft, New York Times, Sep 16, 1947. p. Enforcement And Public Protection, Chapter 45. 418. Emergency Management, Subchapter B. 32Kerry Emanuel, Divine Wind: The History and Powers And Duties Of Governor " in Tex. Gov't Science of Hurricanes (New York, 2005). p. 194. Code (2005). 33 Ibid. p. 195. 44 Thames Shipyard & Repair Co. v United 34 64 Statutes 1245-1254, 81st Congress, 2d States 350 F3d 247 (2003). Session, Chapter 1228- Jan 12, 1951. 45 , "The Louisiana Homeland Security and 35 See for example, Alabama Code § 31-9-1-24 Emergency Assistance and Disaster Act, § (2005) TITLE 31. MILITARY AFFAIRS AND 29:724 D," in La. R.S. CIVIL DEFENSE CHAPTER (2005). 9. EMERGENCY MANAGEMENT, which still 46 , "The Louisiana Homeland Security and includes a provision requiring that those Emergency Assistance and Disaster Act, § involved in civil defense/emergency 29:737. B. (4)." in La. R.S. (2005). preparedness sign a loyalty oath to the United 47 , "Title 33. Military Affairs , Chapter 15, States. Emergency Management And Civil Defense, 36 Storms Rip East; 63 Dead :Eight States Article 1. Emergency Management Law, § 33- Buffeted By Blizzard And Gales Industry 15-17," in Miss. Code Ann. (2005). Crippled, Damage Put in Millions Doctor Uses 48 In Florida the relationship between state and Horse Chicago Daily Tribune, Nov 26, 1950. p. local authorities is “confusing.” While in 1983 1. the state Attorney General interpreted the law as 37Robert K. Plumb, “Rim Of Hurricane Due To prohibiting localities from declaring a state of Lash City With Gales, Tides,” New York Times, emergency and ordering evacuations, little more Sep 11, 1954. p. 1. than a decade later the office of the Attorney 38 Peter Kihss, "Gales Move On The City: General determined that, in fact, localities did Damage Is Severe New York Area Due to Feel possess the authority to order an evacuation the Effects of Hurricane Today Hurricane Ione absent a directive from the governor. Stetson Lashes at Carolina Coast With High Winds and Law review article, p. 854, 857. Office of The Tides," New York Times, September 20. Attorney General of The State of Florida 95-24, 39 For dollar figures, Emanuel, p. 257. Roy Reed, April 3, 1995 “New Orleans Loss In Storm Heavy; 23 Dead in 49 , "Title 20. Military And Civil Defense, Part II. 3 States: Storm Loss High In New Orleans Civil Defense, Chapter 31. Emergency Floodwaters Swirl in Southern Cities After Management, Subchapter III. The Governor Pounding by Hurricane, New York Times Sep 11, And Emergency Management, §3115 (a) " in 1965. p. 1 (2 pp.). Delaware Code Annotated (2005). Florida, 40 The U.S. evacuation approaches contrasted Georgia, Hawaii, Maine, Mississippi statutes with the uniformly mandatory approach applied contain similar language:, " in Cuba, which had suffered about 1,750 deaths Title 17. Military Affairs And Related Matters in 1963’s hurricane Flora when people failed to (Chs. 250-252), Chapter 252. Emergency obey an evacuation order. After that disaster, Management Part I. General Provisions, § according to press reports, Fidel Castro 252.36 " in Florida Annotated Statutes (2005), , personally saw to it that people were evacuated "Title 38. Military, Emergency Management, from vulnerable areas in advance of hurricanes. And Veterans Affairs, Chapter 3. Emergency “Hurricane Takes a Savage Swipe At Cuba, Management, Article 2. Organization And Heads for Mid-Bahamas,” The Washington Post, Administration, UCGA § 38-3-22 (a)," in Times Herald (Oct 1, 1966. p. A1; “Hurricane Official Code Of Georgia Annotated (2005). , " Moves Across West Cuba; Florida Is Alerted , Title 17. Military Affairs And Related Matters New York Times, Jun 8, 1966. (Chs. 250-252), Chapter 252. Emergency Management Part I. General Provisions, § 252.36 ". , " Civil Defense and Emergency Act, §

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128-6," in Hawaii Revised Statutes , , "Title 33. 64Matt Stiles Bill Murphy, Janet Elliott, Military Affairs, Chapter 15. Emergency "Hurricane Rita: The Aftermath; Hurricane Costs; Management And Civil Defense, Article 1. Repayment Sought For Waived Tolls;County Emergency Management Law, . § 33-15-11 " in Wants $ 7 Million That Was Lost In Fees For Mississippi Code Annotated (2005), , "Title 37-B. Using Roads," The Houston Chronicle, Defense, Veterans And Emergency September 27 2005. Management ,Chapter 13. Maine Emergency 65 David Ballingrund, "Hurricane Evacuation Management Agency , Subchapter II. State lesson: If You Aren't Told to Go, Stay Put," St. Emergency Management Provisions, § 741 " in Petersburg Times, April 21 2000. Maine Revised Statutes Annotated (2005). "Title 66 Josh Getlin, "7,500 Evacuees Racked by 33. Military Affairs, Chapter 15. Emergency Anxiety, Confusion, Boredom," Los Angeles Management and Civil Defense, Article 1. Times, Jun 25 1985. Page A1. Emergency Management Law, § 33-15-11" in 67 J Michael Kennedy, “High Risks Seen on East, Mississippi Code Annotated (2005), Gulf Coasts: Hurricane Disaster in Booming Office of the Attorney General of the State of Areas Feared,” Los Angeles Times, Aug 30, 1985. Georgia, "Re: Designated local officials have the p. A1. authority to require evacuation of citizens during 68 Representative Gene Taylor (D-Mississippi), a local emergency, but the Governor may House Bipartisan Select Committee Hearing, exercise his authority over such an evacuation if December 7, 2005. Congressional Quarterly. he believes the emergency is beyond local http://web.lexis-nexis.com. control or constitutes a "state of emergency."" 69 Ann M. Simmons, "One Evacuation is (1983). Enough, Some Say; As Rita Looms, Residents 50 Governor’s Task Force on Evacuation, Refuse to Budge, Mindful of the Hardships Transportation, and Logistics, Final Report to the Suffered in Escaping Katrina or Lacking the Governor, Austin, Texas, February 14, 2006, pp. Means to Mount an Effort to Flee," Los Angeles 4, 8. Times, September 21 2005. 51Public Law 93-288, “Disaster Relief Act 70 David M. Halbfinger, "As Hurricane Isabel Amendments of 1974,” Title II, “Disaster Bears Down, Disaster Plans Are Put into Effect," Preparedness Administration,” and Title III, New York Times, September 16 2003. “Disaster Assistance Administration,” 88 Stat. 71 Schleifstein, "Hurricane Season: Are We 144-146. Ready?." 52David G Tucker and Alfred O. Bragg III, 72 Colonel Jeff Smith (Deputy Director, Louisian "Florida's Law of Storms: Emergency Office of Homeland Security and Emergency Management, Local Government, and the Police Preparedness), House Bipartisan Select Power," Stetson Law Review 30 Stetson L. Rev. Committee Hearing, December 7, 2005. 837 Congressional Quarterly. http://web.lexis- (2001). nexis.com. 53 Thames Shipyard & Repair Co. v United 73 Annie Gowen, "Belle View Evacuation States, 350 F3d 247 (2003). Allegedly Delayed' Official Says County Waited 54 Ibid. Too Long," Washington Post, September 25 55 (727 F. Supp. 200) 2003. 56 ACLU v. Chandler. 458 F. Supp 456.. w. d. 74 Marist College Institute for Public Opinion, tenn, 1978. Report Commissioned by the National Center for 57 Moorhead v. Farrelly - 723 F. Supp. 1109 Disaster Preparedness, Columbia University 58 Ibid, (p. 1113) Mailman School of Public Health (October 59 Ibid, (p. 1113) 2005). 60 Ibid, (p. 1114) 75 Kathleen Blanco (Governor, Louisiana), 61 Neil Johnson and John Railey, "Evacuation House Bipartisan Select Committee Hearings, Procedures: Flurry Before Storm," Tampa December 14, 2005. Tribune, August 5 2002. 76 Ray Nagin (Mayor, New Orleans), House 62 William Booth, "Thousands Evacuated as Bipartisan Select Committee Hearings, Berth Advances," Washington Post, July 11 December 14, 2005. 1996. 77 Need the cite for Neil Frank, Director of the 63 Mark Schleifstein, "Hurricane Season: Are We National Hurricane Center, discussing issue of Ready?," Times-Picayune, May 30 1993. overwarnings in 1977

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78 Representative William Jefferson (D- Evacuation in the Region's History," Times- Louisiana), House Bipartisan Select Committee Picayune, September 26 1999. Hearing, December 7, 2005. Congressional 92 Marist College Institute for Public Opinion, Quarterly. http://web.lexis-nexis.com. Report Commissioned by the National Center for 79 Brent Warr (Mayor, Gulfport, Mississippi), Disaster Preparedness, Columbia University House Bipartisan Select Committee Hearing, Mailman School of Public Health (October December 7, 2005. Congressional Quarterly. 2005). http://web.lexis-nexis.com. 93 Amy L. Fairchild, Ronald Bayer, and James 80 Roy Reed, “Chlorine Barge Recovered Off Colgrove, with Daniel Wolfe, The Searching Baton Rouge :Peril Ruled Out And Evacuees Eyes of Government: The Promise and Specter Return to City,” New York Times, Nov 13, 1965. of Public Health Surveillance (Berkeley: p. 31. University of California Press, 2007, 81 “Magazine Tells of Hurricane Frederic,” forthcoming). University of Alabama News, February 17, 2000, 94 Centers for Disease Control and Prevention, A accessed online at Framework for the Use of Identifiable Public http://uanews.ua.edu/feb00/hurricane021700.htm. Health Data 82 Christopher Shays (R-CT), House Bipartisan with a Focus on HIV/AIDS, draft, July 2005. Select Committee Hearings, December 14, 2005. 95 Governor’s Task Force on Evacuation, 83 , " Alabama Emergency Management Act Of Transportation, and Logistics, Final Report to the 1955, § 31-9-7 " in Code of Alabama (2005). Governor, Austin, Texas, February 14, 2006. 84, "Title 28 Civil Preparedness And Emergency p.5,11. Services 96, "Title 17. Military Affairs And Related Chapter 517 Civil Preparedness. Department Of Matters (Chs. 250-252), Chapter 252. Emergency Management And Homeland Emergency Management, Part I. General Security, § 28-9," in Conn. Gen. Stat. (2004). Provisions . §252.355.(1) Registry of persons 85 , "Title 17. Military Affairs And Related with special needs; notice," in Fla. Stat. (2005). Matters (Chs. 250-252); Chapter 252. 97 , "Executive Law, Article 2-B. State and Emergency Management; Part I. General Local Natural And Man-Made Disaster Provisions, § 252.311," in Florida Annotated Preparedness, NY CLS Exec § 23-a " in New Statutes (2005). York Consolidated Law Service (2005). 86 , " 98 Kevin Metz, "Opal Leaves Anger, Anguish," Title 20. Military And Civil Defense. Part II. Tampa Tribune, October 7 1995. Civil Defense. Chapter 31. Emergency 99 E.R. Shipp, "Galveston Residents Clean Up Management. Subchapter I. General Provisions, After a Costly Visitor," New York Times, August § 3101 " in Delaware Code Annotated (2005). 20 1983. 87, " Alabama Emergency Management Act Of 100 “Final Report of the Select Bipartisan 1955, § 31-9-7 ". Committee,” p. 114. 88 The emergency management assistance 101 Charla Cribb, "Cities Consider Forced compact that many states have signed in order to Evacuation," St. Petersburg Times, May 26 ensure mutual aid and cooperation in the event of 1987. an emergency includes this language. See, for 102 Ibid. example, , "Title 28 Civil Preparedness And 103 Diane Steinle, "Foolhardy Acts of Defiance Emergency Services, Chapter 517 Civil Risked Others' Lives in Storm," St. Petersburg Preparedness. Department Of Emergency Times, August 22 2004. Management And Homeland Security , § 28- 104 Ted Byrd, "Hurricane Jeanne Officials Order 23a., Emergency Management Assistance Evacuations, Urge Caution," Tampa Tribune, Compact," in Connecticut General Statutes September 26 2004. (2004). 105 Bayer and James Colgrove, “Science, Politics 89 Public Law 93-288, Title IV “Federal Disaster and Ideology in the Campaign Against Assistance Programs,” 88 Stat. 154. Environmental Tobacco Smoke,” American 90 Julie Bell and Matthew Hay Brown, " Medical Journal of Public Health 92 (2002): 949-954. considerations thrown into disarray; Katrina's 106 Marian Moser Jones and Ronald Bayer, Wake," The Baltimore Sun September 18 2005. “Paternalism and its Discontents: The Rise and 91 Pam Louwagie, "Lessons Learned; One Year Fall of Motorcycle Helmet Laws,” American Ago, Hurricane Georges Ignited the Largest Journal of Public Health (forthcoming).

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107 Norman Daniels, “Doth OSHA Protect Too 122 Johnson and Railey, "Evacuation Procedures: Much?” Just Health Care (Oxford University Flurry Before Storm." Press, 1985):Chapter 7. 123 R. Robin McDonald, "Hurricane Fran; The 108 James Dao, "Lawmakers Question Louisiana Aftermath," Atlanta Journal and Constitution, Governor on Storm Response and Preparation," September 7 1996. New York Times, December 15 2005. 124 Ibid. 109 Shaila Dewan and Janet Roberts, "Louisiana's 125 Bruce Smith, "Evacuations Begin as Fran Deadly Storm Took Strong as Well as the Moves In," Chicago Sun-Times, September 5 Helpless," New York Times, December 18 2005. 1996. 110 See also Marist College Institute for Public 126 Cribb, "Cities Consider Forced Evacuation." Opinion, Report Commissioned by the National 127 McDonald, "Hurricane Fran; The Aftermath." Center for Disaster Preparedness, Columbia 128 House Report, p. 109. University Mailman School of Public Health 129 Johnson and Railey, "Evacuation Procedures: (October 2005). Flurry Before Storm." 111 “A Failure of Initiative: Final Report of the 130 Nowadsky, pp. 16-20. Select Bipartisan Committee to Investigate the 131 McDonald, "Hurricane Fran; The Aftermath." Preparation for and Response to Hurricane 132 Susan Taylor Martin, "A Message from Katrina,” p. 111-13. Hugo: Destruction in S.C. Holds a Warning for 112Ibid, p. 114. Tampa Bay Area," St. Petersburg Times, 113 Christopher Shays (R-CT), House Bipartisan December 3 1989. Select Committee Hearings, December 14, 2005. 133 Cribb, "Cities Consider Forced Evacuation." 134 114Dennis Hevesi, “Winds of 135 M.P.H. Snap Ibid. 135 Power Lines -- Flooding Reported :Full Force of Terry Ebert (Director, Louisiana office of Hurricane Lashes South Carolina Coast,” New Homeland Security, New Orleans), Bipartisan York Times, Sep 22, 1989. (2 pp.) Select Committee Hearings, December 14, 2005. 136 115 The issue has often been raised in the context Joel Feinberg, Harm to Self: The Moral of religious minorities. For example, Prince v. Limits of the Criminal Law (New York: Oxford Massachusetts 321 U.S. 158 (1944), the U.S. University Press, 1986), pp. 189-195. 137 Supreme Court case overriding the right of a John F. Kelly and Annie Gowen, "Flooding Jehovah’s Witness to have a minor child Forces Evacuation of Towns," Washington Post, distribute religious tracts on the ground that it September 19 2003. 138 constituted child labor. Gowen, "Belle View Evacuation Allegedly 116 Commonwealth of Puerto Rico Statutes Delayed' Official Says County Waited Too §172r, c and d. Long." 139 117 James F. Childress, Ruth R. Faden, Ruth D. Kelly and Gowen, "Flooding Forces Gaare, Lawrence O. Gostin, Jeffrey Kahn, Nancy Evacuation of Towns." 140 E. Kass, Anna C. Mastroianni, Jonathan D. “A Failure of Initiative: Final Report of the Moreno, and Phillip Nieburg, “Public Health Select Bipartisan Committee to Investigate the Ethics: Mapping the Terrain,” Journal of Law, Preparation for and Response to Hurricane Medicine, and Ethics 2002; 30: 170-8. Katrina,”p. 112. 141 118 Colonel Jeff Smith (Deputy Director of the Johnson and Railey, "Evacuation Procedures: Louisiana Office of Homeland Security and Flurry Before Storm." 142 Emergency Preparedness), House Bipartisan “Hurricane Smashes Gulf Coast :Nearly Select Committee Hearings, December 14, 2005. 500,000 Flee Winds, High Tides In Four-State 119 Hsu, "Blanco Criticizes Levees, Hails Area,” The Washington Post , Sep 13, 1979. 143 Evacuation Efforts." Ronald Smothers, “Thousands Flee Coast As 120 Kathleen Blanco (Governor, Louisiana), Hurricane Nears :150,000 Flee as Hurricane House Bipartisan Select Committee Hearings, Nears North Carolina Coast,” New York Times December 14, 2005. Aug 31, 1993. 144 121 Michael Amon, Joshua Partlow, and Estes Thompson, "Bonnie Steams Inland; Raymond McGaffrey, "Isabel's Angry Rampage Hurricane Churns Toward Carolinas; 530,000 Proves to Be 'As Bade as We Expected'; In Evacuate," Columbus Dispatch, August 26 1998. 145 Hurricane's Wake, Residents Assess Damage," McDonald, "Hurricane Fran; The Aftermath." Washington Post, September 21 2003.

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146 Deborah Sharp, "1 Million Wait Out 165 Catalanello, "Mayor Orders Forcible Hurricane: 'This Will Make Hugo Look Weak'," Evacuations." USA Today, August 24 1992. 166 Gumbel, "Hurricane Katrina: Residents 147 III, "Florida's Law of Storms: Emergency Already Planning to Return." Management, Local Government, and the Police 167 Gold, Cart, and Braun, "Police May Force Power." pp. 870-71. Out Residents; Bacteria Counts Off the Charts, 148, "North Carolina Emergency Management U.S. Warns; Congress to Probe Failures." Act of 1977, 166A-15.1 " in N.C. Gen. Stat. 168 Staff Reporters, "Breaking News from The (2005). Times-Picayune and Nola.com; Hurricane 149 Scott Gold, David Zucchino, and Stephen Katrina--The AftermathWeblog for Day 12," Braun, "Katrina's Aftermath; Hundreds Refuse to Times-Picayune, September 7 2005. Evacuate; 'We're Trying to Convince Them 169 Berenson and Broder, "Police Begin Seizing There's Nothing for Them Here,' Official Says," Guns of Civilians." Los Angeles Times, September 6 2005. 170 Ibid. 150 Alex Berenson and John M. Broder, "Police 171 Berenson and Chan, "Forced Evacuation of a Begin Seizing Guns of Civilians," New York Battered New Orleans Begins." Times, September 9 2005. 172 Gold, Cart, and Braun, "Police May Force 151 Alex Berenson and Sewell Chan, "Forced Out Residents; Bacteria Counts Off the Charts, Evacuation of a Battered New Orleans Begins," U.S. Warns; Congress to Probe Failures." New York Times, September 8 2005. 173 Catalanello, "Mayor Orders Forcible 152 Gold, Zucchino, and Braun, "Katrina's Evacuations." Aftermath; Hundreds Refuse to Evacuate." 174 Berenson and Chan, "Forced Evacuation of a 153 Berenson and Broder, "Police Begin Seizing Battered New Orleans Begins." Guns of Civilians." 175 Ibid. 154 Berenson and Chan, "Forced Evacuation of a 176 Ibid. Battered New Orleans Begins." 177 Gold, Cart, and Braun, "Police May Force 155 Berenson and Broder, "Police Begin Seizing Out Residents; Bacteria Counts Off the Charts, Guns of Civilians." U.S. Warns; Congress to Probe Failures." 156 Berenson and Chan, "Forced Evacuation of a 178 Berenson and Chan, "Forced Evacuation of a Battered New Orleans Begins." Battered New Orleans Begins." 157 Rebecca Catalanello, "Mayor Orders Forcible 179 Ebert, House Hearings, December 14, 2005. Evacuations," St. Petersburg Times, September 8 180 Nagin, House Hearings, December 14, 2005. 2005. 181 B.D. Goldstein, “The Precautionary Principle 158 Scott Gold, Julie Cart, and Stephen Braun, Also Applies to Public Health Actions,” AJPH "Police May Force Out Residents; Bacteria 91;9 (September 2001):1358-61. Counts Off the Charts, U.S. Warns; Congress to 182 A. Jordan and T. O’Riodan, “The Probe Failures," Los Angeles Times, September 8 Precautionary Principle in Contemporary 2005. Environmental Policy and Politics,” in 159 Berenson and Chan, "Forced Evacuation of a Protecting Public Health & the Environment: Battered New Orleans Begins." Implementing the Precautionary Principle (eds.) 160 Catalanello, "Mayor Orders Forcible Carolyn Raffensperger and Joel Tickner Evacuations." (Washington, D.C. and Covelo, California: 161 Gold, Zucchino, and Braun, "Katrina's Island Press, 1999):20, 25. Aftermath; Hundreds Refuse to Evacuate." 183 N.A. Ashford, “A Conceptual Framework for 162 Gold, Cart, and Braun, "Police May Force the Use of the Precautionary Principle in Law,” Out Residents; Bacteria Counts Off the Charts, in Protecting Public Health and the U.S. Warns; Congress to Probe Failures." Environment: Implementing the Precautionary 163 Staff Reports, "Breaking News from The Principle (eds.) Carolyn Raffensperger and Joel Times-Picayune and Nola.com; Hurricane Tickner (Washington, D.C. and Covelo, Katrina--The AftermathWeblog for Day 9," California: Island Press, 1999):198-206. Times-Picayune, September 4 2005. 184 Jan Moller, "Communication Called Storm 164 Andrew Gumbel, "Hurricane Katrina: Evacuation Key; Crisis Officials Look at Residents Already Planning to Return as Forced Adusting Tolls, Traffic Lights," Times-Picayune, Evacuation Goes On," The Independent, December 3 2004. September 10 2005.

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185 Tommy Crags, "Some Fear Escape Plan is a 203 “A Failure of Initiative: Final Report of the Road to Nowhere; Parish Lacks Shelter for Select Bipartisan Committee to Investigate the Fleeing Motorists," Times-Picayune, July 21 Preparation for and Response to Hurricane 2001. Katrina,” p. 109. 186 Louwagie, "Lessons Learned; One Year Ago, Hurricane Georges Ignited the Largest Evacuation in the Region's History." 187 Shipp, "Galveston Residents Clean Up After a Costly Visitor." 188 Carl Schneider, “Moral Discourse, Bioetcs, and the Law,” Hastings Center Report (November-December 1996):38. 189 Kelly and Gowen, "Flooding Forces Evacuation of Towns." Gowen, "Belle View Evacuation Allegedly Delayed' Official Says County Waited Too Long." Kelly and Gowen, "Flooding Forces Evacuation of Towns." 190 Gerald Dworkin, “Voluntary Health Risks and Public Policy,” Hastings Center Report (October 1981):26039. 191 Norman Daniels, “Doth OSHA Protect Too Much?” Just Health Care (Oxford University Press, 1985):Chapter 7. 192 Karen Turni Bazile and Amy Blakely, "Evacuation Orders Heeded; But Plaquemines' Bus Plan Breaks Down," Times-Pacayune, September 17 2004. 193 Louwagie, "Lessons Learned; One Year Ago, Hurricane Georges Ignited the Largest Evacuation in the Region's History." 194 Tommy Craggs, "Some Fear Escape Plan is a Road to Nowhere; Parish Lacks Shelter for Fleeing Motorists," Times-Picayune, July 21 2001. 195 Lawrence O. Gostin, Ronald Bayer, and Amy L. Fairchild, “Ethical and Legal Challenges Posed By SARS: Implications for the Control of Severe Infectious Disease Threats,” JAMA 290;4 (December 24, 2003):3229-3237. 196 MK Wynia and L. Gostin, “The Bioterrorist Threat and Access to Health Care,” Science. 2002; 296: 1613. 197 Louwagie, "Lessons Learned; One Year Ago, Hurricane Georges Ignited the Largest Evacuation in the Region's History." 198 “A Failure of Initiative: Final Report of the Select Bipartisan Committee to Investigate the Preparation for and Response to Hurricane Katrina,” p. 110. 199 Ibid., p.111. 200 Ibid., p.106. 201 Governor’s Task Force on Evacuation, Transportation, and Logistics, Final Report to the Governor, p. 8. 202 Public Law 93-288, Title I, Sec.302.

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