The judicial role in life-sustaining medical treatment decisions.

Although there has been speculation regarding the pervasiveness and nature of judicial decisions regarding life-sustaining medical treatment (LSMT), no attempt has been made to empirically assess their prevalence or the issues they address. An exploratory study utilizing a mail survey of a nationwide random sample (N = 905) of state trial court judges was conducted to provide initial information regarding this decision-making process. Twenty-two percent of the responding judges had heard at least one LSMT case, and judicial review did not appear endemic to particular states. The number of judges hearing LSMT cases dropped from 1975 to 1981 but has increased since then. Three major issues predominate: patient competency, appointment of a surrogate decisionmaker, and resolution of the ultimate issue of forgoing LSMT. Relatively few cases either contested a prior directive's validity or involved imposing sanctions for instituting or forgoing LSMT. Although subject to different interpretations, the results suggest the courts are having a significant impact on certain aspects of the LSMT decision-making process. However, the infrequency with which any one judge is called upon to make an LSMT decision causes concern about the judiciary's ability to respond in a timely and appropriate manner. With their potential for a profound effect on the actions of health care providers, greater attention to this decision-making process is warranted.     

Conception and the Irrelevance of the Welfare Principle

This article challenges the assumption that their future children's welfare is a relevant consideration when deciding whether to provide a person with assisted conception services. It does not argue that infertility treatment ought to be available as of right. Rather, this article's proposal is that section 13(5) – which specifies that no-one shall receive assistance with conception unless account has first been taken of the welfare of any child who might be born – should be deleted from the Human Fertilisation and Embryology Act 1990. Extending the 'welfare principle' to decisions taken prior to a child's conception is shown to be unjust, meaningless and inconsistent with existing legal principle.     

Confronting Islamist Insurgencies in Africa: The Case of the Islamic State in Mozambique

The proliferation of Salafi-jihadi insurgencies across Africa challenges the United States’ counterterrorism approach. From its inception, the insurgency in Cabo Delgado, Mozambique was driven by local and foreign dynamics, which have been complicated by additional external intervention in the conflict. Using the Cabo Delgado insurgency, we demonstrate how efforts to address its global dimensions, such as the group's affiliation with the Islamic State, can work against attempts to mitigate its local drivers. We conclude with recommendations for a more effective U.S. response that takes both the local and global dynamics into account. This article builds on our February 2021 report “Combating the Islamic State's Spread in Africa: Assessment and Recommendations for Mozambique,” published by the American Enterprise Institute.     

Governing Campus Speech: a Bottom-Up Approach

I review arguments favoring bans on problematic speech (e.g., hate speech) on campus. Contrasting such calls for top-down regulation, I explore the potential for a “bottom-up approach” to campus speech governance to address vexing concerns pertaining to campus speech without violating free speech and academic freedom principles. I examine the political economy and epistemological dynamics inherent within the two forms of governance. I argue that, relative to a centralized top-down approach, a decentralized bottom-up approach to speech governance avoids political dynamics that bend toward the inappropriate use of power. Further, I argue that a bottom-up approach leaves the discursive space contestable, and therefore more open to new discovery and correction. Recognizing that a bottom up approach is no panacea, I also consider open questions and concerns that warrant further inquiry.     

Conceptualising corporate community development

Globally there is an increasing focus on the private sector as a significant development actor. One element of the private sector’s role emphasised within this new focus has been corporate social responsibility (CSR) activities, whereby the private sector claims to contribute directly to local development. There is now a substantial body of work on CSR but it is a literature that is mostly polarised, dominated by concerns from the corporate perspective, and not adequately theorised. Corporations typically do development differently from NGOs and donors, yet the nature and effects of these initiatives are both under-researched and under-conceptualised. In this paper we argue that viewing CSR initiatives through a community development lens provides new insights into their rationale and effects. Specifically we develop a conceptual framework that draws together agency and practice-centred approaches in order to illuminate the processes and relationships that underpin corporate community development initiatives.