The patient who refuses medical treatment: a dilemma for hospitals and physicians

This article reviews recent case and statutory law concerning patients who refuse medical treatment. Among the special cases considered are: the competent adult patient who refuses treatment on religious or privacy grounds; the incompetent patient whose own wishes were never expressed, but whose family refuses treatment; the incompetent patient who expressed the wish not to be treated before becoming incompetent; and parents who refuse treatment on behalf of their child. It is pointed out that recent court decisions have blurred the distinctions between "extraordinary" care and "ordinary" care and between withholding and withdrawing life-sustaining treatment. Reference is made to the recent trend toward allowing the family of an incompetent patient to assert the patient's rights without court intervention either in the form of direct court order or through guardianship proceedings. Finally, the implications of these legal developments for health care institutions are discussed. A protocol pertaining to incompetent patients is proposed. Health care institutions are encouraged to develop formal policies for dealing with patients who refuse treatment, and to work with their professional associations in lobbying for legislation which will clarify the law in this area.     

An Improved Protection for the (Mentally Ill) Trans Parent: A Queer Reading of AP,Garçon and Nicot v France

The European Court of Human Rights has been deciding cases concerning LGBT rights since the early 1980s. Its case law on trans rights has changed drastically over time, imposing upon the states of the Council of Europe certain minimum standards regarding the legal recognition of gender identity. In its recent judgment of April 2017 the Court laid down a new rule to be adopted by domestic legislation; namely, that the legal recognition of gender transition cannot be made conditional upon pursuing medical or surgical procedures which have (or are likely to have) sterilising effects. This article analyses the judgment from a critical perspective grounded in queer theory, noting both the positive and the negative elements of the Court's decision.     

Whatever Happened to Canadian Children's Equality Rights? A Reconsideration of the Eaton Special Education Case

This paper reconsiders the Canadian Supreme Court Decision in Eaton and examines its implications for the equality rights of Canadian children in general. The suggestion is made that a 'best interest of the child' standard cannot be met if it involves the violation of fundamental Charter rights. Segregated special education placement, when against the wishes of the parents or guardians and with no s. 1 justification, it is argued, is unconstitutional. The latter gives rise to violations of equality provisions with regard to the student's freedom of association, the right to personal autonomy in decision-making for parents in regards to their child's education, as well as, in some cases, security of the person insofar as the psychological, social and cognitive development of the disabled child is concerned. Such an exclusion from the mainstream, if imposed, it is suggested, does not generally meet the test for 'reasonableness' in accommodation consistent with Charter guarantees. The presumption in favor of integration unless the parent or guardian wishes otherwise is, it is argued, a constitutional imperative based on Charter equality rights rather than a preference for one pedagogical theory (integration) over another (segregated special education placement).     

Re Edwards (2011) 4 ASTLR 392: who owns a dead man's sperm?

Re Edwards (2011) 4 ASTLR 392; [2011] NSWSC 478 adds to the small line of cases to have considered whether a woman can not only require medical staff to remove sperm from her dead male partner, but whether she is justified in terms of law and international human rights to use it to create children. In this case a Justice of the New South Wales Supreme Court framed the issue as "what right does a woman have to take sperm from the body of her deceased partner so that she may conceive a child?" He did so, despite the manifest ambiguity and difficulty in characterising the legislative rights in this case, without referring to substantive human rights obligations under international Conventions to which Australia is a ratifying party (particularly Art 10 of the United Nations International Covenant on Economic, Social and Cultural Rights and Art 23 of the United Nations International Covenant on Civil and Political Rights. Technological advances such as those creating the possibility of capturing a dead person's sperm by electro-ejaculation and creating children by subjecting it to intracytoplasmic sperm injection in connection with in vitro fertilisation have altered the balance of individual and social interests in deciding who should be regarded as owning a dead man's sperm and how that relates to basic common law rights of bodily inviolability without free consent. It is to be regretted that in jurisdictions lacking relevant constitutional human rights, or legislation requiring coherence with international human rights, judges do not avail themselves in cases of statutory ambiguity of interpretative insights to be gained from legally binding human rights treaties to which Australia is a party.     

When special needs categories for exceptional students overlap mental health diagnoses: The Canadian experience and its Charter implications

This paper explores Canadian 'educational' categorical systems for special needs students and their relation to mental health diagnoses. Parents wishing to access special education services for their children are generally required to consent to their children being formally assessed. Frequently, the school board committee will require a psychological or psychiatric assessment which may lead to diagnosis of a mental health disorder that overlaps with the special needs category to which the child is assigned. This paper explores whether Canadian parents of exceptional students are in fact providing fully informed and voluntary consent given: (a) frequent parental lack of understanding of the overlap between the so-called 'educational' special needs category and a mental health diagnosis; and (b) the power of the school board to proceed with a special education placement based on a particular category even without parental agreement. The argument is made that making special education service eligibility contingent on meeting the criteria for one or more government approved categories of 'disorder' or 'impairments', some of which overlap mental health diagnoses, infringes Canadian Charter s.15 equality rights as well as s.7 liberty and security of the person rights.     

Mental health legislation and human rights in England, Wales and the Republic of Ireland

In 2005, the World Health Organization (WHO) published its Resource Book on Mental Health, Human Rights and Legislation (Geneva: WHO) presenting a detailed statement of human rights issues which need to be addressed in national legislation relating to mental health. The purpose of this paper is to determine the extent to which revised mental health legislation in England, Wales (2007) and Ireland (2001) accords with these standards (excluding standards relating solely to children or mentally-ill offenders).Legislation in England and Wales meets 90 (54.2%) of the 166 WHO standards examined, while legislation in Ireland meets 80 standards (48.2%). Areas of high compliance include definitions of mental disorder, relatively robust procedures for involuntary admission and treatment (although provision of information remains suboptimal) and clarity regarding offences and penalties Areas of medium compliance relate to competence, capacity and consent (with a particular deficit in capacity legislation in Ireland), oversight and review (which exclude long-term voluntary patients and require more robust complaints procedures), and rules governing special treatments, seclusion and restraint. Areas of low compliance relate to promoting rights (impacting on other areas within legislation, such as information management), voluntary patients (especially non-protesting, incapacitated patients), protection of vulnerable groups and emergency treatment. The greatest single deficit in both jurisdictions relates to economic and social rights.There are four key areas in need of rectification and clarification in relation to mental health legislation in England, Wales and Ireland; these relate to (1) measures to protect and promote the rights of voluntary patients; (2) issues relating to competence, capacity and consent (especially in Ireland); (3) the role of “common law” in relation to mental health law (especially in England and Wales); and (4) the extent to which each jurisdiction wishes to protect the economic and social rights of the mentally ill through mental health legislation rather than general legislation.It is hoped that this preliminary analysis of mental health legislation will prompt deeper national audits of mental health and general law as it relates to the mentally ill, performed by multi-disciplinary committees, as recommended by the WHO.     

Child sex tourism: extending the borders of sexual offender legislation

Child sex tourism, the act of traveling to engage in sexual acts with minors, plagues developing nations worldwide. Several laws have been passed internationally in recent years designed to curtail this practice. Government entities and human rights organizations have driven these efforts. United States citizens represent a significant proportion of participants in child sex tourism. The PROTECT Act of 2003 prohibits United States citizens from participating in sexual acts with minors while traveling, and establishes extraterritorial jurisdiction. The case of Michael Lewis Clark, the first United States citizen convicted under this legislation, is highlighted. Child sex tourism poses unique issues to courts that will require ongoing clarification as challenges arise. This article discusses potential future challenges, describes strategies to address this problem, and relates this issue to psychiatry. Mental health providers may have the role of evaluating both the victims and perpetrators of child sex tourism. The authors propose a classification system for offenses and an initial list of topics to discuss with victims. The authors also describe the proper mechanism for reporting United States citizens suspected of participating in child sex tourism.     

FROM THE INSIDE OUT: CALLING ON STATES TO PROVIDE MEDICALLY NECESSARY CARE TO TRANSGENDER YOUTH IN FOSTER CARE

It is well known that transgender youth in foster care often face egregious discrimination and victimization based on their gender identities. Unfortunately, transgender youth in foster care have also been deprived of transgender-specific medical care that is vital to their health and well-being. This Note advocates that child welfare agencies adopt legislation that will demonstrate their commitment to fulfilling their constitutional duty to provide medically necessary care to transgender youth in their custody. This Note examines recent case law on the topic and addresses counterarguments to the proposal, including risks associated with treatment, high cost, and the stigma of gender identity disorder. Ultimately, this Note concludes that adopting the proposed legislation is a necessary step toward securing health care rights for transgender foster care youth.     

Surrogacy,Identity, Parentage and Childrenʼs Rights – Through the Eyes of a Child

In this article I will focus on two important aspects of children's rights which are impacted by artificial reproductive technology (particularly surrogacy); being the rights to identity and the rights to legal parentage. The United Nations Convention on the Rights of the Child acknowledges the importance of a child's right to identity, to be protected from discrimination on the basis of the status or beliefs of the child's parents, legal guardians or family members. For many children born through surrogacy arrangements, they may have only one or no legally recognized parent. The adults caring for them may have parental responsibility orders but this falls well short of providing children with the benefits and protections that legal parentage does. The issue of identity can be complex. Increasingly, states have recognized the importance of children knowing the circumstances of their birth and being able to access biological and genetic information including medical information. From a child's perspective the issues of identity and parenthood are intertwined. Given the importance of identity, more needs to be done to ensure that identifying information about children born as a result of artificial reproductive technology is properly stored and readily accessible for these children. Denying a child legal parentage when there are no concerns about the care being provided by their parents cannot be justified when considered from a children's rights perspective.     

Safe or sorry? Rights,responsibilities and retribution—the new three Rs of education in New Zealand?

A school is a microcosm of society and thus is subject to the problems existing within society generally. The rights and responsibilities of persons outside the school gates apply within the school also. The school environment is unique in that not only is a young person compelled to attend but he or she must spend a great deal of each day within the school's jurisdiction. May it then be argued that there is an enhanced responsibility of schools towards the emotional and physical welfare of their students in relation to matters within their control? This article will examine whether a New Zealand public school has a responsibility that extends further than a moral duty for the safety of its students. Particularly it will consider a school's potential liability in respect of the various forms of student‐to‐student bullying and harassment. It examines the potential for an action against a school under human rights legislation, at common law, and in criminal law.     

The Tide in Favour of Equality: Same-Sex Marriage in Canada and England and Wales

The tide in favour of legal equality for gay and lesbian individualsand couples continues to roll forward on both sides of the Atlantic.In Canada, the federal Parliament recently passed legislation(the Civil Marriage Act) (CMA) that extends the legal capacityto marry for civil purposes to same-sex couples throughout thecountry. This change in the law was driven not by the executiveand legislative branches of government but by the courts, interpretingand applying the Canadian Charter of Rights and Freedoms (theCharter). On the other side of the Atlantic, in England andWales, the Westminster Parliament in 2004 passed legislation(the Civil Partnership Act) (CPA) that will enable same-sexcouples to obtain legal recognition of their relationships,and to access most of the legal rights and responsibilitiesoffered to married couples. However, unlike the Canadian legislation,civil marriages between same-sex couples will still not be legallyrecognized. This article considers whether the English courtswill also facilitate the legal recognition of same-sex civilmarriage, like their Canadian counterparts. The author concludesthat, in light of recent case law, there is an increasinglystrong argument that the opposite-sex marriage requirement inEngland and Wales violates Article 14 (the equality provision)of the European Convention on Human Rights (ECHR), which isincorporated into UK law by the Human Rights Act, 1998. However,the author also concludes that there are a number of reasonsto be cautious that a positive result would flow, at this point,from a domestic court challenge to the opposite-sex marriagerequirement.     

扣缴义务人责任研究：类型化与反思

税法上扣缴义务人未完全履行扣缴义务，脱法扣缴行为随之产生，扣缴制度的立法目的成空，追究扣缴义务人责任是为必然。依现行税法规定，扣缴义务人不仅将视情况承担“补缴、追缴”，“限期改正、责令改正”、“刑事处罚”等主责任，而且需承担“滞纳金”，“罚款”或“滞纳金与罚款”等一并使用的从责任。责任形态的复杂性和现行税法的诸多缺陷，导致扣缴义务人责任实务运用极为混乱。要想从源头上解决此问题，必须对扣缴义务人责任进行多维定性，以扣缴义务人基本权利的行使作为扣缴制度财政目的的边界，以财政目的的实现作为扣缴义务人义务履行、权利行使的边界。     

International Hague Network of Judges: Significance in Implementation of the 1980 and 1996 Hague Conventions on the Civil Aspects of International Child Abduction

The 1980 Hague Convention on the Civil Aspects of International Child Abduction (“the Convention”) provides for the prompt return to the country of habitual residence of children taken by a parent from one country to another. It was created to address the threshold problem in such cases, that is, which court should determine the rights of the parties involved. In a case under the Convention, the court's concern is which country is the country of habitual residence and practical aspects of the return to ensure the safety of the child and the taking parent. This article will discuss the formation of the International Hague Network of Judges (IHNJ), why it is crucial in the advancement of the Convention's goals, and, specifically, what it does to educate judges and facilitate communication between judges, and how the IHNJ can facilitate the return, including providing information on services, procedures, and protections offered in the countries of return.     

胎儿人身利益保护的法理思考--兼论胎儿在我国未来民法典中的民事主体地位

胎儿没有民事权利能力,其人身利益一旦受到侵害,无法以民事主体身份获得法律保护.文章结合案例和学者观点,检讨了传统法律人格的缺陷,借鉴了国外及我国台湾地区胎儿保护的立法经验,认为未来民事立法应当赋予胎儿一定的民事主体地位.     

INVISIBLE PARTIES: LISTENING TO CHILDREN

This article discusses how children are involved in family court proceedings in New Zealand. On July 1, 2005, the Care of Children Act 2004 came into force. One of the changes brought about by this Act is an increased expectation that children will participate in proceedings involving them, by the court giving the child a reasonable opportunity to express his or her view. Children may participate in three ways, the primary mechanism being through the lawyer for the child. Children's views can also be elucidated through a specialist report, and direct participation can be achieved through judicial interviews. As each child is different, it is important that the unique circumstances of the case are accounted for. This article will discuss how each of the three methods can be combined to tailor an approach that gives every individual child a reasonable opportunity to express his or her view. There are a number of examples given of this approach in practice, showing how the court has adapted the process to accommodate the child's situation and personality.     

E-mail,the Police,and the Canadian Charter of Rights and Freedoms: Retooling Our Understanding of a Reasonable Expectation of Privacy in the Cyber Age

As in other jurisdictions, technological innovation continues to impose burdens on our understanding of the reasonable expectation of privacy in Canada. Recently, the Alberta Court of Queen's Bench was forced to weigh the privacy rights guaranteed under section 8 of the Canadian Charter of Rights and Freedoms against Her Majesty's interest in collecting electronic evidence (in order to facilitate criminal proceedings against an individual who was accused of using e-mail to gain possession of child pornography). For the first time ever in Canada, the Court's analysis focused specifically on the technological aspects of e-mail. Although technological enthusiasts applaud this approach, it has resulted in a decision which, if followed, is sure to render ineffectual the ability of the Canadian Charter of Rights and Freedoms to protect the privacy of Canadian e-mail users against overly intrusive police wire-tap interceptions. Upon a detailed review of this decision (within the context of an overview of the Canadian jurisprudence on unreasonable search and seizure), the author of this paper argues that the traditional test for sanctioning privacy protection must shift away from a merely technological analysis of the actual security offered by the communications medium in question. The author submits that the proper analysis should focus instead on the reasonable Canadian e-mail user's typical understanding and perception of the medium.     

“I WANT MY MOMMIES”: THE CRY FOR MINI‐DOMAS TO RECOGNIZE THE BEST INTERESTS OF THE CHILDREN OF SAME‐SEX COUPLES*

In child custody cases, courts will look to the best interests of a child to maintain visitation/custody rights only with the child's biological parent, not third parties. However, with a same‐sex couple, it is inevitable that one parent will not be the biological parent. Thus, when that parent is in a mini‐DOMA state, where same‐sex couples from non‐mini‐DOMA states do not have to be recognized, that parent will be viewed as a third party and lose all visitation/custody rights if the couple separates. This note advocates that mini‐DOMAs allow both the biological and nonbiological parents of a same‐sex couple to have visitation/custody rights of their children if it would be in the best interest of the children to do so.     

Capacity and medical self-determination in Australia

The expansion of patients' rights and the increasing complexity of the science of medicine raises serious legal and social questions, particularly when they pertain to end-of-life decision-making. Medical science continues to find ways of maintaining or extending life in a body or mind affected by disease or trauma and regular advances in medical technology and practice mean that the natural course of illness or injury will rarely be uninterrupted by some form of medical intervention. This progressive "medicalisation" of death, together with enhanced patient autonomy, means that choices can increasingly be made regarding medical treatment which may ultimately influence both the time and the way in which a person dies. This article examines both legislation and the common law in Australia particularly as it pertains to medical decision-making at end-of-life and the patient's right of self-determination.     

Listening to children: Participation rights of minors in Italy and the United States

This article compares laws and policies in Italy and the US regarding children's right to be heard and to engage in the life of the community. Italy has adopted a strong children's rights perspective, informed by the principles of the Convention on the Rights of the Child (CRC). The US, with its pre-modern constitution and resistance to international law, has been slow to recognise children's rights to voice and agency. The US Supreme Court has extended some due process rights to children in criminal court proceedings, but the US lags far behind Italy in recognition of children's rights to participate in civic life and collective decision-making. Child well-being rankings may reflect these differences in attitudes towards children's rights. Italy ranks significantly higher than the US on objective measures of child well-being and Italian children report superior peer and family relationships.