The de-medicalisation of assisted dying: is a less medicalised model the way forward?

Although assisted dying has been most commonly presented within a medicalised framework, the notion of de-medicalisation is employed in this paper to suggest that there are emerging models of assisted dying in which some medical aspects assumed to be an integral part of the phenomenon are both challenged and diminished. The paper considers cases where relatives have facilitated a loved one's assisted suicide abroad, cases of assisted death in which the assistor in the actual suicide act is a non-medic, and the growing debate surrounding non-medical grounds for desiring death. In evaluating the potential impact of partial de-medicalisation on the assisted dying debate, the argument presented is that whilst a de-medicalised model could well contribute to a richer understanding of assisted dying and a better death for the person who is assisted, there are cogent reasons to retain some aspects of the medicalised model and that a completely de-medicalised model of assisted dying is unrealistic.     

Pushing the boundaries of lawful assisted dying in The Netherlands? Existential suffering and lay assistance

Two matters that have a significant presence in the contemporary Dutch assisted dying debate, are the nature of the suffering required for an assisted death to be lawful, and the issue of who can lawfully assist. This article explores whether the lawful medical assisted dying model is too restrictive in failing to recognise existential suffering, considering selected case studies involving such suffering and lay assisted death. It addresses the question whether The Netherlands would take a trip down a slippery slope if the lawful model of assisted death were extended to cases where individuals are 'tired of life'.     

The online defamation maze: are we finding a way out?

The main purpose of this paper is to examine the efficacy of the first decision that explored online defamation (as opposed to offline defamation) delivered by the Supreme Court of Japan. A discussion of the future implications of the case is then undertaken. The paper supports the First Instance (the Tokyo District Court) decision and its approach, and argues that such an approach might have provided greater implications for the future. The author also argues that the Tokyo District Court seems to have taken a more reflective view on the fluidity of online defamation and the nature of the online environment, and shows a degree of willingness to accept and incorporate such a nature. The author concludes that the Tokyo District Court's approach, although it could be seen as rather radical and extreme, seems to be more persuasive than that of the Supreme Court. It also submits that the court might have brought a more balanced and healthy outcome for the beneficiaries, including not only the claimants, the defendants, but also society as a whole. It is the case that innocent internet users can potentially be both the passive and active recipients of the information (i.e. comments posted on webpage). Before a detailed analysis and examination of the case is undertaken, a brief outline of how Japanese law and its jurisprudence have dealt with the traditional form of defamation (i.e. offline defamation) is provided as background.     

The cost of educating children: The accounts of a nineteenth century girls' boarding school in Orléans,France

Using a collection of 73 bills of a boarding school in Orléans (France), the article examines the cost of educating a child at the end of the nineteenth century. These bills concern the four daughters of a family from the Brittany nobility who each spent about 12 years at boarding school. Items on the bills reveal details of the daily life of the young girls through general boarding expenses, education costs, private lessons, clothing, medicine, and trips home for the holidays. Aspects of the family life of the girls and the boarding school (meals, religious instruction, health, and welfare) are described.     

The cost of educating children: The accounts of a nineteenth century girls' boarding school in Orléans,France

Using a collection of 73 bills of a boarding school in Orléans (France), the article examines the cost of educating a child at the end of the nineteenth century. These bills concern the four daughters of a family from the Brittany nobility who each spent about 12 years at boarding school. Items on the bills reveal details of the daily life of the young girls through general boarding expenses, education costs, private lessons, clothing, medicine, and trips home for the holidays. Aspects of the family life of the girls and the boarding school (meals, religious instruction, health, and welfare) are described.     

Gangs in the DRC and El Salvador: towards a third generation of gang violence interventions?

The phenomenon of gangs in El Salvador and the Democratic Republic of Congo (DRC) has already been researched, but a comparative study of gangs and gang policies is lacking. In this paper we discuss several gang violence prevention initiatives regarding the Mara Salvatrucha and Barrio 18 in El Salvador, and the kuluna and bashege in Kinshasa, DRC. In order to analyze the different gang interventions, we implement the typology of first and second gang violence prevention initiatives (Rodgers et al. 2009), and propose the evolution towards a third generation of gang violence prevention interventions. While first generation initiatives are security and law-enforcement driven, and second generation initiatives socio-preventive driven, third generation initiatives are more politically driven. The latter indicates a shift towards a vision of dialogue and negotiations to deal with gang violence. However, the different generations are not predefined within time and third generation initiatives can also be followed up by first generation initiatives, which was for example the case in the gang truce in El Salvador. Also, comparative gang research includes challenges, especially when the gang phenomenon in one country is better researched and documented than in other countries. As such, we were unable to identify politically-driven initiatives in the DRC to compare with the ones in El Salvador. Further research is thus required. With this paper we not only aim to contribute to the literature on gang violence prevention and reduction initiatives, we also want to push researchers, practitioners and policymakers to look beyond the borders when setting up gang (violence) prevention and rehabilitation projects, and to learn from other regions where similar initiatives have been implemented to deal with comparable issues of gang violence.     

The concept of exceptionality: a legal farce?

How do we decide which treatments should be offered by the National Health Service (NHS) when we cannot afford to fund them all? In the absence of a positive appraisal by the National Institute for Health and Clinical Excellence (NICE), which mandates the provision of a treatment by the NHS, Primary Care Trusts (PCTs) are free to decide whether to provide a particular drug to some, or all, of their population. However, as public bodies, it is a well-established principle of Administrative Law that PCTs are not at liberty to fetter the exercise of their own discretion. They must recognise the possibility that some patients will have exceptional circumstances, and as a consequence, any general policy prohibiting the funding of a drug cannot be absolute. In the absence of statutory guidance on what might constitute exceptional, clinicians are left guessing as to whether their patients might be eligible for funding on the grounds of exceptionality. Using the context of expensive cancer drugs, I will examine the concept of exceptionality from clinical, moral, and legal perspectives, focussing particularly on the role of social factors in determining exceptionality. I will review the cases where PCTs' decisions not to fund cancer drugs were subject to legal action and argue that the courts have provided little guidance on interpreting the term exceptional, and that the concept has a limited role to play in the allocation of scarce health resources at a local level.     

The EU or France? The CSDP Mission in Mali the Consistency of the EU Africa policy

The EU’s role in the recent Mali crisis offers a good opportunity to assess the consistency of the EU’s Africa [Africa as used here refers to Sub-Saharan Africa (SSA)—the region of the EU’s most extensive external policy] policy in the post-Lisbon era. Against the background of the EU’s external policy objectives with special reference to SSA, this Article will particularly offer a comprehensive overview of the legal and policy dynamics of the EU’s Common Security and Defence Policy (CSDP). This will be discussed especially with reference to how they relate to (in)consistency in implementation as illustrated in the EU’s role in the recent Mali crisis. Although the EU initially made a decision to deploy an EU Training Mission to Mali, the EU did not activate the peacekeeping dimension of the CSDP as required at an advanced stage of the crisis. Instead, this gap was filled by France’s unilateral military intervention in Mali. The EU’s inertia in this regard raises the question of the consistency of its external policy instruments and policy objectives towards the region. Without excluding other possible contributing factors, the analysis submits that the ‘partial’ activation of the CSDP in Mali is mainly attributable to the constitutional specificity of the CSDP especially its lack of permanent and planning conduct structures. In any event, it is argued that these do not render the EU’s role in Mali less inconsistent both in the light of the relevant EU external policy instruments and objectives towards SSA in general, and in the light of the CSDP objectives in particular. In general, the Article uses Mali as a case study to illustrate the extent and therefore the limits of the consistency of the EU’s CSDP and its overall policy towards SSA especially post-Lisbon. Whilst acknowledging the current limits of the law in this context, the Article nevertheless argues that the dire implications of inconsistency for the effectiveness of the EU’s policies and for the credibility of the Union make a search for practical, if not legal solutions, a political imperative. This is necessary especially if the EU wants to protect or indeed rebuild its credibility as an international actor in general, and as an effective partner for crisis management in SSA, in particular [The EU’s credibility in much of the African Caribbean and Pacific states, especially SSA is reportedly already at an all-time low (Mackie J et al. in Policy Manag Insights ECDPM 2, 2010)].     

Is limiting financial supervisory liability a way to prevent defensive conduct? The outcome of a European survey

One of the arguments frequently used to limit the liability of financial supervisory authorities is the idea that normal liability rules result in defensive conduct and, therefore, in ineffective financial supervision. The impact of tort law on financial supervisory authorities is, however, highly debated, and no overwhelming empirical evidence exists to support it. This article presents findings from an empirical study on financial supervisors in the member states of the European Union. Targeting senior financial supervisors, the survey presented a series of statements, asking respondents to state their opinions about the impact of financial supervisory liability. In summary, most of the respondents seem to classify the impact of financial supervisory liability as neutral or positive. At most, the evidence from the survey implies an arguably modest degree of deterrence. Because the survey found no significant differences between respondents who perceive the liability of their organization as limited and those who do not, it suggests that limiting financial supervisory liability does not have an impact on the behavior, or at least on the perceptions of the impact of financial supervisory liability, of financial supervisors. Therefore, the study calls into question the widely accepted argument of defensive conduct as a reason for limiting the liability of financial supervisory authorities.     

The most ambitious plan in 26 years of telecoms market reform? No way!

The European Commission's claim that their proposed new telecoms regulation² constitutes “the most ambitious plan in 26 years of telecoms market reform” is preposterous. That honour must belong to the set of new European directives in 2002 which transformed the structure of telecoms regulation and facilitated competition throughout Europe. Instead the plans make great play of a number of actually pretty minor changes and, the Body for European Regulators for Electronic Communications (“BEREC”) has been particularly critical that the proposals will create unnecessary complexity and uncertainty and limit innovation and competition.     

Cohabitation in Europe: a revenge of history?

Unmarried cohabitation is often seen as a radically ‘new’ phenomenon, originating in the 1960s, but in fact it has long historical antecedents. The question is, however, whether traditional and modern cohabitation are comparable and whether we can speak of persistence. This article offers a literature review on cohabitation in Europe, with the focus on persistence over time, integrating the results of a 2013 conference on this topic. What sources are available to confirm or reject such persistence? How should we understand persistence? In terms of the motivations of unmarried cohabitants? Or in terms of the acceptance of the community at large? And if no real persistence is found, does this mean that European cohabitation since the 1970s truly represents ‘new’ behaviour? We show that, on the regional level, the legacy of the past is still visible in factors affecting the timing and frequency of marriage of cohabiting couples. These factors are a mixture of regional socio-economic constraints, the relative cultural importance attached to marriage, the religious history, and the level of secularization.     

The Word Memory Test in medicolegal assessment: a measure of effort and malingering?

The Word Memory Test (WMT) is claimed to measure effort and to detect cognitive response bias. Archival data from n = 2526 cases referred in 2009–2016 for medicolegal assessment were analyzed. Each participant underwent a medical and a psychological examination including a cognitive test battery and several validity measures including the WMT. The WMT validity test scores do not approximately follow a normal distribution. Thus, parametric statistics for WMT validity scores may not be appropriate. WMT performance explains 0–20% of the variance in cognitive test performance. This is more than what substantial brain damage accounts for. The standard uniform cutoff indicating a ‘fail’ in all three WMT effort subtests (equal or less than 82.5% correct responses) seems not supported by the data. Taking into account the context of the testing, cutoffs may be chosen according to the desired sensitivity or specificity. ROC-statistics with modified Slick criteria as gold standard for malingering look alike for the three WMT effort subtests, with a AUC between 0.86 and 0.88. The WMT seems a good indicator of both effort and (Slick) malingering, however, little is gained by administering the entire test.