Supervised injection sites: Health Canada approves Vancouver pilot sites, but concerns remain

The paperwork has been processed, and Health Canada says that two pilot supervised injection sites (SISs) in Vancouver can now proceed, but operational funding for the site to be located in the Downtown Eastside has yet to be secured. Meanwhile, tired of waiting for the sanctioned SISs to open, community groups in Vancouver have begun to operate unsanctioned sites. There are also concerns that even if operational funding for the Downtown Eastside site is obtained, the pilot SIS project is too small in scope to make a major impact on public health in the area.     

Access to health care for illegal immigrants: a specific organisation in France

Health care is a fundamental human right in Europe, and all Member States recognise everyone's right to the access to preventive healthcare and to receive medical care in the event of sickness or pregnancy. Nevertheless, this right is focused on citizens and the application to migrants, particularly undocumented migrants, varies widely in the EU. The French legislation is organized with a humanitarian approach. In this article, the authors present the French system of social protection, the "Couvernture médicale universelle" or CMU, which provides the same protection to asylum seekers and documented immigrants as to nationals, and the "Aide médicale d'état" or AME, that is open to every person who does not fulfil the legal conditions to obtain the CMU, such as illegal immigrants. Created in 1995, recently access to the AME has been restricted. A claim of discrimination has been rejected by the Conseil d'Etat and 215,000 persons received the AME in 2009. The expenses incurred by the AME increased by 17% in 2010, and there is a debate in Parliament to limit care and to ask the recipient for a financial contribution.     

Québec: an outbreak of HIV/AIDS-related stigma and discrimination

In the space of a few weeks in January 2004, actions by three different institutions in Québec combined to threaten the human rights of people living with HIV/AIDS, raise the spectre of mandatory HIV testing, and create unnecessary public fears about the spread of HIV infection. In response to what they called "the worst weeks in recent history for people living with HIV/AIDS in Québec," the Canadian HIV/AIDS Legal Network and COCQ-Sida (the Québec coalition of community-based organizations fighting AIDS) called for a province-wide campaign against HIV/AIDS-related stigma and discrimination. A victory was achieved when a Montréal catholic seminary announced that it had backed down from its initial proposal to mandatorily test all applicants for priesthood for HIV, but much more is needed to fight the rapid outbreak of mandatory-testing proposals.     

Criminal charges against marijuana compassion club volunteers stayed on constitutional grounds

A Court of Québec judge stayed trafficking charges laid in February 2000 against two Montréal men in conjunction with the operation of a medical marijuana compassion club. The judge determined that it would be unjust to allow the criminal procedure to continue. Section 5 of the Controlled Drugs and Substances Act (CDSA) unjustifiably infringed the accuseds' Charter rights to life, liberty, and security of the person (section 7) by prohibiting the distribution of marijuana for medical purposes when no legal source or supply existed at the time.     

Harm-reduction activism: a case study of an unsanctioned user-run safe injection site

Due to the ongoing health crisis among injection drug users in Vancouver, Canada, there have been repeated calls for the establishment of safe injection sites (SISs) since the early 1990s. In April 2003, in response to a large-scale police crackdown and government inaction, a group of activists opened an unsanctioned SIS in Vancouver's Downtown Eastside (DTES). The 327 Carrall Street SIS operated for 181 days despite considerable police harassment and limited financial support. During the operation of the SIS, volunteers supervised over 3000 injections and demonstrated the feasibility of a user-run low-threshold SIS. The experience of the SIS provides valuable lessons for those seeking to advance the interests of injection drug users through community mobilization and direct action approaches. In this article, Thomas Kerr, Megan Oleson, and Evan Wood describe the events surrounding the establishment, operation, and closing of the unsanctioned SIS, and outline the lessons learned.     

农民、就业与法律父爱主义——以《就业促进法》为例

在现代化转型的大背景下,农民就业成为涉及全局的大问题,也是相关立法必须解决的难题。如果立法中的规定强调政府主导而不注重权利保护,就可能导致法律父爱主义的倾向。《就业促进法》浓厚的法律父爱主义色彩埋下了政府裁量权过大、农民就业权受侵蚀等隐患。为此,应彰显农民的就业权利和自由,以理性、确定和比例三原则来规制政府行为,淡化甚至褪去立法的父爱主义色彩,走出价值悖论的迷宫,使该法善始善终,最终实现其促进就业的目的。     

New tainted-blood class actions in Québec and Alberta

In two cases in Québec and Alberta, people infected with HIV and HCV through infected blood and blood products have successfully defended motions to strike out all or parts of their legal actions against federal and provincial governments and the Canadian Red Cross Society (CRCS). On 16 January 2003, the Québec Superior Court ruled that the plaintiffs in a class action could rely on the Krever Commission Report in their application for certification of a class proceeding. On 20 February 2003, the Alberta Court of Queen's Bench dismissed an application brought by the Canadian and Alberta governments to strike out the legal action brought against them. These cases illustrate that the settlement schemes proposed by the federal and provincial governments and the CRCS, and approved by the courts, have not put an end to the civil and constitutional claims brought by people seeking compensation for infection through tainted blood.     

Hiding children to avoid ARV treatment

In the last issue, we reported on the case of a Montréal woman with HIV who lost custody of her two HIV-positive children after refusing to consent to their treatment with antiretroviral therapy.     

Barcelona 2002: law, ethics, and human rights. "I have no watch, but I haven't missed a dose"

Anyone who was fortunate enough to hear Fred Minandi speak in Barcelona must have been moved by what he had to say. Mr Minandi is a person living with HIV/AIDS from Chiradzulu, Malawi, who spoke at Time to Treat: Transforming AIDS Treatment from Right to Reality, a satellite meeting of the XIV International Conference on AIDS held on 7 July 2002, and sponsored by Médecins Sans Frontières (MSF) and the Health Global Access Project. His presentation is a passionate, first-hand account of how antiretroviral therapy has transformed lives, how it has given hope to people, how it has helped to reduce the stigma against AIDS in his community, and how it has contributed to prevention efforts.     

Correctional officers and prevention of HIV transmission among prisoners

The problem of HIV transmission in prisons in Québec and elsewhere is increasingly urgent and requires the attention of federal and provincial authorities. Prison officers are among the key players who should be kept in mind when preventive measures are being developed. We reprint the executive summary of a study conducted in federal and provincial prisons in Québec. The goal of the study was to identify the factors influencing prison officers, with respect to whether they would agree or refuse to make accessible the tools needed for the prevention of HIV transmission among inmates (i.e., condoms, bleach, tattooing equipment, and needles). Among the factors studied are officers' perceptions and beliefs as well as their attitudes, perceived social norms, emotions, and perceived barriers with respect to making preventive tools accessible.     

South Africa: defiance campaign continues

The Treatment Action Campaign (TAC) has continued its "defiance campaign against patent abuse and AIDS profiteering." In partnership with Médecins Sans Frontières (Doctors Without Borders), and with the support of Oxfam and the Council of South African Trade Unions (COSATU), on 28 January 2002 three TAC members returned to South Africa from Brazil carrying generic versions of the antiretroviral drugs zidovudine (AZT), lamivudine (3TC), and nevirapine (NVP). Some of the imported capsules contain a combination of AZT and 3TC.     

论“本质错误”——以罗马法为中心

在罗马法中,本质错误与身份错误、行为性质的错误、标的物错误并称为使行为无效的四种实质性错误。本质错误与材料错误相关又不等同于材料错误。本质错误的内涵见于D.18,1,9,2中的"醋为酒卖"案,是在社会经济功能影响下的标的物之内在特性发生错误。本质错误的外延见于"古杯"案及D.18,1,11、D.18,1,14等文本,涵涉了大部分的材料错误和性别错误,并可以作为一种兜底条款适用于那些对诸如艺术品价值、作者发生错误的情形。本质错误在近代演化为法国法的"实质错误"、意大利法的"本质上的错误"、瑞士法的"重大错误"、德国法和我国台湾地区法的"性质错误",在赋予法官自由裁量权的功能上,它们和中国大陆民法的错误制度殊途同归。     

HIV vaccines in Canada: legal and ethical issues--an overview

In July 2002 the Legal Network released an overview paper on legal and ethical issues related to an HIV vaccine in Canada. The paper, which is based on a more detailed report prepared in collaboration with the Centre for Bioethics of the Clinical Research Institute of Montréal, calls for the establishment of a Canadian HIV Vaccine Plan.     

Development of a harmonised method for the profiling of amphetamines V: Determination of the variability of the optimised method

This paper is the fifth in a series of six in relation to the development of a harmonised method for the profiling of amphetamine [L. Aalberg, K. Andersson, C. Bertler, H. Borén, M.D. Cole, J. Dahlén, Y. Finnon, H. Huizer, K. Jalava, E. Kaa, E. Lock, A. Lopes, A. Poortman-van der Meer, E. Sippola, Development of a harmonised method for the profiling of amphetamines I. Synthesis of standards and compilation of analytical data, Forensic Sci. Int. 149 (2005) 219-229; L. Aalberg, K. Andersson, C. Bertler, M.D. Cole, Y. Finnon, H. Huizer, K. Jalava, E. Kaa, E. Lock, A. Lopes, A. Poortman-van der Meer, E. Sippola, J. Dahlén, Development of a harmonised method for the profiling of amphetamines II. Stability of impurities in organic solvents, Forensic Sci. Int. 149 (2005) 231-241]. The third paper [K. Andersson, K. Jalava, E. Lock, L. Aalberg, Y. Finnon, H. Huizer, E. Kaa, A. Lopes, A. Poortman-van der Meer, M.D. Cole, J. Dahlén, E. Sippola, Development of a harmonised method for the profiling of amphetamines III. Development of the gas chromatographic method, Forensic Sci. Int., in press] dealt with the optimisation of the gas chromatographic and detection methods whereas the fourth paper [K. Andersson, K. Jalava, E. Lock, Y. Finnon, S. Stevenson, L. Aalberg, H. Huizer, E. Kaa, A. Lopes, A. Poortman-van der Meer, M.D. Cole, J. Dahlén, E. Sippola, Development of a harmonised method for the profiling of amphetamines IV. Optimisation of sample preparation, Forensic Sci. Int., in press] concerned the optimisation of the extraction method prior to GC analysis. This paper is a study of the optimised method in order to determine its stability. Investigations of within and between day variations were carried out in four laboratories. Moreover, variations between laboratories were also determined. Both flame ionisation detector (FID) and MS detection were used. One laboratory studied nitrogen-phosphorous detector (NPD) detection as well. For this task, 12 batches of amphetamine were prepared. Six of them were synthesised via the Leuckart route, three via the nitrostyrene route and three via the reductive amination route [A.M.A. Verweij, Impurities in illicit drug preparations: amphetamine and methamphetamine, Forensic Sci. Rev. 1 (1989) 2-11]. Taking into account all studied target compounds and the average results from four laboratories, the within day variation was around 6% for FID and 5% for MS, the between days variation was around 10% for FID and 8% for MS. For NPD detection, within day variation was 5% and between days variation 9% (only one laboratory). Finally, the inter-laboratory variation was about 12% for FID (four laboratories) and 10% for MS (three laboratories).     

AIDS in the workplace: a program that's still relevant

A new AIDS-in-the-Workplace program being implemented in Québec emphasizes the rights of workers living with HIV/AIDS. The program tackles issues such as confidentiality of HIV status, access to insurance benefits, discrimination, and the need for employers to take reasonable measures to accommodate the disabilities of workers.     

Food labeling: nutrient content claims, expansion of the nutrient content claim "lean". Final rule

The Food and Drug Administration (FDA) is amending its food labeling regulations for the expanded use of the nutrient content claim "lean" on the labels of foods categorized as "mixed dishes not measurable with a cup" that meet certain criteria for total fat, saturated fat, and cholesterol content. This final rule responds to a nutrient content claim petition submitted by Nestlé Prepared Foods Co. (Nestlé) under the Federal Food, Drug, and Cosmetic Act (the act). This action is also being taken to provide reliable information that would assist consumers in maintaining healthy dietary practices.     

HIV treatments, vaccines, and microbicides: toward coordinated advocacy

In November 2003, the Canadian HIV/AIDS Legal Network convened a meeting in Montréal of global experts working in the fields of treatments, vaccines, and microbicides. The meeting was historic in that it was the first occasion on which advocates from the three fields had the opportunity to meet and exchange views on policy priorities. In this article, John Godwin provides a summary of the background paper produced for that meeting and of the key outcomes of the meeting. The article describes the reasons why developing a joint advocacy agenda has emerged as a priority for advocacy organizations from the three fields, despite their differing histories and the fact that they have often been positioned as competitors rather than collaborators. The role of a human rights approach in informing joint advocacy and the relevance of the prevention-care-treatment continuum are considered. The article then examines possible areas for joint advocacy, including funding, clinical trials, public private partnerships, tax credits, liability issues, equity pricing, bulk procurement, regulatory issues, manufacture, delivery, and national plans. The article concludes by noting upcoming opportunities for joint advocacy efforts, and outlining the next steps to be taken by the Legal Network to support coordinated advocacy.     

End-of-life healthcare decisions, ethics and law: the debate in Spain

The debate on euthanasia in Spain has been ongoing from the beginning of the 20th century and remains extant. Three periods can be identified: prior to 1978, 1978-2002, and after 2002. The debate increased significantly after the Ramon Sampedro case (1995-1998), and was fuelled with new, although very different cases, such as those of Leganés (2005-2008), Jorge Leon (2006) or Inmaculada Echevarria (2006-2007). As a consequence of these cases in 2008 the Regional Government of Andalusia started a legal process to pass a law regulating end-of-life decisions, excluding euthanasia and assisted-suicide, which was finally enacted in 2010. Two other Spanish regions (Navarra and Aragón) passed similar laws. The central government also initiated a legal process to approve a national law, excluding euthanasia and assisted-suicide. The project failed because of the dissolution of the Parliament in June 2011. The new government will have to decide how to continue the process.     

Arsenic speciation of two specimens of Napoleon's hair

Since 1960, it has been demonstrated by various analytical procedures that high concentrations of arsenic were present in Napoleon's hair. Various authors, indicating that the detected arsenic levels are a consequence of external contamination, have challenged the results of these examinations. We have tested two strands of hair, referenced as Noverraz and Grand Maréchal Bertrand. Samples were incubated 6h in water at 90 degrees C, and arsenic speciation was carried out by HPLC-ICP/MS. The residue was injected on a cation-exchange PRP-X200 column that allows the detection of arsenobetaine and on an anion-exchange PRP-X100 column to test for the mineral forms. In these conditions, the inorganic species As(III), As(V) and their metabolites (DMA and MMA) were separated. Analysis of hair samples highlighted massive amounts of total arsenic (42.1 and 37.4ng/mg). Arsenical species found in the two samples of analyzed hair are distributed in the following: As(III) 31.1 and 44.7%; As(V) 66.3 and 53.2%; DMA 0.42 and 0.15%. Traces of MMA were detected, and 2% of the species could not be identified. These results prove that more than 97% of the arsenic found in the hair of Napoleon is in inorganic form, which is consistent with a chronic intoxication to arsenic.     

Risk assessment and offender victim relationship in juvenile offenders

The present study compares the Historical, Clinical, and Risk Management-20 (HCR-20) checklist in a male offender population of 108 adolescents using the relationship between the offender and the victim as a classification factor. Two types of relationship were retained for comparison purposes: family victim/known victim and unknown victim. All adolescents admitted to the Adolescent program of Montréal's Philippe-Pinel Institute from February 1998 to April 2003 were assessed and their families were met. The HCR-20 checklist was completed for each adolescent. Statistically significant differences were observed for the mean rank of the total score of the HCR-20 and two sub-scales, the historical subscale (H) and the risk management subscale (R). The results indicate that the adolescents who victimize strangers have more violent risk factors compared to those who victimize family/known victims. These results have important implications regarding prevention and treatment.