Access to justice and the need for a holistic approach to the delivery of legal aid services in developing countries: Lessons from South Africa

Jindal Global Law Review - Legal Aid South Africa, in its previous incarnation as the Legal Aid Board, was established in 1969, and began operating in 1971. During the apartheid era the scheme had...     

Medicare and state health care programs: fraud and abuse, civil money penalties and intermediate sanctions for certain violations by health maintenance organizations and competitive medical plans--HHS. Correction to final regulations

This document corrects technical errors that appeared in 42 CFR part 1003 of the final rule published in the Federal Register on July 15, 1994 (59 FR 36072). Specifically, the final rule set forth the Secretary's authority to impose sanctions and civil money penalties on health maintenance organizations, competitive medical plans and other prepaid health plans contracting under Medicare and Medicaid. This correction notice sets forth the corrected text for sections 1003.100, 1003.103 and 1003.106, some of which was inadvertently omitted or amended.     

Balancing public health and practitioner accountability in cases of medical manslaughter: reconsidering the tests for criminal negligence-related offences in Australia after R v Patel

In 2010 Dr Jayant Patel was convicted of several offences on the basis of criminal negligence. Following the Queensland Court of Appeal's 2011 endorsement of the trial judge's decision, the case provides a timely opportunity to review prosecutions for medical negligence criminal offences throughout Australia and to critically examine the tests in assessing whether the balance has been correctly struck. The author argues that the thresholds required for prosecutions for criminal negligence for medical manslaughter are problematic and unduly onerous, and do not adequately strike the balance between the utilitarian value in health care and patient safety, on the one hand, and practitioner accountability and deterrence, on the other. This article considers reforms to remedy the imbalance, including a reformulation of the Criminal Code (Qld) and common law thresholds, proposals for the enactment of a separate offence of criminally negligent manslaughter and the utilisation of corporate prosecutions for manslaughter liability to broaden accountability in health care and promote patient safety on a systemic level.     

The Data Protection (Amendment) Act, 2003: the Data Protection Directive and its implications for medical research in Ireland

Directive 95/46/EC on the Protection of Individuals with regard to the Processing of Personal Data and on the Free Movement of Such Data has been transposed into national law and is now the Data Protection (Amendment) Act, 2003. The Directive and the transposing Act provide for new obligations to those processing data. The new obligation of primary concern is the necessity to obtain consent prior to the processing of data (Article 7, Directive 95/46/EC). This has caused much concern especially in relation to 'secondary data' or 'archived data'. There exist, what seem to be in the minds of the medical research community, two competing interests: (i) that of the need to obtain consent prior to processing data and (ii) the need to protect and foster medical research. At the same time as the introduction of the Act, other prior legislation, i.e. the Freedom of Information Act, 1997-2003, has encouraged candour within the doctor-patient relationship and the High Court in Ireland, in the case of Geoghegan v. Harris, has promulgated the 'reasonable-patient test' as being the correct law in relation to the disclosure of risks to patients. The court stated that doctors have a duty to disclose all material risks to patients. The case demonstrates an example of a move toward a more open medical relationship. An example of this rationale was also recently seen in the United Kingdom in the House of Lords decision in Chester v. Afshar. Within the medical research community in Ireland, the need to respect the autonomy of patients and research participants by providing information to such parties has also been observed (Sheikh A. A., 2000 and Irish Council for Bioethics, 2005). Disquiet has been expressed in Ireland and other jurisdictions by the medical research communities in relation to the exact working and meaning of the Directive and therefore the transposing Acts (Strobl et al). This may be due to the fact that, as observed by Beyleveld "The Directive makes no specific mention of medical research and, consequently, it contains no provisions for medical research as an explicitly delineated category." (Beyleveld D., 2004) This paper examines the Irish Act and discusses whether the concerns expressed are well-founded and if the Act is open to interpretation such that it would not hamper medical research and public health work.     

Working with sex offenders in a climate of public blame and anxiety: How to make defensible decisions for risk

Abstract

Work with sex offenders takes place in a climate of public blame and anxiety. This requires practitioners to adopt the highest standards of practice to ensure that defensible decisions are made. These are decisions that must withstand hindsight scrutiny in the light of a risk management failure. This paper reviews the key practice points that will assist practitioners in making defensible decisions, and the key challenges for practitioners in this challenging area of work.     

Transparency in 21st century fisheries management: Options for public participation to enhance conservation and management of international fish stocks

Abstract

Effective implementation of international environmental and natural resource conservation agreements depends not only upon the cooperation of contracting parties, but also upon the ability of the agreement to win the continuing support and input of non‐governmental stakeholders. This view, accepted and advocated by nations in the 1992 Rio Declaration, Agenda 21, and the recent Aarhus Convention on Public Participation, is now being incorporated into modern regional fisheries management organizations. These and earlier fisheries organizations can benefit from an awareness of how other multilateral agreements that adhere to the Rio Declaration and Agenda 21 tenets have enhanced sustainable development through their provisions for transparency and public participation. This article surveys how these regimes have implemented the principles of access to information, access to decision‐making and access to justice, and makes corresponding recommendations to assist fisheries management organizations in achieving their goals.     

Questioning authorized truth: Resisting the pull of the policy audience and fostering critical scholarship in correctional medical research—A reply to kerle et al.

We encourage all interested parties to read our article (Vaughn and Smith 1999) and not rely on Kerle, Stojkovic, Kiekbusch, and Rowan's (1999) misrepresentations, distortions, selective inclusions, and inartful articulations. We agree with Kerle et al. that there is much misunderstanding at work here; indeed, Kerle et al. misunderstand the purpose, scope, intent, and methodological underpinning of our article. Kerle et al. are confused about (1) the scope of our data, (2) fundamentals of building an inductive argument through interpretative analysis, (3) how to define key concepts, (4) basic research methodology, and (5) what it means to offer a more balanced view. We address each of these concerns.     

Conflict of interest in clinical research: direct payment to the investigators for finding human subjects and health information

The recent death of teenager Jesse Gelsinger in a drug therapy trial has drawn attention to how financial conflicts of interest may compromise patient protection. While research institutions throughout the world have instituted a variety of conflict of interest guidelines, the potential conflicts associated with investigators receiving direct payment from private companies for both the recruitment of patients and the running of clinical trials in pharmaceutical research remains a relatively unexplored area. Clinical researchers undoubtedly deserve to be reasonably compensated for their participation. But these incentive mechanisms also have the potential to create conflicts of interest--both real and perceived.