Another special relationship? Interactions between health technology policies and health care systems in the United States and the United Kingdom

Confronted with similar challenges, the United States and the United Kingdom have adopted very different health technology policies. In the United States, the focus has been on technology creation, in particular the funding of basic biomedical research at the National Institutes of Health. This both reflects and reinforces an innovation-first culture in the United States, including in health. By contrast, the United Kingdom has been much more heavily committed to applied research and evaluative research, including health-technology assessment. That is, while U.S. policy has focused on technology creation, U.K. policy has been more oriented toward technology diffusion. This article surveys the sources of these differences. We consider the impacts of institutional, cultural, and other factors that may explain them, and emphasize that it is hard to disentangle the separate effects of those factors. We conclude with a discussion of the difficulties in drawing cross-national lessons in health technology policy.     

“Memorialization Laws in the United Kingdom: A Response to Fear or an Increased Occurrence?”

Issues of sexual abuse, predation and rape have received an increased degree of attention over the last decade and as a result have overshadowed similarly offensive crimes. Various highly publicized cases of sexual violence against women and children have gripped both the United States and the United Kingdom and have resulted in the implementation of sexual violence laws. Media coverage of an ‘epidemic’ of sexual violence has led some to question whether the frenzy surrounding these publicized cases has created a “fear factor” among parents and caregivers, begging the question as to whether the incidence of sexual violence has increased or whether the heightened sensitivity is a result of increased media reporting. This article examines approximately 12 years of aggregate sexual abuse prevalence data (crimes reported to the police) in England, Wales, Scotland and Northern Ireland, and compared prevalence change points and sexual offense law implementation. The article then examines the possible theory of whether Sarah’s Law could potentially to be a result of increased fear or a moral panic. Findings indicate sex crime rates were declining prior to the law’s implementation, lending cautious support to the proposition that the genesis of Sarah’s Law may have been due to fear, rather than actual increases in sexual crimes.     

The Changing Position of Legal Academics in the United Kingdom: Professionalization or Proletarianization?

This article analyses changes to United Kingdom (UK) university law schools during the period coinciding with Phil Thomas’ career as a law teacher – the latter part of the twentieth century and the first two decades of the twenty-first – in part illustrating the analysis with other examples from Thomas’ career. We will focus specifically on the way in which what it means to be a legal academic has altered, with UK legal academics having been professionalized as a community during this era. Yet, seemingly paradoxically, it is also an era during which, many have suggested, academics in UK universities have become a proletariat.     

Rational rejection? The ethical complications of assessing organ transplant candidates in the United Kingdom and the United States

The practice of allocating scarce organs in medicine is an ethical minefield. Due to the organ shortage, organ procurement agencies in both the United Kingdom and the United States are placed in the unenviable position of having to choose a limited number of patients to compete equally for life-saving treatment. They do this by composing multidisciplinary transplant teams, which must evaluate transplant candidates and their complex range of personal, medical, environmental, psychiatric and financial characteristics. During the candidate assessment process, such teams may often be torn between their moral duty to save those who are most in need, considerations of efficiency, and the battle against forming moral judgments about particular candidates. Several ethical approaches can be adopted by transplant teams during the decision-making process, but do these ideologies provide adequate justification for their sometimes controversial decisions? This article provides a detailed examination of the ethical principles available to transplant teams in the United Kingdom and the United States, and the effect that these principles have on assessment procedures, organ allocation protocols, transplant candidates and their prospects.     

Competition policy in the United States and the United Kingdom ‐ A look at underlying forces*

Summer schools in law are a common feature of Irish legal education today. Originating in the US, summer schools are now an international phenomenon. In 2005, the eLaw Summer Institute (or ELSI), was established at University College Cork as a four-week international summer school. In this article, we reflect on the design and development of ELSI, with reference to three key aspects of this summer school. First, we address issues arising from the intensive teaching aspect of ELSI, including the use of technology as part of a blended learning experience. Second, we explore the challenges posed by the international audience in ELSI. Lastly, we critically examine the comparative elements of the school in terms of curriculum design and delivery of the programme. Our analysis builds upon existing literature in the areas of curriculum design and delivery, intensive teaching, the international classroom and comparative legal studies; and is informed by empirical data in the form of anonymous student questionnaires. The aim of the article is to engage with others involved in summer programmes, to share our experiences and critical analysis and to provide an insight for those not involved in summer school programmes into the challenges and the rewards for students, staff and the institutions involved.     

Robotisation of the manufacturing industries in the EU: Convergence or divergence?

This paper investigates whether convergence or divergence of robot densities in the manufacturing industries of 24 EU countries occurred over the period from 1995 to 2015. An answer to this question permits immediate conclusions with regard to the success of convergence of labour productivities within the manufacturing industries of the EU, since it is expected that the use of robots will contribute to the growth of labour productivity. The empirical analysis is based on the robot data of the International Federation of Robotics and uses the convergence testing approach proposed by Rodrik (Q J Econ 128(1):165–204, 2013). Taking all results together, empirical evidence points to non-convergence of robot densities for a first period from 1995 to 2005, while there is relatively fast conditional as well as unconditional convergence for the second period from 2005 to 2015.

     

A technocratic fix to the "legitimacy problem"? The Blair government and health care rationing in the United Kingdom

The work of the National Institute for Clinical Excellence, an agency which has recently been created by Tony Blair's Labour government to provide guidance on best clinical practice to the National Health Service, has generated considerable controversy in the United Kingdom. It has been argued that the role which the institute plays in appraising cost effectiveness, especially of expensive new health technologies, constitutes explicit, national rationing. Although the employment of scientific and evidence-based criteria as the basis of decisions might have been expected to secure legitimacy for the institute--even when its recommendations have the effect of denying access to a particular treatment--the reaction to much of its work so far indicates that this goal has not been fully achieved. While alterations to structure and procedure may be considered as possible means of addressing the agency's difficulties, such proposals are not without problems. Consequently, in the final analysis, the British example may serve as a demonstration that the inherently political nature of priority-setting in health care precludes any easy technocratic solution.     

Catalyst or Cause? Legislation and the Demise of Machine Politics in Britain and the United States

In the nineteenth century, British and American parties competed by hiring electoral agents to bribe and treat voters. British parties abruptly abandoned this practice in the 1880s. The conventional explanation is that legislation put an end to agent‐mediated distribution. But this explanation leaves many questions unanswered. Why did the parties use agents for decades, even though they imposed great expense on candidates and were viewed as untrustworthy? And why, after decades of half‐hearted reforms, did the House of Commons pass effective antibribery reforms only in 1883? In our formal model, parties hire agents to solve information problems, but agent‐mediated distribution can be collectively suboptimal. Legislation can serve as a credibility device for shifting to less costly strategies.     

Child Support Policy in Australia and the United Kingdom: Changing Priorities But A Similar Tough Deal for Children?

This article examines shifts in child support law and policyin Australia and the UK since the establishment of child supportschemes in both jurisdictions from the late 1980s. Our analysissuggests that while original policy goals in Australia and theUK were broadly similar, they also diverged in important respects.Further, legislative and operational elements of the respectiveschemes as originally enacted have played a key role in influencingsubsequent shifts in the substance and policy of the regimes.Yet the practical implications of currently diverging law andpolicy approaches are likely to be similar, in that most fatherswill pay less child support in the future.     

United Nations Mission to Kosovo: in Violation of the Right to Life?

International organisations are expected to abide to human rights standards in the course of their operations. However, to what standards are transitional regimes held accountable? Should the UN exercising executive powers be held accountable to the same or higher standard than a national government? In this article, the author discusses the legal basis relied upon by a UN internal human rights mechanism, the Human Rights Advisory Panel (HRAP), that declared the UNMIK in violation of its positive obligation to investigate enshrined in Article 2 of the EHRC. A closer look at the opinions issued by the HRAP reveals that it might have misapplied the standard set forth in the relevant jurisprudence of the European Court for Human Rights, and thereby held UNMIK accountable under stricter requirements.     

Allies or Foes? A Review of the Relationship between the International Criminal Court and the United Nations Security Council

Netherlands International Law Review - The question concerning the relationship between the United Nations and the International Criminal Court proved controversial during the drafting of the Rome...     

The European Community and the Member States in the Dispute Settlement Understanding of the WTO: United or Divided?

Opinion 1/94 of the European Court of Justice determined the competence of the European Community and the Member States to conclude and implement WTO Agreements. Whilst the European Community enjoys exclusive competence to implement the Multilateral Agreements on Trade in Goods, it shares joint competence with the Member States in respect of the General Agreement on Trade in Services and the Agreement on Trade-Related Aspects of Intellectual Property Rights. However, the Court’s recognition of a division of competences between the Community and the Member States in WTO agreements has given rise to many fears that such a division would greatly complicate Community and Member State participation in WTO Agreements, would create many problems for them in doing so and, as a result, would greatly impede their successful participation in the WTO. Given the benefit of a number of years’ experience in the WTO, this paper focuses on the Dispute Settlement Understanding (DSU) of the WTO and addresses the extent to which the division of competences between the Community and the Member States has affected their participation in the DSU. Primarily, it aims to examine the extent to which the provisions of the DSU affect Community and Member State participation in dispute settlement within the WTO. It then analyses the duty of co-operation imposed on the Community and on Member States by the Court of Justice in Opinion 1/94 in the implementation of the WTO Agreements and the degree to which this duty influences their pursuit of dispute settlement. Finally, the paper examines the manner in which Community and Member State dispute settlement proceedings have evolved in practice, the extent to which the division of powers has penetrated dispute settlement proceedings and the manner in which the Community, the Member States and other WTO members have addressed it. In essence, the paper attempts both to highlight some of the more obvious consequences and effects that the internal division of powers between the Community and the Member States has for their participation in the DSU and to suggest some ways in which these consequences may be manipulated for their mutual and successful settlement of disputes.     

FDA approved? A critique of the artificial insemination industry in the United States

Artificial insemination by donor is becoming an increasingly popular means to achieving parenthood. While the majority of couples use artificial insemination to overcome fertility problems, many recipients use artificial insemination to avoid passing a genetic disease to their children. However, case studies reveal the inherent dangers of artificial insemination, namely the lack of proper screening methods to avoid passing genetic diseases to children born by artificial insemination. State-by-state regulation, federal guidelines, and private adjudication have all proven to be inadequate methods of regulating the artificial insemination industry. Ginsberg proposes federal regulation as the only means of achieving a safe artificial insemination industry. The proposed federal regulation would include better genetic screening, a more efficient national sperm donor system, and limited disclosure to recipients of artificial insemination and their children. These measures would help to ensure that couples using artificial insemination get what they expect--healthy sperm, a safe artificial insemination process, and ultimately, a healthy child.     

Cut from the Same Cloth? A Comparative Study of Domestic Extremists and Gang Members in the United States

Despite calls for research on the similarities and differences between violent extremist groups and criminal street gangs, there have been few empirical comparisons. We develop a comparative model that emphasizes explicit, spurious, and indirect linkages between the two groups and use national sources of data on domestic extremists and gang members—the Profiles of Individual Radicalization in the United States (PIRUS) and the National Longitudinal Survey of Youth 1997 (NLSY97)—to compare them across group involvement, demographic, family, religion, and socioeconomic status characteristics. Six percent of domestic extremists in PIRUS have a history of gang ties, which constitutes a minimal proportion of domestic extremists and is likely the rare exception among the population of gang members. Gang extremists more closely resemble non-gang extremists in PIRUS than they do gang members in the NLSY97. While these groups have some similarities, one of the major differences is that gang members are younger than domestic extremists. This likely contributes to many of the other differences between the groups across the life course, including marriage, parenthood, unemployment, and education. Given that the evidence is most consistent with the independence model, further comparative testing is needed before generalizing gang-related policies and programs to domestic extremism.     

Justice on the line? A comparison of telephone and face-to-face advice in social welfare legal aid

This paper investigates the impact on legal advice of the major shift to telephone-only services in social welfare legal aid, which took place in April 2013. An empirical study comparing telephone and face-to-face advice reveals that face-to-face contact has considerable advantages in the advice interview. Based on interviews and observations with housing law clients, their lawyers and advisers, the findings of this qualitative study demonstrate that clients and lawyers often find it easier to express themselves and understand each other face-to-face. The face-to-face interview benefits from features including the stronger emotional connection between lawyer and client, non-verbal communication, more expansive conversation and the greater ability to consult and confer over documents. Telephone-only advice may be suitable for some more capable clients and uncomplicated matters, but this qualitative research shows that vulnerable clients are more likely to be adversely affected by the potential disadvantages of telephone-only contact. Clients with more complex social needs or with more serious or urgent cases are better served by face-to-face advice. The findings of this research should inform the LASPO review and future priorities for legal aid funding.     

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)].     

EU GDPR or APEC CBPR? A comparative analysis of the approach of the EU and APEC to cross border data transfers and protection of personal data in the IoT era

This article examines the two major international data transfer schemes in existence today – the European Union (EU) model which at present is effectively the General Data Protection Regulation (GDPR), and the Asia-Pacific Economic Cooperation (APEC) Cross Border Privacy Rules system (CBPR), in the context of the Internet of Things (IoT).While IoT data ostensibly relates to things i.e. products and services, it impacts individuals and their data protection and privacy rights, and raises compliance issues for corporations especially in relation to international data flows. The GDPR regulates the processing of personal data of individuals who are EU data subjects including cross border data transfers. As an EU Regulation, the GDPR applies directly as law to EU member nations. The GDPR also has extensive extraterritorial provisions that apply to processing of personal data outside the EU regardless of place of incorporation and geographical area of operation of the data controller/ processor. There are a number of ways that the GDPR enables lawful international transfer of personal data including schemes that are broadly similar to APEC CBPR.APEC CBPR is the other major regional framework regulating transfer of personal data between APEC member nations. It is essentially a voluntary accountability scheme that initially requires acceptance at country level, followed by independent certification by an accountability agent of the organization wishing to join the scheme. APEC CBPR is viewed by many in the United States of America (US) as preferable to the EU approach because CBPR is considered more conducive to business than its counterpart schemes under the GDPR, and therefore is regarded as the scheme most likely to prevail.While there are broad areas of similarity between the EU and APEC approaches to data protection in the context of cross border data transfer, there are also substantial differences. This paper considers the similarities and major differences, and the overall suitability of the two models for the era of the Internet of Things (IoT) in which large amounts of personal data are processed on an on-going basis from connected devices around the world. This is the first time the APEC and GDPR cross-border data schemes have been compared in this way. The paper concludes with the author expressing a view as to which scheme is likely to set the global standard.