An International Environmental Regime for Population?: from Bucharest to Cairo

The problem of over population has been the subject of much debate since Malthus's 'Essay on the Principle of Population' in 1798. This debate has taken on a new sense of urgency, however, during the last 25 years, as the global implications of rapid population growth have became apparent. Attempts by the international community to establish a regime to deal with the problem have led to the convening of three conferences, Bucharest (1974), Mexico City (1984) and Cairo (1994) But despite propitious signs of consensus during the run up periods to each of these conferences, no international regime has been created This article examines the reasons for both the initial consensus and the eventual dissensus in each case, and concludes that several pre-conditions must be met if a regime is to be established in the future.     

Representation of cerebral bridging veins in infants by postmortem computed tomography

The postmortem diagnosis of shaken baby syndrome, a severe form of child abuse, may be difficult, especially when no other visible signs of significant trauma are obvious. An important finding in shaken baby syndrome is subdural haemorrhage, typically originating from ruptured cerebral bridging veins. Since these are difficult to detect at autopsy, we have developed a special postmortem computed tomographic (PMCT) method to demonstrate the intracranial vein system in infants. This method is minimally invasive and can be carried out conveniently and quickly on clinical computed tomography (CT) systems. Firstly, a precontrast CT is made of the infant's head, to document the original state. Secondly, contrast fluid is injected manually via fontanel puncture into the superior sagittal sinus, followed by a repeat CT scan. This allows the depiction of even very small vessels of the deep and superficial cerebral veins, especially the bridging veins, without damaging them. Ruptures appear as extravasation of contrast medium, which helps to locate them at autopsy and examine them histologically, whenever necessary.     

The Bush Doctrine Revisited: The 2006 National Security Strategy of the USA

In its 2006 National Security Strategy, the USA reaffirms thecontroversial doctrine of pre-emptive self-defence as crucialin the "war on terror" proclaimed after the attacks of 9/11.But it does not provide a detailed examination of pre-emption.The questions left open in the 2002 US National Security Strategyas to what will trigger pre-emptive action, when action againstnon-State actors will be permissible and what degree of forcewill be proportionate in pre-emptive action are still unresolved.The promise that "The reasons for our actions will be clear,the force measured and the cause just" does not offer much inthe way of specific guidance. It is very striking that in thiscontext, the US strategy makes no reference to internationallaw or to the role of the UN Security Council. The other mainfocus of the strategy is on the "promotion of democracy", butit does not go so far as to assert any legal right to use forcefor this purpose, and it makes only passing reference to humanitarianintervention. The EU 2003 Security Strategy provides a markedcontrast in that it does not adopt the doctrine of pre-emptiveself-defence, does not expressly identify "rogue States" anddoes profess respect for international law and for the roleof the UN. Other States have not generally shown themselveswilling to accept a Bush doctrine of pre-emptive self-defence.They agree that there are new threats facing the world frominternational terrorists and the danger of proliferation ofweapons of mass destruction, but the 2005 World Summit showedclearly that there is no general acceptance of pre-emptive action.Moreover, the International Court of Justice still follows acautious approach to self-defence. The 2006 National SecurityStrategy largely reaffirms the doctrines of the earlier 2002Strategy, but whereas the focus in the 2002 Strategy was onthe threat posed by Iraq and North Korea; attention has nowshifted to Iran and Syria, accused of being State sponsors ofterror by Hizbollah and Al-Qaida. The article ends with a discussionof the recent conflict in Lebanon: this raised the crucial questionwhether the war on terror gave Israel a wide right to use force,even a pre-emptive right. The conflict highlights dramaticallythe practical significance of the divisions on the scope ofthe law of self-defence with regard to action against non-Stateactors, pre-emption and proportionality.     

Canadian compulsory community treatment laws: recent reforms

This paper addresses the principles underlying compulsory community treatment (CCT) and discusses the different provisions in Canada's twelve jurisdictions. Comparisons with different models of CCT in other countries are also drawn. CCT is not only intended to reduce relapses it is also a "least restrictive" alternative to in-patient detention. Seven of the twelve Canadian mental health acts allow conditional leave from hospital. Two jurisdictions provide community treatment orders, but require two or three previous in-patient admissions. Criteria for CCT, in most jurisdictions, includes that there is a "likelihood of significant mental or physical deterioration". The requirement for previous hospitalization for CCT in Canada, unlike other countries, precludes CCT for use with first episode patients. Some jurisdictions require consent for CCT. Most jurisdictions explicitly state that the services necessary for the CCT conditions must be available.     

Determination of bromazepam, clonazepam and metabolites after a single intake in urine and hair by LC-MS/MS. Application to forensic cases of drug facilitated crimes

The number of reports on drug facilitated crimes is increasing these last years. Apart from ethanol and cannabis, benzodiazepines (BZD) and analogs are the most common drugs reported to be used probably due to their amnesic and sedative properties. We have developed a rapid and sensitive method using LC-MS/MS triple stage quadrupole (TSQ) for the determination of single exposure to bromazepam (Lexomil, 6 mg) and clonazepam (Rivotril, 2 mg) in urine and hair of healthy volunteers. Chromatography was carried out on a Uptisphere ODB 5 microm, 2.1 mm x 150 mm column (Interchim) with a gradient of acetonitrile and formate 2 mM buffer, pH 3. Urine was extracted with Toxitube A (Varian) and allowed the detection of bromazepam, 3-hydroxy-bromazepam, clonazepam and 7-Aminoclonazepam for more than 6 days. Head hair, collected 1 month after the exposure, was treated by incubation with Soerensen buffer pH 7.6, followed by liquid-liquid extraction with dichloromethane for common BZD. A specific pre-treatment for amino-BZD, with an incubation of 15 min at 95 degrees C in 0.1 N NaOH before liquid-liquid extraction with dichloromethane, gave better recoveries and repeatability. After single exposure, bromazepam was present in powdered hair at 28 pg/mg and 7-Aminoclonazepam at 22 pg/mg in the first 1-cm segment, while no clonazepam was detectable. This method was applied in two forensic cases. It allowed us to determine bromazepam in urine 3 days after the alleged offense and in cut head hair at a concentration of 6.7 pg/mg only in the 2-cm proximal segment. The other case showed the presence of clonazepam and 7-Aminoclonazepam in urine a few hours after the offense and the presence of 7-Aminoclonazepam at about 3.2 pg/mg in axillary hair 4 months later.     

Reforming the relationship between medicine and the law of tort

The Australian Government's medical indemnity package is predicated on the belief that the current crisis is primarily one of insurance. However, an examination of the fault-based tort system illustrates that, irrespective of their insurance status, doctors are profoundly affected by the adversarial process and their response to it is leading to sub-optimal patient care. This article argues that the adversarial system of medical negligence fails to satisfy the main aims of tort law, those being equitable compensation of plaintiffs, correction of mistakes and deterrence of negligence. Instead, doctors experience litigation as a punishment and, in order to avoid exposure to the system, have resorted not to corrective or educational measures but to defensive medicine, a practice which the evidence indicates both decreases patient autonomy and increases iatrogenic injury. This is unacceptable and suggests that the package has missed the point. This article proposes an alternative medico-legal tort scheme which attempts to overcome some of these problems.