Dilemmas for clinicians in use of Community Treatment Orders

Clinicians who treat patients using Community Treatment Orders (CTOs) face many potential dilemmas in their relations with involuntary outpatients and the exercise of their powers. We compare the dilemmas identified in the literature with those reported by responsible clinicians in New Zealand (NZ). These clinicians experienced a number of well-known dilemmas, such as determining the right moment for a person's discharge from a CTO, but they seemed less troubled by some other difficulties than might be expected, usually because they considered involuntary outpatient treatment the best option for the patient or the best way to manage the risks involved. Further dilemmas were identified by the NZ clinicians that have not been widely discussed, concerning the proper scope of clinical authority over patients under CTOs and the decision to revoke involuntary outpatient status. In conclusion, some suggestions are made as to how clinicians might best manage the dilemmas involved.     

Legal Practice and Modes of Dying: Bruno Latour,Technology and the Critical Legal Instance

Few who have ever observed the workings of a legal office would have witnessed a lawyer engaged in file management. Of course, lawyers, together with their clients, will construct the narrative that makes up the file, but the lawyer will not store it, nor see that it is properly labeled, nor ensure that its contents are in place, nor dust it, nor, finally, remove it for disposal at the end of whatever time is deemed sufficient for it to perform all of its functions. At a time when lawyers are being criticized for their levels of client care this paper explores the opportunities that the handling of the legal file affords for the development of an ethic of care that can then be transposed more broadly across legal practice. The essence of the argument is that the legal file is (as much as the client) a proper object of care, and that the care of the file – its maintenance and management – is an appropriate objective for lawyers, and necessary for the development of a legal profession that is truly ‘client-centered’. The argument is developed in three parts, and is largely informed by Bruno Latour’s works on being and technology as developed in We Have Never Been Modern, Aramis or the Love of Technology, and particularly, in an essay, published in 2002, entitled ‘Technology and Morality: The Ends of the Means’. The first part explores how the handling of the legal file exposes those engaged in this activity to legal histories, legal philosophies and legal ethics. The second part explores the content or nature of the obligation of care owed toward the file by the keeper of the file. It argues that the legal file represents human passions quelled or suppressed by legal conflict, and that ‘technical action’, falling broadly under the rubric of maintenance and handling, are ways in which care is expressed when the object of care is supine, dead or passing. The concluding part advances the care of technology as a means of preventing technological domination, or, in the terms of legal practice, the care of the file as a means of deflecting the development of a file culture.     

Dancing on the head of a pin? Foetal life and the european convention

The case of Vo v. France represents the latest phase of the European Court of Human Rights’ thinking on the scope of Article 2 of the European Convention on Human Rights (the right to life) in relation to foetal life where a foetus had been lost owing to a medical accident. The Court by a majority decided that, “even assuming” Article 2 applied to the instant case (albeit to the life of the pregnant woman rather than that of the foetus), it had not been violated. While the facts in Vo were extreme and exceptional, the Court will shortly hear the case of D v. Ireland concerning access to abortion for foetal anomaly, an application made under Articles 3, 8, 10 and 14 of the European Convention. If the case of D were declared admissible, the Court would then have to consider whether a denial of access to abortion for foetal anomaly constitutes inhuman and degrading treatment contrary to Article 3, or an interference with a pregnant woman’s right to respect for private life under Article 8 (and if so, how the doctrine of the margin of appreciation applies). The Grand Chamber precedent of Vo displays ambivalence about whether Article 2 should apply to foetal life, and its resort to the “even assuming” formula spared Member States the difficulty of having to justify their various abortion regimes, by reference to this Article. It remains to be seen whether in a case like D that is directly concerned with abortion, the Court will take a more definite stance on the correct balance to be struck between the State’s interest in protecting foetal life and the Convention rights of pregnant women. Vo v. France [G.C.], judgment of 8th -July 2004, no. 53924/00; D v. Ireland [4th section], no. 26499/02, oral hearing on admissibility and merits, 6 September 2005     

Recognising Family Diversity: the ‘Boundaries’ of <Emphasis Type="Italic">RE G</Emphasis>

In Re G, the Court of Appeal awarded a joint residence order to the appellant, who was the lesbian ex-partner of the child’s full biological mother. The award also indirectly vested the appellant, a social parent, with parental responsibility and extended a body of case law to same-sex couples, which had until now only been applied to heterosexual couples. The initial purpose of this note is to outline the legal issues of the case in the context of the framework of parental responsibility set out in the Children Act 1989, putting forward a test of ‘parental fitness’ (which focuses on active ‘care’ as its central consideration) for social parents who must appeal to the court’s discretion to obtain parental responsibility. Secondly, the note offers at once a positive reading of Re G while highlighting a number of reservations centring upon continued legal preference for the ‘sexual family’. It is argued that while the legal recognition of ‘family diversity’ and parenthood remains modelled on this ‘sexual family’, the relaxation of family ‘boundaries’ (despite legal victories such as Re G) will remain limited. Re G (Children) [2005] E.W.C.A. (Civ.) 462     

Equity and the allocation of health care resources: Proposition or oxymoron?

The rate of changes in the allocation of health care resources has escalated in the past decade in an attempt to provide for cost containment and a more equitable distribution while retaining quality of care. In this issue, economists, physicians, psychologists, and sociologists examine the current health care environment for evidence relevant to the effect of these changes and provide a guideline for future direction.     

Locating the Issue Public: The Multi-Dimensional Nature of Engagement with Health Care Reform

This research examines in detail the structure of the issue public for health care reform, drawing from extensive, nationally representative survey data tapping general attentiveness to news and public affairs, specific interests in health care issues, and motivations (e.g., personal health and financial conditions) to follow health care reform issues. We furthermore adopt a multi-dimensional approach to defining the contours of the issue public for health care policy, separately studying its cognitive, affective, and behavioral underpinnings. Results indicate only weak interconnections across these dimensions—measured through health care knowledge, holding strong opinions on health care issues, and participation in health-related political activities, respectively—and somewhat different structural and motivational patterns underlying each. Theoretical, conceptual and methodological implications of these findings are discussed.Vincent Price and Joseph N. Cappella are Professors in the Annenberg School for Communication at the University of Pennsylvania, where Clarissa David, Brian Goldthorpe, and Marci McCoy Roth are doctoral students. Gathering of the data reported here was supported by grants to Vincent Price and Joseph N. Cappella from The National Science Foundation (Grant EIA-0306801) and the Annenberg Public Policy Center of the University of Pennsylvania. Views expressed are those of the authors alone and do not necessarily reflect opinions of the sponsoring agencies.     

吸毒“正常化”与香港防治毒品政策之转变——以青少年吸食氯胺酮为例

香港政府的防治毒品政策大体可分为两大主轴。第一主轴是刑事司法,包含立法禁毒、执法及针对毒品相关罪行及吸毒者的判刑。第二主轴是社会政策,包括预防吸毒行为、识别吸毒者及提供戒毒复康服务。就吸食氯胺酮而言,香港青少年群体很大程度出现了帕克所述的正常化现象。同时,日常社交圈子中网络状的接触点大幅增加了非滥药群尝试氯胺酮的可能性。这种吸毒正常化对香港毒品防治政策有很大的影响。     

河南省农村养老服务机构的发展现状

随着老龄化社会的到来,如何养老成为人们关注的话题。本文通过对河南省农村养老服务机构发展现状的分析,看到河南存在养老观念陈旧、农村养老服务机构数量少、空间分布不均衡和运营不规范等问题,制约了农村养老服务机构的发展。为适应新形势对农村养老服务机构的需求,政府应发挥主导作用,从政策扶持、观念宣传、机构管理等多方面着手,积极探索新的养老模式,拓宽养老途径,满足农村老年人日益增长的养老需求。     

论“微时代”网络技术的异化

马克思的异化观点揭示了资本主义私有制条件下劳动产品及劳动对劳动者奴役的现象,现代科技异化是对马克思异化观的引申和发展。现代网络通信技术的发展在给人们生活带来极大便利的同时,又在一定程度上超出了人的控制,甚至成为支配、统治人的异己力量。要消除网络技术的负效应,必须凸显科技的人文关怀,推动网络技术的可持续发展,实现科技与社会的良性互动。     

我国未成年人教养保护制度的立法选择

关于未成年人的教养保护,大陆法系国家和英美法系国家分别采取了亲权与监护并行以及由监护吸收亲权两种立法模式。应在对亲权和监护制度进行比较研究以及对我国现行未成年人保护教养制度进行评估的基础上,关注大陆法系国家亲权制度的现代发展,借鉴亲权制度现代发展的成果,就父母对未成年子女的教养保护设立父母照顾制度,与监护制度一起实现未成年人的民法保护。