Autonomy, guardianship and mental disorder: one problem, two solutions

The law in England and Wales governing both the provision of medical care in the case of adults with incapacity and the provision of care and treatment for mental disorder presents serious problems for the principle of patient autonomy. The adult with incapacity has no competence either to consent to or refuse medical treatment but the law provides no statutory structure for substitute decision making on that adult's behalf. On the other hand the law does allow a person with mental disorder to be treated for that disorder despite his or her competent refusal. The nature of these inconsistencies is considered and the implications which flow from the singling out of mental disorder are examined with reference to experience in two Australian jurisdictions. The current proposals for reform of the Mental Health Act are then considered in the light of the conclusions drawn.     

Adoptions Gone Awry: Enhancing Adoption Outcomes Through Postadoption Services and Federal and State Laws Imposing Criminal Sanctions for Private Internet Rehoming

The federal government should invest in adopted children who make up the future of the country and are in dire need of rehabilitation and therapy because of their past circumstances. If the government steps in to rescue vulnerable children from inadequate or abusive birth parents by removal, it should also intervene when adopted families are faced with behavioral problems of adopted children that the adopted parents cannot address on their own. Postadoption services need to be accessible and effective to ensure the success of adopted families. Assisting families in crisis postadoption will lower the instances of dissolution and rehoming and keep adoptive families intact. In cases in which postadoption services fail, uniform federal legislation is necessary to make it a federal crime to advertise children for adoption on the Internet without proper certification and state legislation is required to make it a crime to pass on adopted children to strangers without judicial consent, to dissuade Internet rehoming. Internet rehoming of adopted children should be a serious crime as it is tantamount to child trafficking.© 2014 Association of Family and Conciliation Courts

Key Points for the Family Court Community:
• Postadoption services need to be more accessible and more narrowly tailored to the needs of adoptive families to ensure the success of adoptions.
• Better postadoption services create better adoptive families and adoptive parents will not reach the point of dissolution or private Internet rehoming.
• Adoptive parents should be provided with information regarding all available postadoption resources after adoption is finalized and a government Web site should be created that lists all available resources.
• The federal government needs to provide funding to states that specifically target postadoption services.
• A uniform federal statute is required to punish parties who use Internet forums to avoid government oversight and privately rehome their adopted children.
• States should enact laws that criminalize the unauthorized interstate placements of children.

     

Increasing access to rural maternal health services in Zambia through demand-side interventions

This paper examines a demand-side intervention that significantly increased access to maternal health services in rural Zambia in a context where skilled birth attendance rates had been stagnant for over two decades. Aspects of the intervention design that were crucial to the programme's success were the participatory and adult learning-centred approach used to mobilise intervention communities, the use of a community volunteer model, and the design's sensitivity and responsiveness to underlying social factors and problems. The demand-side intervention is already being scaled up in six districts, and is highly suitable for national level scale-up.     

China’s Response to the Ebola Virus Disease in West Africa

This article examines the Chinese response to the Ebola outbreak in West Africa, first surveying Chinese interests in Guinea, Liberia and Sierra Leone. Many Chinese workers have been evacuated and projects postponed. For the first time, China has extended humanitarian aid to countries facing a public health emergency. China is under pressure to ‘do something’ but faces its own developmental challenges as well as problems of logistics. Chinese knowledge of Africa is still relatively weak and uninformed. Although China’s assistance dwarves that from the other BRICS, the Ebola crisis has revealed problems in Sino-African relations, not least the gap between rhetoric and reality.     

Community rehabilitation workers as catalysts for disability: inclusive youth development through service learning

This paper explores access to health and education for disabled youth in sites with and without community rehabilitation workers (CRWs). A cross-sectional survey using a structured questionnaire was undertaken in nine sites in South Africa, and a snowball sample of 523 disabled youths of both sexes, aged between 18 and 35 years, was selected. The survey found that a significantly larger proportion of disabled youth living in sites with CRWs were seen by health care workers at home, and that there was a large difference in educational access between sites with and without CRWs. CRWs are well positioned to promote equal citizenship for disabled youth through service learning with occupational therapy final year students to improve access to health and education, so that barriers to their participation in economic development are removed.     

Mental Capacity Act,Anorexia Nervosa and the Choice Between Life‐Prolonging Treatment and Palliative Care: A NHS Foundation Trust v Ms X

The Court of Protection decided in A NHS Foundation Trust v Ms X that an anorexia nervosa patient lacked the capacity to refuse treatment for her eating disorder, but that it was not in her best‐interests to be subject to force‐feeding to prolong her life. The Court, vindicating previous judgments in similar cases, considered that the eating disorder rendered the patient incapable of deciding on nutrition and, therefore, that she lacked the capacity to refuse treatment for anorexia nervosa. This paper questions the narrow way in which the patient's decision was characterised by the Court in this and previous cases, which led to an application of the Mental Capacity Act 2005 that is incompatible with the UN Convention on the Rights of Persons with Disabilities because, based on a diagnosis only, anorexia nervosa patients were denied the right to decide where the balance lies between quality and duration of their own lives.     

禁食野生动物的刑法规制与教义阐释——以《刑法修正案(十一)》第四十一条为中心

《中华人民共和国刑法修正案(十一)》增设了针对陆生野生动物以食用为目的的危害行为的法律规制,在原有罪名基础上进一步拓展了野生动物刑法保护的外延。这一立法条款修订与疫情防控的社会背景相关,体现了积极主义刑法观回应社会现实的功能。此次刑法修正案对野生动物的立法完善不仅是尊重动物伦理生命权的体现,而且深层次地涉及公共卫生安全的法益考量,是弱人类中心主义在刑事立法领域的生动展现。野生动物的刑事法律规制并未采用全面保护的立场,这一保护的有限性是刑法作为保障法的地位所决定的,这也决定了在野生动物保护的法律规则体系中,需要审慎辨析刑法与行政法律规范之间的关系。在具体适用时应当结合此次修正案的条文设置进行教义分析,合理把握具体要件的内涵与彼此之间的逻辑关系,防范以保护之名而随意逾越刑法边界。     

守正、发展与创新:“十四五”时期医疗保障的完善思路

人口结构、就业形态、新时代的健康政策与脱贫攻坚任务、技术发展等宏观环境,为“十四五”时期医疗保障的发展提供了机遇也提出了挑战。立足“十一五”到“十三五”医疗保障从无到有、从制度全民覆盖到实践全民覆盖、待遇水平持续提升、各项机制跨越式发展等发展脉络,“十四五”时期医疗保障的发展思路应定位于守正、发展与创新。第一,坚守公平共享与切实保障的发展理念;第二,回应健康需求与不平衡、不充分的医保制度现状,在待遇保障、筹资机制、支付方式、基金监管等方面补短板、强弱项;第三,直面新形势的新挑战,在新业态人员参保、大病保障、医疗保障与公共卫生资金统筹衔接等方面实现创新与突破。目标是在“十四五”时期实现一个全民享有、公平适度、法治规范、高效便捷、协同联动的医疗保障制度。     

论精神障碍犯罪嫌疑人的讯问规则

因精神障碍犯罪嫌疑人在受讯问时．有受暗示性较强、依从性及内化性较强、更容易作出虚假供述的特征,因此对精神障碍犯罪嫌疑人的讯问应有特殊的法律规则进行规范。具体而言．应当建立对精神障碍嫌疑人进行适合讯问的评估制度,对于可以在适当成年人在场的情况下讯问的精神障碍嫌疑人．在讯问时应让适当成年人在场对嫌疑人进行保护并监督讯问行为。另外,基于精神障碍嫌疑人对抗讯问的能力较弱,应限制适用威胁、引诱、欺骗等通常情况下具有一定容许性的讯问策略．其它讯问策略也不得超出精神障碍嫌疑人的承受能力。     

试论刑事附带民事诉讼中的精神损害赔偿

现行法律中关于精神损害赔偿的立法尚存在需要统一和规范的条款,刑事附带民事诉讼中精神损害赔偿制度在不同法律规定之间的冲突限制了该制度的实施。精神损害赔偿制度应是刑事附带民事损害赔偿的一部分。在适用该制度时,应具备损害后果、侵权事实、侵权事实与损害后果之间的因果关系、主观过错等构成要件,在司法实践中的具体适用应考虑当事人双方的具体情况。