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Breaking vaccination barriers among migrants? Human rights and crisis preparedness. 打破移民接种疫苗的障碍?人权和危机准备。
IF 1.8 4区 医学 Q1 LAW Pub Date : 2025-01-04 DOI: 10.1093/medlaw/fwaf004
Yana Litins'ka

Vaccination hesitancy is one of the critical threats to public health. The coronavirus disease pandemic reconfirmed that certain groups of populations are more reluctant to vaccinate than others, particularly migrants. This article examines legal obligations related to protecting the right to health in addressing vaccination barriers among newly arrived adult migrants, taking Ukrainians granted temporary protection as an example. From human rights law requirements delineated by the United Nations and Council of Europe, it maps out a framework of vaccination-related obligations. Furthermore, the article tests the framework created in one national legal system-Sweden-to show where the gaps in transposing obligations into national law still exist. To deepen the analysis, the interview study with Ukrainian refugees in Sweden is presented, which allows reflection on what obligations have not reached their recipients and resulted in vaccination barriers. The article advocates for further specification of obligations related to vaccinations in both national and international laws for better crisis preparedness.

疫苗接种犹豫不决是对公共卫生的严重威胁之一。冠状病毒大流行再次证实,某些人群比其他人更不愿意接种疫苗,尤其是移民。本文以获得临时保护的乌克兰人为例,审查了在解决新抵达成年移民接种疫苗障碍方面与保护健康权有关的法律义务。根据联合国和欧洲理事会所规定的人权法要求,它制定了一个与疫苗接种有关的义务框架。此外,本文还测试了在一个国家法律体系中创建的框架——瑞典——以显示在将义务转化为国家法律方面仍然存在的差距。为了深化分析,本文提出了对在瑞典的乌克兰难民的访谈研究,这使人们能够反思哪些义务没有达到他们的接受者并导致疫苗接种障碍。该条主张在国内法和国际法律中进一步明确与疫苗接种有关的义务,以便更好地做好危机准备。
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引用次数: 0
Mental health and capacity laws in Northern Ireland: examining the position of children and young people. 北爱尔兰的精神健康和行为能力法:研究儿童和青少年的状况。
IF 1.8 4区 医学 Q1 LAW Pub Date : 2025-01-04 DOI: 10.1093/medlaw/fwae038
Anne-Maree Farrell, Elizabeth Agnew, Patrick Hann

Mental health and capacity laws applicable to children and young people in Northern Ireland (NI) lack clarity and coherence, with significant gaps in service provision and safeguarding. Drawing on an examination of such laws, we argue that law reform is needed. In the short term, we suggest there is merit in publishing statutory guidance, such as a Code of Practice, to address both the issue of evolving capacity in children and to facilitate best practice in policy and practice. This modest reform in the short term should be accompanied by a firm political commitment to ensuring that NI's innovative fusion mental capacity legislation is fully brought into force in the medium term. Meanwhile, law reform should form part of a holistic approach on the part of NI's policy-makers towards improving mental healthcare provision for children and young people in line with a human rights-based approach. This would include the following: increased allocation of funding and resources to facilitate more timely access to suitable treatment and related services; enhancing participation in policy, judicial, and clinical decision-making that impacts their lives; and employing a range of executive accountability mechanisms to drive improvements in such provision over time.

适用于北爱尔兰(NI)儿童和青少年的心理健康和行为能力法律缺乏明确性和一致性,在服务提供和保障方面存在巨大差距。通过对这些法律的研究,我们认为需要进行法律改革。在短期内,我们建议发布法定指南,如《行为准则》,以解决儿童能力不断发展的问题,并促进政策和实践中的最佳做法。在短期内进行适度改革的同时,还应该做出坚定的政治承诺,确保北爱尔兰创新的融合精神行为能力立法在中期内全面生效。与此同时,法律改革应该成为北爱尔兰政策制定者的整体方法的一部分,以基于人权的方 法来改善儿童和青少年的精神医疗服务。这将包括以下内容:增加资金和资源分配,以促进更及时地获得适当的治疗和相关服务;加强对影响其生活的政策、司法和临床决策的参与;以及采用一系列行政问责机制,以推动此类服务的长期改善。
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引用次数: 0
Future challenges for UK regulation of brain organoid research. 英国对脑类器官研究监管的未来挑战。
IF 1.8 4区 医学 Q1 LAW Pub Date : 2025-01-04 DOI: 10.1093/medlaw/fwae047
Emily Jackson

One of this century's most dramatic scientific developments is the reprogramming of stem cells in order to create organoids, that is, self-organizing 3D models that mimic the structure and function of human organs. This article considers whether brain organoids in particular might raise any new questions for law, now or in the near future. If complex human brain organoids were to become capable of consciousness or sentience, the current regulation of human tissue research, which protects the interests of tissue donors, might need to be supplemented in order to protect the interests of the tissue itself. Human brain organoids can also be implanted into animal hosts, and if this were to result in animals with significantly enhanced cognitive abilities, additional protective measures might become necessary.

本世纪最引人注目的科学发展之一是干细胞的重新编程,以创造类器官,即模仿人体器官结构和功能的自组织3D模型。本文考虑的是,无论是现在还是不久的将来,类脑器官是否会给法律带来新的问题。如果复杂的人脑类器官能够具有意识或感知能力,那么为了保护组织本身的利益,可能需要对目前保护组织捐赠者利益的人体组织研究规定进行补充。人脑类器官也可以植入动物体内,如果这能显著增强动物的认知能力,可能就需要采取额外的保护措施。
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引用次数: 0
A common law power to dissect: a medico-legal history. 普通法的权力解剖:医法史。
IF 1.8 4区 医学 Q1 LAW Pub Date : 2025-01-04 DOI: 10.1093/medlaw/fwaf006
Joshua Shaw

Some jurists claimed there was a common law power to dissect the human body prior to and outside of the Anatomy Act 1832. That power formed part of the privileges of physicians, surgeons, and apothecaries, and, accordingly, the common law to the extent it recognized those privileges. It is best evidenced in the late-nineteenth and early-twentieth centuries-most authoritatively by the Court of Queen's Bench in R v Price in 1884, the Québec Superior Court in Phillips v Montreal General Hospital in 1908, and the reasons of the inquiry into the conduct Dr William Ramsay Smith in 1903, but also in the comments of writers in law manuals until the mid-twentieth century. The existence of a common law power to dissect challenges narratives ordinarily told about the history of anatomy law specifically and the law of the dead generally. The power may also still exist if legislation in a jurisdiction has not displaced or substantially altered it. Through medico-legal history, the author argues that the medical lawyer can benefit from re-examining old doctrines. Heterodox elements in old doctrines suggest alternative possibilities for the law, allowing medical law's histories to be retold.

一些法学家声称,在《1832年解剖法》之前和之后,有一项普通法的权力可以解剖人体。这种权力构成了内科医生、外科医生和药剂师特权的一部分,因此,普通法在一定程度上承认了这些特权。这一点在19世纪末和20世纪初得到了最好的证明——最权威的是1884年的“R诉Price”案,1908年的“qusamicbec高等法院”对菲利普斯诉蒙特利尔总医院案,以及1903年调查威廉·拉姆齐·史密斯医生行为的原因,但直到20世纪中叶,法律手册作者的评论也体现了这一点。普通法权力解剖的存在挑战了通常关于解剖法的历史和一般关于死者的法律的叙述。如果一个司法管辖区的立法没有取代或实质上改变该权力,该权力也可能仍然存在。通过医法史,作者认为医学律师可以从重新审视旧学说中获益。旧学说中的非正统元素为法律提供了另一种可能性,使医疗法律的历史得以重述。
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引用次数: 0
Parental autonomy and children's health: a patriarchal dilemma in the Middle East, with particular emphasis on Kuwait. 父母的自主权与儿童的健康:中东地区父权制下的两难选择,重点是科威特。
IF 1.8 4区 医学 Q1 LAW Pub Date : 2025-01-04 DOI: 10.1093/medlaw/fwaf007
Bashayer Al Majed

In 2020, Kuwaiti mothers won legal medical guardianship over their children, enabling them to authorize medical treatment, this despite still not having autonomy for their own medical care, yet being vicariously liable for potential tort caused by their child. This dichotomy raises questions over the implementation of the new legislation, if the mother and the male guardian had opposing views over the child's health. Recent years have seen the UK cases of Charlie Gard and Alfie Evans initiate passionate ethical debate when courts invoked Parens Patriae, superseding parental autonomy and supporting clinicians' decisions to withdraw life support. Middle Eastern courts tend to support parental decisions; however, strict civil laws exist regarding the continuation and cessation of life support. This article examines the patriarchal culture in the Middle East and explores whether a Kuwaiti mother's medical autonomy would be upheld in the event of a parental dispute over their child's treatment and end-of-life care, within the framework of the Kuwaiti Civil Code No. 67 of 1980. The article concludes that matriarchal guardianship would likely be undermined; however, legislative changes are the first step and advances in palliative care across the Middle East are introducing a changing culture towards open parental discussions and shared decision-making, slowly making the mother's decisive voice a part of the norm.

2020年,科威特母亲获得了对子女的法律医疗监护,使她们能够授权进行医疗,尽管她们仍然没有自己医疗保健的自主权,但却要为子女可能造成的侵权行为承担间接责任。如果母亲和男性监护人对儿童的健康持相反意见,这种二分法就会对新立法的执行产生疑问。近年来,英国的查理·加德(Charlie Gard)和阿尔菲·埃文斯(Alfie Evans)案件引发了激烈的伦理辩论,法院援引父母的父权,取代父母的自主权,支持临床医生撤回生命维持设备的决定。中东法院倾向于支持父母的决定;然而,对于生命维持系统的继续和停止,存在着严格的民事法律。本文考察了中东的父权文化,并探讨了在1980年《科威特第67号民法典》的框架内,如果父母就子女的治疗和临终关怀发生争执,科威特母亲的医疗自主权是否会得到维护。文章的结论是,母系监护可能会被破坏;然而,立法改革是第一步,整个中东地区姑息治疗的进步正在引入一种不断变化的文化,即公开的父母讨论和共同决策,慢慢地使母亲的决定性声音成为常态的一部分。
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引用次数: 0
Guy's and St Thomas'-v-Knight [2021] EWHC 25: Dignity in English law. Guy's and St Thomas'-v-Knight [2021] EWHC 25:英国法律中的尊严。
IF 1.8 4区 医学 Q1 LAW Pub Date : 2024-11-01 DOI: 10.1093/medlaw/fwae027
Melanie J Weismann
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引用次数: 0
Editorial: Reproductive health, choice, and justice. 社论:生殖健康、选择与公正。
IF 1.8 4区 医学 Q1 LAW Pub Date : 2024-11-01 DOI: 10.1093/medlaw/fwae039
Bev Clough, Sara Fovargue, Rob Heywood, José Miola
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引用次数: 0
Towards a rights-based approach for disabled women's access to abortion. 以权利为本,促进残疾妇女获得堕胎服务。
IF 1.8 4区 医学 Q1 LAW Pub Date : 2024-11-01 DOI: 10.1093/medlaw/fwae026
Magdalena Furgalska, Fiona de Londras

This article adds to the still limited scholarship on the impact of abortion laws and policies on people with disabilities and those with diminished capacity who seek abortion. We argue that neither the legal nor policy framework currently operating in England and Wales adequately incorporates and protects the rights of people with disabilities or those experiencing mental ill-health. Rather, the law and policy framework jeopardizes their reproductive agency. We argue that greater attention to and incorporation of standards contained within the UN Convention on the Rights of Persons with Disabilities (including the sources produced by its Committee) and implementation of guidelines produced by the World Health Organization would result in a rights-affirming framework that supports disabled women's reproductive agency, enhances their effective enjoyment of human rights, and supports them in accessing quality abortion care.

关于堕胎法律和政策对寻求堕胎的残疾人和行为能力减弱者的影响,本文对仍然有限的学术研究进行了补充。我们认为,目前在英格兰和威尔士实施的法律和政策框架都没有充分纳入和保护残疾人或精神疾病患者的权利。相反,法律和政策框架损害了他们的生育权。我们认为,更多地关注并纳入联合国《残疾人权利公约》(包括其委员会编制的资料来源)中所载的标准,并执行世界卫生组织编制的准则,将产生一个支持残疾妇女生殖机构的权利确认框架,增强她们有效享有人权的能力,并支持她们获得高质量的堕胎护理。
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引用次数: 0
FemTech: empowering reproductive rights or FEM-TRAP for surveillance? FemTech:赋予生殖权利还是监控 FEM-TRAP?
IF 1.8 4区 医学 Q1 LAW Pub Date : 2024-11-01 DOI: 10.1093/medlaw/fwae035
Dylan Hofmann

The emergence of FemTech technologies promises to revolutionize women's health and reproductive rights but conceals an insidious trap of surveillance and control in the hands of private and state actors. This article examines the extent to which FemTech technologies, under the guise of empowerment, enable private actors to play a leading role in managing reproductive rights, replacing largely inactive States in this crucial function. The analysis shows how private FemTech companies are becoming critical players in implementing and defending these rights, often in response to the inaction or inadequacies of States. The article approaches the FemTech phenomenon from several angles, including the promises of empowerment, concerns about surveillance and control, and the ambivalent roles of private actors as implementers and defenders of reproductive rights. This structure makes it possible to offer a critical analysis of the legal, societal, and ethical implications of FemTech, highlighting the tensions between the promises of empowerment and the risks of surveillance and control.

女性科技技术的出现有望彻底改变妇女的健康和生殖权利,但却掩盖了私人和国家行为者手中监视和控制的阴险陷阱。本文探讨了女性科技技术打着赋权的幌子,在多大程度上使私人行为者在管理生殖权利方面发挥主导作用,取代在这一关键职能上基本无所作为的国家。分析表明了私营女性科技公司是如何成为落实和捍卫这些权利的关键角色的,这往往是为了应对国家的不作为或不足。文章从多个角度探讨了 FemTech 现象,包括赋权的承诺、对监视和控制的担忧,以及私营行为者作为生殖权利实施者和捍卫者的矛盾角色。这种结构使我们有可能对女性科技的法律、社会和伦理影响进行批判性分析,突出赋权承诺与监视和控制风险之间的紧张关系。
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引用次数: 0
Addressing the consequences of the corporatization of reproductive medicine. 应对生殖医学公司化的后果。
IF 1.8 4区 医学 Q1 LAW Pub Date : 2024-11-01 DOI: 10.1093/medlaw/fwae018
Sara A Attinger, Emily Jackson, Isabel Karpin, Ian Kerridge, Ainsley J Newson, Cameron Stewart, Lucy van de Wiel, Wendy Lipworth

In Australia and the UK, commercialization and corporatization of assisted reproductive technologies have created a marketplace of clinics, products, and services. While this has arguably increased choice for patients, 'choice', shaped by commercial imperatives may not mean better-quality care. At present, regulation of clinics (including clinic-corporations) and clinicians focuses on the doctor-patient dyad and the clinic-consumer dyad. Scant attention has been paid to the conflicts between the clinic-corporation's duty to its shareholders and investors, the medical profession's duty to the corporations within which they practice, and the obligations of both clinicians and corporations to patients and to health systems. Frameworks of regulation based in corporate governance and business ethics, such as stakeholder models and 'corporate social responsibility', have well-recognized limits and may not translate well into healthcare settings. This means that existing governance frameworks may not meet the needs of patients or health systems. We argue for the development of novel regulatory approaches that more explicitly characterize the obligations that both corporations and clinicians in corporate environments have to patients and to society, and that promote fulfilment of these obligations. We consider mechanisms for application in the multi-jurisdictional setting of Australia, and the single jurisdictional settings of the UK.

在澳大利亚和英国,辅助生殖技术的商业化和公司化创造了一个诊所、产品和服务的市场。虽然这可以说增加了患者的选择,但由商业需要决定的 "选择 "可能并不意味着更高质量的医疗服务。目前,对诊所(包括诊所公司)和临床医生的监管主要集中在医生与患者的关系以及诊所与消费者的关系上。诊所-公司对其股东和投资者的责任、医疗专业人员对其执业的公司的责任以及临床医生和公司对患者和医疗系统的义务之间的冲突却很少得到关注。基于公司治理和商业道德的监管框架,如利益相关者模式和 "企业社会责任",具有公认的局限性,可能无法很好地转化为医疗环境。这意味着现有的管理框架可能无法满足患者或医疗系统的需求。我们主张开发新的监管方法,更明确地描述企业和临床医生在企业环境中对患者和社会应尽的义务,并促进这些义务的履行。我们考虑了在澳大利亚的多司法管辖区环境和英国的单一司法管辖区环境中的应用机制。
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引用次数: 0
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Medical Law Review
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