Mental disability and voting rights: Bridging the knowledge and uptake gap

By Prof Judy Laing, Professor of Mental Health law, Rights and Policy (University of Bristol Law School)

As the general election approaches and you consider whether to use your vote, spare a thought for the thousands of people who are detained in psychiatric hospitals or living in residential care/nursing homes, and who may not even realise that they are entitled to vote, or be given the opportunity to do so.

Government statistics suggest that there were 21,439 people reported as being subject to compulsory detention under the Mental Health Act 1983 on 31st March 2018, and over three quarters of these people were being detained in hospital in England.[1] The majority of these detained patients have the same right to vote as the general population, but they are one of the most disenfranchised groups in society.  Surveys have found that psychiatric in-patient uptake and knowledge of voting rights is generally poor. For example, a study on the general election in 2010 found that eligible psychiatric in-patients were half as likely to register as the general population; half as likely to vote if registered, and patients who had been in hospital for longer periods were particularly affected.[2] Moreover, research also suggests that knowledge of patients’ voting rights amongst mental health professionals could be improved.[3] (more…)

Abortion Law Reform in Northern Ireland

By Dr Sheelagh McGuinness, Reader in Law (University of Bristol Law School) & Professor Sir Jonathan Montgomery, Professor of Healthcare Law (UCL Laws).

Credit: Rossographer

October 22nd 2019 marked a momentous day for those who have advocated for decades for liberalisation of Northern Ireland’s restrictive abortion laws.[1] Following the implementation of Section 9 of the Northern Ireland Executive Formation Act 2019, abortion up until 24 weeks gestation is decriminalised. In addition to this, an obligation has been placed on the Secretary of State for Northern Ireland to ensure that adequate regulations are in place by the end of March 2020 to ensure a human rights compliant framework for provision of abortion care.

This is the first of a two-part blog. Here we focus on what decriminalisation of abortion means for regulation of abortion in Northern Ireland.[2] In the next part we will provide an account of what the content of human rights compliant abortion regulations should be. (more…)

Abortion in Northern Ireland: The Ewart Judicial Review Judgment

By Dr. Jane Rooney, Lecturer in Law (University of Bristol Law School)

NB: Abortion law in Northern Ireland is set to change on 22nd October 2019 if the suspended Northern Irish Assembly continues to not function on or after 21st October. This blog post contextualises and recognises the continued relevance of judicial review proceedings challenging the prohibition on abortion in Northern Ireland in cases of fatal foetal abnormality within a dynamic, multi-layered legal, political and social context.

On 3rd October 2019, the High Court of Justice in Northern Ireland decided that Northern Irish abortion law was incompatible with the Human Rights Act 1998 (HRA) insofar as it prohibited abortion in cases of fatal foetal abnormality (FFA). Justice Keegan decided to refrain from pronouncing on the remedy before hearing further submissions by the parties involved: she delayed the decision over whether to make a declaration of incompatibility (DOI) pending further submissions.[1]  This judicial review case follows a momentous year in activism, litigation, and legislative reform on abortion in Northern Ireland. The following provides context to the judgment, and a summary of the key reasoning employed. It then focuses on the DOI point which is yet to be concluded. A DOI should be made for two primary reasons. First, this remedy is warranted in the circumstances of the prohibition on abortion in cases of FFA. It can be distinguished from Nicklinson which introduced the idea that a DOI need not be made despite finding an incompatibility. Second, to proceed with refusing a DOI despite finding an incompatibility, and normalising Nicklinson, would have broader consequences for the human rights protection system in the UK. (more…)

Promoting the next generation of health law scholarship

By Prof John Coggon and Prof Judy Laing (Bristol University Law School)

In October 2017, we were proud and honoured to mark the launch of the Centre for Health, Law, and Society (CHLS) in the University of Bristol Law School. The Centre is founded on ambitious aims to push the boundaries of scholarship in health law: expand its methods and approaches; broaden its practical reach and points of focus; enhance its place in shaping education; and increase its engagement with, relevance to, and impacts on people, organisations, regulators, and policy-makers across society.

Our launch event allowed a showcase of the breadth of scholarly interest and inquiry within CHLS, as well as an opportunity to hear presentations from leading figures in health, law, and associated disciplines. We start from a basic premise that the value and significance of health requires understandings from ranging disciplinary perspectives, looking across social sectors and actors. We are interested in the roles served by law to protect and promote rights, achieve greater social justice, and to ensure that health and other fundamental values are secured fairly for all.

Since the time of our launch, CHLS has gone from strength to strength. Our community of students, academics and collaborators continues to grow. And we are delighted in March 2019 to publish a Special Issue of the Northern Ireland Legal Quarterly (NILQ), which shows well the depth, range and reach of our ambitions. The Special Issue comprises contributions from 11 of CHLS’ members, as well as from colleagues from other universities. They represent legal scholarship that engages with ethical considerations and social justice, history, human rights, philosophy, politics and social sciences. They approach questions spanning from very individualised rights, to population- and systems-level analyses. (more…)

Nanny states and grown-up debates on alcohol policy

By Prof John Coggon, Professor of Law (University of Bristol Law School)

Photo: Flickr

Debates on alcohol policy are necessarily complex and controversial, and a complete consensus on how we should regulate this area will not be achieved. Like other lawful but regulated products, alcohol presents benefits and harms that may be understood from ranging perspectives. These include views based in cultural, economic, ethical, historical, legal, medical, population-based, religious, and social understandings. Of necessity, outlooks on alcohol policy and the role of regulation therefore vary both within and across such differing sources of critique. The values—positive and negative—of alcohol at individual, familial, community, commercial, and population levels thus call for careful, reasoned, and respectful public debates.

Even within the context of public health analysis, we cannot just look to scientific studies to inform and determine policy: we are required to consider forms of ‘evidence’ from different disciplines and sectors. This is well explained in a recent publication by the Health Foundation, with papers applied to child obesity but with lessons that are generalisable across health policy. However, for many working in public health, or members of wider communities who have interests in what makes good health policy, challenges emerge in relation to the conduct of public debates: often care, reason, and respect are replaced by simplistic slurs and assertions. And in this context, accusations of nanny statism are a key and persistent example. (more…)

Transgender and Intersex Rights in the EU and EFTA

By Dr Peter Dunne, Lecturer in Law (University of Bristol Law School) and Dr Marjolein van den Brink, Assistant Professor (University of Utrecht).

*This blog post reflects the views of the authors alone. The blog has not been approved by, and should not be understood as the opinion of, the European Commission or European Network of Legal Experts in Gender Equality and Non-Discrimination*

On 20 November 2018, to mark the Transgender Day of Remembrance, the European Commission (DG Justice and Consumers) published a new survey on transgender (trans) and intersex equality rights. The report – entitled Trans and intersex equality rights in Europe – a comparative analysis (‘the Report’) – was co-authored by Peter Dunne (Bristol Law School) and Marjolein van den Brink (University of Utrecht). It considers the existence (or lack thereof) of gender recognition and non-discrimination guarantees for trans and intersex populations in 28 European Union and three European Free Trade Association countries (EFTA).

At a moment when gender rights are the subject of intense political and media debate in the United Kingdom, the Report is a timely reminder of the real, substantive inequalities which transgender and intersex communities experience on a daily basis. While the Report evidences some welcome progress in the spheres of gender identity, gender expression and sex characteristics, it reinforces existing research (e.g. here, here) showing that – both de jure and de facto – trans and intersex individuals experience less secure protection than cisgender peers and persons who do not experience intersex variance. (more…)

NHS procurement and Brexit: limited scope for no-deal preparations

By Dr Albert Sanchez-Graells, Reader in Economic Law and Member of the Centre for Health, Law, and Society (University of Bristol Law School).

As Brexit day approaches and the UK and the EU fail to complete their negotiations for a withdrawal and transition agreement to ensure an ‘orderly Brexit’, more and more voices will raise strong concerns about the impact of a no-deal Brexit for important sectors of the UK economy and public sector. In a leaked letter, the trade association of NHS providers sent a clear warning message to the public bodies in charge of running the English NHS (NHS England and NHS Improvement). As widely reported by the press, NHS providers made it clear that poor co-ordination by ministers and health service bosses means there has been a failure to prepare for the UK to be left without a Brexit deal, and that this could mean “both stockpiles and shortages of medicines and medical devices”.

NHS providers have thus requested that the Department of Health and Social Care, NHSE and NHSI accelerate preparations for a no-deal Brexit. In this post, I argue that there is very limited scope for no-deal preparations concerning medical equipment and consumables, and that this can have a very damaging impact on the running of the NHS post-Brexit, given that it annually spends approximately £6 billion on goods (such as every day hospital consumables, high cost devices, capital equipment and common goods). (more…)

Is mental health finally emerging from the shadows into light?

By Dr Judy Laing, Reader in Law and Co-Director of the Centre for Health, Law, and Society (University of Bristol Law School).

Mental Health Awareness Week (14-20th May) is a good opportunity for us to reflect on how far mental health has emerged from the shadows over the last decade. For too long, mental health has been neglected in England and Wales, and this is particularly true for our main political parties, where up until quite recently, mental health has rarely featured in pre-election manifestos. There are now positive signs that this is changing and the nation’s mental health is now firmly on the political agenda.

As the King’s Fund identified in a report in 2015, mental health has finally become a political priority for the major political parties. We saw evidence of this in Theresa May’s Conservative party conference speech in October 2017, as she expressed her desire to tackle the injustice and stigma associated with mental health. This was accompanied by a government pledge to direct additional resources to frontline mental health services and staff. This rhetorical commitment to prioritise mental health is welcome and long overdue, but of course, it must be followed by clear action on the ground in terms of additional staff, services and support, if we are going to witness a radical change in the reality of life for the 1 in four of us who will suffer from a mental health problem each year. (more…)

Working together to combat global health inequalities

By Prof John Coggon, Professor of Law, and Dr Judy Laing, Reader in Law, co-Directors of the Centre for Health, Law and Society (University of Bristol Law School).

The World Health Organization (WHO) celebrated its 70th anniversary last month, on 7th April 2018, which is World Health Day. The WHO was established in 1948 and one of its founding principles provides that:

the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.

The WHO has achieved a considerable amount in that time by focusing on many of the key challenges to reducing global health inequalities. Some of the most recent challenges faced by the WHO are the rise in drug resistance across the globe, as well as the threat of global pandemics, as witnessed with the Ebola virus outbreak in West Africa in 2014, and the burdens of noncommunicable disease. International organisations such as the WHO have a crucial role to play in tackling these threats to our health fairly and effectively, but it cannot achieve change alone. The WHO must do so in partnership with national governments and other key actors. Within these agendas, there are crucial roles for law and governance as levers to help create the conditions in which people can enjoy good physical and mental health.

One of the world’s leading global health law scholars, and one such key actor and WHO collaborator, Professor Larry Gostin, visited the Centre for Health, Law, and Society (CHLS) at the University of Bristol in April 2018 as a Benjamin Meaker Visiting Professor. He came to talk about his collaborations with the WHO, and to explore some of the key global health challenges with staff and students from across and beyond the university. A key focus throughout his visit was the ways that we can and should link scholarship with activism, policy, and practice: a question at the heart of the mission of CHLS. (more…)

Strengthening the Capacity for Ethical Public Health

By Prof John Coggon, Professor of Law and Co-Director of the Centre for Health, Law, and Society (University of Bristol Law School).  Honorary Member of the Faculty of Public Health.*

© Rookuzz..

Public health is proudly an evidence-based field. But evidence without values cannot tell us what we should do.

We need public health ethics if we are to understand and explain, by reference to the classic definition of public health advanced by Winslow, what we, as a society, ought to do to assure the conditions in which people can enjoy good health and equitable prospects for health. Using the ‘organised efforts of society’ to protect and promote health and well-being is an ethical goal—indeed, as many of us would argue, it is an ethical imperative. And to be achieved, it requires law and policy. To evaluate when threats to health warrant a public health response, scientific analyses must be complemented by matters such as the balancing of values, an assessment of the relative merits of different possible interventions, an appreciation of the likely risks and impacts of intervening, and a sensitivity to political and cultural contexts and realities. (more…)