scholarly journals No Means No, Or Does It? A Comparative Study of the Right to Refuse Treatment in a Psychiatric Institution

2016 ◽  
Vol 44 (2) ◽  
pp. 137-172
Author(s):  
Mehgan Gallagher

AbstractAround the world, people with mental disabilities are subject to many types of behavioral therapies against their will, including medications and restraints. This is especially true of people who are institutionalized. These intrusions are in violation of fundamental international human rights principles. People with mental disabilities are often stripped of many of their basic rights, including the right to determine what is done to their bodies. This article compares the prevailing law on the right to refuse treatment for people with mental disabilities in an institutional setting in three different nations on three continents, specifically in the United States, Kenya, and Brazil.

1982 ◽  
Vol 37 (8) ◽  
pp. 974-975
Author(s):  
Thomas G. Gutheil

2020 ◽  
Vol 2020 (3) ◽  
pp. 5-23
Author(s):  
Grzegorz W. Kolodko ◽  

The huge leap made by the Chinese economy over the past four decades as a result of market reforms and openness to the world is causing fear in some and anxiety in others. Questions arise as to whether China’s economic success is solid and whether economic growth will be followed by political expansion. China makes extensive use of globalization and is therefore interested in continuing it. At the same time, China wants to give it new features and specific Chinese characteristics. This is met with reluctance by the current global hegemon, the United States, all the more so as there are fears that China may promote its original political and economic system, "cynicism", abroad. However, the world is still big enough to accommodate us all. Potentially, not necessarily. For this to happen, we need the right policies, which in the future must also include better coordination at the supranational level.


Author(s):  
Carl H. Coleman

Abstract One of the central tenets of contemporary bioethics is that mentally competent persons have a right to refuse medical treatment, even if the refusal might lead to the individual’s death. Despite this principle, laws in some jurisdictions authorize the nonconsensual treatment of persons with tuberculosis (TB) or other serious infectious diseases, on the grounds that doing so is necessary to protect the safety of others. This chapter argues that, in the vast majority of situations, overriding a refusal of treatment for infectious disease is not justifiable, as the risk to third parties can be avoided by the less restrictive alternative of isolating the patient. At the same time, it rejects the extreme position that the nonconsensual treatment of infectious disease is never appropriate. Instead, it concludes that compelling an individual to undergo treatment for infectious diseases may be ethically justifiable in exceptional situations if a refusal of treatment poses a grave risk to third parties, the treatment is not overly burdensome and has been established to be safe and effective, and less restrictive alternatives, including humanely isolating the patient, are not feasible under the circumstances. The burden should be on those seeking to compel unwanted treatment to demonstrate that these requirements have been met.


Author(s):  
François Grosjean

The author discovered American Sign Language (ASL) and the world of the deaf whilst in the United States. He helped set up a research program in the psycholinguistics of ASL and describes a few studies he did. He also edited, with Harlan Lane, a special issue of Langages on sign language, for French colleagues. The author then worked on the bilingualism and biculturalism of the deaf, and authored a text on the right of the deaf child to become bilingual. It has been translated into 30 different languages and is known the world over.


Author(s):  
Cheryl Colopy

A low dam girdles the Ganga about sixty miles beyond Bhagalpur. More than a mile and a half across, the structure is the longest barrage in the world. It has 109 gates, almost twice as many as the Koshi barrage I traveled over near the Nepal-India border. Its name, Farakka, is anathema to people throughout Bangladesh. In India mainly fishermen on the Ganga know much about it. The barrage, which sits just eleven miles from the international border that separates the tiny nation from its big neighbor, has poisoned relations between the two governments for forty years. The story of Farakka is one of the thorniest river disputes on the subcontinent. Whole books have been written about it on both sides of the border as well as by international commentators, not to mention the technical treatises it has engendered. The barrage did not accomplish the task for which it was built and has harmed people in both India and Bangladesh. Farakka offers a warning about how not to handle transboundary rivers to prevent complex subcontinental watersharing problems from becoming crises in the future. Borders fragment the river system in the Ganges basin, creating unique transboundary water management challenges. To visualize the Indian subcontinent’s river-sharing problems, imagine a slice of pizza. Take a bite out of the middle of the bumpy top crust. That’s Nepal. Then take a small bite out of the right, or eastern edge, just below the crust. That’s Bangladesh. The rest of the slice is India. These three nations share the greater Ganges basin. The river spills into the Bay of Bengal in Bangladesh after flowing across the wide top part of India. Many of the river’s major tributaries come from Nepal. The smaller slice of pizza to the west would include Pakistan and the Indus River, but that’s another complicated story. Now move the piece of pizza to North America and pretend the United States is the majority of the slice.


Author(s):  
Jessica W. Berg ◽  
Paul S. Appelbaum ◽  
Charles W. Lidz ◽  
Lisa S. Parker

From its inception, the law of informed consent has been based on two premises: first, that a patient has the right to receive sufficient information to make an informed choice about the treatment recommended; and second, that the patient may choose to accept or to decline the physician’s recommendation. The legitimacy of this second premise should be underscored because it is too often belied by the everyday language of medical practice. Getting a consent is medical jargon that implies that patient agreement is the only acceptable outcome. Indeed, the term informed consent itself suggests that patients are expected to agree to be treated rather than to decline treatment. Unless patients are viewed as having the right to say no, as well as yes, and even yes with conditions, much of the rationale for informed consent evaporates. Nonetheless, the medical profession’s reaction to patients who refuse treatment often has been less than optimal. The right to refuse treatment is frequently ignored in practice because it is inconsistent with the history and ethos of medicine (1,2). Physicians are trained to treat illness and to prolong life; situations in which they cannot do either—not because of limitations of knowledge or technology, but because patients or third parties reject their recommendations for care—evoke profound feelings of frustration and even anger. It would not be too much to suggest that these confrontations challenge an essential element of the medical identity. Physicians’ reactions to these situations are varied. Some will contend with patients over their refusal, while others, having assimilated a distorted version of patients’ right to refuse treatment, may too quickly abandon their patients to the consequences of their choices, thereby depriving them of the guidance for which patients traditionally have turned to their physicians. Regardless of the quality of care offered to patients or the degree of concern of those who treat them, some patients will have reasons of their own to decline treatment. Before considering how clinicians might respond to these situations, this chapter reviews the status of the law regarding treatment refusal, surveying a legal landscape that has seen dramatic changes in the last decade.


Author(s):  
David Abulafia

The Allied victory over Germany in the Second World War, like that in the First, left the Mediterranean unsettled. After Greece emerged from its civil war with a pro-western government, there were ever louder rumbles in Cyprus, where the movement calling for enôsis, union with Greece, was gathering pace again. Precisely because the Greeks sided with the West, and because Turkey had kept out of the war, during the late 1940s the United States began to see the Mediterranean as an advance position in the new struggle against the expanding power of the Soviet Union. The explicit theme was the defence of democracy against Communist tyranny. Stalin’s realism had prevented him from supporting Communist insurgency in Greece, but he was keen to find ways of gaining free access to the Mediterranean through the Dardanelles. In London and Washington, the fear that Soviet allies would establish themselves on the shores of the Mediterranean remained real, since the partisan leader in Yugoslavia, Tito, had played the right cards during the last stages of the war, even winning support from the British. Moreover, the Italians had lost Zadar along with the naval base at Kotor and chunks of Dalmatia they had greedily acquired during the war, while Albania, after an agonizing period of first Italian and then German occupation, had recovered its independence under the Paris-educated Communist leader Enver Hoxha, whose uncompromising stance was to bring his country into ever-greater isolation. When he took power, Hoxha imagined that his country would form part of a brotherly band of socialist nations, alongside Tito’s renascent Yugoslavia and the Soviet Union. Close ties with the Yugoslavs were sealed by economic pacts which reveal Tito’s hope of drawing Albania into the Yugoslav federation. Hoxha had other aspirations, and in his view Albania’s right to defend every square inch of the national territory extended into the waters off the Albanian coast: the Corfu Channel, long used as a waterway linking Greece to the Adriatic, was mined to prevent foreign incursions. Britain decided to send warships through the channel, asserting its right to police the Mediterranean on behalf of the nations of the world.


Author(s):  
Rodney A. Smolla

This chapter begins with an account of Anna Anderson, an immigrant to the United States who claimed to be the Grand Duchess Anastasia of Russia that was exposed to be fake after a DNA test. It discusses the collusive connections between Russia and the American radical alt-right. It also identifies several figures that were prominent in the Unite the Right events in Charlottesville in 2017 and strongly supported the candidacy and presidency of Donald Trump. The chapter highlights how alt-right groups idolize Russia's leader Vladimir Putin, seeing him as the sort of strong-willed authoritarian dedicated to “traditional values” that the world needs. It discloses how Russia has been the hospitable home and host of American right-wing extremists, such as David Duke who moved to Russia in 1999.


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