Health Law Research Articles

Coercive Vaccination Policy in Nigeria: Legal Perspectives

Background: In December 2021, the Nigerian federal government declared a compulsory COVID-19 immunisation for all employees of government. This declaration by the government has been viewed by some Nigerians as a contravention of the fundamental rights of Nigerian citizens. Aim: This study was aimed at identifying the human rights concerns surrounding vaccination mandates from the perspective of legal practitioners in Nigeria. Methods: This study was a cross-sectional study that used a semi-structured self-administered questionnaire to interview legal practitioners practicing in Uyo, Nigeria. The survey focused on identifying human right concerns surrounding vaccination mandates. Results: One hundred and five legal practitioners participated in the study. Data analysis revealed that 79 (75.2%) of our respondents agreed that vaccination mandates to prevent an epidemic is well within the powers of the state, while 97 (92.4%) asserted that the Nigerian constitution gives the state authority to enact health laws including quarantine and vaccination laws to protect its citizens. According to 59% (n=62) of our respondents, the only exception to a mandatory vaccination is an offer of apparent or reasonably certain proof to the state’s board of health that the vaccination would seriously impair health or probably cause death. Conclusion: In the opinion of majority of the legal practitioners interviewed, the Nigerian constitution gives the state the power to implement measures established by legislation to protect the health of her citizens. Thus, coercive vaccination policies by the state to protect the public from an epidemic outbreak of a disease which threatens the safety of citizens may be legally binding on the citizens.

Practical implications of overlapping mental capacity assessments.

Richard Griffith, Senior Lecturer in Health Law at Swansea University, considers the practical implications of undertaking mental capacity assessments with a person across a range of different decisions.

Determinants of Road Traffic Crash Fatalities: A Case of Road Accidents in India, 2004–2018

The purpose of this study is to determine the factors that influence deaths in road accidents in India. The study uses panel econometric methodologies such as the fixed effects model, random effects model, and Hausman–Taylor instrumental variable technique to achieve this goal. Unobserved heterogeneity between states/union territories (UTs) and time is accounted for by time-fixed and state-fixed effects. Based on the panel data set from Indian states/UTs for the period 2004–2018, the study confirms previous results that motorisation, population, urbanisation and income level are all potential contributors to road accidents and fatalities. It also shows that spending on health care and law enforcement appears to help the Indian states minimise mortality in road traffic accidents. On the one hand, spending on health care facilities can provide health-related assistance to persons who have been involved in traffic accidents; on the other hand, spending on police increases the enforcement of rules, resulting in a reduction in traffic accidents. Thus, to lessen the economic and financial cost of road accidents in the country, the government should focus on boosting both per capita health expenditure and per capita police expenditure. JEL Codes: C23, C26, H51, I18, L92, O18, R41, R42

Global Health Law for a Safer and Fairer World.

Global Health Law for a Safer and Fairer World.

Mental health patients' preferences regarding restrictive interventions: An integrative review.

INTRODUCTION: The use of restrictive interventions is a violation of patients' rights that causes physical and psychological harm and which is a well-known challenge globally. Mental health law and legislative principles and experts agree that when restrictive interventions are applied, the least restrictive alternative should be used. However, there is no consensus on what is the least restrictive alternative, especially from the patient perspective. To investigate the literature on mental health patients' preferences regarding restrictive interventions applied during admission to a psychiatric hospital. An integrative review informed by the PRISMA statement and thematic analysis were undertaken. There were tendencies towards patients preferring observation and, for the majority, mechanical restraint was the least preferred restrictive intervention. Factors such as environment, communication and duration were found to influence patients' preferences. There is a lack of agreement on how best to measure patients' preferences and this complicates the choice of the least restrictive alternative. Nonetheless, our findings show that staff should consider environment, communication and duration when applying restrictive interventions. More research on restrictive interventions and the least restrictive alternative is warranted, but agreement is needed on standard measures, and a standard global definition of restrictive interventions.

The ISO 45001 standard and its relationship with the Occupational Health and Safety Law, Peruvian case

The implementation of an Occupational Health and Safety Management System is essential in organizations to take care of the integrity of people and avoid illnesses. The objective of the study is to relate the international standard ISO 45001 with an Occupational Health and Safety Law, with the aim that organizations that are currently complying with the regulations of their country can know which provisions they are complying with link to the standard. ISO 45001 and which ones are still pending, and in this way, they have an input for compliance with the international standard. For this analysis, the Occupational Health and Safety Law of Peru will be used as a guideline, which will provide a guide so that this analysis can be replicated with the laws of other countries. From the results obtained, it is concluded that the Peruvian OSH Law partially complies with the ISO 45001 standard.

Criminal Liability Arising from Medical Malpractice on Patients: A Review from the Perspective of Positive Law And Islamic Law

The suspicion in cases of medical malpractice in is only slightly raised, meanwhile, there are actions by the health profession by doctors as medical personnel which have the potential to be a malpractice that can be reported by the public, but are not resolved legally because the community only has limited knowledge of science medical and because there is no form of specific legal regulations governing malpractice in Indonesia so that the occurrence of these malpractices can cause legal problems. This study aims to determine criminal liability for medical malpractice acts committed by doctors to patients in anticipating and dealing with medical malpractice problems in criminal cases. The research method used in this study is doctrinal, where the author collects material from the literature, both hardcopy and softcopy, which is related to the title of this research by using an analysis of the research object. Criminal malpractice occurs when a patient dies or is disabled and/or seriously injured as a result of actions taken by health workers who are careless or less careful in making efforts to treat patients who die or are disabled and are criminally liable as a result of medical malpractice acts committed. doctors on patients can be accounted for under Article 359 and Article 360 of the Criminal Code. In this case the health law is considered insufficient and does not clearly regulate the crime of medical malpractice. So it is necessary to regulate the crime of medical malpractice by giving birth to a new health law, namely by explicitly regulating criminal liability for medical malpractice acts by doctors against patients in Indonesia.

LEGAL FRAMEWORK FOR PROTECTION OF MS PATIENTS’ RIGHTS IN AZERBAIJAN

Multiple sclerosis (MS) is a chronic disease that frequently results in enduring some level of disability. The rights of individuals affected by MS exhibit a nuanced and multifaceted character, extending beyond the purview of purely healthcare legislation. Assistive technologies (ATs) significantly improve the quality of life of that category of patients. To ensure MS patients’ rights, Azerbaijan health law is closely intertwined with disability law and state social security, which also includes ATs provision. The legislation of Azerbaijan in the context of ensuring the rights of MS patients is quite progressive and covers many issues, including the right to get free medicines, ATs, and recreation. The recent inclusion of some medications for MS on the WHO list of essential medicines (EML) creates the basis for further improvement of legislation in the field of treatment of this category of patients. This paper discusses MS treatment and related legislation within the framework of Azerbaijan health law.

The CRPD and mental health law reform in Scotland

Scotland's mental health and capacity legislation and its implementation is underpinned by European Convention on Human Rights (ECHR) informed principles, and such legislation and its implementation has remained largely ECHR compliant. It is designed to protect individuals' autonomy from inappropriate and disproportionate nonconsensual intrusions but its scope is largely limited to this. However, since the legislation was enacted at the start of the twenty first century the UK subsequently ratified the UN Convention on the Rights of Persons with Disabilities (CRPD) which requires the law and related practice to focus on giving effect to all the rights of persons with mental disabilities (people living with psychosocial, cognitive and intellectual disabilities) on an equal basis with others and to actively support such equality in rights enjoyment.The Terms of Reference of the independent Scottish Mental Health Law Review (2019–2022) included considering and making recommendations to align Scotland's mental health and capacity legislation with the CRPD. After engaging widely with stakeholders its recommendations sought to strengthen the voice of persons who use services and of those who care for them, reduce the need for non-consensual measures and secure rights to the help and support necessary to live a good life. In order to achieve this, it recommended, amongst other things, a refocusing on mental health and capacity law together with a Human Rights Enablement, Supported Decision Making and Autonomous Decision Making framework.

Legal Aspects in Implementing an Informed Consent System in Patient Health Practices

This research explores the legal aspects related to the implementation of the Informed Consent System in patient health practice. This system is a crucial ethical foundation in the relationship between medical personnel and patients, ensuring thorough understanding before patients consent to medical procedures or research. The research focus includes analysis of legal requirements, authority rights, and legal consequences related to Informed Consent. Additionally, this research investigates recent developments in health law, such as data protection and patient privacy regulations, and explores legal cases that can shape the framework for practice. By detailing the legal aspects involved, this research aims to provide a holistic view of the implementation of the Informed Consent System, strengthen regulatory compliance, and encourage a better understanding of rights and responsibilities in healthcare practice. It is hoped that the implications of this research will provide solid guidance for health practitioners and researchers in ensuring legal and ethical compliance in administering Informed Consent.

'Border Country': health law in a devolved UK.

How are we to understand and research health law under devolution in the UK? Building on work in law and geography, we argue that the figure of the border is key to the production and implementation of devolved health law and the variety of forms that this takes. The utility of border thinking in this context is shown through a review of thematic areas, including infectious disease control, access to health care, and abortion, each instantiating a distinct bordering process. In each, we consider recent developments in policy and legislation, framed with reference to constitutional change, and the politics of devolution in the UK. Taking Wales as an exemplary site, we argue that health law produces borders in traditional and non-traditional places. It creates and blurs territories. It is equally constituted by pluralistic bordering practices. On the basis of this theoretically informed review, we conclude by proposing a cross-disciplinary legal, ethical, and socio-legal research agenda for future research.

The World Health Organization was born as a normative agency: Seventy-five years of global health law under WHO governance.

The World Health Organization (WHO) was born as a normative agency and has looked to global health law to structure collective action to realize global health with justice. Framed by its constitutional authority to act as the directing and coordinating authority on international health, WHO has long been seen as the central actor in the development and implementation of global health law. However, WHO has faced challenges in advancing law to prevent disease and promote health over the past 75 years, with global health law constrained by new health actors, shifting normative frameworks, and soft law diplomacy. These challenges were exacerbated amid the COVID-19 pandemic, as states neglected international legal commitments in national health responses. Yet, global health law reforms are now underway to strengthen WHO governance, signaling a return to lawmaking for global health. Looking back on WHO's 75th anniversary, this article examines the central importance of global health law under WHO governance, reviewing the past successes, missed opportunities, and future hopes for WHO. For WHO to meet its constitutional authority to become the normative agency it was born to be, we offer five proposals to reestablish a WHO fit for purpose: normative instruments, equity and human rights mainstreaming, sustainable financing, One Health, and good governance. Drawing from past struggles, these reforms will require further efforts to revitalize hard law authorities in global health, strengthen WHO leadership across the global governance landscape, uphold equity and rights at the center of global health law, and expand negotiations in global health diplomacy.

Changes in Use of Hepatitis C Direct-Acting Antivirals After Access Restrictions Were Eased by State Medicaid Programs

Direct-acting antivirals (DAAs) are safe and highly effective for curing hepatitis C virus (HCV) infection, but their high cost led certain state Medicaid programs to impose coverage restrictions. Since 2015, many of these restrictions have been lifted voluntarily in response to advocacy or because of litigation. To estimate how the prescribing of DAAs to Medicaid patients changed after states eased access restrictions. This modified difference-in-differences analysis of 39 state Medicaid programs included Medicaid beneficiaries who were prescribed a DAA from January 1, 2015, to December 31, 2019. DAA coverage restrictions were measured based on a series of cross-sectional assessments performed from 2014 through 2022 by the US National Viral Hepatitis Roundtable and the Center for Health Law and Policy Innovation. Calendar quarter when states eased or eliminated 3 types of DAA coverage restrictions: limiting treatment to patients with severe liver disease, restricting use among patients with active substance use, and requiring prescriptions to be written by or in consultation with specialists. States with none of these restrictions at baseline were excluded. Quarterly number of HCV DAA treatment courses per 100 000 Medicaid beneficiaries. Of 39 states, 7 (18%) eliminated coverage restrictions, 25 (64%) eased restrictions, and 7 (18%) maintained the same restrictions from 2015 to 2019. During this period, the average quarterly use of DAAs increased from 669 to 3601 treatment courses per 100 000 Medicaid beneficiaries. After states eased or eliminated restrictions, the use of DAAs increased by 966 (95% CI, 409-1523) treatment courses per 100 000 Medicaid beneficiaries each quarter compared with states that did not ease or eliminate restrictions. The results of this study suggest that there was greater use of DAAs after states relaxed coverage restrictions related to liver disease severity, sobriety, or prescriber specialty. Further reductions or elimination of these rules may improve access to a highly effective public health intervention for patients with HCV.

Solidarity as a Political Determinant of Health: Insights from EU Competition Policy.

The connection between law and political determinants of health is not well-understood, but nevertheless it is suggested that the two are inseparable, and that this represents an "upstream" level with scope for influencing other determinants of health (particularly social). Solidarity underpins European healthcare systems and given its clear link with redistribution, can be seen as a means to address health inequities. As such, solidarity may be seen as a political determinant of health in the specific context of EU competition policy. A range of EU case law, Treaty provisions, and Commission publications relating to EU competition policy are analysed. Solidarity is typically juxtaposed as antithetical to competition, thus underpins exceptions to the applicability of the prohibitions on anticompetitive agreements, abuse of dominance, and state aid. Case law indicates a further dynamic between definitions of solidarity at EU and national levels. This analysis leads to two groups of considerations when framing solidarity as a political determinant of health in the EU competition policy context: firstly, the predominance of solidarity suggests it may shape competition reforms, and secondly the EU-Member State dynamic which indicates less EU-level reach into national competition reforms in healthcare than may be expected.

Deviating from the Norm? The Pregnant Body in Scandinavian Health Law

Abstract This article explores how the political ideal of data interacts with the legal entitlement of autonomy in the care of pregnant people guided by feminist theory and critical approaches to data. Using Scandinavian legislation and administrative practice, it analyses how the presence or absence of data, namely scientific evidence, interacts with pregnant people’s legal autonomy in healthcare. Data –particularly scientific evidence - is shown as something that is not neutral but open to interpretation and misappropriation. First, administrative complaints illustrate that not only a lack of scientific studies on pregnant people but also patriarchal attitudes have implications for care. Second, Scandinavian legislation authorizes the involuntary detention of pregnant drug users despite an absence of evidence supporting such drastic actions. Third, complaints bodies are found to frame injury to pregnant bodies as a natural consequence of birth, despite clear evidence as to the duties of healthcare professionals in preventing harm. A relational approach that sees the pregnant body and fetus as integrated though quintessentially unequal is needed. Evidence is not the only answer; an approach that recognizes the dignity of pregnant people must be central. This requires eliminating coercion, recognizing the pregnant patient as the decision maker in healthcare choices and prizing the birthing patient’s voice as a valuable data source.

A right to health-based approach to dental caries: towards a comprehensive control strategy.

Health is a matter of human rights and dental caries is the most common non-communicable disease (NCD) globally. Consequently, dental caries is a matter of human rights and its control, particularly prevention, must be a priority. Although largely preventable, this is too often neglected, both in the literature of human rights- and health law, and in dental research. The right to oral health has recently been acknowledged by the World Health Organization (WHO), but it is insufficiently clear what this right entails. This article introduces a right to health-based narrative in the context of dental caries. The right to health is stipulated in human rights treaties, including the International Covenant on Economic, Social and Cultural Rights (ICESCR) and the Convention on the Rights of the Child (CRC). States that are Parties to these treaties, which are virtually all States globally, are mandated to ensure the enjoyment of individuals' right to the highest attainable standard of health, including oral health. Dental caries is a matter of human rights. States have binding obligations to address dental caries: they require the regulation of the healthcare system, i.e. the traditional focus on operative care, but also put the regulation of other risk factors on an equal footing, such as the regulation of the living environment and access to fluoride. A right to health-based approach to dental caries thus offers a comprehensive approach to dental caries control, particularly prevention.

Legal Analysis of Health Professional Ethics in Improving Health Services in the Perspective of Islamic Law

Health is a human right and one of the elements of welfare that must be realized in accordance with the ideals of the nation as stated in Pancasila and the 1945 Constitution of the Republic of Indonesia. Regarding the matters already listed in the 1945 Constitution, health workers in serving the community, are also bound by ethics and health law. In carrying out health services, health workers must comply with professional ethics (professional code of ethics) and also comply with the law, the rules set out in the law. Ethics in medical action in Islamic literature is known as adab. Adab in hadith and early post-Islamic literature means proper speech, good ethics, and correct procedures. Islamic law has laid down rules that concern health services and care, including the health of society and the state at large and has contributed greatly to the modern medical science that is developing today. With this research, the researcher conducts research activities objectively on the reality of the subject under study, in the sense that reality is seen from the angle of those being studied. This qualitative research is more concerned with the accuracy and adequacy of the data.

Distance learning Revisited: Students’ Preferences and Attitudes in the Post-Pandemic Era

In Spring 2020, there was a sudden shift from face-to-face (F2F) to distance learning (DL) due to the Covid-19 Pandemic. A study by Al-Jarf (2020) showed that 55% of the students and instructors preferred F2F instruction and were not satisfied with DL due to unfamiliarity, lack of training, interaction, technical problems and others. In the Fall Semester 2021, Saudi universities resumed F2F instruction in combination with some online classes. In some emergencies such as weather conditions, all students study online rather than cancelling classes. This status quo has continued until now. This study explores students’ preferences for DL vs F2F learning, their attitudes towards each and reasons for their preferences.  Responses to a survey showed that 36% of the students in the sample prefer DL because it has become a necessity during emergencies such as pandemics and wars. They can check the lecture recording any time. They save commuting time. In addition, 40% of the respondents prefer F2F instruction because they get better grades. It is more suitable for science classes (labs, experiments, anatomy). Participation, interaction, and questions make a difference. In DL, students can leave Blackboard or Zoom, walk around, and take a nap, whereas in F2F, they focus better. Some health sciences, engineering, law, and/or business instructors talk about their experiences and views of the job market which is enriching and enjoyable for the students.  Moreover, 17% have no preference and believe that the mode of learning depends on the instructors’ competence, teaching techniques used, integration of technologies, and online resources, interaction, engagement, and students’ participation. Participants’ views and recommendations are given in detail.

Scanning European Needs and Expectations Related to Livestock Biosecurity Training by Using the World Café Method

The European Union Animal Health Law (2016/429) emphasizes disease prevention, underpinned by livestock biosecurity, surveillance, and traceability, as key aspects to minimize the risk of animal diseases. An important element of biosecurity is the training of key actors involved in implementing it. However, their needs and expectations regarding this training are poorly known. Under the COST action BETTER (CA20103), a World Café was organized to identify the needs and expectations of biosecurity training for farmers, veterinary practitioners, veterinary students, and other actors. A total of 78 participants distributed in four groups participated in the World Café. Needs and expectations were identified and ranked in decreasing order of importance. For farmers, the most important aspects were training focusing on practical aspects, the planning of training sessions in the day to accommodate workload, the need to prepare multiple reminders of upcoming training, and the short duration of events. For veterinary practitioners, it was considered that a mixed approach, including a theoretical and a practical part where people are invited to create a biosecurity plan and a follow-up report, were the most important features of training. For veterinary students, creating a good knowledge of the main principles of biosecurity was found as an essential element of training. Regarding other actors, gaining an understanding in the spread of pathogens and the repercussions on the cost of animal products that diseases might have (consumers), training on good/best practices of cleaning and disinfection and the development of clear protocols (transporters), and a mixture of formal and informal training and training on communication skills (other actors) were considered important. The World Café was a useful method to have a first identification, discussion, and differentiation on livestock biosecurity training needs and expectations of the key actors, although additional follow-up research involving more participants from more diverse countries with different coverage of cultures and education would be beneficial. These needs and expectations are relevant and should be considered when designing new training courses.

Evaluation of occupational health and safety training for nursing students

Introduction. Nurses, who constitute the largest part of the healthcare team, start to encounter many occupational exposures from the beginning of their education and this exposure continues throughout their professional lives.
 Aim. The aim of the study is to evaluate the effect of occupational health and safety education on the knowledge levels of second year nursing students.
 Materials and Methods. The sample of the quasi-experimental research with a single-group pre-test post-test design consisted of 261 second-year nursing students. The data of the research were collected with the "Descriptive Characteristics Questionnaire" and the "Occupational Health and Safety Training Questionnaire" between March-June 2018.
 Results. The average age of the students participating in the research is 20.87±1.31. When the pre-test and post-test occupational health and safety knowledge levels of nursing students were compared, it was found that the rates of knowing the occupational health and safety law correctly, knowing the responsibilities of the employees, knowing the occupational hazards for the health workers, and knowing what to do to prevent the sharps injuries were statistically significant. level was found to increase (p <0.05).
 Conclusion. In the study, in which the effect of occupational health and safety education given to second-year nursing students on occupational health and safety knowledge levels was evaluated, it was determined that the education provided an increase in the students' knowledge of occupational health and safety law, occupational hazards and protection from occupational hazards for healthcare workers, notification of occupational accidents and waste management.