Principle Of Self-determination Research Articles

A cascade of disparities: Health and health care access for people with intellectual disabilities

People with ID represent approximately 2% of the population and, as a group, experience poorer health than the general population. This article presents recent conceptualizations that begin to disentangle health from disability, summarizes the literature from 1999 to 2005 in terms of the cascade of disparities, reviews intervention issues and promising practices, and provides recommendations for future action and research. The reconceptualization of health and disability examines health disparity in terms of the determinants of health (genetic, social circumstances, environment, individual behaviors, health care access) and types of health conditions (associated, comorbid, secondary). The literature is summarized in terms of a cascade of disparities experienced by people with ID, including a higher prevalence of adverse conditions, inadequate attention to care needs, inadequate focus on health promotion, and inadequate access to quality health care services. Promising practices are reviewed from the perspective of persons with ID, providers of care and services, and policies that influence systems of care. Recommendations across multiple countries and organizations are synthesized as guidelines to direct future action. They call for promoting principles of early identification, inclusion, and self-determination of people with ID; reducing the occurrence and impact of associated, comorbid, and secondary conditions; empowering caregivers and family members; promoting healthy behaviors in people with ID; and ensuring equitable access to quality health care by people with ID. Their broadscale implementations would begin to reduce the health disparity experienced by people with ID.

The Wrong Vocabulary of Right: Minority Rights and the Boundaries of Political Community

International law has long concerned itself with the boundaries of political communities that it regards as sovereign states. Yet when it engages questions about the nature and scope of rights that individuals and groups possess in the face of sovereign authority, it invariably assumes that international human rights should protect universal features of what it means to be a human being. This paper argues that international human rights law ought to advance a richer mission than what universalism presupposes, one that is much more closely related to normative questions surrounding the allocation, distribution and protection of sovereign authority. One dimension of this mission is to promote a just international distribution of sovereign authority, which implicates a different vocabulary of human rights - one that draws on the normative force of the principle of self-determination. This vocabulary has yet to be developed in no small measure because the field has been defined by the language of universalism. Its development would have the effect of casting debates in democratic theory about the legitimacy of minority rights in different terms. Instead of assuming the legitimacy of the boundaries of the broader political community in which minority rights are claimed, it would comprehend minority rights as mechanisms that possess the potential - depending on their nature and scope - to vest democracy's edges with normative significance.

Developing the public health practitioner workforce in England: Lessons from theory and practice

The paper focuses on public health practitioners who collectively represent one of three key workforce groups identified by England's Chief Medical Officer as critical to the successful delivery of national public health policy priorities. We report on two areas of work which attempt to address the following two-part question: in developing the public health practitioner workforce in England, what is needed, and how do we do it? First, we describe a five-component conceptual framework for developing the public health workforce which is grounded in data derived from a national Open Space event hosted by the University of the West of England in March 2005. The five components are (i) strategic support and oversight; (ii) national technical and professional support; (iii) national career building; (iv) local organisational development, and (v) sub-regional skills development. Key elements of each component are described in the paper. Second, we describe in some detail a new multidisciplinary skills development programme which illustrates one of the framework components (sub-regional skills development). The programme, established in January 2005, is aimed at three key groups of public health practitioners: health visitors (specialist community public health nurse), school nurses and environmental health officers. Its main features and some initial evaluation findings are presented. To be effective, activities aimed at supporting the development of the public health practitioner workforce should, where possible, aim to be congruent with core public health principles of self-determination and collective responsibility. We also conclude that leadership and vision at a national level, combined with local implementation of evidence-based training programme such as the one described could help to achieve much greater and more rapid progress in skilling up the existing public health practitioner workforce than has been possible up to now. But we note that this requires sustained investment, robust sector-wide delivery frameworks, and a group of committed local public health champions.

An Inquiry into the Turkish ‘School’ of International Law

This paper seeks to examine major Turkish textbooks of public international law, focusing particularly on a small number of core areas in this discipline: historical origins and basic features; formal sources; main subjects; the law of territory; international law and development. These textbooks show a strong inclination towards Eurocentrism and positivism due to their denial of the vigour of 'soft law', as manifested for instance in UN General Assembly resolutions, and of their marginal treatment of 'international law and development'. What is more, substantive issues of international law are not discussed in a critical way; rather the procedures of the discipline are given priority. This is almost to suggest that Turkish international law scholars hold the view that their raison d'etre is confined to 'technical expertise', and that the relationship between law, other disciplines and society lies outside their domain. In the final analysis, therefore, the hard core of issues integral to international law and having a deep impact on international politics, such as the search for a New International Economic Order (NIEO), the principle of self-determination and human rights are either entirely bypassed or treated only very narrowly in Turkish international law textbooks.

General practice — chaos, complexity and innovation

Primary health care (PHC) reforms focus on improving access to and effectiveness of general practice services, with greater emphasis on health promotion, prevention and chronic disease management, and integration with population health approaches. Currently, reforms are often based on scant evidence from the most accessible and easily known PHC domains and activities, yet most PHC is complex and poorly understood. Complexity theory is based on understanding patterns that are not predictable by traditional evidence and social knowledge, within a complex adaptive system. Complexity knowledge provides a way of understanding the general practitioner's role in PHC in self-organising local networks, with a capacity to generate new solutions integrated through historical and social connections. Complex systems provide a framework for an expanded knowledge base, debate and discussion of reforms and development of PHC goals and strategies.

Ensino de matemática, ética e sociedade: A etnomatemática e a modelagem como possibilidades

O objetivo deste artigo é fazer uma discussão sobre Ensino de Matemática na intenção de entendê-lo como um projeto que deve vislumbrar a vida em sociedade, de forma ética. Desse modo, apresento a noção pessoal de cidadania ética e os seus pilares de sustentação: consciência e autonomia. A seguir, aponto e discuto a Etnomatemática, materializada sob a forma de Modelagem Matemática, como sendo uma proposta de ensino que pode ser uma alternativa para esse fim.

Ethnic minority issues in China's foreign policy: perspectives and implications

As a multinational state, China's ethnic minority issue (e.g. Tibet and Xinjiang) is always a large political concern. China often treats this issue exclusively as a sovereignty matter and refutes outside criticism. What is the viable explanation of China's position? Is China's behavior consistent with the global norms and international law, especially the principle of national self-determination? This paper addresses these questions through an examination of China's ethnic minority issues in the context of foreign policy and international relations.

De Budapest à Kaboul via Prague : l’esprit de suite de l’internationalisme socialiste

It is a well-established principle of international law that the threat or use of force against the territorial integrity or political independence of any State is forbidden. It is also recognized that every State has the sovereign and inalienable right to choose its economic System as well as its political social and cultural Systems in accordance with the will of its people, without outside interference, coercion or threat in any form whatsoever. But international law does not prohibit the use of force in the exercice of the right of self-defence if an armed attack occurs and some writers state that there is no rule of international law which forbids the government of one state from rendering assistance to the government of another state. This article is primarily concerned with legal issues related to soviet invasion of Afghanistan; its purpose is to examine official statements put forward in Moscow in order to justify the legality of this armed intervention. As will be seen, there is a perfect similarity between legal arguments used in 1956, 1968 and 1980; this is being done in order to give the domestic crisis an international colouring and to justify a demand for foreign intervention. It must be noted that Soviet troops are "not interfering" in the international affairs of Afghanistan: on the contrary, they are "fighting for" the principle of socialist self-determination of the people of Afghanistan... By definition a war conducted by the USSR is a just and defensive war...

Le droit de refuser un traitement psychiatrique au Québec

There are various types of incapacity in the civil law of Québec. The provisions of the Civil Code concerning the interdiction of incapable persons are now supplemented by various statutes. In all cases, a curator — and generally the public curator — is appointed to accept or refuse treatment for an incapable person. Except in cases of serious emergency, it is clearly established that any treatment, whether medical or psychiatric, must be preceeded by the patient's informed consent. While some recourses already exist to protect the rights of an incapable patient for whom a curator has been appointed, this is not the case for psychiatric patients who are of legal age and legally competent, but who refuse treatment. In these cases, it is suggested that the decisions of Québec courts that have recognized a « defacto incapacity » and, consequently, forcible treatment on the basis of the « parens patriae » doctrine, may be ill-founded. This opinion is based on the application of the principles of self-determination and the inviolability of the human person, and by establishing a parallel with constitutional rights recognized by American courts which are now echoed in the new Canadian Charter of Rights. The author suggests that all recourses involving refusal of treatment be referred to a centralized administrative tribunal, in the light of the reform of the Civil Code.

Militant Democracy, Legal Pluralism, and the Paradox of Self-Determination

The international legality of militant democracy - when and how a constitutional democracy can legally act in an antidemocratic manner to combat threats to its democratic existence - is far from clear. The legality of legal pluralism - the extent to which international law authorizes transformative political agendas that seek to implement forms of religious, cultural or national autonomy - is also unclear. The elusive legality of these political developments creates conditions for the abuse of power both by states acting in defense of democracy, and by religious, cultural and national communities seeking a measure of legal autonomy. Marked by a shared normative commitment to the paradoxical principle of self-determination, the relationship between legal pluralism and militant democracy provides insight into the legality of both developments in ways that might be overlooked by viewing each in isolation. That this is the case is revealed dramatically by the recent decision of the European Court of Human Rights in Refah v. Turkey, in which the Court upheld the banning of a political party that advocated a form of legal pluralism which would introduce elements of Islamic law into the Turkish legal order. Refah v. Turkey establishes a legal site in which contestations over the boundaries of legal pluralism and militant democracy will take place in the future, and reveals how European human rights law seeks to realize the democratic potential of self-determination.

Politikversagen als Ursache der deutschen Sozialstaatskrise / Political Failure as a Cause of the Crisis of the German Welfare State

Zusammenfassung In der Untersuchung wird die Frage erörtert, ob Politikversagen eine wesentliche Mitursache für die hohe Arbeitslosigkeit und die Krise des deutschen Sozialstaates ist. Der Verfasser stellt zunächst das Politikversagen in der Sozialversicherungspolitik, insbesondere in Form der vorgezogenen Altersrente und der Verletzung des Prinzips der Selbstverwaltung sozialer Angelegenheiten, dar. Die Verletzung dieses Prinzips zeigte sich vor allem und am deutlichsten darin, dass Sozialleistungen für die Bevölkerung Ostdeutschlands durch Sozialbeiträge der westdeutschen Arbeitgeber und Arbeitnehmer statt durch Steuern finanziert wurden. Er geht dann auf das Politikversagen in der Europapolitik ein, das in der Verwirklichung der Wirtschafts- und Währungsunion vor der Herstellung der Politischen Union liegt und einen aggressiven innereuropäischen Steuerwettbewerb mit negativen Folgen für die öffentlichen Haushalte und die Beschäftigung in der Bundesrepublik ermöglichte. Schließlich geht er auf die Überforderung der Arbeitsmarktpolitik ein. Diese Überforderung ist einerseits eine Folge des mit dem Vertrag von Maastricht verbundenen Verzichts auf eine Beschäftigungspolitik mit Hilfe der Geld- und Währungspolitik sowie der Verdrängung des nachfrageorientierten, keynesianischen Konzepts der Beschäftigungspolitik durch das Konzept der angebotsorientierten Wirtschaftspolitik. Andererseits beruht diese Überforderung auf einer Überschätzung der möglichen Beschäftigungseffekte der Arbeitsmarktpolitik.

Advance directives and Living Wills

The article focuses on the philosophical, ethical and juridical problems concerning Advance directives and Living Wills (underlining analogies and differences). The author makes a critical comparison between the theories supporting Living Wills (the liberal theory appealing to the principle of self-determination and the utilitarian theory on the "quality of life") and the reasons against them (with reference to the foundation of the absolute value and dignity of human life till the end).

Aboriginal community patrols in Australia: Self-policing, self-determination and security

This article emerges from research conducted across Australia on Aboriginal self-policing initiatives, generically referred to as "Community Patrols", "Aboriginal Patrols" or "Night Patrols". The study was intended to produce a national profile of Patrols, and similar services, around Australia. Our research reveals that Aboriginal people are actively engaged in a diversity of self-policing practices in urban, rural and remote communities across Australia. These policing practices differ markedly from those offered by the mainstream police and the private security sector in a number of crucial respects: the most obvious being that they are largely staffed by volunteers, operate without an arsenal of formal powers, and do not offer a commodified security service. Aboriginal Community Patrols are local initiatives by Aboriginal people evolved to intervene in situations where Indigenous people are at risk of enmeshment in the criminal justice system, or where they face multiple hazards associated with community disorder, alcohol, drugs and violence. Recent theorizing on the nature of contemporary policing, stressing some of the benefits of becoming linked to local security networks, provides a useful conceptual space for exploring the potential role of Indigenous self-policing, providing that principles of self determination are not sacrificed in the process.

Managing People and Landscapes: IUCN’s Protected Area Categories

The International Union for the Conversation of Nature (IUCN) is the lead organization in the selection, establishment and management of protected areas. In order to accomplish its advisory management function, IUCN maintains a worldwide list of protected areas. Each protected area on the list is placed into one of 6 categories based on its management goals. In addition to the identification of biological goals, a protected area's classification identifies what human activities are allowed in that protected area. The classification scheme thus organizes the lives of people living in and around protected areas and has material consequences for local communities that can be at odds with the principle of self-determination. IUCN is placed in a difficult position in that it promotes both self-determination of local peoples and conservation. It tries to bring these two goals into harmony in its approach to protected area classification. After briefly tracing the evolution of IUCN's position on people and protected areas, we will describe the classification system, and then turn to an examination of the ways that local peoples are managed. We conclude with a discussion of the difficult task IUCN faces in trying to rectify peoples' rogjts with conservation needs.

Community Treatment Orders: An Uncertain Step

Whenever organized psychiatry claims to speak for the rights of others, it is perhaps time to step back and reevaluate the landscape-for altruism has had, at times, a dark heart. Community treatment orders (CTOs), controversial tools now widely adopted in various guises, have sparked a debate within (and without) the profession. Although it makes for odd bedfellows and splits between colleagues, the debate has also highlighted the arguments of those who see treatment as a right and those who see it as a choice. The case for the right to treatment has, perhaps disingenuously, been made to force treatment on individuals whose psychiatric illness arguably deprives them of choice. The discussion has involved the Canadian Charter of Rights and Freedoms, section 7 of which, for example, has traditionally been interpreted as upholding an individual's right to refuse treatment for a mental illness (1,2). The principle of self-determination has run into Gray's human needs perspective that long-term institutionalization is no liberty at all (3). The almost uniform condemnation by psychiatrists of the recent Supreme Court of Canada decision in the case of Starson vs Swayze (4) suggests that there may be a point that we, not the Court, have missed. In our zeal to treat the ill, we may set aside their wishes, however uninformed or psychotically influenced. Each iteration of modern pharmacologie treatment is heralded as state-of-the-art and well thought-out, even as yesterday's remedies are relegated to generic graves. With hindsight several years hence, that certainty in drug choice may seem a little awkward, as each emperor, time after time, begins to lose his clothes. From today's perspective, refusing high dosage haloperidol injections doesn't seem so psychotic. Nevertheless, people with mental illness continue to fall between the cracks of an increasingly complicated health care system, while our duty to our patients and to society requires an assertive role in caring for those too ill to care for themselves. As social services thin, reliance on medication becomes a greater factor in ensuring adequate care. Some of the illnesses we deal with in psychiatry can imprison our patients-the keys to those prisons often taking the form of modern-day psychotropics. When these patients appear incapable of consenting to treatment (a legal determination), we use the legal determination of incapacity as a tool to turn the key in the lock. Psychiatry, we recall, is no stranger to coercive interventions-and a utilitarian model attenuates the discomfort of forced detention or treatment. In this issue, Dr Richard O'Reilly examines the various arguments made in the debate over CTOs (5). A thoughtful advocate for CTOs and author of a Canadian Psychiatric Association position paper on the subject (6), he takes time to examine the protagonists' philosophical differences, outlining their positions, carefully analyzing the arguments, and applying this to current practice. His view of CTOs takes into account the context, including, importantly, the limited resources available. Many questions still remain unanswered in the CTO debate. In their well-researched paper, Dr Marvin Swartz and Dr Jeffrey Swanson look at the current state of the evidence available for CTOs (7). CTOs, mandatory outpatient treatment, or involuntary outpatient commitment (OPC) are available in various forms in many countries. Comparing outcome studies is complicated by the additional forces striving to improve medication adherence. Both authors have been at the forefront of research into OPC. Together, they conducted the first randomized controlled trial into the effectiveness of OPC and community-based care management (8). Although showing some positive outcomes, their study had limitations and showed results contrary to the New York OPC study (9). Although it remains difficult to interpret and compare studies, owing to wide variations in implementation and practice, the results offer guidance in providing care for our seriously ill patients. …

The Seductiveness of Moral Disgust

looked at closely, is not a pretty thing. redeems it is the idea only. The ferocious rapacity of Kurtz's search for ivory is ennobled in his own eyes by his plans to bring civilization to the savages. In the end, of course, this idea redeems nothing at all. When Marlow finds Kurtz, at the final bend of the river, all there is to show of Kurtz's civilizing mission is a row of native heads stuck on pikes and the tattered remains of Kurtz's concluding report to the International Society for the Suppression of Savage Customs, on the final page of which the delirious Kurtz had scribbled, Exterminate all the Brutes! Conrad's work is a fable about late-nineteenth-century imperialism at the end of its tether, paralyzed by futility and sapped by the temptations of an all destroying nihilism. It is also about the seductions of moral disgust: having failed to civilize the savages, Kurtz turns against them all the force of his own moral self-disillusion. We tell ourselves that we are living in a postimperial age. What is about the new world order, supposedly, is that it is not imperial. Decolonization in Africa and Asia, the collapse of the Soviet empire, the general triumph of the principle of national self-determination all lead us to think that the reflexes and impulses laid bare so mercilessly by Conrad now belong to the forgotten history of our conscience. Central to this assumption is the idea that the interventions of the post-1989 period were humanitarian rather than imperial in their

Process and Product in Designing a New Curriculum: The Training of Special Care Counselors at Vanier College

The Special Care Counseling program at Vanier College has a curriculum development process for redefining a professional, pre-service training program to prepare students for clinical work as child and youth workers, behavioral technicians, educators, family support workers, and recreational technicians. Based on a set of pre-determined competencies, the department developed a new curriculum organized around the principle of “need fulfillment” and the principles of self-determination, inclusion/integration, and normalization. These were then used as guides for designing a 3-year program of study including courses and fieldwork.

Fifty years on: Turkey's voting orientation at the UN general assembly, 1948–97

As is well known, the United Nations (UN) has been at the forefront of endeavours pertaining to the progressive development of international law for over 50 years. To realize its objectives, the UN has had to find ways of encouraging international co-operation designed to cope with certain economic, political and social problems that could not be resolved by individual states alone. These problems are varied, and are subject to an evolutionary legal process. They range from 'human rights' issues to the 'protection of the environment', from 'self-determination' to the 'rights of women', from 'the search for a new international economic order' to the 'rights of refugees and displaced persons', and so on. For its part, this study deals with three of the outstanding issues which fall into the category of 'progressive' international law: 1. Decolonization and the principle of self-determination; 2. Search for a new international economic order; 3. Human rights. This particular focus derives from the fact that these themes reflect a great deal about the foreign policy choices of states. Secondly, they have had more far-reaching implications for the conduct of international relations than other issues of international law. Besides, there has been much controversy around these subjects since the foundation of the United Nations. This study accordingly tries to explore, within a chronological framework, Turkey's voting preferences in the UN over these subjects in the past 50 years. The main crux of the analysis made here centres around the UN General Assembly (GA) discussions over various resolutions, declarations and decisions. It is generally agreed that the voting behaviour in the General Assembly is a clear expression of a given state's foreign policy orientation. It indicates the way in which the ruling elites define the nation's goals and expectations and reflects 'its actual behaviour rather than its claims or

The principle of self-determination in the family law through history and today

In the jubilee year 2004, Serbia marks the 200th anniversary of The First Serbian Uprising, structuring of modern Serbian state and its legal system comparatively speaking, France marks the 200th anniversary of passing the French Civil Code, one of the most significant civil codifications in the 19th century. It was an occasion to study certain institutions of family law through history and today. The used approach is modern, we studied the ways how the principle of self-determination influenced the family-legal solutions today, and we investigated if one could talk about the effect of this principle in the historical sense, too. The principle of self-determination implies the possibility for the subjects of family-legal relations to arrange their own relations themselves ? both the partner and parent relations. However, this principle undergoes significant limitations in the family law because the family relations are personal relations by character, as well as because of the need to protect the weaker participant, both the weaker partner or a child who needs protection stemming from his/her very status. Within marriage law, the principle of self-determination of the spouses (extramarital partners) is, among other things, made concrete through the possibility for an agreement about the effects of marriage (extramarital union), then through the possibility of agreed divorce, while the procedure of mediation in the marriage litigation contributes to the realization of the mentioned principle. As for the effects of marriage (extramarital union), the paper particularly discusses property relations, that is the marriage property contract, because it is at the moment a current issue in our domestic law. Within the relations between parents and children, the concretization of the principle of self-determination in parental care is significant, particularly in the situations when the relations between the parents were disturbed and resulted in a separation or a divorce with the joint parental care (application of the parental right). All institutions are analyzed in the positive law, in the historical context (solutions from the Serbian Civil Code the former Hungarian Law), and viewed comparatively in the European legal systems of the east and west European countries.

Striving for autonomy in a contingency‐governed world: Another challenge for individuals with developmental disabilities

AbstractThe purpose of this article is to provide the reader with an orientation to the concepts and principles of autonomy and self‐determination and the application of those concepts and principles to working with children and adolescents who have intellectual and developmental disabilities (ID/DD), including autism. Self‐determination is essentially the ability of a person to be autonomous as to meaningful life choices and encompasses activities such as problem solving, decision making, goal setting, self‐observation and evaluation, self‐management and reinforcement, acquiring an internal locus of control, experiencing positive attributions of efficacy and outcome expectancy, developing a realistic and positive self‐image, and self awareness. The lack of opportunities for self‐determination, personal expression and consideration of personal preferences experienced by this population has been associated with increased psychiatric disturbance. Several principles supporting self‐determination, including positive psychology and use of positive alternatives, are discussed by the authors. Further, practices that generate more opportunities for individuals to exercise personal control and autonomy across activities and environments in order to prevent psychological problems are discussed. Finally, the school psychologist's role in promoting the development of autonomy and self initiative among children and adolescents with ID/DD are outlined within the contexts of assessment practices, interventions and curriculums, positive behavior support technology, and continued educational reforms and systems change. © 2004 Wiley Periodicals, Inc. Psychol Schs 41: 143–153, 2004.