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While the number of medical human rights programs has increased, there is substantial unmet need for forensic evaluations among asylum seekers throughout the United States. From September 2019 through May 2020, the Mount Sinai Human Rights Program has coordinated pro bono forensic mental health evaluations by telephone or video for individuals seeking protected immigration status who are unable to access in-person services. The national network clinicians conducted 32 forensic evaluations of individuals in eight U.S. states and Mexico seeking immigration relief. Remote forensic services have been a relevant solution for individuals in immigration detention, particularly during the COVID-19 pandemic., Competing Interests: Declaration of Competing Interest Dr. Katz is the national trauma consultant for Advanced Recovery Systems. The other authors declare that they have no competing interests., (Copyright © 2020 Elsevier B.V. All rights reserved.)

In the course of a few short weeks, many of the established legal frameworks relating to decision-making in England & Wales in respect of those with impaired decision-making capacity have been ripped up, or apparently rendered all but unusable. Although the Mental Capacity Act 2005 itself has not been amended, the impact of other legislation (especially the Coronavirus Act 2020) means that duties towards those with impaired decision-making capacity have been radically changed. This article reflects the experience of a practising barrister in England & Wales grappling with the impact of COVID-19 upon the Mental Capacity Act 2005 across a range of fields in the weeks after the world appeared to change in mid-March 2020., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Objective: to comprehend the existing possibilities for the exercise of human rights by persons with mental disorders who are institutionalized in a psychiatric hospital, from the perception of professionals., Method: this is a qualitative descriptive-exploratory study conducted at a Psychiatric Hospital in the state of São Paulo, Brazil. For data obtention, eleven professionals responded to a semistructured questionnaire. The traditional content analysis proposed by Bardin based the data analysis., Results: the professionals know the human rights and try to preserve them in the hospital scope, although they recognize that the persons hospitalized are not entirely respected due to the lack of public policies or their non-suitability to the Brazilian reality., Final Considerations: the structuring of extra-hospital services is necessary, as well as the comprehension of the professionals that act in psychiatric hospitals about the objectives and the functioning of such devices to assure opportunities of exercising rights by institutionalized persons.

Background: Promoting patients' rights is essential for defining the standards of clinical services within a country. Given their responsibilities, nurses can be the primary target for research to investigate the issue of patients' rights within a healthcare system. As such, assessing the knowledge of nurses about patients' rights is an essential step toward improving the quality of healthcare in limited resource settings like Sudan., Objectives: We aimed to assess the level of knowledge about patients' rights among the nursing staff at Friendship Teaching Hospital in Sudan., Methods: This hospital-based cross-sectional study was carried out at the Friendship Teaching Hospital in Sudan. We surveyed the totality of nurses (95) at the hospital using an amended survey. The data were analyzed in SPSS software using descriptive and inferential statistics., Ethical Consideration: The study was approved by the Research Unit of Khartoum Ministry of Health and the Hospital administration. All respondents gave verbal consent prior to participating in the study., Results: Only 48.4% of the participants knew about the existence of the Sudanese Charter of patients' rights. Nonetheless, our analysis found that 65.8% of nurses had acceptable level of knowledge (scored more than 75% of the total knowledge score) of patients' rights, and none of the participant scored less than 50% of the total knowledge score. Finally, we found no statistical association between the knowledge score and demographic data, educational level, whether the participant knows about the existence of the Charter or not and a number of other factors., Conclusion: Nurses' lack of knowledge about the existence of the Sudanese Charter of patients' rights adopted in 2009 rights confirms the need for further efforts by Ministry of Health to promote the document. Furthermore, further research is needed to investigate the disconnect between nurses' lack of knowledge about the existence of the charter and their awareness of the rights within the charter as well as the actual implementation of rights.

Running bioethics workshops one after the other can become a mundane affair, primarily because of the similarity of their content and discourse. However, conducting a workshop for participants from conflict zones such as Palestine provided an entirely new perspective for this author. While the bioethics discourse may translate into useful and actionable guidelines in the free world to help uphold human dignity, to those living in occupied territories and conflict zones, in the face of their lived lives, it appears little more than a self-serving academic exercise by "parachute bioethicists".

This essay examines two Portuguese novels about colonialism and its legacies: António Lobo Antunes's Fado Alexandrino (1983) and Aida Gomes's Os Pretos de Pousaflores ( The Blacks from Pousaflores ) (2011). Fado Alexandrino perpetuates the use of Black women's raped bodies as a plot device to represent colonial violence, while Gomes's narrative empowers racialized victims of sexual abuse and challenges dominant public memories of the Colonial War. A close reading of these novels, contextualized against the background of scholarly debates about the representation of sexual violence, exposes both the perils and potential of cultural works to preserve the memory of rape in armed conflict.

A Woman in Berlin (1954) has undoubtedly shaped global understanding of wartime rape. The present article focuses on the diarist's use of humor to process her disorientation, assert her subjectivity, and build affective links with other victims. I consider how the diary's tone influenced its reception and thus how aesthetic analysis might illuminate the conditions under which stories about sexual violence become audible, as well as the ways in which the "cultural politics of emotion" (to quote the title of Sarah Ahmed's 2004 study) can both foster and obstruct human rights projects.

The Brown Human Rights Asylum Clinic (BHRAC) is a medical student-led organization affiliated with Physicians for Human Rights that collaborates with medical and mental health clinicians, lawyers, and community organizations to provide pro bono medical affidavits to undocumented individuals seeking legal status in the United States. Affidavits can document and corroborate the physical and psychological evidence of trauma alleged by asylum seekers, leading to better legal outcomes. This article describes our innovative program, partnerships, and workflow, as well as demographics and statistics from our past seven years of operation. Since its founding in 2013, BHRAC has conducted 55 medical evaluations, the majority involving Spanish-speaking female-identifying individuals from Guatemala, El Salvador, and the Dominican Republic. Thirteen individuals have been granted legal status, one individual was denied status, and the rest of the cases are pending. BHRAC has experienced a marked increase in affidavit requests. This paper serves as a call to action for medical professionals to become involved in this work.

This article explores the current debate which exists within the United Nations human rights system regarding the right to liberty of persons with psychosocial disabilities. Article 14 of the UN Convention on the Rights of Persons with Disabilities states that the existence of a disability cannot be a justificatory ground for the involuntary detention of a person. In interpreting Article 14, the UN Committee on the Rights of Persons with Disabilities has called for States Parties to repeal legislation which provides for detention based on the existence of a psychosocial disability, either solely or in combination with other factors such as a perceived dangerousness or need for treatment - essentially requiring the abolition of mental health laws. However, a number of other human rights bodies within the UN, including the Human Rights Committee, have continued to affirm the lawfulness of deprivations of liberty under mental health legislation in certain circumstances. This article will set out the current state of this discourse and conclude by making a determination on the governing legal interpretation of the right to liberty of persons with psychosocial disabilities under international law., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Objective: To explore the social construction of obstetric violence developed by Tenek and Nahuatl women in Mexico., Method: Qualitative, socio-critical study conducted through focal groups in which were deepened the childbirth experiences lived in the period 2015-2016., Results: Participation of 57 women. Through discourse analysis, it was identified that participants do not have enough information about obstetric violence and/or sexual and reproductive rights. This makes the association of their negative experiences with the legal term "obstetric violence" impossible. Most of their speeches correspond to the legal denomination of "obstetric violence". Experiences like prolonged fasting or the use of technologies for invading their privacy were narrated like situations they perceive as violent, but have not been incorporated within the legal term., Conclusion: Multiple actions against women's human rights take place within delivery rooms. Most remain unidentified by users, since they have not socially constructed the image of obstetric violence. However, that fact does not make them less susceptible to feel attacked and denigrated during their childbirth experiences.

Purpose: Despite overall reductions in levels of smoking in the UK, rates of offender smoking remain high. In 2016, it was announced that prisons in England and Wales would gradually introduce a smoking ban. The purpose of this paper is to explore offenders' perceptions around the upcoming smoking ban., Design/methodology/approach: A total of eight focus groups were conducted in four prisons across the North of England. Both smoking and non-smoking offenders participated in the focus groups, and thematic analysis was used to explore the findings., Findings: Themes generated from the data were "freedom and rights", "the prison environment" and "guiding support". Participants discussed how the smoking ban was viewed as a punishment and restricted their freedom, with perceptions as to why the ban was being implemented centring around others trying to control them. Participants expressed concerns around the financial implications of the smoking ban on already stretched prison resources. Participants also recommended improving the nicotine replacement therapy on offer, and increasing the range of leisure activities within the prison to prepare for the smoking ban., Originality/value: Overall, it was apparent that participants' awareness of the smoking ban was generally poor. It is recommended that offenders need to be made more aware of the smoking cessation support they will receive and given the opportunity to ask questions about the smoking ban. Increasing offenders' awareness of the ban may reduce stress associated with a perceived lack of choice around their smoking behaviours.

Objective: To analyze health as a right from the perspective of care of the self, in the conception of nursing professionals., Method: Qualitative study, carried out in a Federal Hospital of the city of Rio de Janeiro, with the participation of 10 nurses and 20 nursing technicians through interviews recorded, transcribed and analyzed in light of the Discursive Textual Analysis., Results: Two categories emerged: Health as the right of professionals and their "non-right" to health; and Care of the self for the health professional: work and torture., Conclusion: There are many challenges to overcome, such as the search for satisfactory public funding, the need to improve the quality of Primary Health Care services, the implementation of a care model compatible with the country's demographic and epidemiological situation; all professionals need an effective endorsement for care of the self, such as their knowledge of the right to health.

Introduction:: Despite being considered as a contravention under some countries' legislation, the therapeutic use of Cannabis sativa has been growing in Brazil, due to the promising results observed in many pathologies. Such a scenario has fostered the need to deepen discussions on the subject and possibly revise legislation governing the substance use and access., Objectives:: Identify the types of stigma related to the therapeutic use of Cannabis and describe the strategies people use to overcome stigma., Methods:: This integrative review was carried out in the databases PubMed, Scopus, CINAHL, MEDLINE, PsycINFO, Web of Science, and Cochrane Library, with 565 articles being retrieved. Triads' cross-check were done, first maintaining the "cannabis" and "therapeutic use" pair, added by "stigma," "bioethics," "ethics," "social consequences," and "legal consequences." The final selection resulted in six articles., Ethical Consideration:: However, the ethical issues that pervade and regulate decisions on this subject must be considered., Results:: Different dimensions and types of stigma related to the therapeutic use of Cannabis have been identified. The bioethical principle of autonomy was an expression of citizenship and human rights, mitigating internal conflicts related to self-stigma and the effects of external stigma on the person's life., Conclusion:: It was possible to identify the types of stigma related to the therapeutic use of Cannabis is an internal dimension represented (self-stigma) and an external dimension, represented (social and structural stigmas) and to identify strategies adopted to face this stigma: skills training group for users, elaboration of laws and specific programs to clarify the therapeutic use of Cannabis with a greater social scope, and support for family members. Thus, contributing to the building of people's autonomy in a broader context of decision-making autonomy and executive autonomy will provide the development of people's capacity to perform complex tasks of self-management and, consequently, to continue promoting and preserving their decision-making process and their capacity to plan and perform tasks associated with managing their lives and their treatments.

Advocacy for people using health and social care services is widely promoted but its theoretical foundation is under-developed and its impact poorly conceptualised. This paper explores the liberatory potential of independent advocacy, using Fricker's concept of 'epistemic injustice' as a framework. People experiencing mental distress are particularly vulnerable to epistemic injustices as a consequence of deeply embedded social stigma resulting in a priori assumptions of irrationality and unreliability such that their knowledge is often discounted or downgraded. The mental health service user/survivor movement is at the forefront of validating personal experience and narrative to secure a different ontological and epistemological basis for mental distress. A foundational strand of this is advocacy to enable people to give voice to their experience. The case of independent mental health advocacy (IMHA) services under mental health legislation in England, provides an opportunity to critically examine whether advocacy can promote epistemic justice as a result of the legally sanctioned encounter between clinical assessment and subjective experience, pivoting on judgements about risk. This paper draws on empirical data from a national evaluation of IMHA services, which included 90 individual interviews with people subject to detention and three focus groups with mental health service users. Fricker's concept of epistemic injustice is used as a lens to investigate how this type of advocacy might mitigate forms of epistemic injustice, and thereby promote greater social justice in mental health. The concept of epistemic injustice provides a valuable theoretical basis for understanding the worth of advocacy in addressing testimonial injustice as well as its relative weakness in overcoming hermeneutical injustice. The challenge of independent advocacy to the dominant discourse within mental health is considered and questions raised about the place of advocacy in modern democratic mental health systems., (Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: Female genital mutilation is a health and human rights issue which extends to western countries. It is estimated that there are some seventeen thousand women and girls living in Spain who have either been mutilated or are at risk of being so. Healthcare professionals face the challenge of providing adequate care in response to this emerging problem., Aim: To discover the repercussions of female genital mutilation on the health of sub-Saharan women residing in Spain, as well as the healthcare received., Methods: A life-history qualitative research design was utilized. The study population included 14 genitally mutilated women residing in the Region of Murcia who had given birth in Spain and been attended to by the national public healthcare system., Results: Women suffer physical, psychological, obstetric and sexual health issues as a result of female genital mutilation and despite having a favourable perception of the healthcare received during the pregnancy and the delivery, the provision of health education, detection and treatment of female genital mutilation by healthcare professionals was seen to be lacking., Conclusions and Practical Implications: Healthcare policy must address insufficiencies in delivering adequate care to immigrant women who have been the victim of female genital mutilation by implementing the necessary resources and training for professionals to effectively meet the specific healthcare needs of this population and prevent this cruel practice from being perpetuated., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Children with neurologic conditions benefit from international conventions, and national treaties, policies and regulations that safeguard their human rights. These regulations also exist to serve as guidance in the creation of comprehensive systems of care, inclusive environments, accessible societies and communities that allow these children to thrive and to achieve the best of their capacities. This narrative review of issues related to human rights and advocacy in pediatric neurologic disabilities will provide an overview of the human rights conventions that relate to children with disabilities, and the most current approaches implicating health care providers in rights promotion for these individuals and their families. We also suggest venues for professionals to advocate for their patients, and suggest strategies to consider rights-based approaches as a mean to provide holistic care in a social neurology framework., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Even in relatively tolerant countries, antigay bias remains socially divisive, despite being widely viewed as violating social norms of tolerance. From a Justification-Suppression Model (JSM) framework, social norms may generally suppress antigay bias in tolerant countries, yet be "released" by religious justifications among those who resist gay rights progress. Across large, nationally representative US samples (Study 1) and international samples (Study 2, representing a total of 97 different countries), over 215,000 participants, and various indicators of antigay bias (e.g., dislike, moral condemnation, opposing gay rights), individual differences in religious attendance was uniquely associated with greater antigay bias, over and above religious fundamentalism, political ideology, and religious denomination. Moreover, in 4 of 6 multilevel models, religious attendance was associated with antigay bias in countries with greater gay rights recognition, but was unrelated to antigay bias in countries with lower gay rights recognition (Study 2). In Study 3, Google searches for a religious justification ("love the sinner hate the sin") coincided temporally with gay-rights relevant searches. In U.S. (Study 4) and Canadian (Study 5) samples, much of the association between religious attendance and antigay bias was explained by "sinner-sin" religious justification, with religious attendance not associated with antigay bias when respondents reported relatively low familiarity with this justification (Study 5). These findings suggest that social divisions on homosexuality in relatively tolerant social contexts may be in large part due to religious justifications for antigay bias (consistent with the JSM), with important implications for decreasing bias. (PsycINFO Database Record, ((c) 2018 APA, all rights reserved).)

This article explores the complex position of local physicians at times of political unrest or conflict, conceptualizing local medical voluntarism as a form of collective action. It analyzes the evolving interpretation of medical neutrality among Egyptian physicians who provided medical assistance to injured protesters in the Egyptian uprising (2011-2013). In-depth interviews with 24 medical and non-medical volunteers on their perception of medical neutrality were matched with their mobilization and participation history, showing the extent towards which political considerations influenced their voluntary medical engagement. The results firstly show that revolutionary political considerations played a central role in the physicians' mobilization into medical networks active in the protests, as well as in their interpretation of their medical and non-medical activities. Secondly, I argue that the interpretation of medical neutrality among Egyptian physicians evolved significantly over time. A special type of medical volunteer took shape, the mīdānī physician. This physician openly expresses his/her political convictions and adheres to (self-defined) humanitarian principles through a conscious reconciliation of the two. The article details the increasing difficulty of this task after the revolutionary movement splintered into competing factions and citizens ended up fighting each other instead of authoritarian rule., (Copyright © 2018. Published by Elsevier Ltd.)

Background: Accountability for ensuring sexual and reproductive health and rights is increasingly receiving global attention. Less attention has been paid to accountability mechanisms for sexual and reproductive health and rights at national and sub-national level, the focus of this systematic review., Methods: We searched for peer-reviewed literature using accountability, sexual and reproductive health, human rights and accountability instrument search terms across three electronic databases, covering public health, social sciences and legal studies. The search yielded 1906 articles, 40 of which met the inclusion and exclusion criteria (articles on low and middle-income countries in English, Spanish, French and Portuguese published from 1994 and October 2016) defined by a peer reviewed protocol., Results: Studies were analyzed thematically and through frequencies where appropriate. They were drawn from 41 low- and middle-income countries, with just over half of the publications from the public health literature, 13 from legal studies and the remaining six from social science literature. Accountability was discussed in five health areas: maternal, neonatal and child health services, HIV services, gender-based violence, lesbian/gay/bisexual/transgender access and access to reproductive health care in general. We identified three main groupings of accountability strategies: performance, social and legal accountability., Conclusion: The review identified an increasing trend in the publication of accountability initiatives in Sexual and Reproductive Health and Rights (SRHR). The review points towards a complex 'accountability ecosystem' with multiple actors with a range of roles, responsibilities and interactions across levels from the transnational to the local. These accountability strategies are not mutually exclusive, but they do change the terms of engagement between the actors involved. The publications provide little insight on the connections between these accountability strategies and on the contextual conditions for the successful implementation of the accountability interventions. Obtaining a more nuanced understanding of various underpinnings of a successful approach to accountability at national and sub national levels is essential., Competing Interests: The authors have declared that no competing interests exist.

This scoping study assessed the realization of the rights for persons with disabilities in Rwanda since the signing of the United Nations Convention on the Rights of Persons with Disabilities (UN CRPD) in 2008. Underpinned by the five-stage framework of Arksey and O'Malley, the scoping study examined peer-reviewed literature published between 2008 and 2017. Nine electronic databases were searched using keywords specific to disability in Rwanda. Data were charted by three reviewers according to pre-determined and emergent categories. Descriptive statistics were used to describe the data sources. A total of 60 scholarly articles met the inclusion criteria. Within the research, studies pertaining to the UN CRPD Articles of health, awareness raising, accessibility, and children with disabilities were the most published. The literature identified a movement towards the realization of the rights for persons with disabilities in Rwanda since the country signed the UN CRPD. Despite efforts to meet these rights, discrimination against persons with disabilities still exists and greater investment in the disability sector is needed, particularly for justice, social protection, and mental health services. Given the state of the evidence, concerning research gaps also exist in regards to deinstitutionalization and protection issues (i.e., violence and abuse). This consolidation of evidence may help to inform the decision-making priorities for government and civil society organizations in policy and programming and also direct future research.

Recent protests on dozens of campuses have led to the cancellation of controversial talks, and violence has accompanied several of these protests. Psychological science provides an important lens through which to view, understand, and potentially reduce these conflicts. In this article, we frame opposing sides' arguments within a long-standing corpus of psychological research on selective perception, confirmation bias, myside bias, illusion of understanding, blind-spot bias, groupthink/in-group bias, motivated skepticism, and naive realism. These concepts inform dueling claims: (a) the protestors' violence was justified by a higher moral responsibility to prevent marginalized groups from being victimized by hate speech, versus (b) the students' right to hear speakers was infringed upon. Psychological science cannot, however, be the sole arbiter of these campus debates; legal and philosophical considerations are also relevant. Thus, we augment psychological science with insights from these literatures to shed light on complexities associated with positions supporting free speech and those protesting hate speech. We conclude with a set of principles, most supported by empirical research, to inform university policies and help ensure vigorous freedom of expression within the context of an inclusive, diverse community.

Competing Interests: POTENTIAL CONFLICT OF INTEREST: The author has indicated she has no potential conflicts of interest to disclose.

Objective: Antistigma programs may be guided by 3 differing agendas: services (promote treatment engagement), rights (help people achieve rightful goals), and self-worth (facilitate self-worth and efficacy). This study examined the construct validity of this perspective by examining the factor structure of importance ratings of the 3 agendas. The study examined how importance might be viewed differently by the population as a whole versus a subsample of people who reported previous experience with mental health services and hence could be directly harmed by stigma., Methods: 373 individuals recruited using Mechanical Turk completed importance ratings for each of the 3 agendas. Measures of public stigma were completed to examine concurrent validity of importance ratings. Those who reported taking medications for a psychiatric disorder were divided into a separate group and completed a measure of self-stigma., Results: Outcomes seemed to confirm the factor structure of the 3 agendas model thereby offering partial support for the framework. Group analyses showed the services agenda was viewed as more important than rights or self-worth. People with mental health experience viewed the services agenda as more important than the other 2. However, dividing the mental health group into low and high self-stigma revealed that those with low self-stigma rated the rights agenda as more important. Conclusions and Implication for Practice: Participants with lower self-stigma identify the harm brought by stigma and thus endorse rights and self-worth more than those with higher self-stigma. Implications of these findings are discussed to assist to prioritize agendas for public health campaigns. (PsycINFO Database Record, ((c) 2018 APA, all rights reserved).)

Background: Some developed countries have recently changed their role in the context of international recruitment, becoming donors due to socio-economical and political factors such as recessions. This is also the case in Italy, where there has been a flow of immigrant nurses out of the country that has been documented over the past several years. In a short time, it has become a donor country to other developed European countries, such as the United Kingdom., Aims: To advance knowledge in the context of human rights conflicts and ethical implications of the decision-making process of nurses who migrate between developed countries, such as from Italy to the United Kingdom, during times of recession., Research Design: A case study based on the descriptive phenomenological approach was undertaken in 2014. Participants and research context: A total of 26 Italian newly graduated nurses finding a job in the United Kingdom were interviewed via Skype and telephone. Ethical considerations: The Internal Review Board of the University approved the project., Findings: In accordance with the descriptive phenomenological approach undertaken, three main themes emerged: (1) escaping from the feeling of being refused/rejected in order to be desired, (2) perceiving themselves respected, as a person and as a nurse, in a growth project and (3) returning if the country changes its strategy regarding nurses., Discussion: Ethical implications in the context of human rights, such as autonomy of the decision, social justice and reciprocal obligation, non-maleficence and double effect, have been discussed., Conclusion: The call for investing in nurses and nurses' care in developed countries facing recession is urgent. Investing in nurses means respecting individuals and citizens who are at risk of developing health problems during the recession.

This article addresses the controversy associated with the construct schizophrenia/psychosis/madness, indicating the need to acknowledge the multiplicity of experiences and interpretations which arise through the use of the construct. The plurality and complexity intrinsic to the phenomenon, the discrepancies in its possible meanings and the value of first-hand experience are indicated as aspects whose recognition is indispensable to both understanding suffering and confronting it socio-educationally. Using interviews carried out in September 2013 and May 2014 with six people diagnosed at least with schizophrenia, who gave their informed consent to participate, these dimensions are explored. Additionally, madness is examined from a queer perspective as a possible space of political expression that permits new paths and forms of social circulation among those afflicted.

Opposition to gay rights is prevalent in countries around the world. Recent correlational research suggests that opposition to gay rights may be driven by an interaction between one's own short-term mating orientation (i.e. willingness to engage in casual sex) and representations of gay people as sexually promiscuous. Here, we experimentally manipulated representations of gay men by randomly assigning participants to read one of two versions of a fictitious newspaper article, one of which contained faux scientific evidence confirming the stereotype that gay men are promiscuous, and the other containing faux scientific evidence refuting the stereotype. We found that the manipulation interacted with short-term mating orientation (STMO) to predict opposition to gay rights, such that low-STMO individuals (i.e. more averse to casual sex) exhibited more support for gay rights when assigned to read the stereotype-refuting article compared to the stereotype-confirming article, whereas high-STMO individuals (i.e. less averse to casual sex) were not significantly influenced by the manipulation. We discuss the implications of these findings for the study of antigay attitudes, as well as for recent societal changes in acceptance of homosexuality.

Protecting human rights has increasingly become a focus of regulation regarding individuals with Intellectual Disability (ID). While this focus on rights has succeeded in protecting people with ID from many of the most insidious abuses of the past, an over-emphasis on the human rights of people with ID while ignoring other aspects of their personalities and environments can create challenges. This article proposes the use of a dialectical model to address challenges raised by the relationship between two equally valid but often unequally considered approaches, namely, rights-based and person-centered. Suggestions are provided for using this model to meaningfully support individuals to reach their person-centered goals while continuing to recognize and address their individual rights, responsibilities, and challenges.

After analysing the concluding observations of the Committee on the Rights of Persons with Disabilities, hereafter referred to as the Committee, this paper examines how the Committee has sustained a protective, medical, and gender binary model to address the sexual and reproductive rights of persons with disabilities. To break away from this narrow approach to sexuality, I call for an understanding of sex/gender that is more fluid and shifting, recognising the ability of persons with disabilities to express and act upon desire consensually, and bringing into the discussion issues of sexual orientation and gender identity.

Rehabilitation remains a significant concern among survivors of the 1994 genocide in Rwanda. Rehabilitation falls under tertiary prevention, which is a core function of public health. Despite efforts to introduce various rehabilitation programmes for genocide survivors in Rwanda, these initiatives have often proved inadequate in meeting their long-term needs. The failure of the Rwandan Government, international community, United Nations, and other Non-Government Organisations (NGOs) calls into serious question their commitment to international human rights laws. Rehabilitation should be regarded as a free-standing human right for genocide survivors and a human rights-based approach to the rehabilitative process should incorporate measurable outcomes based on an agreed ethical framework. The author calls upon the international community to reiterate its concerns about genocide survivors and reaffirm its commitments to human rights. The main issues discussed in this article are: the long-term needs of survivors of the 1994 genocide; what is already provided, and the gaps; how Stucki's Rehabilitation Cycle framework (a problem-solving tool) can help improve current provision; the role of the international community, NGOs, and genocide survivors' organisations in advancing rehabilitation; and the need for a human rights-based approach to rehabilitation. A strong recognition of the right to rehabilitation is crucial. An ethical framework related to the human rights-based approach should also assist in setting outcomes that can be measured against agreed standards, ensuring: rights that have been violated are identified; the accountability of each service provider in promoting rehabilitation; rehabilitation which is inclusive and non-discriminatory; participation by encouraging collaboration with survivors rather than doing things for them; and empowerment by enabling survivors to understand their rights and have the confidence to challenge or question when their rights have been violated.

Background: After the end of Second World War, the recent experience of the Nazi horrors stimulated a debate about the political use of psychiatry. Over the years, the focus shifted on major dictatorships of the time and especially on Soviet Union., Aims: This article aims to provide a critical review of the ways in which psychiatry was used by totalitarian regimes of the 20th century., Methods: We summarized relevant literature about political use of psychiatry in totalitarian regimes of the 20th century, with particular focus on Fascism, Nazism, Argentina dictatorship, Soviet Union and China., Results: One of the features that are common to most of the dictatorships is that the use of psychiatry has become more prominent when the regimes have had the need to make more acceptable the imprisonment of enemies in the eyes of the world. This for example happened in the Nazi regime when sterilization and killing of psychiatric patients was explained as a kind of euthanasia, or in the Soviet Union after the formal closure of the corrective labor camps and the slow resumption of relations with the capitalistic world, or in China to justify persecution of religious minorities and preserve economic relations with Western countries., Conclusion: Psychiatry has been variously used by totalitarian regimes as a means of political persecution and especially when it was necessary to make acceptable to public opinion the imprisonment of political opponents.

Recent years have brought a growing social and public commitment to the promotion of children's rights and children's well-being around the world, and these have become important goals of all those striving to improve children's lives. In spite of the intimate ideological connection between the concepts of children's rights and children's well-being, they have evolved separately both theoretically and empirically. In the current article, we present a study exploring the empirical association between these 2 concepts based on data from the International Survey on Children's Well-Being. This unique survey explores children's own perspectives on their well-being (subjective well-being), their perceptions and knowledge of their rights, and their reports on their right to participation. It includes data from more than 54,000 children aged 8-12 from 16 countries around the world. Our results showed clear cross-national differences between children's knowledge and perceptions of their rights and their reports on participation. Also, children's participation in different contexts in their lives showed an association with their subjective well-being; a weaker association was found between children's knowledge and perceptions of their rights. These results indicate that children's right to participation and, to some degree, their knowledge and thinking about their rights is an indicator of their well-being. (PsycINFO Database Record, ((c) 2017 APA, all rights reserved).)

The goal of the study reported in this article was to explore the conceptualizations of human rights and human rights practice among students and supervisors in social work field settings. Data were collected from 35 students and 48 supervisors through an online survey system that featured two open-ended questions regarding human rights issues in their agency and human rights practice tasks. Responses suggest that participants encountered human rights issues related to poverty, discrimination, participation/self-determination/autonomy, violence, dignity/respect, privacy, and freedom/liberty. They saw human rights practice as encompassing advocacy, service provision, assessment, awareness of threats to clients' rights, and the nature of the worker-client relationship. These results have implications for the social work profession, which has an opportunity to focus more intently on change efforts that support clients' rights. The study points to the possibilities of expanding the scope of the human rights competency within social work education and addressing the key human rights issues in field education., (© 2016 National Association of Social Workers.)

This article addresses the precarious place of transgender and gender non-cis persons in relation to their discrimination-protections in recent legal, medical, and ethical policies in the United States. At present, there exists a contradiction such that trans persons are considered "pathological" enough that they are included in the latest iteration of the American Psychiatric Association's Diagnostic and Statistical Manual (DSM-V) as "gender dysphoric," but they are not included in the category of "disabled" under the Americans with Disabilities Act (ADA). As such, trans persons in America are subject to the stigma of pathology (albeit with medical treatment) without the full protections of the ADA. By contrast, transgender and non-cis-gender Americans find their queer cohorts who are HIV-positive to be fully protected by the ADA. We ask whether transgender and non-cis-gender persons should embrace their (already pathologized) personhood as a disability. Sometimes "choosing disability" affords more rights than it deploys stigma.

In developing a science of morality, many examples are provided not only to document the moral progress that has been made over the centuries, but also the reasons why and how this progress has been made. Instead of moralizing about human action and social problems that we find deplorable or undesirable, ever since the Scientific Revolution and the Enlightenment we started seeing them as problems to be solved. A science of morality begins with the discovery of rights and other moral values and emotions, starting with the recognition of the individual as an autonomous moral agent with an evolved natural desire to survive and flourish., (© 2016 New York Academy of Sciences.)

In two recent judgements, the European Court of Human Rights (ECtHR) has given an alarming signal regarding the placement, care and treatment of mentally disordered offenders in Belgium. This article analyses these judgements and the Court's assessment that Belgium faces a structural problem regarding the detention of people with a mental illness in prison. By exploring other recent ECtHR decisions across the EU and combining this with an analysis of international norms and standards, it contends that there is something amiss regarding the post-trial approach towards mentally disordered offenders in an EU-wide context. The potential hazards of this situation, from both an individual and an EU perspective are then presented by analysing the EU Framework Decision on the transfer of prisoners (which aims to facilitate offender rehabilitation) and the EU Court of Justice's interpretation of the relationship between instruments like the Framework Decision that are based on mutual recognition and fundamental rights. Lastly, the EU's initiative for enhancing procedural rights in criminal proceedings through the Roadmap trajectory, and the subsequent Commission Recommendation of 27 November 2013, are scrutinized. Based on this research, the article pinpoints the flaws and vacuums that currently exist for mentally disordered offenders, and the negative outcome this may have on the legitimacy and effectiveness of the European Area of Freedom, Security and Justice., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Juvenile suspects are routinely expected to possess an accurate recall of written or oral Miranda warnings. This study addresses the Miranda-related comprehension recall and reasoning of legally involved juveniles. It is the first juvenile research to compare systematically two levels of complexity for Miranda warnings with the three modalities (oral, written, or combined) of administration. Unexpectedly, easily read written warnings marginally outperformed the combined modality. In order to examine Miranda reasoning, three juvenile groups were operationalized: impaired, questionable, and likely adequate. Predictably, the impaired and questionable groups possessed significantly lower verbal abilities than the likely-adequate reasoning group. In addition, the likely-adequate group exhibited the strongest appreciation of the adversarial context in which Miranda waiver decisions are rendered. The discussion addresses the marked disparities in Miranda recall from a total recall versus component-by-component understanding of Miranda rights. It also considers more generally how crucially important Miranda misconceptions might be remedied. Copyright © 2016 John Wiley & Sons, Ltd., (Copyright © 2016 John Wiley & Sons, Ltd.)

Suspects, especially innocent ones, are highly susceptible to waiving their interrogation rights. This research tested the ability of two strategies to overcome innocent suspects' willingness to waive their rights. One strategy was based on the social influence of scarcity (i.e., not constraining the pre-interrogation time limit). The other strategy focused on disrupting individuals' cognitive fluency during the decision-making process (i.e., violating their induced expectation of offering a waiver). Disrupting innocent individuals' cognitive fluency increased their willingness to invoke their rights and, notably, was not qualified by interactions with any other factors. However, scarcity did not influence individuals' pre-interrogation decision-making. Results also further established the association between innocent individuals' naïve mindset and their willingness to waive their rights - specifically, innocents' willingness to waive their rights increased with the strength of their just world beliefs. The theoretical and applied implications of these findings are discussed. The importance and benefit of reforming pre-interrogation protocols using fair and feasible strategies that would disrupt suspects' cognitive fluency are emphasized. Copyright © 2016 John Wiley & Sons, Ltd., (Copyright © 2016 John Wiley & Sons, Ltd.)

In this study, the relationship between agency, communion, and the active, passive, and revenge forms of entitlement is examined. Results indicate that active entitlement was positively related to agency, negatively to communion (Study 1), and unrelated to unmitigated agency and communion (Study 2). Passive entitlement was positively related to communion (in regular and unmitigated forms) and negatively related to agency (in both forms). Revenge entitlement was positively related to agency (unmitigated and regular), and negatively related to both regular and unmitigated communal orientations. Detected relationships were independent from self-esteem (Study 1). The findings are discussed in relation to distinctions between narcissistic and healthy entitlement, and within the context of the three-dimensional model of entitlement., (© 2015 International Union of Psychological Science.)

Ethno-racial people with mental health disabilities experience multiple inequities and differential outcomes when interacting with Ontario's civil mental health laws. Given the increasing multi-racial population in Ontario, there is a need to develop mechanisms to address these intersecting issues. Other countries that have created evaluative tools for mental health legislation include the United Kingdom and Australia. Australia's Rights Analysis Tool, the United Kingdom's Race Equality Impact Assessment, the Scottish Recovery Tool, and the World Health Organization's Mental Health and Human Rights checklist are examples of evaluative tools developed for mental health legislation. Such a tool does not exist in Canada, let alone in Ontario specifically. Thus, this study developed a Cultural Analysis Tool (CAT) consisting of specific and meaningful thematic questions that can be used by practitioners when addressing issues of culture and equity for ethno-racial people with mental health disabilities interacting with Ontario's civil mental health laws. It is hoped that the CAT, and the research underlying its development, will enable practitioners to critically question whether cultural and intersecting concerns are being appropriately addressed within an ethno-racial client's case and, furthermore, how equitable outcomes can be achieved. This article describes and analyzes the methodology, research and qualitative data used to develop the CAT. It then presents and examines the CAT itself. The qualitative data was drawn from thirty-five semi-structured interviews with seven members of each of the following groups: (1) ethno-racial people with mental health disabilities including in-patients and ex-patients, (2) lawyers who practice in the area of mental health law, (3) health care professionals including psychiatrists, nurses and social workers, (4) service providers such as front-line case workers at mental health agencies and (5) adjudicators, government advisors and academics. After an analysis of these data, the CAT's questions were refined through an expert review (involving the qualitative technique of member-checking) using three focus groups comprised of ethno-racial people with mental health disabilities, mental health lawyers and service providers and health care professionals., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Since its inception in 1968, the concept of whole-brain death has been contentious, and four decades on, controversy concerning the validity and coherence of whole-brain death continues unabated. Although whole-brain death is legally recognized and medically entrenched in the United States and elsewhere, there is reasonable disagreement among physicians, philosophers, and the public concerning whether brain death is really equivalent to death as it has been traditionally understood. A handful of states have acknowledged this plurality of viewpoints and enacted "conscience clauses" that require "reasonable accommodation" of religious and moral objections to the determination of death by neurological criteria. This paper argues for the universal adoption of "reasonable accommodation" policies using the New Jersey statute as a model, in light of both the ongoing controversy and the recent case of Jahi McMath, a child whose family raised religious objections to a declaration of brain death. Public policies that accommodate reasonable, divergent viewpoints concerning death provide a practical and compassionate way to resolve those conflicts that are the most urgent, painful, and difficult to reconcile.

A growing number of bioethics papers endorse the harm threshold when judging whether to override parental decisions. Among other claims, these papers argue that the harm threshold is easily understood by lay and professional audiences and correctly conforms to societal expectations of parents in regard to their children. English law contains a harm threshold which mediates the use of the best interests test in cases where a child may be removed from her parents. Using Diekema's seminal paper as an example, this paper explores the proposed workings of the harm threshold. I use examples from the practical use of the harm threshold in English law to argue that the harm threshold is an inadequate answer to the indeterminacy of the best interests test. I detail two criticisms: First, the harm standard has evaluative overtones and judges are loath to employ it where parental behaviour is misguided but they wish to treat parents sympathetically. Thus, by focusing only on 'substandard' parenting, harm is problematic where the parental attempts to benefit their child are misguided or wrong, such as in disputes about withdrawal of medical treatment. Second, when harm is used in genuine dilemmas, court judgments offer different answers to similar cases. This level of indeterminacy suggests that, in practice, the operation of the harm threshold would be indistinguishable from best interests. Since indeterminacy appears to be the greatest problem in elucidating what is best, bioethicists should concentrate on discovering the values that inform best interests., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

Article 12 of the Convention for the Rights of Persons with Disabilities recognizes all persons with disabilities as having legal capacity in all areas of life. However, in adherence to the Israeli Legal Capacity and Guardianship Law (1962), many persons with intellectual disability (ID) or mental illness (MI) have these rights revoked because of the appointment of a guardian. Little is known about these persons' perceptions about guardianship and supported decision making (SDM). Using focus groups, we examined the perceptions of persons with ID, persons with MI, and parents regarding guardianship and SDM. Most participants expressed their desire to adopt a model of SDM in their daily decision making, though differences were found among the groups. Persons with MI emphasized their right to be independent in decisions regarding their lives, and parents of these persons aspired to support their children to reach independence, except in times of crisis. Persons with ID also desired more independence, but they were uncertain if this would be possible for them. Some individuals with ID preferred that decisions regarding their lives be made on their behalf. Parents of persons with ID felt that it was critical for them to serve as guardians of their children. Recommendations are provided on how to promote the legal capacity of individuals with disabilities. (PsycINFO Database Record, ((c) 2016 APA, all rights reserved).)

Human rights advocates play a critical role in promoting respect for human rights world-wide, and engage in a broad range of strategies, including documentation of rights violations, monitoring, press work and report-writing, advocacy, and litigation. However, little is known about the impact of human rights work on the mental health of human rights advocates. This study examined the mental health profile of human rights advocates and risk factors associated with their psychological functioning. 346 individuals currently or previously working in the field of human rights completed an internet-based survey regarding trauma exposure, depression, posttraumatic stress disorder (PTSD), resilience and occupational burnout. PTSD was measured with the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C) and depression was measured with the Patient History Questionnaire-9 (PHQ-9). These findings revealed that among human rights advocates that completed the survey, 19.4% met criteria for PTSD, 18.8% met criteria for subthreshold PTSD, and 14.7% met criteria for depression. Multiple linear regressions revealed that after controlling for symptoms of depression, PTSD symptom severity was predicted by human rights-related trauma exposure, perfectionism and negative self-appraisals about human rights work. In addition, after controlling for symptoms of PTSD, depressive symptoms were predicted by perfectionism and lower levels of self-efficacy. Survey responses also suggested high levels of resilience: 43% of responders reported minimal symptoms of PTSD. Although survey responses suggest that many human rights workers are resilient, they also suggest that human rights work is associated with elevated rates of PTSD and depression. The field of human rights would benefit from further empirical research, as well as additional education and training programs in the workplace about enhancing resilience in the context of human rights work.