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This thesis seeks to identify the moral wrong of torture, and to trace the relationship between that wrong and the definition of torture in international law. Because understanding a concept's modern manifestation requires an understanding of its history, the thesis begins by tracing the historical trajectory of legal prohibitions of different forms of ill-treatment beginning with the English Bill of Rights in 1689, subsequently articulated in the 1948 Universal Declaration of Human Rights, that 'no one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment'. This prohibition, almost universally accepted by States, has come to be interpreted as embodying a hierarchy with torture at the apex. The shift towards a hierarchical interpretation of the prohibition of torture and ill-treatment in international law was remarkable, both for its decisiveness and for its surprisingly recent occurrence. The reasons for that shift are examined, before turning to a consideration of the competing accounts of what it is that makes torture wrong. Two predominant accounts of the moral wrong of torture are identified, described here as the ‘dignitarian’ and the 'defencelessness' accounts. Although most international instruments and judicial decisions on torture implicitly reflect the dignitarian account, the thesis argues that this account is open to challenge on normative grounds. Instead, it argues that the preferable account of the moral wrong of torture is a modified form of the defencelessness account, according to which torture is the deliberate infliction of severe pain or suffering in the context of a profoundly asymmetric power relation. Finally, the thesis turns to a consideration of the definitions of torture in international law. It contends that there are distinct conceptions of torture operating in the criminal paradigm, and in the human rights paradigm, respectively. While both conceptions of torture at present reflect the dignitarian account, the thesis argues that there is scope in the human rights paradigm for a more expansive 'defencelessness' conception of torture to be adopted.

Article 3 of the European Convention on Human Rights ostensibly provides absolute protection against torture and inhuman or degrading treatment or punishment. Despite what the Court says, this protection is not unqualified. Article 3 now embodies a two-tiered protection, with torture alone attracting a ‘special stigma’. This hierarchical approach is traceable to the seminal decision of Ireland v United Kingdom, and Part A of this thesis demonstrates that it is deeply flawed. The hierarchy between torture and other forms of ill-treatment (the Ireland hierarchy) has become entrenched in the Court’s case law. It continues to manifest in the Court’s narrow definition of torture, and its expansive interpretation of inhuman and degrading treatment. This thesis argues that the growing breadth of the latter concept has occurred in tandem with, and may partly explain, the rapid increase in the number of Article 3 violations found by the Court each year. These developments have carried important consequences. There have been policy consequences for the member states in areas such as national security (where deportation of terrorist suspects is sought to be used as a policy tool) and prisoners’ rights (where the proportionality of sentences, conditions of detention and administrative penalties within prisons, are all now subject to European supervision). In addition to the policy consequences, the expanding second tier of the Ireland hierarchy has carried legal consequences for the Court’s conception of Article 3. It has compelled the Court to introduce limiting devices into its case law on inhuman and degrading treatment. The introduction of these limiting devices, into what is an ostensibly unqualified domain, challenges the position of Article 3 as an absolute right.

Recent cases in the European Court of Human Rights have placed greater emphasis on the quality of legislative debate when determining whether to apply the margin of appreciation to the decisions of member States. This paper explores how courts in general might go about assessing the quality of legislative debate about rights, and presents a set of criteria against which such debate can be assessed. While pushing at the boundaries of constitutional orthodoxy, this paper looks ahead to a framework of democratic dialogue where sovereignty is shared between courts, Parliament and other constitutional organs. In this context, it argues that courts ought to defer where certain criteria are met in the process of parliamentary deliberation on the rights questions which come before them.

Recent cases in the European Court of Human Rights have placed greater emphasis on the quality of legislative debate when determining whether to apply the margin of appreciation to the decisions of member States. This paper explores how courts in general might go about assessing the quality of legislative debate about rights, and presents a set of criteria against which such debate can be assessed. While pushing at the boundaries of constitutional orthodoxy, this paper looks ahead to a framework of democratic dialogue where sovereignty is shared between courts, Parliament and other constitutional organs. In this context, it argues that courts ought to defer where certain criteria are met in the process of parliamentary deliberation on the rights questions which come before them.

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Biomarkers of dietary exposure or nutritional status are sought actively to overcome limitations of traditional dietary methodology. We compared plasma and adipose tissue biomarkers for carotenoids and tocopherols. The data consisted of samples from 91 men and 122 women, ages 45-70 years, from the control group of the European Community Multicentre Study on Antioxidants, Myocardial Infarction, and Cancer of the Breast (EURAMIC) Study. Pearson correlations between plasma and adipose tissue measurements for β-carotene, lycopene, and α-tocopherol adjusted for smoking status displayed low, although significant, correlations of 0.39, 0.24, and 0.39, respectively. The correlation was further stratified by sex. After being corrected for measurement error using deattenuation factors obtained from a reproducibility study, the stratified correlation coefficients were as high as 0.80 for β-carotene in men, 0.62 for lycopene in women, and 0.52 for α- tocopherol in women. In addition, plasma and adipose tissue measurements from the myocardial infarction (MI) subset of the EURAMIC study population were used to evaluate the odds of MI, adjusting for confounders. We found that the concentration of lycopene in plasma was not positively associated significantly with MI (odds ratio, 1.78; P = 0.26). Adipose tissue lycopene, in contrast to reports elsewhere on the total population, showed an inverse association with MI (odds ratio, 0.62; P = 0.15). These results suggest that plasma and adipose carotenoids represent different markers for nutritional status and cannot be used interchangeably in epidemiological and dietary validation studies.

The fatty acid content of adipose tissue in postmenopausal breast cancer cases and controls from five European countries in the European Community Multicenter Study on Antioxidants, Myocardial Infarction, and Cancer (EURAMIC) breast cancer study (1991-1992) was used to explore the hypothesis that fatty acids of the omega-3 family inhibit breast cancer and that the degree of inhibition depends on background levels of omega-6 polyunsaturates. Considered in isolation, the level of omega-3 or omega-6 fat in adipose tissue displayed little consistent association with breast cancer across study centers. The ratio of long-chain omega-3 fatty acids to total omega-6 fat showed an inverse association with breast cancer in four of five centers. In Malaga, Spain, the odds ratio for the highest tertile relative to the lowest reached 0.32 (95% confidence interval 0.13-0.82). In this center, total omega-6 fatty acid was strongly associated with breast cancer. With all centers pooled, the odds ratio for long-chain omega-3 to total omega-6 reached 0.80 for the second tertile and 0.65 for the third tertile, a downward trend bordering on statistical significance (p for trend = 0.055). While not definitive, these results provide evidence for the hypothesis that the balance between omega-3 and omega-6 fat may play a role in breast cancer.

Outbreaks of community-acquired Pseudomonas aeruginosa folliculitis have recently been described in association with health spa whirlpools. In February 1984 we detected an outbreak of Pseudomonas folliculitis among hospital staff and patients using a swimming pool in a newly constructed physiotherapy unit. A rash developed in 5 (45%) of the 11 physiotherapists who had used the pool, as compared with 0 of the 17 who had not (p less than 0 005). Pseudomonas folliculitis also developed in 6 (21%) of 29 outpatients and 4 (33%) of 12 inpatients who had used the facility; Pseudomonas infection of a surgical wound also developed in 1 of the 4 inpatients. The epidemic curve was consistent with a continuing common-source outbreak. P. aeruginosa, serotype O:10, was isolated from three physiotherapists, the patient with an infected surgical wound and the pool. A case-control study of pool users did not identify risk factors for infection, although the physiotherapists had spent longer in the pool than had the patients. After hyperchlorination and structural repairs to the pool, no further cases were identified among pool users. This outbreak is the first reported nosocomial outbreak of Pseudomonas folliculitis. Further investigation is needed to determine the risk of serious Pseudomonas infections in hospitalized patients using physiotherapy pools.