Developing a legal framework for advance healthcare planning: Comparing England & Wales and Ireland

This article examines the legislative frameworks for advance healthcare planning in England & Wales (the Mental Capacity Act 2005) and in Ireland (the Assisted Decision-Making (Capacity) Act 2015), undertaking a comparative analysis of each measure, with particular focus on the detail of the approaches taken. It is only through this kind of detailed focus that the normative choices made by legislation can fully be understood and evaluated. The article argues that, in several respects, possibly because the drafters were able to reflect lessons learned from other jurisdictions, the Assisted Decision-Making (Capacity) Act 2015 provides a more rounded and complete form of advance healthcare planning than that provided by the Mental Capacity Act. This is on the basis that it provides more protection for patient choice; better potential for delivery on the choices made; and a more appropriate balance between formalities and enforceability

Best interests in the Mental Capacity Act: time to say goodbye?

Article 12 of the United Nations Convention on the Rights of Persons with Disabilities, as interpreted by the Committee on the Rights of Persons with Disabilities in General Comment No. 1, offers a vision for law’s response to capacity impairments which differs in crucial ways from that contained in the Mental Capacity Act 2005. The Committee rejects the functional test for capacity and requires that a ‘will and preferences’ paradigm must replace the ‘best interests’ paradigm and that all substitute decision-making regimes must be abolished. This article draws on the position adopted in General Comment No. 1 in evaluating the best interests standard in the Mental Capacity Act. It sets out the normative case for a stronger legislative endorsement of will and preferences and the inclusion of greater support mechanisms but rejects the contention that all substitute decision-making can, or should, be abolished. It also argues that the best interests standard in the Mental Capacity Act retains some revolutionary potential and that, pending legislative reform, this can be further developed through the courts

Epistemic Injustice in White Academic Feminism

This paper will focus on the ways in which white feminist academics commit epistemic injustice in their approach to the work of women of color (WOC). Drawing from feminist epistemology, particularly the works of Miranda Fricker, Gaile Pohlhaus, and Kristie Dotson, I aim to show that white feminist academics’ (WFA) treatment of WOC’s work takes the form of willful hermeneutical ignorance that results in contributory injustice. Among the objections I address is the concern that attempts to solve the problem of contributory injustice may lead to the epistemic exploitation of WOC, as well as the fact that WFAs themselves face a second-class status within academic philosophy

Delivering effective nursing care to children and young people outside of a hospital setting

This report may be reproduced for the purposes of private research and study; in addition, excerpts may be included in professional journals or conference presentations as long as acknowledgement is given and there is no association with advertisingOver the course of the last fifty years, there has been a reduction of approximately 75 per cent in the total number of children’s hospital beds in the United Kingdom [UK]; at the same time, there has been an increase in the amount and range of care now being provided in other environments that are located within outside of hospital settings. This shift in terms of the location and provision of care has meant that there has been an impact on the preparation and training that healthcare staff require. The Health Outcomes Forum specifically recommended: “That HEE [Health Education England] address the workforce education, training and development requirements (including capacity and capability) to refocus service provision at home or closer to home” (Department of Health, 2012: 52). This scoping project was financed and commissioned by Health Education North Central and East London Local Education and Training Board [HE NCEL LETB] in January 2014 and was undertaken by the University of Hertfordshire between February 2014 - August 2014. The project was funded to facilitate the consideration of the educational needs of the nursing workforce in relation to out of hospital care for children and young people, thus enabling the future potential development of out of hospital services to meet the health needs of the children and young people living in the HE NCEL geographical are

The Death of Print Magazines in Fashion: The Fight to Stay Relevant During the Digital Era and a Look at the Future of Fashion Print Magazines

We have found ourselves in a digital era. For the past ten years, the public’s Internet usage per day has skyrocketed across all age groups, which in turn, has had an effect on the print industry (e.g. books, magazines, newspapers). As technology has progressed, many have turned to online magazines and journals to receive their fashion news. Given this rapid advance in digital technology, in my honors thesis, I plan to focus on the effect of digital media on print, specifically in the context of fashion magazines. Specifically, I will explore the history of the fashion magazine, its efforts to stay relevant, and make predictions about the future of print magazines. Overall, I predict that while the magazine industry continues to branch off into various other digital alternatives in order to stay relevant, print will continue to serve as an important fashion news outlet, as the fashion industry and demand for fashion news will continue to grow. Following these predictions, I have also created an original fashion magazine issue, available both digitally and in print. The content of this magazine includes advertisements, articles, and interviews that highlight the future of the fashion industry, as well as current trends and relevant topics

The Determination and Pharmacokinetics of Methimazole in Biological Fluids

The Determination and Pharmacokinetics of Methimazole in Biological Fluids. The development of methimazole therapy, its mechanism of action and pharmacokinetics in man have been briefly reviewed. Specific, sensitive analytical methods were developed for methimazole and 3-methyl-2-thiohydantoin using gas chromatography- mass spectrometry. Trideutromethylimidazole was successfully synthesised and used as the internal standard. Extraction methods were developed for the separation of methimazole from various biological media. Using these specific methods, various clinical investigations were undertaken. Dosage linearity was shown when the plasma concentrations and kinetics of patients on a low dosage regimen where compared to those on a high dosage regimen. A lack of accumulation was also indicated as the plasma concentrations were shown to be at steady-state. Plasma concentrations of methimazole could be correlated with its effect on the inhibition of organification. Thus, the great divergence in the therapeutic response to the drug in thyrotoxicosis is obviously not due to differences in plasma pharmacokinetics or the extent of inhibition of organification of iodine. No significant differences between pharmacokinetic parameters after oral administration to euthyroid and hyperthyroid patients were observed. Thus, it appears that thyroid hormones do not depress or increase the metabolism of methimazole and therefore there are no pharmacokinetic reasons to adjust the dose of methimazole during treatment of thyrotoxicosis. Results for intrathyroidal concentrations supported the concept that methimazole is actively concentrated in the thyroid gland by showing no linearity with dose, an increase in thyroid/plasma concentration ratios with time and a decrease in thyroid/plasma concentration ratio with increasing dose thus indicating a saturated system. However, results for the percentage inhibition of iodide organification appears to be in direct conflict with the intrathyroidal levels. It is likely that the perchlorate discharge test underestimates the duration of action of methimazole as it does not gauge the extent of inhibition of coupling by methimazole. The analysis of infant plasma samples in conjunction with maternal plasma and milk samples showed that the maternal milk/plasma concentration ratio approached unity and that infant plasma levels of methimazole were significant. However, the clinical indices showed no abnormalities in their thyroid function. Therefore, with low doses and careful thyroid monitoring, methimazole is suitable for the treatment of hyperthyroidism in breast-feeding mothers