The Hybrid Legal Geographies of a War Crimes Court

This paper explores the implications of understanding war crime trials as hybrid legal spaces. Drawing on twelve months of residential fieldwork in the Court of Bosnia and Herzegovina, Sarajevo, it examines the circulation of evidence, the choreography of the court room and the nature and possibilities for legal observation. Analyzing hybrid legal geographies foregrounds the material and embodied nature of trials, illuminating the forms of comportment, categorization and exclusion through which law establishes its legitimacy. Rather than emphasizing separation and distance, the lens of hybridity illuminates the multiple ways in which war crimes trials are grounded in the social and political context of present day Bosnia and Herzegovina. Consequently this analysis traces the disjuncture between the imagined geographies of legal jurisdiction and the material and embodied spaces of trial practices. In conclusion we argue that the establishment of the Court of Bosnia and Herzegovina illustrates the tensions that emerge when an institution of trial justice is used to strengthen the coherence of a post-conflict state.This paper is based on research funded by the Economic and Social Research Council (RES-061-25-0479).This is the accepted manuscript. The final version is available from http://www.tandfonline.com/doi/abs/10.1080/00045608.2014.892365

Sedation in palliative care – a critical analysis of 7 years experience

BACKGROUND: The administration of sedatives in terminally ill patients becomes an increasingly feasible medical option in end-of-life care. However, sedation for intractable distress has raised considerable medical and ethical concerns. In our study we provide a critical analysis of seven years experience with the application of sedation in the final phase of life in our palliative care unit. METHODS: Medical records of 548 patients, who died in the Palliative Care Unit of GK Havelhoehe between 1995–2002, were retrospectively analysed with regard to sedation in the last 48 hrs of life. The parameters of investigation included indication, choice and kind of sedation, prevalence of intolerable symptoms, patients' requests for sedation, state of consciousness and communication abilities during sedation. Critical evaluation included a comparison of the period between 1995–1999 and 2000–2002. RESULTS: 14.6% (n = 80) of the patients in palliative care had sedation given by the intravenous route in the last 48 hrs of their life according to internal guidelines. The annual frequency to apply sedation increased continuously from 7% in 1995 to 19% in 2002. Main indications shifted from refractory control of physical symptoms (dyspnoea, gastrointestinal, pain, bleeding and agitated delirium) to more psychological distress (panic-stricken fear, severe depression, refractory insomnia and other forms of affective decompensation). Patients' and relatives' requests for sedation in the final phase were significantly more frequent during the period 2000–2002. CONCLUSION: Sedation in the terminal or final phase of life plays an increasing role in the management of intractable physical and psychological distress. Ethical concerns are raised by patients' requests and needs on the one hand, and the physicians' self-understanding on the other hand. Hence, ethically acceptable criteria and guidelines for the decision making are needed with special regard to the nature of refractory and intolerable symptoms, patients' informed consent and personal needs, the goals and aims of medical sedation in end-of-life care