Terrorism, forgiveness and restorative justice

This paper is intended to enhance understanding of the complexities of restorative justice in cases of terrorism from a victimological perspective. It does so first by analysing what separates terrorism from other forms of crime. The author argues that the main distinction concerns the peculiarly public nature of terrorism, in which the attack on the direct victims is intended to influence a (far) larger group of so-called vicarious victims. This means that the public is likely to experience terrorist attacks as attacks on themselves. As a consequence the public can feel entitled to processes of forgiveness which in turn can conflict with the direct victims’ own experience. To illuminate this issue the paper proposes a novel distinction in third party forgiveness processes: between public forgiveness, i.e. forgiveness relating to the public wrongfulness inherent in crime, and vicarious forgiveness, i.e. the public’s experience of forgiveness itself. The complexities for restorative justice after terrorism can be then be viewed in terms of the tensions between the direct victims’ private and the publics’ vicarious forgiveness processes. Este artículo pretende facilitar la comprensión de las complejidades de la justicia restaurativa en casos de terrorismo desde una perspectiva victimológica. Lo hace primero mediante el análisis de lo que separa el terrorismo de otras formas de delincuencia. El autor sostiene que la distinción principal se refiere a la naturaleza pública específica del terrorismo, ya que mediante el ataque a las víctimas directas se pretende influir en el grupo (mucho) más grande de las llamadas víctimas vicarias. Esto significa que es probable que el público sienta los ataques terroristas como ataques contra ellos mismos. De esta forma, el público puede sentirse con derecho sobre los procesos de perdón, lo que, a su vez, puede entrar en conflicto con la propia experiencia de las víctimas directas. Para iluminar esta cuestión, el artículo propone una novedosa distinción en los procesos de perdón de tercera parte: entre el perdón público, es decir, el perdón en relación con la injusticia pública inherente al crimen, y el perdón vicario, es decir, la experiencia del público sobre el propio perdón. Las complejidades de la justicia restaurativa en casos de terrorismo pueden entonces verse en términos de las tensiones entre los procesos de perdón de las víctimas directas privadas y los de las víctimas públicas vicarias

A World of Struggle Meets the Faces of Injustice (Judith Shklar and Current Affairs)

This is a difficult task to perform. It is most often a good deal easier to offer a reflection on a paper with which one would beg to differ, than with one to which one’s own thinking is aligned. This is doubly so if the article in question is phrased as eloquently and insightfully as Professor Kennedy’s was. I might be well advised to merely state, “I concur”, and he said, “it is better than I will ever be able to” and leave it at that

Medical dispute committees in the Netherlands:A qualitative study of patient expectations and experiences

BACKGROUND: Health care incidents, such as medical errors, cause tragedies all over the world. Recent legislation in the Netherlands has established medical dispute committees to provide for an appeals procedure offering an alternative to civil litigation and to meet the needs of clients. Dispute committees incorporate a hybrid procedure where one can file a complaint and a claim for damages resulting in a verdict without going to court. The procedure is at the crossroads of complaints law and civil litigation. This study seeks to analyze to what extent patients and family members' expectations and experiences with dispute committees match the goals of the new legislation. METHODS: This qualitative, retrospective research includes in-depth, semi-structured, face-to-face interviews with patients or family members who filed a complaint with a dispute committee in the Netherlands. The researchers conducted an inductive, thematic analysis of the qualitative data. RESULTS: A total of 26 interviews were held with 30 patients and family members. The results showed that participants particularly felt the need to be heard and to make a positive impact on health care. Some wished to be financially compensated, for others money was the last thing on their mind. The results demonstrated the existence of unequal power relationships between participants and both the defendant and dispute committee members. Participants reported the added value of (legal) support and expressed the need for dialogue at the hearing. Participants sometimes experienced closure after the proceedings, but often did not feel heard or felt a lack of a practical outcome and a tangible improvement. CONCLUSIONS: This study shows that participants' expectations and experiences were not always met by the current set up of the dispute committee proceedings. Participants did not feel heard, while they did value the potential for monetary compensation. In addition, some participants did not experience an empowered position but rather a feeling of a power misbalance. The feeling of a power misbalance and not being heard might be explained by existing epistemic injustice, which is a concept that should be carefully considered in processes after health care incidents

Global Justice and Global Criminal Laws: The Importance of Nyaya in the Quest for Justice after International Crimes

This brief contribution to the debate concerning global law draws on the authors’ analysis of international criminal justice. It argues that the extent to which international criminal law is in fact contributing to global justice in the aftermath of international crimes remains to be seen. In particular, the smooth relationship between international criminal law and the perception of justice can be called into question, as it relies too heavily on the idea that going through the motions of westernized forms of international criminal law will automatically inculcate a sense of justice in victimized populations, while 'en passant' contributing to the resurrection of the rule of law. The connection to broader issues in global justice and global law will draw heavily on Amartya Sen’s recent critique of John Rawls’ Theory of Justice, in which the former employs the ancient Sanskrit notions of 'niti' and 'nyaya'

Patients at the centre after a health care incident:A scoping review of hospital strategies targeting communication and nonmaterial restoration

OBJECTIVE: This study aimed to provide an overview of the strategies adopted by hospitals that target effective communication and nonmaterial restoration (i.e., without a financial or material focus) after health care incidents, and to formulate elements in hospital strategies that patients consider essential by analysing how patients have evaluated these strategies. BACKGROUND: In the aftermath of a health care incident, hospitals are tasked with responding to the patients' material and nonmaterial needs, mainly restoration and communication. Currently, an overview of these strategies is lacking. In particular, a gap exists concerning how patients evaluate these strategies. SEARCH STRATEGY AND INCLUSION CRITERIA: To identify studies in this scoping review, and following the methodological framework set out by Arksey and O'Malley, seven subject‐relevant electronic databases were used (PubMed, Medline, Embase, CINAHL, PsycARTICLES, PsycINFO and Psychology & Behavioral Sciences Collection). Reference lists of included studies were also checked for relevant studies. Studies were included if published in English, after 2000 and as peer‐reviewed articles. MAIN RESULTS AND SYNTHESIS: The search yielded 13,989 hits. The review has a final inclusion of 16 studies. The inclusion led to an analysis of five different hospital strategies: open disclosure processes, communication‐and‐resolution programmes, complaints procedures, patients‐as‐partners in learning from health care incidents and subsequent disclosure, and mediation. The analysis showed three main domains that patients considered essential: interpersonal communication, organisation around disclosure and support, and desired outcomes. PATIENT CONTRIBUTION: This scoping review specifically takes the patient perspective in its methodological design and analysis. Studies were included if they contained an evaluation by patients, and the included studies were analysed on the essential elements for patients

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570