'It's like being conscripted, one volunteer is better than 10 pressed men': A qualitative study into the views of people who plan to opt-out of organ donation

Objectives. To overcome the shortage of organ donors, Scotland and England are introducing an opt-out organ donor registration system in 2020. This means individuals will be automatically considered to consent for donation unless they actively opt-out of the register. Research has found that emotional barriers play a key role in donor decisions under opt-in legislation, yet little is known about factors that influence donor decisions under opt-out consent. Our objectives were to investigate attitudes towards organ donation and opt-out consent from individuals who plan to opt-out, and to explore the reasons why they plan to opt-out. Design. Qualitative interview study Methods. Semi-structured interviews were conducted with 15 individuals from Scotland (n=14) and England (n=1) who self-reported the intention to opt-out of the register following the legislative change to opt-out. The interviews were transcribed verbatim and analysed using thematic analysis. Results. Three main themes were identified; (1) consent versus coercion, which describes the perception of freedom of choice under an opt-in system and fears of “Government interference” and threatened autonomy under opt-out, (2) self-protection, encompassing fears of medical mistrust, bodily integrity concerns and apprehension regarding the recipient selection process. Lastly, (3) ‘riddled with pitfalls’, which includes the notion that opt-out consent may increase susceptibility of stigma and reproach when registering an opt-out decision. Conclusions. This study reinforces existing opt-in literature surrounding medical mistrust and bodily integrity concerns. A threat to one’s autonomous choice and heightened reactance arising from perceptions of unwarranted Government control have emerged as novel barriers

The translation of articles from the United Nations Convention on the Rights of the Child into education legislation:the narrowing of Article 12 as a consequence of translation

This paper is concerned with the inclusion, exclusion and reshaping of articles within the United Nations Convention on the Rights of the Child (CRC) as they are translated into English education legislation. The CRC comprises 54 articles aimed at outlining rights and freedoms for children and was ratified by the United Kingdom (UK) government in 1991. The paper builds on a previous publication by the authors which highlighted how the mobilisation of articles within the CRC into professional practice undergoes multiple translations. This paper takes an in‐depth and critical look at the first stage of the translation process in which articles are mobilised from the CRC into national legislation. Specifically, the paper presents findings from a documentary analysis which explored the translation of principles pertaining to Article 12 of the CRC into English Education Regulations, Acts and Statutory Guidance for schools. Findings demonstrate that the reshaping of the article within education legislation strongly reflects the government's priorities and agendas. The study raises new insights into the need to establish processes to ensure the full mobilisation of Article 12 and questions whether specific principles pertaining to the article could or should be incorporated into national legislative systems.Output Status: Forthcoming/Available Onlin

Venue Shift Following Devolution: When Reserved Meets Devolved in Scotland

This article examines the means used to address blurred or shifting boundaries between reserved UK and devolved Scottish policy. It outlines the main issues of multi-level governance and intergovernmental relations in Scotland and the initial problems faced in identifying responsibility for policy action. While it suggests that legislative ambiguities are now mainly resolved with the use of ‘Sewel motions', it highlights cases of Scottish action in reserved areas, including the example of smoking policy in which the Scottish Executive appears to ‘commandeer' a previously reserved issue. However, most examples of new Scottish influence suggest the need for UK support or minimal UK interest

Cytotoxic chemotherapy for incurable colorectal cancer: living with a PICC-line

<b>Aims.</b> (i) To determine which aspects of living with a peripherally inserted central catheter (PICC) line cause Modified de Gramont (MdG) patients most difficulty. (ii) To explore MdG patients' views of the PICC-line experience. (iii) To determine if patients view PICC-lines as a benefit or a burden when receiving ambulatory MdG chemotherapy. <b>Design.</b> A two-stage, descriptive study. <b>Methods.</b> Phase 1 comprised semi-structured interviews. Phase 2 surveyed the MdG population. Phase 1 interview data informed the Phase 2 questionnaire. The setting was a West of Scotland Cancer Care Centre and the sample was: Phase 1, a convenience sample of 10 MdG patients; Phase 2, 62 consecutive patients. <b>Results.</b> A response rate of 93·9% for Phase 2. The majority of PICC-line patients held favourable views towards having a PICC-line and adapted well with minimal disruption to daily life. Concerns were evident regarding coping at home with a PICC-line, chemotherapy spillage, dealing with complex information and the responsibility of patients/carers regarding PICC-line management. Patients preferred ambulatory chemotherapy to in-patient treatment. <b>Conclusions.</b> PICC-lines should be considered for more chemotherapy patients but service development is necessary to ensure individual needs are addressed. <b>Relevance to clinical practice.</b> Contributes to the PICC-line literature by providing a national patient perspective on a range of daily living activities (DLAs). PICC-line patients prefer out-patient ambulatory chemotherapy rather than in-patient treatment. The longer a patient has a PICC-line, the more able they are to manage activities such as dressing. Concerns remain over chemotherapy spillage, partner/carer responsibility for PICC-line maintenance and the proper balance between required information and what the patient wants to know

Mind the implementation gap?:Police reform and local policing in the Netherlands and Scotland

In 2013 the governments of the Netherlands and Scotland established national police forces, replacing a tradition of largely autonomous regional police organizations. In both jurisdictions, these radical reforms have raised concerns about the consequences of these national police structures for local policing and for relationships with local communities and local government. Drawing on documentary sources and interview material from each jurisdiction and informed by insights from the policy implementation literature, the key question addressed in this article is how has the legislation that created the new national police forces been put into effect at a local level? Focusing on the impact on the governance, organization and delivery of local policing, the article reveals how the implementation in both jurisdictions involves interpretation and discretion by multiple actors so that gaps are emerging between the national ‘policy promises’ set out in the legislation and the ‘policy products’ experienced in local contexts