Can Law Improve Prevention and Treatment of Cancer?

The December 2011 issue of Public Health (the Journal of the Royal Society for Public Health) contains a symposium entitled: Legislate, Regulate, Litigate? Legal approaches to the prevention and treatment of cancer. This symposium explores the possibilities for using law and regulation – both internationally and at the national level – as the policy instrument for preventing and improving the treatment of cancer and other leading non-communicable diseases (NCDs). In this editorial, we argue that there is an urgent need for more legal scholarship on cancer and other leading NCDs, as well as greater dialogue between lawyers, public health practitioners and policy-makers about priorities for law reform, and feasible legal strategies for reducing the prevalence of leading risk factors. The editorial discusses two important challenges that frequently stand in the way of a more effective use of law in this area. The first is the tendency to dismiss risk factors for NCDs as purely a matter of individual \u27personal responsibility\u27; the second is the fact that effective regulatory responses to risks for cancer and NCDs will in many cases provoke conflict with the tobacco, alcohol and food industries. After briefly identifying some of the strategies that law can deploy in the prevention of NCDs, we briefly introduce each of the ten papers that make up the symposium

The Sanctity of Life and the Right to Die: Social and Jurisprudential Aspects of the Euthanasia Debate in Australia and the United States

This paper reviews social and legal issues in the current euthanasia debate. Focusing on Australia and the United States, the author argues that the legalization of physician-assisted suicide ( PAS ) and/or active voluntary euthanasia ( AVE ) is inevitable within the short to medium term, given recent developments which have undermined the sanctity of life ethic. Legal factors supporting this assessment include the changing definition of death, the growth of a legallyrecognized right to self-determination extending to the withdrawal of life-support, and the recognition by some courts that life support may be withdrawn without consent because life is considered to be futile. The law, in turn, reflects broader changes in prevailing social philosophies that have been greatly influenced by rising individualism, the technological revolution in medicine and the promotion of debate through television and other media. Public opinion polls, the fragmentation of medical opinion over PAS/AVE and the declining influence of churches are also creating the conditions under which legalization would be a viable social policy. This paper reviews the emerging jurisprudence establishing a fight to die in Australia, the United States and the Netherlands. In view of the likelihood of PAS/AVE reform, the author argues that it is vital to articulate a stable philosophical basis for PAS/AVE which will provide a principled basis for any further incremental derogation from the sanctity of life ethic

Global action, but national results:strengthening pathways towards better health outcomes for non-communicable diseases

Global governance of non-communicable diseases (NCDs) has moved beyond the World Health Organization (WHO) to become a shared responsibility of WHO, the United Nations General Assembly, and other willing stakeholders. Despite the significant attention NCDs have received, progress towards global goals and political commitments remains disappointing. This lack of progress calls for greater attention to be given to how actions taken at the international level can lead to improvements in health at the country level. This paper reviews progress in the global response to NCDs by highlighting the role of pathways–both current and potential–for translating global aspirations into national actions that improve health outcomes. Important pathways to national action include the development of normative instruments, political accountability mechanisms, provision of economic support and technical assistance, and other forms of engagement we refer to as ‘institutional pathways’. We find that global leadership on NCDs has focused predominantly on generating a suite of normative instruments for influencing national policy, together with global targets and reporting processes but with inadequate development assistance for NCDs, or investment in capacity building. We point to the distinctively legal and regulatory nature of many priority interventions identified by WHO for NCD prevention and control, arguing that legal capacity building of both government and civil society stakeholders is a vital, cost-effective yet neglected pathway for strengthening national responses. We outline a modest vision for global, regional and national leadership in capacity-building and in promoting the role for law in NCD prevention and control

Legal capacities required for prevention and control of noncommunicable diseases

Law lies at the centre of successful national strategies for prevention and control of noncommunicable diseases. By law we mean international agreements, national and subnational legislation, regulations and other executive instruments, and decisions of courts and tribunals. However, the vital role of law in global health development is often poorly understood, and eclipsed by other disciplines such as medicine, public health and economics. This paper identifies key areas of intersection between law and noncommunicable diseases, beginning with the role of law as a tool for implementing policies for prevention and control of leading risk factors. We identify actions that the World Health Organization and its partners could take to mobilize the legal workforce, strengthen legal capacity and support effective use of law at the national level. Legal and regulatory actions must move to the centre of national noncommunicable disease action plans. This requires high-level leadership from global and national leaders, enacting evidence-based legislation and building legal capacities

Advancing the Right to Health: The Vital Role of Law

Effective laws and an enabling legal environment are essential to a healthy society. Most public health challenges – from infectious and non-communicable diseases to injuries, from mental illness to universal health coverage – have a legal component. At global, national and local levels, law is a powerful tool for advancing the right to health. This tool is, however, often underutilized. This report aims to raise awareness about the role that public health laws can play in advancing the right to health and in creating the conditions for all people to live healthy lives. The report provides guidance about issues and requirements to be addressed during the process of developing or reforming public health laws, with case studies drawn from countries around the world to illustrate effective practices and critical features of effective public health legislation. Advancing the right to health: the vital role of law is the result of a collaboration between the World Health Organisation, the International Development Law Organisation (IDLO), the O’Neill Institute for National and Global Health Law, Washington D.C., USA, and Sydney Law School, University of Sydney. The Project Directors were: Professor Lawrence O. Gostin, Linda D. and Timothy J. O’Neill Professor of Global Health Law and University Professor, Georgetown University; Faculty Director, O’Neill Institute for National and Global Health Law, Georgetown University; Mr David Patterson, Senior Legal Expert – Health; Department of Research & Learning, International Development Law Organization; Professor Roger Magnusson, Professor of Health Law & Governance, Sydney Law School, University of Sydney; Mr Oscar Cabrera, Executive Director, O’Neill Institute for National and Global Health Law, Georgetown University Law Center; Ms Helena Nygren-Krug (2011–2013), Senior Advisor, Human Rights & Law, UNAIDS. The content and structure of the report reflect the consensus reached at the second of two international consultations in public health law that preceded the preparation of the report, hosted by WHO and IDLO in Cairo, Egypt, 26-28 April 2010. Part 1 introduces the human right to health and its role in guiding and evaluating law reform efforts, including efforts to achieve the goal of universal health coverage. Part 2 discusses the process of public health law reform. The law reform process refers to the practical steps involved in advancing the political goal of law reform, and the kinds of issues and obstacles that may be encountered along the way. Part 2 identifies some of the actors who may initiate or lead the public health law reform process, discusses principles of good governance during that process, and ways of building a consensus around the need for public health law reform. Part 3 turns from the process of reforming public health laws to the substance or content of those laws. It identifies a number of core areas of public health practice where regulation is essential in order to ensure that governments (at different levels) discharge their basic public health functions. Traditionally, these core areas of public health practice have included: the provision of clean water and sanitation, monitoring and surveillance of public health threats, the management of communicable diseases, and emergency powers. Building on these core public health functions, Part 3 goes on to consider a range of other public health priorities where law has a critical role to play. These priorities include tobacco control, access to essential medicines, the migration of health care workers, nutrition, maternal, reproductive and child health, and the role of law in advancing universal access to quality health services for all members of the population. The report includes many examples that illustrate the ways in which different countries have used law to protect the health of their populations in ways that are consistent with their human rights obligations. Countries vary widely in terms of their constitutional structure, size, history and political culture. For these reasons, the examples given are not intended to be prescriptive, but to provide useful comparisons for countries involved in the process of legislative review

The healthiness of food and beverage advertising on Sydney train stations: regulation and policy implications

The results of this study highlight the inadequacy of Australia’s voluntary self-regulatory system in protecting train commuters from exposure to unhealthy food and beverage advertising. Regulatory action by state government, such as placing a cap on the number of discretionary food advertisements per station, is required to address this issue

Optical and mechanical properties of amorphous Mg-Si-O-N thin films deposited by reactive magnetron sputtering

In this work, amorphous thin films in Mg-Si-O-N system were prepared in order to investigate the dependence of optical and mechanical properties on Mg composition. Reactive RF magnetron co-sputtering from magnesium and silicon targets were used for the deposition of Mg-Si-O-N thin films. Films were deposited on float glass, silica wafers and sapphire substrates in an Ar, N2 and O2 gas mixture. X-ray photoelectron spectroscopy, atomic force microscopy, scanning electron microscopy, spectroscopic ellipsometry, and nanoindentation were employed to characterize the composition, surface morphology, and properties of the films

Non-communicable diseases and global health governance: enhancing global processes to improve health development

This paper assesses progress in the development of a global framework for responding to non-communicable diseases, as reflected in the policies and initiatives of the World Health Organization (WHO), World Bank and the UN: the institutions most capable of shaping a coherent global policy. Responding to the global burden of chronic disease requires a strategic assessment of the global processes that are likely to be most effective in generating commitment to policy change at country level, and in influencing industry behaviour. WHO has adopted a legal process with tobacco (the WHO Framework Convention on Tobacco Control), but a non-legal, advocacy-based approach with diet and physical activity (the Global Strategy on Diet, Physical Activity and Health). The paper assesses the merits of the Millennium Development Goals (MDGs) and the FCTC as distinct global processes for advancing health development, before considering what lessons might be learned for enhancing the implementation of the Global Strategy on Diet. While global partnerships, economic incentives, and international legal instruments could each contribute to a more effective global response to chronic diseases, the paper makes a special case for the development of international legal standards in select areas of diet and nutrition, as a strategy for ensuring that the health of future generations does not become dependent on corporate charity and voluntary commitments. A broader frame of reference for lifestyle-related chronic diseases is needed: one that draws together WHO's work in tobacco, nutrition and physical activity, and that envisages selective use of international legal obligations, non-binding recommendations, advocacy and policy advice as tools of choice for promoting different elements of the strategy