Judicial Review and Parliamentary Debate: Enriching the Doctrine of Due Deference

Recent cases in the European Court of Human Rights have placed greater emphasis on the quality of legislative debate when determining whether to apply the margin of appreciation to the decisions of member States. This paper explores how courts in general might go about assessing the quality of legislative debate about rights, and presents a set of criteria against which such debate can be assessed. While pushing at the boundaries of constitutional orthodoxy, this paper looks ahead to a framework of democratic dialogue where sovereignty is shared between courts, Parliament and other constitutional organs. In this context, it argues that courts ought to defer where certain criteria are met in the process of parliamentary deliberation on the rights questions which come before them

Measurement of CO3-610, a Potential Liver Biomarker Derived from Matrix Metalloproteinase-9 Degradation of Collagen Type III, in a Rat Model of Reversible Carbon-Tetrachloride-Induced Fibrosis

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Association between the 2008–09 Seasonal Influenza Vaccine and Pandemic H1N1 Illness during Spring–Summer 2009: Four Observational Studies from Canada

In three case-control studies and a household transmission cohort, Danuta Skowronski and colleagues find an association between prior seasonal flu vaccination and increased risk of 2009 pandemic H1N1 flu

Infliximab versus second intravenous immunoglobulin for treatment of resistant Kawasaki disease in the USA (KIDCARE): a randomised, multicentre comparative effectiveness trial

Background Although intravenous immunoglobulin (IVIG) is effective therapy for Kawasaki disease, 10–20% of patients have recrudescent fever as a sign of persistent inflammation and require additional treatment. We aimed to compare infliximab with a second infusion of IVIG for treatment of resistant Kawasaki disease. Methods In this multicentre comparative effectiveness trial, patients (aged 4 weeks to 17 years) with IVIG resistant Kawasaki disease and fever at least 36 h after completion of their first IVIG infusion were recruited from 30 hospitals across the USA. Patients were randomly assigned (1:1) to second IVIG (2 g/kg over 8–12 h) or intravenous infliximab (10 mg/kg over 2 h without premedication), by using a randomly permuted block randomisation design with block size of two or four. Patients with fever 24 h to 7 days following completion of first study treatment crossed over to receive the other study treatment. The primary outcome measure was resolution of fever at 24 h after initiation of study treatment with no recurrence of fever attributed to Kawasaki disease within 7 days post-discharge. Secondary outcome measures included duration of fever from enrolment, duration of hospitalisation after randomisation, and changes in markers of inflammation and coronary artery Z score. Efficacy was analysed in participants who received treatment and had available outcome values. Safety was analysed in all randomised patients who did not withdraw consent. This clinical trial is registered with ClinicalTrials.gov, NCT03065244. Findings Between March 1, 2017, and Aug 31, 2020, 105 patients were randomly assigned to treatment and 103 were included in the intention-to-treat population (54 in the infliximab group, 49 in the second IVIG group). Two patients randomised to infliximab did not receive allocated treatment. The primary outcome was met by 40 (77%) of 52 patients in the infliximab group and 25 (51%) of 49 patients in the second IVIG infusion group (odds ratio 0·31, 95% CI 0·13–0·73, p=0·0076). 31 patients with fever beyond 24 h received crossover treatment: nine (17%) in the infliximab group received second IVIG and 22 (45%) in second IVIG group received infliximab (p=0·0024). Three patients randomly assigned to infliximab and two to second IVIG with fever beyond 24h did not receive crossover treatment. Mean fever days from enrolment was 1·5 (SD 1·4) for the infliximab group and 2·5 (2·5) for the second IVIG group (p=0·014). Mean hospital stay was 3·2 days (2·1) for the infliximab group and 4·5 days (2·5) for the second IVIG group (p<0·001). There was no difference between treatment groups for markers of inflammation or coronary artery outcome. 24 (44%) of 54 patients in the infliximab group and 33 (67%) of 49 in the second IVIG group had at least one adverse event. A drop in haemoglobin concentration of at least 2g/dL was seen in 19 (33%) of 58 patients who received IVIG as either their first or second study treatment (three of whom required transfusion) and in three (7%) of 43 who received only infliximab (none required transfusion; p=0·0028). Haemolytic anaemia was the only serious adverse events deemed definitely or probably related to study treatment, and was reported in nine (15%) of 58 patients who received IVIG as either their first or second study treatment and none who received infliximab only. Interpretation Infliximab is a safe, well tolerated, and effective treatment for patients with IVIG resistant Kawasaki disease, and results in shorter duration of fever, reduced need for additional therapy, less severe anaemia, and shorter hospitalisation compared with second IVIG infusion

Rethinking torture in international law

This thesis seeks to identify the moral wrong of torture, and to trace the relationship between that wrong and the definition of torture in international law. Because understanding a concept's modern manifestation requires an understanding of its history, the thesis begins by tracing the historical trajectory of legal prohibitions of different forms of ill-treatment beginning with the English Bill of Rights in 1689, subsequently articulated in the 1948 Universal Declaration of Human Rights, that 'no one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment'. This prohibition, almost universally accepted by States, has come to be interpreted as embodying a hierarchy with torture at the apex. The shift towards a hierarchical interpretation of the prohibition of torture and ill-treatment in international law was remarkable, both for its decisiveness and for its surprisingly recent occurrence. The reasons for that shift are examined, before turning to a consideration of the competing accounts of what it is that makes torture wrong. Two predominant accounts of the moral wrong of torture are identified, described here as the ‘dignitarian’ and the 'defencelessness' accounts. Although most international instruments and judicial decisions on torture implicitly reflect the dignitarian account, the thesis argues that this account is open to challenge on normative grounds. Instead, it argues that the preferable account of the moral wrong of torture is a modified form of the defencelessness account, according to which torture is the deliberate infliction of severe pain or suffering in the context of a profoundly asymmetric power relation. Finally, the thesis turns to a consideration of the definitions of torture in international law. It contends that there are distinct conceptions of torture operating in the criminal paradigm, and in the human rights paradigm, respectively. While both conceptions of torture at present reflect the dignitarian account, the thesis argues that there is scope in the human rights paradigm for a more expansive 'defencelessness' conception of torture to be adopted.</p

Rethinking torture in international law

This thesis seeks to identify the moral wrong of torture, and to trace the relationship between that wrong and the definition of torture in international law. Because understanding a concept's modern manifestation requires an understanding of its history, the thesis begins by tracing the historical trajectory of legal prohibitions of different forms of ill-treatment beginning with the English Bill of Rights in 1689, subsequently articulated in the 1948 Universal Declaration of Human Rights, that 'no one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment'. This prohibition, almost universally accepted by States, has come to be interpreted as embodying a hierarchy with torture at the apex. The shift towards a hierarchical interpretation of the prohibition of torture and ill-treatment in international law was remarkable, both for its decisiveness and for its surprisingly recent occurrence. The reasons for that shift are examined, before turning to a consideration of the competing accounts of what it is that makes torture wrong. Two predominant accounts of the moral wrong of torture are identified, described here as the âdignitarianâ and the 'defencelessness' accounts. Although most international instruments and judicial decisions on torture implicitly reflect the dignitarian account, the thesis argues that this account is open to challenge on normative grounds. Instead, it argues that the preferable account of the moral wrong of torture is a modified form of the defencelessness account, according to which torture is the deliberate infliction of severe pain or suffering in the context of a profoundly asymmetric power relation. Finally, the thesis turns to a consideration of the definitions of torture in international law. It contends that there are distinct conceptions of torture operating in the criminal paradigm, and in the human rights paradigm, respectively. While both conceptions of torture at present reflect the dignitarian account, the thesis argues that there is scope in the human rights paradigm for a more expansive 'defencelessness' conception of torture to be adopted.</p

A critique of the decision of the European Court of Human Rights in Ireland v United Kingdom, and its effect on Article 3 jurisprudence

Article 3 of the European Convention on Human Rights ostensibly provides absolute protection against torture and inhuman or degrading treatment or punishment. Despite what the Court says, this protection is not unqualified. Article 3 now embodies a two-tiered protection, with torture alone attracting a ‘special stigma’. This hierarchical approach is traceable to the seminal decision of Ireland v United Kingdom, and Part A of this thesis demonstrates that it is deeply flawed. The hierarchy between torture and other forms of ill-treatment (the Ireland hierarchy) has become entrenched in the Court’s case law. It continues to manifest in the Court’s narrow definition of torture, and its expansive interpretation of inhuman and degrading treatment. This thesis argues that the growing breadth of the latter concept has occurred in tandem with, and may partly explain, the rapid increase in the number of Article 3 violations found by the Court each year. These developments have carried important consequences. There have been policy consequences for the member states in areas such as national security (where deportation of terrorist suspects is sought to be used as a policy tool) and prisoners’ rights (where the proportionality of sentences, conditions of detention and administrative penalties within prisons, are all now subject to European supervision). In addition to the policy consequences, the expanding second tier of the Ireland hierarchy has carried legal consequences for the Court’s conception of Article 3. It has compelled the Court to introduce limiting devices into its case law on inhuman and degrading treatment. The introduction of these limiting devices, into what is an ostensibly unqualified domain, challenges the position of Article 3 as an absolute right.</p

Judicial Review and Parliamentary Debate: Enriching the Doctrine of Due Deference

Recent cases in the European Court of Human Rights have placed greater emphasis on the quality of legislative debate when determining whether to apply the margin of appreciation to the decisions of member States. This paper explores how courts in general might go about assessing the quality of legislative debate about rights, and presents a set of criteria against which such debate can be assessed. While pushing at the boundaries of constitutional orthodoxy, this paper looks ahead to a framework of democratic dialogue where sovereignty is shared between courts, Parliament and other constitutional organs. In this context, it argues that courts ought to defer where certain criteria are met in the process of parliamentary deliberation on the rights questions which come before them