Access, equity and the role of rights in health care

Modern health care rhetoric promotes choice and individual patient rights as dominant values. Yet we also accept that in any regime constrained by finite resources, difficult choices between patients are inevitable. How can we balance rights to liberty, on the one hand, with equity in the allocation of scarce resources on the other? For example, the duty of health authorities to allocate resources is a duty owed to the community as a whole, rather than to specific individuals. Macro-duties of this nature are founded on the notion of equity and fairness amongst individuals rather than personal liberty. They presume that if hard choices have to be made, they will be resolved according to fair and consistent principles which treat equal cases equally, and unequal cases unequally. In this paper, we argue for greater clarity and candour in the health care rights debate. With this in mind, we discuss (1) private and public rights, (2) negative and positive rights, (3) procedural and substantive rights, (4) sustainable health care rights and (5) the New Zealand booking system for prioritising access to elective services. This system aims to consider: individual need and ability to benefit alongside the resources made available to elective health services in an attempt to give the principles of equity practical effect. We describe a continuum on which the merits of those, sometimes competing, values-liberty and equity-can be evaluated and assessed.

Implications of Commons Act 2006 for the registration of land as a town or village green

This paper describes the main changes of Commons Act 2006 for the registration of land as a town or village green. The purpose of the Commons Act 2006 is to protect common land and promote sustainable farming, public access to the countryside and the interests of wildlife. The changes under s15 of the Commons Act 2006 include the additional 2-year grace period for application, discounting statutory period of closure, correction of mistakes in registers, disallowing severance of rights, voluntary registration, replacement of land in exchange and some other provisions. The transitional provision contained in s15(4) Commons Act 2006 is particularly a cause for controversy as DEFRA has indicated buildings will have to be taken down where development has gone ahead and a subsequent application to register the land as a green is successful, obliging the developer to return the land to a condition consistent with the exercise by locals of recreational rights, which sums up that it would be harder in future to develop land which has the potential to be registered as a town or village green.

Republicanism, rights and democratic Athens

Cartledge and Edge (2010) argue that the modern republican tradition offers a useful framework for understanding the Athenian concept of freedom; and that within this framework the Athenians protected their freedoms without reference to any concept of rights. This paper agrees with both of these conclusions but identifies and corrects three assumptions behind Cartledge and Edge’s argument: that the only purpose of rights is to protect individual freedoms against the state; that rights have no place at all in the republican tradition; and that the ancient Greeks did not understand rights. In fact the Athenians did have an understanding of rights but they did not use rights to protect freedoms. The reason for this is that the protected freedom is a very modern and particularly sophisticated application of the concept of rights.

The role of the consumer-citizen in environmental protest in the 1990s

This paper links market‐based ‘protest’ strategies, as used recently by environmental protest groups and other sociations, to citizenship theory, seeking to open a debate about the role of the consumer‐citizen. It is suggested that such consumer‐citizenship, whereby protest and political action are encouraged through market mechanisms, and limited through state action, is an important feature of late‐modernity. The paper seeks to illustrate how advanced capitalist societies are producing reworked forms of rights relationships. This is discussed within the context of the rhetoric of ‘active’ citizenship as used in UK politics and through examples of recent environmental protests and other consumer‐citizen strategies.

EU membership of the WTO: international trade disputes and judicial protection of individuals by EU Courts

The European Union (EU) is embedded in a pluralistic legal context because of the EU and its Member States’ treaty memberships and domestic laws. Where EU conduct has implications for both the EU’s international trade relations and the legal position of individual traders, it possibly affects EU and its Member States’ obligations under the law of the World Trade Organization (WTO law) as well as the Union’s own multi-layered constitutional legal order. The present paper analyses the way in which the European Court of Justice (ECJ) accommodates WTO and EU law in the context of international trade disputes triggered by the EU. Given the ECJ’s denial of direct effect of WTO law in principle, the paper focuses on the protection of rights and remedies conferred by EU law. It assesses the implications of the WTO Dispute Settlement Understanding (DSU) – which tolerates the acceptance of retaliatory measures constraining traders’ activities in sectors different from those subject to the original trade dispute (Bananas and Hormones cases) – for the protection of ‘retaliation victims’. The paper concludes that governmental discretion conferred by WTO law has not affected the applicability of EU constitutional law but possibly shapes the actual scope of EU rights and remedies where such discretion is exercised in the EU’s general interest.

Raz on rights: human rights, fundamental rights and balancing

After clarifying the outlines of Raz’s interest theory of rights and its relationship to aspects of the principles theory of rights, I consider how his recent observations on human rights fit (or fail to fit) into the interest theory. I then address two questions. First, I elaborate on Raz’s definition of morally fundamental rights, arguing that he is right in claiming that there are no such rights. I then show that the interest theory accommodates the notion that rights may take qualitative precedence over conflicting considerations – a question that has become increasingly relevant in light of recent writing on rights.

Intellectual property management in M&A transactions

Purpose – The purpose of this paper is to focus on the intellectual property (IP) aspects of mergers and acquisitions (M&A) transactions. Design/methodology/approach – A holistic approach is proposed that embraces IP as an integral part of the M&A process in the form of a roadmap for the strategic and purposeful management of IP assets in M&A deals. Findings – Addressing IP issues in transactions in isolation can lead to undesirable consequences (e.g. considerable costs for unplanned purchases of rights). IP due diligence and IP integration project processes can be automated using collaborative software solutions. Thereby, risk can be reduced through the creation of a high level of transparency and predefined responsibilities. Practical implications – Although the proposed IP management framework is based on intellectual property matters relevant to German jurisdiction, conclusions derived and the proposed roadmap are transferable to other jurisdictions and hence have a broader relevance. Evidence for this is provided by the successful application of the roadmap in the context of the multinational transaction stated above. Originality/value – This paper is based on the authors' collective experience, insight and reflected observation of M&A practice gained in advisory M&A roles in management consultancies over a period of more than a decade. The paper summarizes the authors' reflections and observations and brings these into the context of the current management literature. Moreover, this paper builds on earlier published research.

Plant variety protection in developing countries: A view from the private seed industry in India

Many developing countries are currently engaged in designing and implementing plant variety protection systems. Encouraging private investment in plant breeding is the key rationale for extending intellectual property rights to plant varieties. However, the design of plant variety protection systems in developing countries has been dominated by concerns regarding the inequities of a plant variety protection system, especially the imbalance in the reward structure between plant breeders and farmers. The private seed industry, a key stakeholder in plant variety protection, appears to be playing only a peripheral role in the design of the intellectual property rights regime. This paper explores the potential response of the private seed industry in India to plant variety protection legislation based on a survey of major plant breeding companies. The survey finds that the private seed industry in India is generally unenthusiastic about the legislation and plant variety protection is likely to have only a very limited impact on their research profile and expenditures on plant breeding. Measures designed to curb the 'excessive' profits of breeders, farmers' rights provisions and poor prospects for enforcement of rights are seen to be seriously diluting breeders' rights, leaving few incentives for innovation. If the fundamental objective of plant variety protection is to stimulate private investment in plant breeding, then developing countries need to seriously address the question of improving appropriability of returns from investment.

Muscle hypertrophy driven by myostatin blockade does not require stem/precursor-cell activity

Myostatin, a member of the TGF-beta family, has been identified as a powerful inhibitor of muscle growth. Absence or blockade of myostatin induces massive skeletal muscle hypertrophy that is widely attributed to proliferation of the population of muscle fiber-associated satellite cells that have been identified as the principle source of new muscle tissue during growth and regeneration. Postnatal blockade of myostatin has been proposed as a basis for therapeutic strategies to combat muscle loss in genetic and acquired myopathies. But this approach, according to the accepted mechanism, would raise the threat of premature exhaustion of the pool of satellite cells and eventual failure of muscle regeneration. Here, we show that hypertrophy in the absence of myostatin involves little or no input from satellite cells. Hypertrophic fibers contain no more myonuclei or satellite cells and myostatin had no significant effect on satellite cell proliferation in vitro, while expression of myostatin receptors dropped to the limits of detectability in postnatal satellite cells. Moreover, hypertrophy of dystrophic muscle arising from myostatin blockade was achieved without any apparent enhancement of contribution of myonuclei from satellite cells. These findings contradict the accepted model of myostatin-based control of size of postnatal muscle and reorient fundamental investigations away from the mechanisms that control satellite cell proliferation and toward those that increase myonuclear domain, by modulating synthesis and turnover of structural muscle fiber proteins. It predicts too that any benefits of myostatin blockade in chronic myopathies are unlikely to impose any extra stress on the satellite cells.

Hydrochemical processes in lowland rivers: insights from in situ, high-resolution monitoring

This paper introduces new insights into the hydrochemical functioning of lowland river systems using field-based spectrophotometric and electrode technologies. The streamwater concentrations of nitrogen species and phosphorus fractions were measured at hourly intervals on a continuous basis at two contrasting sites on tributaries of the River Thames – one draining a rural catchment, the River Enborne, and one draining a more urban system, The Cut. The measurements complement those from an existing network of multi-parameter water quality sondes maintained across the Thames catchment and weekly monitoring based on grab samples. The results of the sub-daily monitoring show that streamwater phosphorus concentrations display highly complex dynamics under storm conditions dependent on the antecedent catchment wetness, and that diurnal phosphorus and nitrogen cycles occur under low flow conditions. The diurnal patterns highlight the dominance of sewage inputs in controlling the streamwater phosphorus and nitrogen concentrations at low flows, even at a distance of 7 km from the nearest sewage treatment works in the rural River Enborne. The time of sample collection is important when judging water quality against ecological thresholds or standards. An exhaustion of the supply of phosphorus from diffuse and multiple septic tank sources during storm events was evident and load estimation was not improved by sub-daily monitoring beyond that achieved by daily sampling because of the eventual reduction in the phosphorus mass entering the stream during events. The results highlight the utility of sub-daily water quality measurements and the discussion considers the practicalities and challenges of in situ, sub-daily monitoring.

Whatever works: proportionality as a constitutional doctrine

In The Global Model of Constitutional Rights Kai Möller claims that the proportionality test is underlain by an expansive moral right to autonomy. This putative right protects everything that advances one’s self-conception. It may of course be limited when balanced against other considerations such as the rights of others. But it always creates a duty on the state to justify the limitation. Möller further contends that the practice of proportionality can best be understood as protecting the right to autonomy. This review article summarizes the main tenets of Möller’s theory and criticizes them on two counts. First, it disputes the existence of a general right to autonomy; such a right places an unacceptably heavy burden on others. Second, it argues that we do not need to invoke a right to autonomy to explain and justify the main features of the practice of proportionality. Like other constitutional doctrines, proportionality is defensible, if it is grounded in pragmatic –mainly epistemic and institutional- considerations about how to increase overall rights compliance. These considerations are independent of any substantive theory of rights.

Climate justice in a carbon budget

The fact of a carbon budget given commitment to limiting global-mean temperature increase to below 2°C warming relative to pre-industrial levels makes CO2 emissions a scarce resource. This fact has significant consequences for the ethics of climate change. The paper highlights some of these consequences with respect to (a) applying principles of distributive justice to the allocation of rights to emissions and the costs of mitigation and adaptation, (b) compensation for the harms and risks of climate change, (c) radical new ideas about a place for criminal justice in tackling climate change, and (d) catastrophe ethics.