The legitimacy of the UN Security Council: evidence from recent General Assembly debates

Existing research on the legitimacy of the UN Security Council is conceptual or theoretical, for the most part, as scholars tend to make legitimacy assessments with reference to objective standards. Whether UN member states perceive the Security Council as legitimate or illegitimate has yet to be investigated systematically; nor do we know whether states care primarily about the Council's compliance with its legal mandate, its procedures, or its effectiveness. To address this gap, our article analyzes evaluative statements made by states in UN General Assembly debates on the Security Council, for the period 1991–2009. In making such statements, states confer legitimacy on the Council or withhold legitimacy from it. We conclude the following: First, the Security Council suffers from a legitimacy deficit because negative evaluations of the Council by UN member states far outweigh positive ones. Nevertheless, the Council does not find itself in an intractable legitimacy crisis because it still enjoys a rudimentary degree of legitimacy. Second, the Council's legitimacy deficit results primarily from states' concerns regarding the body's procedural shortcomings. Misgivings as regards shortcomings in performance rank second. Whether or not the Council complies with its legal mandate has failed to attract much attention at all.

Investigating the prevalence and causes of prescribing errors in general practice: the PRACtICe Study

Aim: To determine the prevalence and nature of prescribing errors in general practice; to explore the causes, and to identify defences against error. Methods: 1) Systematic reviews; 2) Retrospective review of unique medication items prescribed over a 12 month period to a 2% sample of patients from 15 general practices in England; 3) Interviews with 34 prescribers regarding 70 potential errors; 15 root cause analyses, and six focus groups involving 46 primary health care team members Results: The study involved examination of 6,048 unique prescription items for 1,777 patients. Prescribing or monitoring errors were detected for one in eight patients, involving around one in 20 of all prescription items. The vast majority of the errors were of mild to moderate severity, with one in 550 items being associated with a severe error. The following factors were associated with increased risk of prescribing or monitoring errors: male gender, age less than 15 years or greater than 64 years, number of unique medication items prescribed, and being prescribed preparations in the following therapeutic areas: cardiovascular, infections, malignant disease and immunosuppression, musculoskeletal, eye, ENT and skin. Prescribing or monitoring errors were not associated with the grade of GP or whether prescriptions were issued as acute or repeat items. A wide range of underlying causes of error were identified relating to the prescriber, patient, the team, the working environment, the task, the computer system and the primary/secondary care interface. Many defences against error were also identified, including strategies employed by individual prescribers and primary care teams, and making best use of health information technology. Conclusion: Prescribing errors in general practices are common, although severe errors are unusual. Many factors increase the risk of error. Strategies for reducing the prevalence of error should focus on GP training, continuing professional development for GPs, clinical governance, effective use of clinical computer systems, and improving safety systems within general practices and at the interface with secondary care.

Putting the Canal on the map: Panamanian agenda-setting and the 1973 Security Council meetings

In the early 1970s, Panama’s negotiations with the United States over the status of the Panama Canal ground to a standstill. General Omar Torrijos had rejected treaties left unratified by previous governments only to receive a less generous offer from the Nixon administration. Realizing that the talks were being ignored in Washington, the Panamanian government worked to internationalize the previously bilateral issue, creating and exploiting a high-profile forum: Extraordinary meetings of the UN Security Council in March 1973 held in Panama City. In those meetings, Panama isolated the United States in order to raise the issue’s profile and amplify the costs of leaving the matter unsettled. Using underutilized Panamanian sources, this article examines that meeting, the succeeding progress, and the effect of this early stage on the final negotiations several years later. The case also illustrates how, during the unsettled international environment of the 1970s, a small state utilized international organizations to obtain attention and support for its most important cause.