Bringing It All Together: Leveraging Social Movements and the Courts to Advance Substantive Human Rights and Climate Justice

Although significant literature and jurisprudence has amassed on rights-based climate litigation over recent years, less research and case law has emerged on poverty-related court cases and the fulfilment of economic, social, and cultural rights (ESCR) in Canada. Fewer still are studies exploring the interlinkages between these areas of inquiry. The purpose of this paper is to explore, using Canada as a case study, rights-based developments in climate litigation cases and how these could impact the innovative advancement of ESCR (e.g. to food, housing and water). Typically, issues of justiciability and standing emerge, impeding the realization of such rights. Given the grave threats we now face, climate cases and social movements must be brought together to better hold state actors accountable for their rights obligations. We implore the legal community to explore ways to traverse juridical obstacles to realize the interdependencies of human rights and protect the planet from calamitous climate change.

Ensuring oversight and protection of life, health and well-being of all detained by the Russian Federation and in Russian controlled territories of Ukraine

OBJECTIVES

Military action by Russian forces against Ukraine commenced on 24 February 2022. The Office of the United Nations High Commissioner for Human Rights has observed serious human rights violations in the context of the Ukraine war. A range of people are detained, not limited to those meeting the definition of prisoners of war, or prisoners, but including Russian soldiers who refuse to fight and the enforced disappearance of Ukrainian civilians.

STUDY DESIGN

This is a Commentary article.

METHODS

This Commentary concerns the detainee's right to humane conditions of detention and right to life, health and well-being (including access to medical care) when in detention in Russian-controlled territories of Ukraine and when transported into and detained in the Russian Federation itself.

RESULTS

There is evidence of violations of the rules of war and of fundamental human rights. Prohibition of torture and other ill treatment of people deprived of their liberty is shared across international human rights and humanitarian law frameworks.

CONCLUSIONS

Russia will leave the European Court of Human Rights on 16 September 2022. The United Nations Human Rights Council must swiftly respond and create new mechanisms to monitor Russian detention standards and uphold fundamental human rights to protect the lives, health and well-being of those detained, regardless of their status as prisoner, prisoner of war or other.

Dignity at the end of life: from philosophy to health care practice - Lithuanian case

Regulation and clinical practices regarding end of human life care differ among the nations and countries. These differences reflect the history of the development of state health systems, different societal values, and different understandings of dignity and what it means to protect or respect dignity. The result is variation in the ethical, legal, and practical approaches to end-of-life issues. The article analyzes the diversity of strategies to strengthen dignity at the end of life of terminally ill patients and to highlight the legal preconditions and limitations for implementing these strategies in independent Lithuania, as a former state of the Soviet Union. It is based on the critical analysis of philosophical literature, legal national and international documents and scientific evidence related to the issue. The author argues that the legal system in Lithuania is not sufficient to ensure the patient's dignity at the end of life and remains far behind other Western European countries. Legal regulations in Lithuania do not guarantee the right of the patient to express his or her will regarding the future treatment, including the refusal of resuscitation, do not regulate the termination of burdensome, non-viable and meaningless treatment that is undesired by the patient, and limit the accessibility of palliative care with its necessary quality and comfort.

The human right to safely give birth: data from 193 countries show that gender equality does affect maternal mortality

BACKGROUND

While a reduction in the global maternal mortality ratio (MMR) has slowed, newer strategies are needed to achieve an ongoing and sustainable reduction of the MMR. Previous studies have investigated the association between health system-related factors such as wealth inequalities, healthcare access and use on maternal mortality. However, a women's rights-based approach to address MMR has not been studied, excluding the health system-related factors. This study aimed to analyse the association between gender equality and MMR globally.

METHODS

Using structural equation modelling (SEM), secondary and open access data from the United Nations and other international agencies from 193 countries were analysed using structural equation modelling (SEM). Gender-sensitive variables that represented the theoretical, conceptual framework of the study were selected. The association between latent variable gender equality and the outcome, MMR, was examined in the SEM. A second SEM model (n = 158) was designed to include two variables related to gender-based violence.

FINDINGS

The latent variable, gender equality, was negatively associated with MMR (p < 0‧001, Z = -6‧96, 95% CI: - 6508.98 to - 3141.89 for Model 1 and p < 0‧001, Z = -7‧23, 95% CI: - 6045.356 to - 3467.515 for Model 2).

INTERPRETATION

Gender equality was significantly associated with maternal mortality. Investing in higher education for women, improving their paid employment opportunities, increasing participation in leadership roles and politics, reducing intimate partner violence (IPV) and ending child marriage can significantly reduce maternal mortality.

Vulnerability and Entitlements

The article examines the merits of both human rights and citizenship as systems to protect vulnerable individuals. The idea of vulnerability is presented as a more reliable concept than the dignity of the individual in comparative research. The body is basic to vulnerability.

Introduction: Human rights and global health special issue

The emergence of the field of health and human rights during the closing decades of the twentieth century offered the promise of an important shift of perspective within global health. It has been increasingly questioned, however, to what extent the health and human rights framework has indeed succeeded in ushering in a new era of global health governance and justice, as the topic has remained marginalised, marked by regional inequalities, and often dominated by legalist visions and global North perspectives. The articles and commentaries in this special issue seek to create a space where a number of other perspectives and voices can be part of the discussion. They add new perspectives and offer roadmaps for how to rewire the ways in which knowledge is constructed and relationships are formed in the field of health and human rights. In doing so, they present important possibilities for how to build a more just and egalitarian field.

[Suicide prevention in the context of assisted suicide]

The verdict of the German Federal Constitutional Court from 26 February 2020 made it clear that every person is granted the right to end his or her own life, provided it is the person's own free will. It is also within his or her rights to utilize assistance in doing so, if such assistance is offered. This freedom to end one's life and to utilize assistance is not limited to terminal illnesses or situations of unbearable suffering. However, the High Court has also demanded that lawmakers ensure the safety of vulnerable people by making certain that the decision for suicide is in fact made out of the person's own free will. This free decision-making capability can be substantially impaired by acute psychosocial stressors, by mental illnesses but also by third party influence. Therefore, a liberalization of assisted suicide must unconditionally be accompanied by a massive strengthening of suicide prevention measures, which clearly prioritize the help to live over the help to die. This article reviews the scientifically established methods for suicide prevention and makes demands to lawmakers to comprehensively implement such measures.

Scientists' warning on population

Humanity must commit to transformative change on all levels in order to address the climate emergency and biodiversity collapse. In particular, stabilizing and ultimately reducing the human population size is necessary to ensure the long-term wellbeing of our species and other life on Earth. We show how this transition can be accomplished in an equitable framework that promotes human rights. Specifically, we issue a global appeal for women and men to have at most one child and call for policy-makers to implement population policies that improve education for girls and young women and ensure the availability of high-quality family-planning services.

The Public Health Response to COVID-19 in Vietnam: Decentralization and Human Rights

Human rights constitute a universal concern in different countries’ responses to COVID-19. Vietnam is internationally praised for its success in containing the pandemic; nevertheless, human rights issues are a key area that needs to be assessed and improved. Little legal and ethical research is available on human rights in Vietnam, particularly in its response to COVID-19, however. In Vietnam, decentralization took place during the pandemic: higher authorities delegated power to lower ones to make and implement public health measures. Unfortunately, many measures made and implemented decentrally caused human rights concerns or breaches. This article aims to study what makes such measures cause human rights concerns or breaches. It argues that several social, legal, and political factors, including an inadequate understanding of human rights, the undefined breadth of discretion, and lack of supervision, are underlying factors for such problematic decentralized measures. Accordingly, this paper proposes two solutions (i) improving the supervision of the decentralization process, and (ii) improving the understanding of human rights. While Vietnam should learn from the international community to improve its measures, lessons and experience from Vietnam can also contribute to a richer dialogue and better protection of human rights globally.

The United States detention system for migrants: Patterns of negligence and inconsistency

The United States of America (US) detains more migrants than any other nation. Customs and Border Patrol (CBP) and Immigration and Customs Enforcement (ICE) detain adults and families under the Department of Homeland Security, while unaccompanied minors are housed under the Office of Refugee Resettlement (ORR) within the Department of Health and Human Services. Migrants are subject to the standards and oversight of each individual agency and facility where they are detained. This paper presents an analysis of whether the current US migrant detention system upholds the standards of each agency to maintain the health of migrants. A review of peer and grey literature, along with interviews with key informants (KI) who had worked in or visited ICE, CBP, or ORR facilities since January 2018 were undertaken. Analysis of the literature review and KI interviews covered five thematic areas: health, protection of vulnerable populations, shelter, food and nutrition, and hygiene. Thirty-nine peer-reviewed publications and 28 US Office of Inspector General reports from 2010 to 2020 were reviewed. Seventeen KI interviews were conducted. Though all three detention agencies had significant areas of concern, CBP's inability to abide by its health standards was particularly alarming. The persistence of low compliance with standards stemmed from weak accountability mechanisms, minimal transparency, and inadequate capacity to provide essential services. We have five recommendations: (1) expand independent monitoring and evaluation mechanisms; (2) standardize health standards across the three agencies; (3) develop a systematic evaluation tool to help external visitors, including members of Congress, assess the degree of implementation of standards; (4) enforce consequences for private contractors who violate standards; and (5) restrict the use of waivers that allow detention facilities to circumvent compliance with standards. Ultimately, the US federal government should explore and implement alternatives to detention to maintain the health and dignity of the individuals under its care.

Incidence and type of restrictive practice use in nursing homes in Ireland

Background

Use of restrictive practices (RP) in care settings may sometimes be warranted but can also conflict with human rights. Research to date has focused primarily on physical and chemical RP, however other forms are also used. Better understanding of practice can inform RP reduction. This study describes the incidence of all types of RP use reported from nursing homes in Ireland.

Methods

RP notifications from nursing homes reported in 2020 were extracted from the Database of Statutory Notifications from Social Care in Ireland. The primary outcome measurement was the national incidence of use (frequency of RP/occupancy per 1000 residents) of categories and types of RP. Secondary outcome measurements such as percentage of facilities reporting use and quarterly median incidence of use in these facilities were calculated.

Results

Seventy thousand six hundred sixty-three RP uses were notified from 608 facilities (33,219 beds). National incidence of RP use per 1000 residents was, all categories: 2465.1, environmental: 1324.5, physical: 922.5, chemical: 141.1; ‘other’: 77.0. The most frequently used RPs per category were, environmental: door locks; physical: bedrails; chemical (where drug specified): antipsychotics; ‘other’: privacy. 90.5% of nursing homes reported using at least one type of RP in the 12-month period. Quarterly incidence of any RP use in these facilities was median 1.642 (IQR: 0.018 to 18.608) per bed.

Conclusions

Nursing homes in Ireland regularly use RP; only 9.5% reported no RP use in the 12-month period. A wide variety of types of RP were reported. Environmental and ‘other’ (largely psychosocial) RP contributed notably to total RP use and warrant attention alongside the traditional focus on physical and chemical RP. Policy implications include the need for more comprehensive RP definitions.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-022-03450-4.

The Academic Freedom Index and Its indicators: Introduction to new global time-series V-Dem data

The Academic Freedom Index is the first conceptually thorough assessment of academic freedom worldwide and a times series dataset going back to 1900. While some previous datasets exist, they are geographically limited and methodologically or conceptually insufficient to offer a comprehensive picture of the levels of academic freedom across time and space. This paper introduces the new expert-coded dataset that includes the overall Academic Freedom Index alongside several specific indicators, to which more than 2050 country experts around the world have contributed and which is freely available as part of V-Dem's time-series data releases. The paper discusses its advantages compared to other types of data on academic freedom, details the conceptualization of the new indicators, and offers a content and convergent validation of the results. The dataset provides ample opportunities for scholars to conduct in-depth research on academic freedom and its infringements, and for policymakers and advocates to monitor and analyze patterns and trends of academic freedom around the world.

Business Versus Ethics? Thoughts on the Future of Business Ethics

To commemorate 40 years since the founding of the Journal of Business Ethics, the editors in chief of the journal have invited the editors to provide commentaries on the future of business ethics. This essay comprises a selection of commentaries aimed at creating dialogue around the theme Business versus Ethics? (inspired by the title of the commentary by Jeffrey Harrison). The authors of these commentaries seek to transcend the age-old separation fallacy (Freeman in Bus Ethics Q 4(4):409-421, 1994) that juxtaposes business and ethics/society, posing a forced choice or trade off. Providing a contemporary take on the classical question "if it's legal is it ethical?", David Hess explores the role of the law in promoting or hindering stakeholder-oriented purpose and governance structure. Jeffrey Harrison encourages scholars to move beyond the presupposition that businesses are either strategic or ethical and explore important questions at the intersection of strategy and ethics. The proposition that business models might be inherently ethical or inherently unethical in their design is developed by Sheila Killian, who examines business systems, their morality, and who they serve. However, the conundrum that entrepreneurs are either lauded for their self-belief and risk-taking, or loathed for their self-belief and risk-taking, is discussed by M. Tina Dacin and Julia Roloff using the metaphor of taboos and totems. These commentaries seek to explore positions that advocate multiplicity and tensions in which business ethics is not either/or but both.

Public procurement of artificial intelligence systems: new risks and future proofing

Public entities around the world are increasingly deploying artificial intelligence (AI) and algorithmic decision-making systems to provide public services or to use their enforcement powers. The rationale for the public sector to use these systems is similar to private sector: increase efficiency and speed of transactions and lower the costs. However, public entities are first and foremost established to meet the needs of the members of society and protect the safety, fundamental rights, and wellbeing of those they serve. Currently AI systems are deployed by the public sector at various administrative levels without robust due diligence, monitoring, or transparency. This paper critically maps out the challenges in procurement of AI systems by public entities and the long-term implications necessitating AI-specific procurement guidelines and processes. This dual-prong exploration includes the new complexities and risks introduced by AI systems, and the institutional capabilities impacting the decision-making process. AI-specific public procurement guidelines are urgently needed to protect fundamental rights and due process.

Risk and safety profile of electronic nicotine delivery systems (ENDS): an umbrella review to inform ENDS health communication strategies

OBJECTIVES

This umbrella review aims to summarise the evidence about electronic nicotine delivery systems' (ENDS) risk and safety health profile to inform ENDS health communication strategies.

DATA SOURCES AND STUDY SELECTION

Six databases were searched for systematic reviews presenting evidence on ENDS-related health effects. Ninety reviews divided into five categories were included: toxicity=20, health effects=40, role in smoking cessation=24, role in transition to combustible cigarettes (CCs)=13 and industry marketing claims=4.

DATA EXTRACTION

Findings were synthesised in narrative summaries. Meta-analyses were conducted by study type when appropriate. Quality assessment was conducted using the Measurement Tool to Assess Systematic Reviews. The Institute of Medicine's Levels of Evidence Framework was used to classify the evidence into high-level, moderate, limited-suggestive and limited-not-conclusive.

DATA SYNTHESIS

We found high-level evidence that ENDS exposes users to toxic substances; increases the risk of respiratory disease; leads to nicotine dependence; causes serious injuries due to explosion or poisoning; increases smoking cessation in clinical trials but not in observational studies; increases CC initiation; and exposure to ENDS marketing increases its use/intention to use. Evidence was moderate for ENDS association with mental health and substance use, limited-suggestive for cardiovascular, and limited-not-conclusive for cancer, ear, ocular and oral diseases, and pregnancy outcomes.

CONCLUSIONS

As evidence is accumulating, ENDS communication can focus on high-level evidence on ENDS association with toxicity, nicotine addiction, respiratory disease, ENDS-specific harm (explosion, poisoning) and anti-ENDS industry sentiment. Direct comparison between the harm of CCs and ENDS should be avoided.

PROSPERO REGISTRATION NUMBER

CRD42021241630.

Addressing the Syndemics of HIV, Mental Health, and COVID-19 Using the Health and Human Rights Framework among Youth Living with HIV, in Uganda: an Interpretive Phenomenological Study

Stigma and discrimination negatively impact the prevention, treatment, and care of HIV. The COVID-19 pandemic increased this complexity and created a cluster of synergistic health contexts, wherein the physiological aspects of HIV and the social and environmental conditions increased the vulnerability in health outcomes for youth living with HIV (YPLHIV) in Kampala, Uganda. We used interpretive phenomenological analysis (IPA) and the syndemics framework to understand the lived experiences of YPLHIV. From December 2020 to May 2021, six qualitative focus groups were held with 31 youth living with HIV to understand the lived experiences of YPLHIV. The guided questions used were audio-recorded, transcribed verbatim, and coded for thematic analysis. Findings highlight the complexity of intersecting stigma of HIV and COVID-19 that have worsened antiretroviral treatment adherence and mental health issues due to lack of access to critical needs such as fears of food insecurity, health-related worries, the fear of perishing due to COVID-19, and human rights concerns related to gender and sexual identity. The study recommends addressing human rights-related concerns in addition to health-related concerns to comprehensively mitigate the syndemics of HIV and COVID-19 for YPLHIV in Uganda.

Challenges to the right to health in sub-Saharan Africa: reflections on inequities in access to dialysis for patients with end-stage kidney failure

Realization of the individual’s right to health in settings such as sub-Saharan Africa, where health care adequate resources are lacking, is challenging. This paper demonstrates this challenge by illustrating the example of dialysis, which is an expensive but life-saving treatment for people with kidney failure. Dialysis resources, if available in sub-Saharan Africa, are generally limited but in high demand, and clinicians at the bedside are faced with deciding who lives and who dies. When resource limitations exist, transparent and objective priority setting regarding access to such expensive care is required to improve equity across all health needs in a population. This process however, which weighs individual and population health needs, denies some the right to health by limiting access to health care.

This paper unpacks what it means to recognize the right to health in sub-Saharan Africa, acknowledging the current resource availability and scarcity, and the larger socio-economic context. We argue, the first order of the right to health, which should always be realized, includes protection of health, i.e. prevention of disease through public health and health-in-all policy approaches. The second order right to health care would include provision of universal health coverage to all, such that risk factors and diseases can be effectively and equitably detected and treated early, to prevent disease progression or development of complications, and ultimately reduce the demand for expensive care. The third order right to health care would include equitable access to expensive care. In this paper, we argue that recognition of the inequities in realization of the right to health between individuals with “expensive” needs versus those with more affordable needs, countries must determine if, how, and when they will begin to provide such expensive care, so as to minimize these inequities as rapidly as possible. Such a process requires good governance, multi-stakeholder engagement, transparency, communication and a commitment to progress. We conclude the paper by emphasizing that striving towards the progressive realization of the right to health for all people living in SSA is key to achieving equity in access to quality health care and equitable opportunities for each individual to maximize their own state of health.

The rights to legal capacity, personal freedom, and safety during psychiatric hospitalizations at a general hospital

The aim of this study is to analyze the exercise of rights to legal capacity, personal freedom, and safety during psychiatric hospitalizations at a general hospital in an inner city from the state of São Paulo, Brazil, from the perspective of patients. This is a cross-sectional qualitative research study. Data were collected by interviewing 20 patients in the process of being discharged from the studied hospital who agreed to participate in the investigation. The guiding instrument of this interview was based on the WHO QualityRights interview tool and the obtained data were processed by means of thematic and content analyses. Results showed that the legal processes resulting from the Psychiatric Reform did not ensure the full exercise of the human rights of people with mental disorders admitted at general hospitals. Participants generally did not know about their rights to have access to their information and referred that they received information about their own health or these were given to their representatives.

Beyond the Right to Have Freedom: Religion and Belief in the Context of COVID-19 Health Emergency Regulation in Indonesia

This article argues that the right to have and express freedom can be restricted for several reasons, including a public safety emergency. In line with this idea, this article discusses government regulations in response to the COVID-19 pandemic, which had a crucial impact on the discourse on the right to freedom in Indonesia. Methodologically, this study uses critical qualitative analysis to overview the focus issue of this research in academic work and mainstream media coverage. At this point, this study uses relevant and recently published information regarding the intersection between Indonesian government regulations related to COVID-19 and the manifestation of the right to freedom, especially freedom of religion. This article provides an essential finding that restrictions on the right to have freedom are justified in consideration of public health due to the COVID-19 pandemic. International human rights conventions explain this mechanism. This article is a timely and contextual academic review with two contributions. First, this article theoretically adds information to academic discussions around the intersection between human rights, religion, and state regulation. Second, this study will help the state and religion build a constructive response to the COVID-19 pandemic and future crises. This contribution can be elaborated more profound and comprehensive in future research.

The Food System Summit's Disconnection From People's Real Needs

The United Nations (UN) Food Systems Summit held in September 2021 has left the world with a jumble of ideas and no clear path forward for transforming the world's food systems. The Summit was touted as the ultimate place to provide the world with solutions - but it never clarified the problems with the dominant food systems leaving participants with no coherent or cohesive framework. Most distressingly, the Food Systems Summit did not put the COVID-19 pandemic and ensuing food crisis anywhere on its agenda. In this Policy Perspective, the author, the UN Special Rapporteur on the Right to Food, provides his first-hand account of the effects of the Summit not focusing on people's immediate needs during a food crisis. The author briefly touches upon the Summit's role in the global debate around meat consumption. This debate exemplifies how the Summit did very little to change the substance of global food debates. Instead, the Summit can be understood as an inter-corporate contest that did not have any substantive regard for social justice or human rights.

Global arsenic dilemma and sustainability

Arsenic (As) is one of the most prolific natural contaminants in water resources, and hence, it has been recognized as an emerging global problem. Arsenic exposure through food exports and imports, such as As-contaminated rice and cereal-based baby food, is a potential risk worldwide. However, ensuring As-safe drinking water and food for the globe is still not stated explicitly as a right neither in the United Nations' Universal Declaration of Human Rights and the 2030 Sustainable Development Goals (SDGs) nor the global UNESCO priorities. Despite these omissions, addressing As contamination is crucial to ensure and achieve many of the declared human rights, SDGs, and global UNESCO priorities. An international platform for sharing knowledge, experience, and resources through an integrated global network of scientists, professionals, and early career researchers on multidisciplinary aspects of As research can act as an umbrella covering the activities of UN, UNESCO, and other UN organizations. This can deal with the mitigation of As contamination, thus contributing to global economic development and human health. This article provides a perspective on the global As problem for sustainable As mitigation on a global scale by 2030.

The interaction of environmental systems and human development in a time of wild cards. A big data enhanced foresight study

The article contributes to the research discussion around the human-natural and social-ecological systems by identification of a comprehensive list of global trends related to integrated interaction between environmental systems and human development, including climate change, pollution, new quality of economic growth, and challenges for education and healthcare. The foresight study behind it encompasses a combination of quantitative (big data ) and qualitative (expert) methods. This approach allows for a systemic vision of structural shifts, assessing their probability and impact. The outcomes of the study include the list of global environmental and human development trends and factors classified by STEEPV categories, their effects that split into opportunities and threats, and an assessment of their inter-relation and mutual impact. Policy implications focus on possible areas of intervention for sustainable growth.

Transnational Advocacy at the United Nations for Social Workers

Advocating at the United Nations is a daunting task for many social workers. The United Nations (UN) is so extensive, its system of agencies and relationships is complex and overlaid by politics, and there is no clear entry point for affecting change at the United Nations. However, as more of the social and human rights issues social workers confront in their practices have global roots and international implications, it becomes imperative that social workers seeking justice learn how to shape policies and decisions made at the UN. Advocating for policy changes beyond national boundaries is known as transnational advocacy. This paper guides the reader through the UN structure, and the roles of member states and non-state workers are discussed. Non-governmental organizations (NGOs) are a common vehicle for social workers to advocate at the UN. This paper introduces readers to the types of status NGOs hold at the UN, how NGOs advocate at the UN, and how social workers are currently represented at the UN. Two case examples of advocacy efforts are shared. One takes place at the High-level Political Forum, and the other involves the intersection of the UN General Assembly's Third Committee and the Human Rights Council.

Is AI recruiting (un)ethical? A human rights perspective on the use of AI for hiring

The use of artificial intelligence (AI) technologies in organizations' recruiting and selection procedures has become commonplace in business practice; accordingly, research on AI recruiting has increased substantially in recent years. But, though various articles have highlighted the potential opportunities and ethical risks of AI recruiting, the topic has not been normatively assessed yet. We aim to fill this gap by providing an ethical analysis of AI recruiting from a human rights perspective. In doing so, we elaborate on human rights' theoretical implications for corporate use of AI-driven hiring solutions. Therefore, we analyze whether AI hiring practices inherently conflict with the concepts of validity, autonomy, nondiscrimination, privacy, and transparency, which represent the main human rights relevant in this context. Concluding that these concepts are not at odds, we then use existing legal and ethical implications to determine organizations' responsibility to enforce and realize human rights standards in the context of AI recruiting.