Photo of a globe with a bandage tied around it

Struggles for Human Rights in Health in an Age of Neoliberalism: From Civil Disobedience to Epistemic Disobedience

This is the abstract of a paper by Alicia Ely Yamin. You can read the full paper in the Journal of Human Rights Practice here.

By Alicia Ely Yamin

Abstract

Like other contributors to this special issue and beyond, I believe we are at a critical inflection point in human rights and need to re-energize our work broadly to address growing economic inequality as well as inequalities based on different axes of identity. In relation to the constellation of fields involved in ‘health and human rights’ specifically—which link distinct communities with dissonant values, methods and orthodoxies—I argue that we also need to challenge ideas that are taken for granted in the fields that we are trying to transform. After setting out a personal and subjective account of why human rights-based approaches (HRBAs) are unlikely to be meaningful tools for social change as they are now generally being deployed, I suggest we collectively—scholars, practitioners and advocates—need to grapple with how to think about: (1) biomedicine in relation to the social as well as biological nature of health and well-being; and (2) conventional public health in relation to the social construction of health within and across borders and health systems. In each case, I suggest that challenging accepted truths in different disciplines, and in turn in the political economy of global health, have dramatic implications for not just theory but informing different strategies for advancing health (and social) justice through rights in practice.

Nurse holding a patient's hand

Toward a Just and Learning Culture in the NHS

By John Tingle

NHS Resolution has several functions in the NHS (National Health Service) in England which include managing legal claims brought against NHS hospitals and other health organisations, as well as important patient safety responsibilities. They have recently published guidance on supporting a just and learning culture for staff, patients, and caregivers following incidents in the NHS.

The guidance is wide ranging and includes examples of just and learning culture development practices. Example one is a just and learning charter that NHS hospitals and other health organisations can adapt or adopt. The NHS charter provides in the first paragraph a sample introductory pledge:

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Red stethoscope coiled in the shape of a heart

The NHS in England Launches a New Patient Safety Strategy

On July 2, 2019 a new National Health Service (NHS) patient safety strategy was launched in England. The strategy promises many things and lays out the future trajectory of NHS patient safety policy making.

Aidan Fowler, the NHS National Director of Patient Safety highlights the scale of the NHS patient safety problem in the foreword to the strategy:

 Too often in healthcare we have sought to blame individuals, and individuals have not felt safe to admit errors and learn from them or act to prevent recurrence…The opportunity is huge. Hogan et al’s research from 2015 suggests we may fail to save around 11,000 lives a year due to safety concerns, with older patients the most affected. The extra treatment needed following incidents may cost at least £1 billion (p3).

 

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Border patrol facility

ICE Raids Hold Health Implications Beyond Borders

By Lilo Blank

A health care environment already rife with navigational challenges for immigrant communities likely just became much more complicated and more dangerous even after planned US Immigrant and Customs Enforcement (ICE) court-ordered arrests and deportations this past Sunday, July 14, in 10 major U.S. cities never really materialized.

News articles from New Jersey to California detail immigrant communities on high alert, with many members of those communities fearing to go out in public. As the LA Times reports, whether this self-induced quarantining is a “one-day shift” or whether it will continue remains to be seen, but it is likely one will further harm immigrant populations, particularly Latinx and Hispanic communities. The planned (though largely uneventful ICE raids) are authorized by the Immigration and Nationality Act, which was amended in 1996 to include the  Illegal Immigration Reform and Immigrant Responsibility Act, including section 287(g). Read More

NHS logo on the side of a building

Testing the Temperature of Patient Safety in the NHS

In terms of transparency and accountability the National Health Service ( NHS) in England is excellent at producing insightful, well-produced reports on health quality and patient safety. It does this on a regular basis and one of the great difficulties faced by NHS nurses and doctors today is the sheer volume of reports published. It’s an impossible task for nurses and doctors to keep up to date with all the reports published and to maintain heavy workloads in resource constrained environments. It’s also hard for health care staff to know which reports to prioritize and which are authoritative.

There is an urgent need for the NHS to create a one stop, patient safety information hub which collects reports from all NHS sites and other important global sites, putting everything into one accessible place. Some recent reports on written patient complaints have been published which are helpful in assessing, testing patient safety and health quality in the NHS. Read More

swarm of media and tv cameras

The Hidden Cost of Misinformation: Harms from Opioid Hysteria Extend Beyond Overdose Deaths

Fentanyl is a potent opioid analgesic and has been the center of the opioid and overdose epidemic. As an illicit agent, fentanyl is often in the form of a powder, which is then either insufflated (the fancy medical term for snorting) or dissolved in water and injected intravenously. It is fifty to one-hundred times more potent than heroin, the drug it replaced as the illicit opioid of choice. It can cause significant euphoria and analgesia, which is why it is so widely used. It can also cause respiratory depression or complete respiratory arrest, the reason it can be so deadly. It is readily absorbed when insufflated or injected and the actions are almost immediate. These are the facts.

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Pills spilling out of a few bills rolled in a cylinder

New Podcast Tackles Drug Pricing, Market Power, and More

About 24 percent of adults report difficulty in affording prescription drugs, including 9 percent who report it is “very difficult” to afford them and 15 percent who report it is “somewhat difficult.” Approximately 11 percent of adults reported rationing high-priced drugs in 2017.

Recently, @Arnold_Ventures launched a new podcast, “Deep Dive with Laura Arnold,” that tackles the issue of drug prices. In its debut episode, podcast host Laura Arnold sits down with David Mitchell, founder of Patients for Affordable Drugs, who began his fight for drug pricing reform after a devastating diagnosis of an incurable blood cancer. The cost of his medicine each year: $325,000. They discuss a broken system built to serve those who make money — not those who depend on it for their health.

“Our mission is to improve people’s lives by fixing broken systems,” Arnold says. “We view drug pricing as a broken system, and not just from a theoretical perspective, but from a human perspective. We see this as a crisis in our nation. People can’t afford their drugs, and the consequences for all of us, both personally and from a societal perspective, are dire.”

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A group of surgeons perform an operation in a hospital operating theatre.

Keeping up to Date with Global Patient Safety

One of the great difficulties in patient safety and health quality is keeping up to date with all the material that is produced. A myriad number of patient safety and health resources exist globally. By sharing good quality resources, we can help advance the global patient safety agenda.

NHS Resolution (the operating name of the National Health Service Litigation Authority) has excellent patient safety and clinical negligence resources, learning materials and should be viewed as a priority global information source.

NHS Resolution is a Special Health Authority and is a not-for-profit arm’s length body of the Department of Health and Social Care.It is a part of the NHS and has several functions including handling negligence claims on behalf of NHS organizations and independent sector providers of NHS care in England who are members of the NHS Resolution indemnity schemes. Read More

American Opioid Litigation: A Conversation with Professor Elizabeth Chamblee Burch

Professor Elizabeth Chamblee Burch

In my last post about recent developments in American aggregate opioid litigation, I teased about a future segment documenting a fantastic conversation with Professor Elizabeth Chamblee Burch. This post delivers that promise. Professor Burch is Fuller E. Callaway Chair of Law at the University of Georgia School of Law and an expert in complex litigation, mass torts, multidistrict litigation, and civil procedure.

Readers can access her impressive scholarly contributions on these topics here.

As Professor Burch elucidates in her research, the United States civil justice system has witnessed the waning of class certification cases and, concomitantly, the rise of multidistrict litigation (MDL) to resolve high-stakes, aggregate civil disputes.

This trend includes the massive national multidistrict litigation currently pending in the United States District Court for the Northern District of Ohio (Opioid MDL). Unlike class certification litigation, which is governed by Federal Rule of Civil Procedure 23, the MDL process is subject to the 1968 Multidistrict Litigation ActRead More

Back view of a little boy wearing a backpack walking to school

Zeroing In on “Zero Tolerance” School Discipline Laws

By Alexandra Hess

Exclusionary school discipline (ESD) policies, also known as Zero Tolerance policies, enforce disciplinary measures like suspension, expulsion, or law enforcement referral to address particular student behaviors.

Though it began as part of the Gun-Free Schools Act of 1994, which mandated one-year expulsion for possessing a firearm at school, ESD became more widely adopted over time. Now, the policies apply nationwide to a broad range of behaviors — from damaging property and fighting, to possessing a cell phone or tobacco, as well as behaviors described by subjective terms often undefined in the law, like willful defiance, obscenity, or profanity. Read More