Sarah Sargent

Transnational networks and United Nations human rights structural change: the future of indigenous and minority rights

Indigenous rights have developed in a very different trajectory than minority rights within the United Nations. This is remarkable given that indigenous rights were once seen as simply contained within the larger umbrella of minority rights, and that many groups can claim access to both the differing bodies of rights. The article proposes a model to explain the differences in the strength and effectiveness of minority and indigenous rights structures at the UN. This model characterises transnational campaign pressure as a key variable to explain the differences. Transnational networks have been studied for their effect on the transfer of norms from international to domestic spheres, but the effect of their pressure on the structures of international organisations has not been considered. The model highlights the effects that transnational networks have on the UN human rights structures. Yet the path of future development of indigenous and minority rights at the UN is uncertain. Understanding the effects that transnational networks have on UN human rights structures and how those structures in term impact upon the strength of minority and indigenous rights is an area ripe for continued research.

Understanding the decision-making environment for people in minimally conscious state

ABSTRACT Patients in minimally conscious state (MCS) show minimal, fluctuating but definitive signs of awareness of themselves and their environments. They may exhibit behaviours ranging from the ability to track objects or people with their eyes, to the making of simple choices which requires the ability to recognise objects and follow simple commands. While patients with MCS have higher chances of further recovery than people in vegetative states, this is not guaranteed and their prognosis is fundamentally uncertain. Therefore, patients with MCS need regular input from healthcare professionals to monitor their progress (or non-progress) and to address their needs for rehabilitation, for the provision of an appropriate environment and equipment. These requirements form a backdrop to the potentially huge variety of ethical-legal dilemmas that may be faced by their families, caregivers and ultimately, the courts. This paper analyses the decision-making environment for people with MCS using data obtained through four focus groups which included the input of 29 senior decision makers in the area. The results of the focus group study are presented and further explored with attention on recurrent and strong themes such as lack of expertise, resource issues, and the influence of families and friends of people with MCS.

A Grounded Theory Analysis of a Focus Group Study

Decisions about whether to reassess the clinical condition of patients in a minimally conscious state are a cornerstone of clinical care and management. The outcome of clinical reassessment determines whether efforts to rehabilitate should be escalated, maintained, or targeted more specifically to achieve optimal outcomes. The results of reassessment also underpin decisions to withhold or withdraw life-sustaining treatment from this patient group. Actual decisions about whether to reassess tend to be taken by members of multidisciplinary teams. For this reason, focus groups were chosen to ascertain the views and perceptions of senior decision-makers as to whether minimally conscious patients should have a fundamental “right” to be reassessed. Constructivist grounded theory was used to analyze the data. The results reveal that a range of factors will influence whether these patients are reassessed clinically. This case study discusses why focus groups using a grounded theory analysis were chosen to address the research question. A description is provided of the coding process that was used to develop theory from the focus group data. This case study will help researchers to understand how these methodologies are carried out as well as to identify the types of insight that can be gained from their use.

Transracial adoption in England: a critical race and systems theory analysis

The legal requirements of transracial adoption of children in England changed in 2014. An amendment to the law removed a requirement that due consideration be given to the ‘childs religious persuasion, racial origin and ethnic and linguistic background’. This change was motivated by the belief that to do so would increase the number of transracial adoptions and thus decrease the number of children in care awaiting adoption. The likelihood of this change being successful is examined through a combination of critical race theory and systems theory. The combination of these theories permits an investigation into the communications between the political, legal and child welfare systems. This paper offers an enriched evaluation of the interactions of the child welfare, legal and political systems that should be of use to those who work in those systems, as well as providing a basis for understanding why this legal amendment will not achieve its objectives.