A growing body of research reveals that the psychosocial risks faced by lawyers working in the legal assistance sector are not being adequately managed by employers, which is taking its toll on the on the mental wellbeing of lawyers. In this qualitative study, 16 lawyers from the sector in Australia describe measures that could be taken to manage these risks. This includes managing work loads/type/clarity/control, supporting isolated staff, creating supportive teams, training, supervision and mentoring, effective and supported managers, rewards and recognition, a safe physical environment, recruitment and retention, risk assessment and management processes, reporting mechanisms and adequate policies and procedures. Participants recommended preventative measures, suggestions solutions need to be tailored to lawyers and their work setting; and be actioned and modelled from the top of the organisation. The rich detail provided by participants offers employers in the sector a much needed list of strategies to implement.
Intimate partner violence (IPV) remains a significant global health and human rights problem affecting one in three women globally and in Colombia. While IPV and feminicide are preventable, little research has documented public health-justice programs effective in addressing IPV in real-world conditions in Latin America. We investigated the functioning and limitations of Bogotá's Single Route of Attention for Women Victims of Violence and at Risk of Feminicide. From 2022-2025, we employed qualitative methods, using purposive and snowball sampling to conduct 23 in-depth interviews, one focus group and debriefings. We harnessed the perspective of human rights lawyers, supplemented by expert key informants, utilizing cycles of constant comparative analyses to derive three core findings: (1) health professionals (HPs) mistrust human rights lawyers; (2) HPs require greater sensitization to gender-based violence to assist victims; and (3) a dearth of understanding and attendant action by prosecution and police to address victims' imminent risk of harm and feminicide. Findings identified salient opportunities for these entities to minimize harm and feminicide across victims' contact with officials. Despite strengths of this novel program, lack of a public health vision for IPV prevention, systemic omissions in justice and inattention to gender norms facilitating IPV pose limitations.
The present research aimed to develop a psychometrically sound measure of moral injury for lawyers. In study I, deductive and inductive approaches were used to generate an initial item pool. Furthermore, the item pool was reviewed and finalized with the help of experts' opinions. In order to explore factor structure and ensure psychometric properties of the scale, a purpose sample comprised of lawyers (N = 226, mean age = 31, SD = 5.2) was recruited. Results indicated a three-factor structure of moral injury-betrayal, transgression, and value system conflict. Four items were retained in each factor: betrayal (1,2,3,4), transgression (5,6,7,8), and value system conflict (9,10,11,12). In study II, another independent sample was recruited to confirm the factor structure. The three-factor structure produced by EFA was found to fit the data with three-factor solution with initial item loadings > 0.40. The Chi-square value was 70.41 (df = 51), with CFI = 0.97, GFI .95, TLI = 0.96, RMR = 0.01, and RMSEA = 0.04. The alpha reliability of the overall scale and subscales was 0.78, 0.70, 0.82, and .74, respectively. Study III demonstrated evidence of convergent and discriminant validity. Positive correlation of moral injury with pathological lying (r = 0.50, p < 0.01) and decisional fatigue (r = 0.49, p < 0.01) ensured its convergent validity, while a non-significant relationship with internet addiction provided evidence of discriminant validity.
暂无摘要(点击查看详情)
This article asks whether and how law matters in ethics advisory work in the fields of health, medicine and science, and whether it is law or legal knowledge, or both, that matters. Written from the perspective of four law professors, each with first-hand experience of ethics advisory groups, it examines the framing of academic legal expertise on ethics advisory groups and explains why this framing requires ongoing negotiation.
Lawyers and law professors are increasingly involved in interdisciplinary scientific teams and grant research to answer ethical, legal and policy questions related to biomedical topics. Yet, the methods that lawyers use to conduct legal research and analysis are not always familiar to scientists and social scientists conducting peer review of a proposed project with legal aims or a publication reporting a legal study. To better facilitate interdisciplinary ethical, legal, and social implications collaboration, there is a need to better explain how legal research methodologies can provide robust tools to address a range of nuanced biomedical questions. This paper explores legal research and analysis methodologies relevant to federally funded research and scientific inquiry. It sets out different ways that legal research and analysis can advance and support biomedical, bioethics, and health law research and then demonstrates how these benefits can be realized using case studies from existing literature.
The landmark 1995 judgment by the Supreme Court of India included doctors within the purview of the Consumer Protection Act (CPA) 1986, hinting that other professions, including legal services, could also fall under its ambit. However, in 2024, the apex court ruled in 'Bar of Indian Lawyers Through its President vs DK Gandhi PS National Institute of Communicable Diseases and Anr.', that lawyers are not liable for professional deficiencies under the CPA, emphasising the lack of universal standards for assessing dereliction of duty in legal services. Although this landmark verdict let advocates off the hook, it calls into question the Court's 30-year-old decision. This ruling has reignited the debate on whether doctors should be equated with other service providers under the CPA 2019, particularly in light of the rise in defensive medicine practices, which increase healthcare costs and erode doctor-patient trust. In this commentary, we will discuss the analysis and observations of the apex court in the DK Gandhi case, contributing to the ongoing discourse on medical liability under the CPA in India.
The sources of judicial dissatisfaction with, and criticism of, expert healthcare evidence are traced to unqualified, careless, overworked and unscrupulous experts and a failure on the part of some experts to work collaboratively with their instructing lawyers during the litigation process. The suggested remedies are: adherence to the clear professional standards that already exist, appropriate training for which the foundations should be laid during undergraduate medical education, continuing professional development, credentialing complemented by instructing solicitors and counsel ensuring that the expert is appropriate for the case and aware of their duties, collaborative working between expert and instructing lawyer, peer and institutional support and quality control including peer review of reports and case-based discussion of reports.
There is a widespread perception among academics, doctors and patients that the common law can effectively drive the development and incorporation of patients' autonomy-based rights into medical practice. However, there is reason to doubt that this is correct.We present a critical analysis of this view, prompted by themes that emerged from interviews with n=31 lawyers and n=24 doctors as part of a larger interdisciplinary study. We focus on the limitations of case law in driving autonomy-respecting clinical practice. Part I examines how the development and impact of decided cases is dominated by practical and economic considerations. It also considers the lack of understanding of case law among clinicians and the extent to which this limits its ability to drive change. Part II sets out our reasons for treating these limitations as a cause for concern. In Part III, we conclude by considering different levers for supporting case law in creating or confirming autonomy-respecting norms in medical practice, suggesting ways in which these might be developed further.We argue that clinical negligence litigation is important as a guide to clinical practice and a means of enforcing autonomy-based patient rights but that it cannot be relied upon to drive changes in practice. Both professional guidance and legislation can augment case law but, for them to be effective, proper communication between doctors and legislators, courts, lawyers and insurance organizations is essential.
In the United Kingdom, over 2.5 million health and social care professionals are registered by 13 statutory professional regulators. When professional conduct falls below standard, registered professionals may face an investigation into matters such as their conduct, health or competence via fitness to practise processes. Very serious cases are heard in public by an independent adjudication panel. The public, the largest source of concerns, may be asked by the regulator to be cross-examined in a hearing where their evidence may be crucial. Witness cross-examination is known to be distressing in the criminal context, where the victim is questioned about the harm they experienced and how they faced the alleged perpetrator. In fitness to practise, retelling stories could be similarly retraumatising. Our research focuses on the public (and colleagues) who raise concerns, including that they have been harmed by a professional, and examines their experience of engaging with fitness to practise processes. The study employed multiple qualitative methods. Public website materials were analysed using thematic content analysis, accessibility and readability algorithms and a useability survey about submitting a complaint (n = 11). The views of the public and those with personal experience of fitness to practise validated our analysis of the web content (n = 15). Sociolegal analysis was conducted of the United Kingdom's social work/social care regulators' conceptualisations of witness vulnerability and special measures. Twenty-seven registrants' employers were approached, and 25 were interviewed about organisational support for registrants, patients and service users. Data collection via regulators (n = 285) with small numbers via social media included surveys, (n = 64 in total) across 9 regulators, interviews (n = 47) across 10 regulators, ethnographic observation of hearings (n = 22) with 81 days of observation across 9 regulators, and documentary analysis of hearings determinations and witness statements across 13 regulators (n = 207). Project recommendations were coproduced through six formative workshops involving public members, legal, health and social care professionals, regulatory staff and lawyers and academics. Analytic methods included institutional ethnography, thematic analysis and narrative portraits. The website information for the public was often too much or too little, in inaccessible formats, and requiring high literacy and digital skills. The social care regulators' conceptions of vulnerability largely relied on inherent factors (e.g. disability), or misconduct categories, rather than being situationally sensitive to witnesses' diverse needs. The experience of those who had been harmed was found to be profoundly distressing for most participants at each stage of the fitness to practise process: having to retell their story, uncertainty about when and where they would need to respond, and taking part in a legalistic and adversarial process where their evidence, and credibility, were questioned. Findings informed 20 recommendations. Project resources are available for all stakeholders. This project provides globally unique evidence of the experiences of the public involved in health and care professional regulation. It recommends improvement of professional regulation through public-focused information, compassionate and trauma-informed communications and support, and for independent cross-regulator evaluation. Our research was informed throughout by people who had personal experience of fitness to practise, regulators, employers, lawyers and professional bodies. This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR131322. This study is about how the public are involved in the regulation of health and social care professionals in the United Kingdom. Over 2 million professionals (e.g. doctors and social workers) are registered by law with their regulator. If their behaviour is substandard, they can be investigated. In the most serious cases, this might include a public hearing where a decision will be made about whether they can continue to practise. This process is called fitness to practise. We know the process is stressful for professionals. We wanted to find out how the process works for the public, who may be involved by raising a concern and by giving evidence at a hearing. We focused on people who may have been harmed by professionals, because little is known about their experiences of fitness to practise. We examined the information for the public on 13 regulators’ websites. We undertook a survey of people who had raised a concern, and we interviewed people who had been part of a hearing. We examined documents, including witness statements, legal documents and policies, and we observed hearings. We interviewed the public, lawyers and independent hearing panel members. We held four workshops to coproduce our recommendations with members of the public, regulators, health, social care, lawyers and academics. We found that most of the regulators’ websites presented too much or too little information, which was too complex, in inaccessible formats and made the process of navigating the website difficult. Members of the public who had been harmed and who raised a concern and took part in investigations and hearings mainly found the process to be onerous, protracted, distressing and disappointing. We found regulators and employers often did not offer enough support to the public. We produced recommendations and resources to improve these processes.
Substance use disorders (SUDs) among healthcare workers, legal professionals, and pilots pose risks to public safety and professional performance. Physician health programs (PHPs), lawyer assistance programs (LAPs), and the Human Intervention Motivational Study (HIMS) program for pilots aim to address these challenges through structured referral, treatment, and monitoring. PHPs and LAPs operate through state-based programs with guidance from national organizations such as the Federation of State Physician Health Programs (FSPHP) and the Commission on Lawyer Assistance Programs (CoLAP). In contrast, HIMS follows a standardized federally regulated model. Despite shared goals, no prior study has systematically compared these distinct frameworks. Using the READ (Ready, Extract, Analyze, Distill) framework for document analysis, this study reviewed best practice guidelines from FSPHP and CoLAP alongside publicly available HIMS materials to compare treatment referral, monitoring/aftercare expectations, and return-to-work policies. All three programs emphasize rehabilitation and confidentiality but differ in structure. FSPHP guidelines provide detailed recommendations for evaluation, monitoring, and reintegration; HIMS materials outline evaluation and recertification requirements and associated monitoring expectations; and CoLAP offers flexible guidance that emphasizes support and early intervention. Adherence to the guidelines is not well documented at the state or organizational levels, underscoring variability within professions. This study compares the FSPHP, CoLAP, and HIMS guidelines, offering insights into standardizing aftercare, monitoring, and return-to-work policies for safety-sensitive professionals. Aligning state and organizational level programs more closely with national guidance may enhance accountability, improve equity, and reinforce public safety.
This review examines whether mental health consumers are asked how they want legal services to be provided in studies of civil mental health jurisdictions, and the extent to which consumer researchers were involved in these studies. A Consumer-perspective Critical Reflection Tool was applied to assess consumer involvement and alignment with human rights frameworks. Consumer leadership and participation were largely absent in the studies identified. Only one study included consumer researchers, and none reported consumer leadership in setting agendas, design, data collection, analysis, or evaluation. Participants' voices were frequently missing, supported decision-making was rarely operationalised, and intersectionality received little attention. Many studies adopted paternalistic or therapeutic frames that positioned lawyers as protective rather than representative of clients' expressed preferences. Few papers articulated concrete implementation plans for change or strategies to build consumer knowledge. The findings indicate a systemic disconnect between the rights rhetoric of civil mental health law and the practices of legal representation. Legal services and research should reorient to consumer-led, CRPD-consistent approaches, embed supported decision-making, and ensure routine, meaningful elicitation and documentation of consumers' will and preferences to guide advocacy and adjudication.
Artificial intelligence (AI) is increasingly integrated into mental health care, legal decision-making, and forensic practice. Proponents argue that AI can augment professional judgment by improving prediction, efficiency, and consistency. Yet AI operates fundamentally differently from human reasoning: AI predicts, whereas clinicians and lawyers understand. Predictions alone cannot replace the human reasoning, contextualisation, and justification that clinical and legal decision-making require. This article examines four central tensions that arise when integrating AI into mental health and legal contexts: epistemic, ethical, relational, and legal tensions. These tensions illustrate the limits of purely algorithmic decision-making and the critical importance of maintaining meaningful human oversight. To assist clinicians, lawyers, and institutions navigate these challenges, the HUMAN framework provides a structured approach grounded in five core principles: Human judgment, Understand the model, Monitor performance, Accountability, and Narrative. Each component places human reasoning and ethical responsibility at the centre of AI-supported practice, ensuring that technological innovation strengthens rather than undermines the foundations of psychiatry and law. While AI may transform certain aspects of practice, human professionals retain overall responsibility, with particular emphasis on compassion, empathy, care, presence, and moral reasoning. Ultimately, these are the qualities that matter most.
My list of medically related anniversaries for 2026 (events in years ending '26 and'76) includes:• Births: Abū al-Walīd Muḥammad ibn Aḥmad ibn Rushd, the physician better known as Averroes (1126); the Flemish botanist Charles de L'Ecluse (Carolus Clusius) (1576); Amadeo Avogadro, Italian physicist (1776); Johann Spurzheim, German physician (1776); George Birkbeck, English physician (1776).• Deaths: Francis Bacon (1626); Jean Anthelme Brillat-Savarin, French lawyer and gastronome (1826); Friedrich Wilhelm Weiß, German physician and composer (1826); René Laënnec, French physician (1826); Philippe Pinel, French physician (1826); Walter Channing, American physician (1876); Victor Babeș, Romanian physician and bacteriologist (1926); William Bateson, English biologist (1926); Emile Coué, French pharmacist and psychologist (1926); Camillo Golgi, Italian anatomist (1926); Emil Kraepelin, German psychiatrist (1926); Einar Aaser, Norwegian physician (1976); Andrew Arthur Abbie, Australian anatomist and anthropologist (1976); Jacques Monod, molecular biologist (1976); George Whipple, American physician (1976); Alexander S Wiener, American physician (1976).• Biomedical texts published: Observationes medicae circa morborum acutorum historiam et curationem by Thomas Sydenham (1676); A Comment on Forty two Histories Discribed [sic] by Hippocrates in the First and Third Books of his Epidemics by John Floyer (1726); The botanical arrangement of all the vegetables naturally growing in Great Britain by William Withering (1776); De generis humani varietate nativa by Johann Friedrich Blumenbach (1776); L'uomo delinquente (Criminal Man) by Cesare Lombroso (1876); Geographical distribution of animals by Alfred Wallace (1876); The theory of the gene by Thomas Hunt Morgan (1926).• Clinical therapies introduced: George Richards Minot and William Parry Murphy (treatment of pernicious anaemia with liver, 1926).• Biochemical and bacteriological observations: Karl Wilhelm Scheele (uric acid in kidney stones, 1776); Otto Unverborden (discovery of aniline, 1826); Robert Koch (the anthrax bacillus, 1876); James Batcheller Sumner (crystallisation of jackbean urease, 1926).• Establishment of the Edinburgh Medical School (1726) and of The Body Shop (Anita Roddick, 1976).• Epidemics of typhus in Spain (1576) and Ebola virus infection in Yambuku, Zaire (1976).• Nobel prizes for physiology or medicine awarded to Baruch Samuel Blumberg for identifying Australia antigen as an indicator in the blood of hepatitis B and to Daniel Carleton Gajdusek for his work on the origin and spread of infectious diseases, particularly slow virus infections and specifically kuru (both 1926), and to Johannes Andreas Grib Fibiger for discovering the Spiroptera carcinoma (1976).
Image-Based Sexual Abuse (IBSA), including deepfake sexual abuse - where fake yet lifelike sexual content is generated of non-consenting persons - constitutes a growing form of digitally mediated gender-based violence that remains largely under-researched within non-Anglophonic contexts. This study explores how IBSA is constructed and perceived by both laypeople and lawyers in Greece, a Southern European setting characterised by economic precarity, traditional gender norms, and evolving yet challenging legal frameworks. Drawing on semi-structured interviews with 21 participants either originating from or living in Greece (n = 16 lay persons, n = 5 legal professionals), we employed constructionist thematic analysis to examine how participants discursively frame IBSA, its motivations, barriers to reporting, legal challenges, and preventative measures. Five themes were identified: (1) constructions of IBSA as gendered violence motivated by control, humiliation, and financial exploitation; (2) barriers to reporting shaped by shame, stigma, and widespread mistrust in police institutions; (3) legal barriers related to financial inaccessibility and fragmented, outdated legal frameworks; (4) the central role of informal support networks alongside calls for education and public awareness; and (5) deepfake technologies as an emergent form of economic exploitation, particularly impacting sex workers within a legal vacuum. The findings highlight the need for structurally informed, context-sensitive responses to IBSA that address the intersections of gender, law, technology, and economic vulnerability.
Accurately quantifying belief strength in heuristics-and-biases tasks is crucial yet methodologically challenging. In this paper, we introduce an automated method leveraging large language models (LLMs) to systematically measure and manipulate belief strength. We specifically tested this method in the widely used "lawyer-engineer" base-rate neglect task, in which stereotypical descriptions (e.g., someone enjoying mathematical puzzles) conflict with normative base-rate information (e.g., engineers represent a very small percentage of the sample). Using this approach, we created an open-access database containing over 100,000 unique items systematically varying in stereotype-driven belief strength. Validation studies demonstrate that our LLM-derived belief strength measure correlates strongly with human typicality ratings and robustly predicts human choices in a base-rate neglect task. Additionally, our method revealed substantial and previously unnoticed variability in stereotype-driven belief strength in popular base-rate items from existing research, underlining the need to control for this in future studies. We further highlight methodological improvements achievable by refining the LLM prompt, as well as ways to enhance cross-cultural validity. The database presented here serves as a powerful resource for researchers, facilitating rigorous, replicable, and theoretically precise experimental designs, as well as enabling advancements in cognitive and computational modeling of reasoning. To support its use, we provide the R package baserater, which allows researchers to access the database to apply or adapt the method to their own research.
Medical-legal partnership (MLP) is an intervention embedding legal professionals within a clinical setting to address patients' health harming legal needs (HHLN). While much of the literature focuses on the role of the lawyer in the partnership, less is understood about the role of the clinician. Data were collected about MLP medical champions from workshop attendees at an MLP conference held by the Solomon Center at Yale Law School, a leader in health law. From the 107 concepts collected at the workshop, 40 mechanisms by which the medical champion can best serve an MLP were identified and ranked by expert MLP champions, using a Delphi method. Medical champions' relations with the legal team and with direct patient care were of high priority, in contrast with their role in larger scale advocacy. The findings from this study provide evidence that medical champions are a cornerstone of MLPs as they understand clinical workflows, are aware of patient population needs, and can support the multi-disciplinary MLP team to address HHLN. By gaining a deeper understanding of the potential responsibilities and actionable steps that a medical champion can undertake, it is possible to mitigate the challenges faced by MLPs and enhance their implementation and longevity.
Best interests under the Mental Capacity Act 2005 has been cast as an empowering, person-centred process that protects a person's rights and freedom of action. In practice this laudable goal is constrained by monetary and temporal resources. Drawing on a qualitative study which encompassed the views of patients, carers, healthcare professionals, and lawyers, we observe that, where resources are inadequate, the quality of decision-making declines and the options on offer are restricted. While austerity has disproportionately disadvantaged people with disabilities and additional needs in numerous ways, in mental capacity law, the impact of this is evident in the gap between the protection of procedural and substantive rights offered by the law. While the courts deal robustly with challenges to 'faulty' procedure, challenging substantive issues is difficult and has limited prospects of improving outcomes, even if the decision is clearly inadequate in any sensible interpretation of the court's aspiration to person-centredness. Tracing these differences back to the different logics of the European Convention on Human Rights and the United Nations Convention on the Rights of Persons with Disabilities, we argue that, as things currently stand, the law cannot resolve these issues, dooming the aspiration to person-centredness to remain constrained and provisional.
The McCabe Centre for Law and Cancer's international legal training programme (ILTP) aims to raise the capacity of government lawyers from low- and middle-income countries to use the law to address noncommunicable diseases (NCDs). We used qualitative data to evaluate impacts of this long-term capacity-building programme to complement tangible impacts, such as law and policy reform found in an earlier evaluation. We undertook 17 interviews with alumni of and stakeholders involved with the ILTP over the period 2014-23. The interviewer conducted semistructured interviews. Two reviewers used inductive content analysis to code the interviews. We found that alumni and stakeholders valued the programme's role in building networks of participants with legal skills relevant to NCDs and in empowering individuals to become champions for NCDs. Interviewees also took a broader view of impact than the completion of individual law and policy reform projects, considering many law and policy changes, regional initiatives, and leadership roles of alumni beyond those formally supported as part of the programme to have been a key impact of the programme. The study highlights the need to invest in NCD legal capacity building and leadership for the long term. We find that building a community of people with the skills, confidence, and commitment to act on NCDs is a key impact of such programmes, in addition to laws and policies developed.