Chapter 5 marks the beginning of a more pointed analysis and justification of partial excuse across Part III, as the target site of the Real Person Approach. The chapter is concerned with exploring the nature and purpose of partial excuse through a historical overview, and with clarifying the version of the defence used to underpin the Universal Partial Defence (UPD), through touring divergent definitional and structural approaches of other common law jurisdictions. Key issues that bear on the definition of the UPD are also introduced. This analysis forms the backdrop of the argument for universalising partial excuse across all offence categories and expanding its grounds beyond mental disorder and provocation/loss of control. Core challenges to universalisation are explained and responded to, concerning the application of partial excuse to homicide only, its characterisation as a form of mitigation at the pre-verdict stage, and issues relating to both coordination and the notion of partial responsibility.

The legal systems of countries as dissimilar as Ecuador, Bolivia, New Zealand, the United States, and Uganda have recognized nature as a subject of rights. This chapter contributes to the description, analysis, and comparison of the global discursive patterns that convey and underpin the rights of nature from the perspectives of comparative law and global legal pluralism. The first part of the chapter examines three types of discourse related to rights of nature: the prototypical models, discourses that reproduce the paradigmatic models, and discourses that resist the rights of nature. The second part analyzes rights of nature from two perspectives that are central to contemporary comparative law: the political economy of legal knowledge and explanatory theories of legal change. Rights of nature challenge conventional notions of which countries create and exchange legal knowledge. They have been articulated by historically weak or marginalized countries or peoples, and they have been incorporated in national legal systems through heterodox processes of South–South and South–North exchange.

Observation medicine in New Zealand has grown considerably in the last decade, driven by the shorter stays in emergency departments health target and the growth of emergency medicine as a specialty. Evidence that the growth of this service has mostly been appropriate and within suggested guidelines, is indicted by most hospitals admitting < 20% of patients to their emergency medicine governed observation unit and most subsequently admitting < 20% of these to an in-patient ward. Average lengths of stay are less than 12 hours and caseloads commonly include toxicology, low-risk chest pain and abdominal pain although the gamut of minor medical and surgical conditions are seen.

After completing a fellowship in observation medicine with Dr. Graff in Connecticut, USA, Dr. Mahadevan, started the first observation unit (OU) at National University Hospital in Singapore in 2004. After two additional Singapore physicians completed a fellowship with Dr. Mace in Cleveland, Ohio, USA in 2006-2007, additional OUs were started. Currently, there are seven OUs in Singapore. In 2016, the OU became a “hybrid” unit with the admission of pediatric patients above 6 years of age. During the COVID-19 pandemic in early 2020, the OU was converted into a pandemic isolation ward for suspected COVID + patients in order to increase ED capacity. For reimbursement there needed to be the approval from the government that observation patients could use their medical savings called Medisave). Various protocols have been developed including a protocol on the management of primary spontaneous pneumothorax.. One merit of observation medicine has been a reduction in overall length of stay in the hospital, thus freeing up more inpatient beds for the needy and sicker patients.

After the Second World War, ambitions to develop a collective security arrangement among Western allies for the defence of the South-East Asia region started to emerge from many quarters. Australia and New Zealand began planning for a security alliance that would include regional nations as well as foreign powers, and Britain’s attention returned to supporting the defence of its colonial possessions. Australia and New Zealand did not achieve a security alliance initially, and defence planning in the immediate postwar years rested on a negotiated agreement focused on the British Commonwealth.

This chapter explores the relationship between primary health care (PHC), health literacy and health education with empowering individuals, groups and communities to improve and maintain optimum health. PHC philosophy encompasses principles of accessibility, affordability, sustainability, social justice and equity, self-determination, community participation and intersectoral collaboration, which drive health care service delivery and health care reform. Empowerment is a fundamental component of social justice, which seeks to redistribute power so those who are disadvantaged can have more control of the factors that influence their lives. Lack of empowerment is linked to poorer health outcomes due to limited control or agency, associated with poorer social determinants of health. This influences personal resources, agency and participation, as well as limited capacity to access services and opportunities. Health care professionals and systems need to work in ways to promote the empowerment of individuals, groups and communities to achieve better health outcomes.

Good nursing practice is based on evidence, and undertaking a community health needs assessment is a means of providing evidence to guide community nursing practice. A community health needs assessment is a process that examines the health status and social needs of a particular population. It may be conducted at a whole-of-community level, a sub-community level or even a subsystem level. Nursing practice frequently involves gathering data and assessing individuals or families to determine appropriate nursing interventions. This concept is transferable to an identified community when the community itself is viewed as the client.

Sex and gender have a significant relationship to health and health outcomes for women, men, and sexually and gender-diverse people. Sex relates to biological attributes, whether born female or male, while gender identity relates to how someone feels and experiences their gender, which may or may not be different to their physiology or sex at birth. Biological characteristics expose women and men to different health risks and health conditions. Gender also exposes people to different health risks, and gender inequity impacts on their potential to achieve health and well-being.

Chronic conditions, or non-communicable diseases, are the leading cause of death worldwide. Chronic conditions are responsible for 41 million deaths and 17 million premature deaths across the world each year. Most of these deaths are due to four major conditions: cardiovascular disease, cancer, chronic respiratory disease and diabetes. However, other chronic conditions, including injuries that result in persistent disability and mental health disorders, also contribute to increased morbidity and mortality. The significant increase in preventable chronic conditions and the need to manage these are major healthcare concerns of the industrialised world.

Primary health care (PHC) is a philosophy or approach to health care where health is acknowledged as a fundamental right, as well as an individual and collective responsibility. A PHC approach to health and health care engages multisectoral policy and action which aims to address the broader determinants of health; the empowerment of individuals, families and communities in health decision making; and meeting people’s essential health needs throughout their life course. A key goal of PHC is universal health coverage, which means that all people have access to the full range of quality health services that they need, when and where they need them, without financial hardship.

In the ‘classic’ sense, health professionals often view the health of individuals from a three-part biopsychosocial model of health. In this case, the ‘psych’ part relates directly to ‘mental health’. However, it is important to resist the temptation to separate this part from the bio and social aspects of the well-established model. Instead, it is best to view all parts of the established model as equally important and inter-related to each other. For instance, it is difficult to maintain good mental health and well-being if we lack either good social or ‘bio’ (physical) health. Traditionally, however, health professionals have tended to focus on the physical health component of the biopsychosocial model, especially those working in acute hospital/clinic environments. From a primary health care perspective, the ‘social’ (community development-focused) aspect is supposed to be the most dominant part of the model.

Sexual health nurses are employed to work in a range of practice settings and work with diverse population groups. Sexual and reproductive health care is considered a human right and is fundamental to positive well-being. The nurses role in sexual and reproductive health varies between settings within and across different jurisdictons. Work settings include dedicated sexual health clinics, family planning services, community health centres, women’s health services, correctional services, general practices and tertiary education settings. In some juristictions, nurses also provide care in publicly funded sexual health clinics aimed at providing services to specific priority population groups to increase their access to services and reduce the prevalence of adverse sexual and reproductive health outcomes including sexually transmitted infections and unplanned pregnancy.

Home-based care is common practice in many countries and has had a long tradition in Australia and Aotearoa New Zealand. Home-based care now takes many forms, including the acute care program Hospital in the Home, a range of chronic disease programs and community aged care. Home-based care provides many benefits to consumers, reducing their need to travel to services and associated costs. It also allows the health care provider to have a holistic picture of the consumers and for the consumers to feel empowered to manage their health care issues in their own homes, while continuing with normal daily activities in a setting that they are comfortable in.

Approximately one in every six people have some form of disability and about one-third of these people have a severe or profound limitation to their daily activities and function. As a subgroup, they are some of the most marginalised and disadvantaged, often experiencing disparate chronic and complex health problems when compared to the general population. In addition, they sometimes encounter disabling challenges accessing the health system and have experienced poor quality care from health professionals whose capacity to understand their needs, and how to best respond to them, is limited. This chapter seeks to inform health care professionals about the intersection of health and disability so that they can better work with people with a disability no matter the health context.