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This chapter examines the engagement of women next of kin of forcibly disappeared individuals in Sri Lanka with the Consultation Task Force on Reconciliation Mechanisms (CTF). The CTF was tasked with consulting on the design of four transitional justice mechanisms in 2016, including an Office on Missing Persons. Even though the government refused to respect the findings of this process, the chapter shows that the CTF generated a significant archive that can be probed as an ‘archive of desire’. This archive can help us to understand not only the demands of victim-survivors in relation to what form of justice or what kind of mechanisms they believe can deliver justice, but also the depth of affective feelings and investments underlying these demands. In post-war Sri Lanka, this archive continues to challenge and resist dominant narratives of denial and efforts to entrench impunity for forced disappearances. However, such archives equally serve as a resource to build solidarity across differences, to cultivate practices of listening to the ‘Other’, and to refigure the state towards recognising and redressing its sovereign violence.
Drawing on extensive consultations with relevant stakeholders in Uganda, this chapter seeks to understand how the international standardisation of transitional justice has impacted domestic transitional justice processes in Uganda, and notably victims’ roles therein. It zooms in on the increasingly sanitised involvement and participation of local stakeholders, including victims. The chapter shows how, despite the presence of language such as ‘local consultation’, ‘participation’, and ‘victims-centeredness’, a genuine intention among decision-makers to give meaningful effect to such principles has been missing. As such, formal ‘compliance’ with ideas about civil society and victim participation, as endorsed by international standards and guidelines about transitional justice, has not resulted in outcomes that met the expectations and demands of most local civil society and victim groups in Uganda. The chapter focuses mainly on the process surrounding the adoption of Uganda’s Transitional Justice Policy, but adds perspectives from other relevant frameworks and processes where particularly relevant.
This chapter examines ‘Regulatory Policy’ by addressing various questions that arise in considering ‘whether’ and ‘how’ to regulate. Regulatory policy includes a range of methodologies such as cost-benefit analysis and regulatory impact assessment. This chapter focuses on the methodologies used by public regulators. This chapter discusses the methods that help regulators assess who will be impacted by regulation, whether a regulation is effective, and what its costs and benefits will be. The chapter discusses the history of regulatory policy and delves into cost-benefit analysis, regulatory impact assessment, and consultations. The chapter includes a brief analysis of better regulation policies.
The Dispute Settlement Understanding (DSU) was one of the chief results of the Uruguay Round. Dispute settlement under the GATT had not been binding. Adoption of panel reports could be, and too often was, blocked by the losing party. All of the major trading members wanted dispute settlement to be binding, to have definitive results. They carefully constructed a complex system to remedy past defects. It had internal inconsistencies that only became apparent over time.
The question of how best to tackle anthropogenic climate change is a thorny one: besides scientific uncertainty regarding the consequences of climate change, another difficulty is that the recommendations of climate experts may clash with the priorities of citizens, interest groups and political institutions. With the European Green Deal, the European Union (EU) recently made significant advances in climate policy; at the same time, and as is well known, the EU and its institutions have long been criticised for their “democratic deficit” and for their failure to involve all civil society actors equally in EU law-making processes. This article sheds light on the legal framework governing civil society participation in EU law-making, and more specifically on the Commission’s consultations pursuant to Article 11(3) of the Treaty on European Union. It then critically assesses selected features of two consultations conducted by the Commission in connection with the European Climate Law, which it evaluates from the perspective of the EU primary law principles of democracy, openness and transparency. Through this analysis, and by suggesting how future climate consultations could be further improved, the article aims to contribute to the (still nascent) legal scholarship on civil society participation in environmental and climate policy.
This qualitative study aimed to investigate communication about death in consultations with patients undergoing chemotherapy with no curative intent. Specifically, we examined (i) how the topic of death was approached, who raised it, in what way, and which responses were elicited, (ii) how the topic unfolded during consultations, and (iii) whether interaction patterns or distinguishing ways of communicating can be identified.
Methods
The data consisted of 134 audio-recorded follow-up consultations. A framework of sensitizing concepts was developed, and interaction patterns were looked for when death was discussed.
Results
The subject of death and dying was most often initiated by patients, and they raised it in various ways. In most consultations, direct talk about death was initiated only once. We identified 4 interaction patterns. The most frequent consists of indirect references to death by patients, followed by a direct mention of the death of a loved one, and a statement of the oncologists aiming to skip the subject.
Significance of results
Patients and oncologists have multiple ways of raising, pursuing, addressing and evacuating the subject of death. Being attentive and recognizing these ways and associated interaction patterns can help oncologists to think and elaborate on this topic and to facilitate discussions.
To maintain the highest level of your four reserve factors it is necessary to know how to interact with the medical profession and the medications they prescribe. It is also valuable to understand and appreciate the perspective of clinical research. As patients, we have the right to have our story and voice heard, to be treated like human beings. Our stories are an important part of who we are. Many people are exceptionally passive in their pursuit of medical care and will accept whatever negligence, avoidance, or abuse they receive. It’s up to us to be a powerful advocate for our own welfare and insist on having medical professionals listen to our stories and attend to our needs. Ways to choose physicians are discussed. Also reviewed are how to manage your medications, vaccines, and how to lower the risk of medical errors. Guidelines are presented on the advantages and dangers of participation in clinic research. It is necessary to be an active participant in your own care and fierce in the pursuit of what’s best for you.
Chapter 12 describes the multiple notification requirements contained in the Agreement on Safeguards on domestic regulations on safeguard measures as well as on key aspects of specific safeguard actions. The chapter explains the consequences of these notifications and the specific actions that other Members may take to defend their commercial interest. It also discusses the question of the adequate opportunity to hold consultations under Article 12.3 of the agreement, and the question of cross-notifications to be made by third Members. The Chapter presents statistics on the use of safeguard investigations, safeguard measures and rebalancing actions in the light of the notifications made by WTO Members between 1995 and 2020.
Chapter 15 contains an explanation of the basic rules and procedures contained in Article XIX of the GATT 1994, in the light of the developed requirements and rules contained in the Agreement on Safeguards. It is a summary that places most of the provisions of the Agreement on Safeguards in perspective with Article XIX as the starting point of the multilateral regime on safeguard measures.
Chapter 14 covers the provision on dispute settlement and consultations in the Agreement on Safeguards. This provision follows the general dispute settlement rules and procedures contained in the WTO Dispute Settlement Understanding and Articles XXII and XXIII of the GATT 1994. It is technically the legal basis for the handling of disputes on the application of the Agreement on Safeguards. Chapter 14 explains how the dispute settlement process operates at its different stages and the usual issues that arise in the conduct of safeguard disputes. The chapter also provides statistics on the performance of the WTO dispute settlement mechanism in respect of safeguard investigations and safeguard measures. It provides practical considerations derived from the experience of the author as an active litigant in dispute settlement proceedings.
Chapter 8 explains a process that is unique to the multilateral safeguard mechanism and that is sometimes misunderstood: the process of rebalancing. The chapter examines the conceptual questions that arise with the general notion of rebalancing as relating to a negotiation-derived consequence. It notes that the obligation of maintaining the balance of concessions informs the whole rebalancing exercise, in particular the consultations under Articles 8.1 and 12.3, the consideration of the means of compensation, and the notion of the withdrawal of substantially equivalent concessions and other obligations under the GATT 1994. The Chapter also explains the temporary suspension of the right to take rebalancing action under Article 8.2, and the natural tension that exists between the mandates of this provision and the conduct of dispute settlement proceedings under the DSU.
This chapter contains a comprehensive, step-by-step analysis of the consultations phase in WTO dispute settlement. Then the chapter examines the practice and procedure used to establish a WTO panel and the composition of the panel. The chapter then analyzes the panel process step-by-step, including the organizational meeting, the working procedures, the written submissions to the panel, the hearings of the panel, the interim report, and the final report. The chapter also discusses the role of third parties and of the WTO Secretariat in the panel process.
Except as otherwise provided herein, the Dispute Settlement Understanding is applicable to consultations and the settlement of disputes under this Agreement.
To design regulatory policies, agencies depend on information from the industries they are tasked to regulate. Therefore, agencies can organise consultations with the aim of obtaining information from different perspectives. This article focuses on stakeholder diversity in agency public consultations. We ask to what extent is information provided by stakeholders other than the regulated sector, such as other business interests, experts or nonbusiness interests? Stakeholder diversity is relevant as it may prevent agencies to become exposed to one-sided information and capture by specialised interests. Are there consultation design factors that foster consultation diversity? Or, is (a lack of) consultation diversity structurally shaped by the context in which an agency operates? Analysing a wide range of public consultations organised by European Union regulatory agencies indicates that most information agencies receive via consultations comes from regulated interests and that the limited participation of nonregulated interests is highly tenacious.
To advance understanding of the discrete nature of the communication processes and social interactions occurring in nurse practitioner consultations.
Background
Preceding qualitative investigations of nurse practitioner consultations have, when conducting interviews with participants, often exclusively sampled either nurse practitioners or patients. Furthermore, previous qualitative studies of the nature of nurse practitioner consultations have not typically also sampled carers attending with patients for nurse practitioner consultations. Accordingly this study was developed, in part, to address this exclusivity of sampling in qualitative research of nurse practitioner consultations by developing an inclusive sample of patient, carer and nurse practitioner participants of nurse practitioner consultations, so as to conjointly develop an understanding of the multiple perceptions of those participants of communication processes occurring in nurse practitioner consultations.
Methods
Qualitative component of a larger mixed methods case study of communication processes and social interactions in nurse practitioner consultations, utilising individual semi-structured interviews with the patient (n = 9), carer (n = 2) and nurse practitioner (n = 3) participants of video-recorded consultations derived from a nurse practitioner-led general practice clinic. Interview transcripts were initially analysed via an emergent thematic analysis, followed up by computer-assisted qualitative data analysis with NVivo 9.
Findings
The participants’ perceptions of nurse practitioner consultation communication processes and social interactions were represented through six themes: Consulting style of nurse practitioners; Nurse practitioner – GP comparisons; Lifeworld content or lifeworld style; Nurse practitioner role ambiguity; Creating the impression of time and Expectations for safety netting. The findings identify a need for policy makers to address a perceived ambiguity of the nature of the nurse practitioner role amongst patients and carers. The benefits of nurse practitioners using personable, everyday lifeworld styles of communication for optimising interactions, sharing clinical reasoning and conveying a sense of having time for patients and carers in consultations are also identified.
Obesity is a major public health issue and primary care practitioners are well placed to opportunistically raise the issue of overweight or obesity with their patients.
Aim and methods
This study investigated the prevalence of weight discussion in primary care consultations with overweight and obese patients, in a practice in Fife, Scotland, and described weight-related communication using video analysis.
Findings
Weight was raised in 25% of consultations with overweight and obese patients. GPs initiated weight discussion more often than patients; however, these attempts were often blocked by patients. Weight-related outcomes were more common when patients initiated the weight discussion. This study confirms the potential of video analysis for understanding primary care weight discussion. It also suggests that GPs may benefit from a communication-based intervention to tackle patient blocking behaviours and contributes to the evidence suggesting that interventions targeted to increase the prevalence of weight-related discussions with their patients are needed.
Requests for specialty consultation are common in emergency departments (EDs) and often contribute to delays in throughput. Our objectives were to describe the contribution of the consultation process to total ED length of stay (LOS) through novel metrics and illustrate causes of delay.
Methods:
We conducted a prospective cross-sectional study at three Canadian tertiary care centres. Adult ED patients with requested medical/surgical consultations were enrolled. We created original metric intervals: total consultation time (TCT) defined as the interval from the initial consultation request to the disposition decision, consult response time (CRT) from the request to the consultant arrival, and decision-making interval (DMI) from arrival to the disposition decision. The consultation impact index (CII) was defined as the percentage of ED LOS consumed by the TCT. Reasons for delay were documented if time stamps exceeded preset benchmarks.
Results:
The median TCT for 285 patients was 138 minutes (interquartile range [IQR]: 82–239 minutes), whereas the median total ED LOS was 778 minutes (IQR 485–1,274 minutes). The median CRT was 55 minutes (IQR 21–115 minutes), and the median DMI was 58 minutes (IQR 25–126 minutes). The CII measured 26% (95% CI 23–28). Major contributors to consultation delay included urgent ward issues, simultaneous ED consultations, and the need for additional laboratory or radiographic investigations.
Conclusion:
The consultation process is highly variable and has an important impact on ED LOS. We describe novel measures related to consultation performance and provide an analysis of what causes delays. These results can be used to seek improvements in the consulting process.
This article concerns the second round of consultations on the drafting of the 2002 Immigration and Refugee Protection Regulations. In this context, it explores the nature of the “communication space” within which regulatory authorities and interest groups interact with each other. The authors analyse the extent to which the consultations met their main goal of remedying the lack of democratic legitimacy in the process of drafting the regulations. Both discourse analysis and analysis of the concrete results of the consultations reveal that the “communication space“ is shaped by certain pre-established rules. The authors codify and compare the arguments put forward by interest groups in their proposals for modifications as well as the justifications offered by Citizenship and Immigration Canada. They conclude that issues capable of calling into question the soundness of regulatory interventions, having already been dealt with during the first round of consultations, are seldom raised during the second round. The authors also assert that the relationship between state and non-state actors is complementary and interdependent rather than antagonistic, noting that interventions by interest groups have a real impact on the regulations. Consultation is at the root of plurality of modes of production of law within the legal order of the state. The article highlights the complementary nature of the norms produced by state and other sources of normativity and draws attention to the importance of the cooperation between state and civil society actors.