Active afforestation of drained peatlands is not a viable option under the EU Nature Restoration Law.

The EU Nature Restoration Law (NRL) is critical for the restoration of degraded ecosystems and active afforestation of degraded peatlands has been suggested as a restoration measure under the NRL. Here, we discuss the current state of scientific evidence on the climate mitigation effects of peatlands under forestry. Afforestation of drained peatlands without restoring their hydrology does not fully restore ecosystem functions. Evidence on long-term climate benefits is lacking and it is unclear whether CO2 sequestration of forest on drained peatland can offset the carbon loss from the peat over the long-term. While afforestation may offer short-term gains in certain cases, it compromises the sustainability of peatland carbon storage. Thus, active afforestation of drained peatlands is not a viable option for climate mitigation under the EU Nature Restoration Law and might even impede future rewetting/restoration efforts. Instead, restoring hydrological conditions through rewetting is crucial for effective peatland restoration.

Our hands are tied: abortion bans and hesitant medicine.

Trained for decades to analyze risks, benefits, unique body compositions, and complex medical scenarios, healthcare providers are now faced with one of medicine's most trying obstacles: how to practice medicine when new abortion bans contradict best practice standards. Drawn from qualitative interviews with medical providers in Tennessee, USA conducted between October 2022 and December 2022, this study shows how medical providers often must make medical decisions based on legal risks as opposed to standards of care. This is particularly significant as malpractice insurance does not cover criminal charges. In states with abortion bans, often hastily implemented and subject to changes by lawmakers, medical providers are now practicing a new kind of defensive medicine in an effort to protect themselves from legal threats. We call this hesitant medicine, where providers often experience a tension between their own legal protection and the well-being of their patients, making them hesitant to provide necessary abortion care. This has serious, far-reaching consequences. We focus on three distinct arenas impacted by this new form of defensive medicine, specifically: providers' decision-making around patient care, impacts on patient relationships, and finally, what we call the ultimate defense, leaving states with abortion bans to move to states with fewer legal risks. We conclude with commentary on potential ways to reduce the negative impacts of these trends.

Impacts of pilot carbon emission trading policies on urban environmental pollution: Evidence from China.

The trading of carbon emissions is a crucial regulatory method to address environmental pollution issues. This study takes China's carbon emission trading pilot policy established in 2013 as a quasi-natural experiment and uses the DID model to empirically test the urban panel data from 2006 to 2019. The results show that the carbon emission trading pilot policy can effectively reduce urban environmental pollution, and this effect is more noticeable in mid-western cities, northern cities, cities with fewer resources, and large-scale cities. In addition, to address the urban environmental pollution problem through this policy, the government is encouraged to raise its environmental protection awareness and put more effort into the innovation of technology. In general, this study uses carbon emission trading policies from China to confirm that market-based incentive environmental regulation tools can effectively reduce environmental pollution in urban areas. These findings can provide more theoretical support and empirical evidence for the government to use mechanisms of the market to effectively solve pollution problems, improve ecological environment quality, and accelerate the realization of green economy.

Awareness and practice of Revised Code of Dental Ethics and Consumer Protection Act among dental practitioners in Andhra Pradesh: A cross sectional study.

BACKGROUND: Given the imperative for dental practitioners to be familiar with the existing ethical principles and laws governing their practice, this study aimed to evaluate awareness and practice of the dentists (code of ethics) regulations 2014 and consumer protection act 2019 among dental practitioners in Andhra Pradesh state, India. METHODS: A cross sectional study was conducted among 384 dental practitioners in Andhra Pradesh state, India. A questionnaire consisting of 25 items was used to assess awareness and practice of the dentists (code of ethics) regulations and consumer protection act. The data collected were analysed using IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp. RESULTS: Only 53(13.8%) dental practitioners in the study were aware that the dentists (code of ethics) regulations had been revised in 2014. About 190 (49.5%) practitioners were aware of the precise period for mandatory preservation of patient records. Most dental practitioners (278, 72.4%) accepted commissions in the form of gifts or cash from laboratories, radiologists, or pharmacists and 306 (79.7%) dental practitioners used unregistered dental lab technicians as employees in their practice. Furthermore, 297 (77.3%) practitioners were found to provide or sell drugs to patients in their clinic/office. The new regulations under consumer protection act 2019 were unknown to 194 (50.5%) dental practitioners. CONCLUSIONS: The present study indicates that the awareness of dental practitioners towards the dentists (code of ethics) regulations 2014 and consumer protection act 2019 is inadequate. It highlights the need for training programmes and curriculum changes with a focus on ethical and legal issues in clinical dental practice.

COMMENTARY: Protecting healthcare privacy: Analysis of data protection developments in India.

Patient privacy is essential and so is ensuring confidentiality in the doctor-patient relationship. However, today's reality is that patient information is increasingly accessible to third parties outside this relationship. This article discusses India's data protection framework and assesses data protection developments in India including the Digital Personal Data Protection Act, 2023.

COMMENTARY: Public health ethics and the Kerala Public Health Act, 2023.

This commentary looks at the Kerala Public Health Act (KPHA), passed on November 28, 2023, through the lens of public health ethics. While the Act recognises the importance of prevention and strengthening of social systems, it falters in the public health ethics and human rights framework, ignoring international public health principles such as the Siracusa Principles and guidelines for individual diseases such as tuberculosis. The Covid-19 pandemic in India itself offers ample learnings, which have been disregarded, on the need for caution against state overreach. Principles such as autonomy, privacy/confidentiality, transparency, accountability, rule of law, least harm etc have not even been given token consideration, making this law a potential tool of abuse, particularly against already vulnerable communities.

Strategies for integrating scientific evidence in water policy and law in the face of uncertainty.

Understanding how human actions and environmental change affect water resources is crucial for addressing complex water management issues. The scientific tools that can produce the necessary information are ecological indicators, referring to measurable properties of the ecosystem state; environmental monitoring, the data collection process that is required to evaluate the progress towards reaching water management goals; mathematical models, linking human disturbances with the ecosystem state to predict environmental impacts; and scenarios, assisting in long-term management and policy implementation. Paradoxically, despite the rapid generation of data, evolving scientific understanding, and recent advancements in systems modeling, there is a striking imbalance between knowledge production and knowledge utilization in decision-making. In this paper, we examine the role and potential capacity of scientific tools in guiding governmental decision-making processes and identify the most critical disparities between water management, policy, law, and science. We demonstrate how the complex, uncertain, and gradually evolving nature of scientific knowledge might not always fit aptly to the legislative and policy processes and structures. We contend that the solution towards increased understanding of socio-ecological systems and reduced uncertainty lies in strengthening the connections between water management theory and practice, among the scientific tools themselves, among different stakeholders, and among the social, economic, and ecological facets of water quality management, law, and policy. We conclude by tying in three knowledge-exchange strategies, namely - adaptive management, Driver-Pressure-Status-Impact-Response (DPSIR) framework, and participatory modeling - that offer complementary perspectives to bridge the gap between science and policy.

Practical implications of overlapping mental capacity assessments.

Richard Griffith, Senior Lecturer in Health Law at Swansea University, considers the practical implications of undertaking mental capacity assessments with a person across a range of different decisions.

[Digital health in Latin America: current legislation and ethical aspectsSaúde digital na América Latina: legislação atual e aspectos éticos]. / Salud digital en América Latina: legislación actual y aspectos éticos.

Objectives: Describe the current legislation on electronic medical records (EMR) and telehealth in Latin American countries and analyze the treatment of confidentiality and professional secrecy. Methods: Between March and September 2022, a survey of the regulations in force in 21 Latin American countries was conducted at two levels: the existence of legislation on EMR and telehealth, and the treatment of confidentiality and professional secrecy in EMR and telehealth. A data extraction form was prepared for each country. Data were collected from official on-line sources. The information was analyzed qualitatively and synthesized in tables when possible. Results: The use of EMR is legally regulated in 16 countries. Nineteen countries have legislation on telehealth. All the countries analyzed safeguard confidentiality and professional secrecy through regulations. However, confidentiality and professional secrecy are mentioned in 11 countries in the context of telehealth, and in only nine countries in the context of EMR. Conclusions: Since the start of this century, Latin America has made progress in the legislation of digital tools for health care, such as EMR and telehealth. There is also interest in ethical issues related to the use of EMR and telehealth, particularly confidentiality and professional secrecy, aspects that should be strengthened in digital health.

Objetivo: Descrever a legislação vigente sobre prontuários eletrônicos e telessaúde nos países da América Latina e analisar o tratamento da confidencialidade e do sigilo profissional. Métodos: Entre março e setembro de 2022, realizou-se um levantamento sobre a regulamentação vigente nos 21 países latino-americanos incluídos no estudo, em dois níveis: i) existência de legislação sobre prontuários eletrônicos e telessaúde; e ii) tratamento da confidencialidade e do sigilo profissional em prontuários eletrônicos e telessaúde. Uma planilha para extração de dados foi elaborada para cada país. Os dados foram coletados de fontes oficiais disponíveis on-line. Foi realizada uma análise qualitativa das informações, que foram resumidas em tabelas, quando possível. Resultados: O uso dos prontuários eletrônicos é legalmente regulamentado em 16 países. Quanto à telessaúde, 19 países têm legislação sobre essa ferramenta. Todos os países analisados protegem a confidencialidade e o sigilo profissional por meio de regulamentação. No entanto, no contexto da telessaúde, eles são mencionados em 11 países; já no contexto dos prontuários eletrônicos, em apenas 9 países. Conclusões: Desde o início dos anos 2000, a América Latina vem avançando em relação à legislação sobre ferramentas digitais na atenção à saúde, como prontuários eletrônicos e telessaúde. Há também interesse nas questões éticas relacionadas ao uso de prontuários eletrônicos e telessaúde, especialmente em relação à confidencialidade e ao sigilo profissional, embora esses aspectos precisem ser reforçados na saúde digital.

States' Abortion Laws Associated With Intimate Partner Violence-Related Homicide Of Women And Girls In The US, 2014-20.

Women who are pregnant or recently gave birth are significantly more likely to be killed by an intimate partner than nonpregnant, nonpostpartum women of reproductive age, implicating the risk of fatal violence conferred by pregnancy itself. The rapidly increasing passage of state legislation has restricted or banned access to abortion care across the US. We used the most recent and only source of population-based data to examine the association between state laws that restrict access to abortion and trends in intimate partner violence-related homicide among women and girls ages 10-44 during the period 2014-20. Using robust difference-in-differences ecologic modeling, we found that enforcement of each additional Targeted Regulation of Abortion Providers (TRAP) law was associated with a 3.4 percent increase in the rate of intimate partner violence-related homicide in this population. We estimated that 24.3 intimate partner violence-related homicides of women and girls ages 10-44 were associated with TRAP laws implemented in the states and years included in this analysis. Assessment of policies that restrict access to abortion should consider their potential harm to reproductive-age women through the risk for violent death.

Chapitre 1. La charge professionnelle du télétravailleur.

The organization of work through the remote practice of professional activity maintains a strong link with the notion of workload, given the implications that can be generated in terms of duration, work intensification and therefore overload for the teleworker. The legal mobilization of this notion is developing with the very expansion of the practice of telecommuting. Under the banner of the employer’s general safety obligation, case law and legislation are likely to evolve (by reinforcing the obligation to control and monitor workloads), as is the case with the « forfait en jours » system, another flexible work organization method.

Chapitre 4. L'accident du travail chez soi.

The widespread use of teleworking during the health crisis reduced the flow of occupational accident claims by 20%. This applies to commuting accidents, as well as claims related to « immediate » or “deferred” risks (Rapp. annuel 2020 de l’Assurance maladie - Risques professionnels : Eléments statistiques et financiers, déc. 2021, p. 2 and 113). On the basis of these figures, working at home could be analyzed as a means of preventing occupational risks and improving workers’ health. In reality, however, these figures should not obscure the fact that telecommuting is a major occupational hazard. This is all the more the case given that, while telecommuting was not very widespread before the pandemic, it is now popular with employees and is being developed by many companies as a source of productivity (Rapp. CNP, May 16 2022). We therefore need to keep a close eye on the development of workplace accident legislation in this area, its adaptability to the specific claims experience of teleworkers and its perfectibility, not forgetting the thorny question of the possible recognition of the employer’s inexcusable fault in the event of the accident being covered by professional legislation.

Chapitre 2. Le télétravail et la prévention des risques professionnels.

The Covid-19 pandemic has spurred the development of telecommuting in many companies, which are now tending to make it a permanent fixture for activities that lend themselves to it. Despite its advantages, however, telecommuting does not exclude all occupational risks when carried out from the employee’s home. Under these conditions, the employer must guarantee the protection of teleworkers’ health by virtue of his safety obligation. But the implementation of a preventive approach is severely challenged by a private space that is beyond the employer’s control. What are these difficulties? How can we proceed? The ANI of November 26, which clarifies the legal framework for telecommuting, offers a few clues, and suggests a form of empowerment for employees and their managers.

Chapitre 3. La prévention des risques psychosociaux en contexte de télétravail : des questions (encore et toujours) en suspens.

For a long time, telecommuting was an atypical and little-used form of work organization. But the health crisis has changed all that. The rise of telecommuting has led to a radical transformation of the professional landscape. Its impact on the health of teleworkers is both major and little-known. In particular, the psychosocial risks induced by this work organization are difficult to grasp. What’s more, the law applicable to the protection of health in the workplace has not been adapted. All these circumstances call into question the need to create a common set of rules specific to telecommuting.