Discriminatory attitudes against unvaccinated people during the pandemic.

During the COVID-19 pandemic, sizeable groups of unvaccinated people persist even in countries with high vaccine access1. As a consequence, vaccination became a controversial subject of debate and even protest2. Here we assess whether people express discriminatory attitudes in the form of negative affectivity, stereotypes and exclusionary attitudes in family and political settings across groups defined by COVID-19 vaccination status. We quantify discriminatory attitudes between vaccinated and unvaccinated citizens in 21 countries, covering a diverse set of cultures across the world. Across three conjoined experimental studies (n = 15,233), we demonstrate that vaccinated people express discriminatory attitudes towards unvaccinated individuals at a level as high as discriminatory attitudes that are commonly aimed at immigrant and minority populations3-5. By contrast, there is an absence of evidence that unvaccinated individuals display discriminatory attitudes towards vaccinated people, except for the presence of negative affectivity in Germany and the USA. We find evidence in support of discriminatory attitudes against unvaccinated individuals in all countries except for Hungary and Romania, and find that discriminatory attitudes are more strongly expressed in cultures with stronger cooperative norms. Previous research on the psychology of cooperation has shown that individuals react negatively against perceived 'free-riders'6,7, including in the domain of vaccinations8,9. Consistent with this, we find that contributors to the public good of epidemic control (that is, vaccinated individuals) react with discriminatory attitudes towards perceived free-riders (that is, unvaccinated individuals). National leaders and vaccinated members of the public appealed to moral obligations to increase COVID-19 vaccine uptake10,11, but our findings suggest that discriminatory attitudes-including support for the removal of fundamental rights-simultaneously emerged.

Estimating the value of democracy relative to other institutional and economic outcomes among citizens in Brazil, France, and the United States.

How much do citizens value democracy? How willing are they to sacrifice their liberties and voting rights for growth, equality, or other social outcomes? We design a conjoint experiment in nationally representative surveys in Brazil, France, and the United States in which respondents choose between different societies that randomly vary in their economic outcomes (country income, income inequality, social mobility), political outcomes (democracy, public health insurance), and the level of personal income for each respondent. Our research allows us to estimate the respondents' willingness to trade off democracy for individual income (as well as other societal attributes). We find that, on average, individuals are strongly attached to democracy and a robust welfare state. They prefer to live in a country without free democratic elections only if their individual income multiplies by at least three times and in a country without public health insurance only if their individual income more than doubles. After estimating these preferences at the individual level for all respondents, we show that, although there is an authoritarian minority in all three countries, forming a nondemocratic majority (by offering more income and/or other goods to respondents) is very unlikely. Our findings imply that, contrary to a growing discussion about the crisis of democracy, liberal democratic values remain substantially robust in high and middle income democracies.

Human rights and the COVID-19 pandemic: a retrospective and prospective analysis.

When the history of the COVID-19 pandemic is written, the failure of many states to live up to their human rights obligations should be a central narrative. The pandemic began with Wuhan officials in China suppressing information, silencing whistleblowers, and violating the freedom of expression and the right to health. Since then, COVID-19's effects have been profoundly unequal, both nationally and globally. These inequalities have emphatically highlighted how far countries are from meeting the supreme human rights command of non-discrimination, from achieving the highest attainable standard of health that is equally the right of all people everywhere, and from taking the human rights obligation of international assistance and cooperation seriously. We propose embedding human rights and equity within a transformed global health architecture as the necessary response to COVID-19's rights violations. This means vastly more funding from high-income countries to support low-income and middle-income countries in rights-based recoveries, plus implementing measures to ensure equitable distribution of COVID-19 medical technologies. We also emphasise structured approaches to funding and equitable distribution going forward, which includes embedding human rights into a new pandemic treaty. Above all, new legal instruments and mechanisms, from a right to health treaty to a fund for civil society right to health advocacy, are required so that the narratives of future health emergencies-and people's daily lives-are ones of equality and human rights.

Stopping the Vicious Cycle: Equitable Enforcement Strategies to Achieve Safe, Stable, and Accessible Housing for People with Disabilities.

Policy Points People with disabilities experience a vicious cycle of poverty, poor health, and marginalization partly because of the inequitable implementation and enforcement of laws, including underenforcement of civil rights and housing laws and overenforcement of punitive nuisance and criminal laws. Inequitable enforcement reflects policy choices that prioritize powerful entities (e.g., landlords, developers) to the detriment of people who experience intersectional structural discrimination based on, for example, race, disability, and income. Equitable enforcement, a process of ensuring compliance with the law while considering and minimizing harms to marginalized people, can promote health and disability justice by increasing access to safe, stable, and accessible housing.

Health Risks of Unaccompanied Immigrant Children in Federal Custody and in US Communities.

Unaccompanied immigrant children continue to arrive at the US-Mexico border and are at high risk for ongoing abuse, neglect, and poor mental and physical health. We are medical and legal experts in the fields of immigrant and refugee health, child abuse, and the legal rights of international refugee and migrant children. We provide an overview of US federal agencies with custody of unaccompanied immigrant children, a summary of medical care provided while in custody, and recent findings from the independent Juvenile Care Monitor Report mandating new custodial conditions for immigrant children while in federal custody. We provide recommendations to improve the health and well-being of unaccompanied immigrant children while in custody and once released to US sponsors. (Am J Public Health. 2024;114(3):340-346. https://doi.org/10.2105/AJPH.2023.307570).

From moral rights to legal rights? Lessons from healthcare contexts.

Many believe the existence of a moral right to some good should lead to recognition of a corresponding legal right to that good. If, for instance, there is a moral right to healthcare, it is natural to believe countries should recognize a legal right to healthcare. This article demonstrates that justifying legal rights to healthcare is more difficult than many assume. The existence of a moral right is insufficient to justify recognition of a corresponding justiciable constitutional right. Further conditions on when it is appropriate to recognize constitutional rights are rarely satisfied in the healthcare case. And focusing on aspirational or statutory rights presents costs for those seeking to justify legal rights on the basis of corresponding moral ones while maintaining empirical challenges for justifying constitutional rights. This suggests movement from a moral right to a corresponding legal one is far from straightforward and justifies examining alternative means of realizing moral socio-economic rights such as the proposed moral right to healthcare.

Global Health Impact: Human rights, access to medicines, and measurement.

Should people have a legal human right to health? And, if so, what exactly does protecting this right require? This essay defends some answers to these questions recently articulated in Global Health Impact. It explains how these answers depend on a particular way of thinking about health and the minimally good life, how quality of life matters at and over time, what various agents should do to help people who are unable to live well enough, and many other things. Moreover, it suggests some ways of improving common metrics for measuring and advancing our collective global health impact.

Debate: Involuntary treatment - not whether, but when and what else is needed.

Involuntary treatment is a complex dialectic balancing self-autonomy and the individual's right to consent to treatment with society's duty to protect those suffering from severe mental illness who are at risk of causing harm to themselves or others. When necessary, involuntary treatment should provide evidence-based and medically justified care, with sufficient oversight and due process to protect the rights of patients. Clinically, the issue is not whether involuntary treatment should ever be used, but rather what other services are needed to enhance the quality of care within comprehensive community systems of care, thus limiting or preventing the need for involuntary interventions while also improving the outcomes of individuals affected by severe mental illness.

Sieyès's Constitutional Jury, the Pennsylvania Council of Censors, and the Debate on the Conservative Power in the French Revolution.

Emmanuel-Joseph Sieyès's 1795 proposal for a Constitutional Jury is usually portrayed as the first proposal for an institution to control the constitutionality of laws, and thus the ancestor of the modern constitutional court. Challenging this view, this article resituates the Constitutional Jury in a broader transatlantic tradition concerned with creating a conservative power, a non-judicial and explicitly political constitutional guardian, and demonstrates the influence of the 1776 Pennsylvania Council of Censors on Sieyès's Constitutional Jury. Drawing upon the insights provided by this tradition, it then reevaluates the history of constitutionalism and the contemporary crisis of constitutional guardianship.

When Do Observers Deprioritize Due Process for the Perpetrator and Prioritize Safety for the Victim in Response to Information-Poor Allegations of Harm?

We examined how observers assess information-poor allegations of harm (e.g., "my word against yours" cases), in which the outcomes of procedurally fair investigations may favor the alleged perpetrator because the evidentiary standards are unmet. Yet this lack of evidence does not mean no harm occurred, and some observers may be charged with deciding whether the allegation is actionable within a collective. On the basis of theories of moral typecasting, procedural justice, and uncertainty management, we hypothesized that observers would be more likely to prioritize the victim's safety (vs. to prioritize due process for the perpetrator) and view the allegation as actionable when the victim-alleged perpetrator dyad members exhibit features that align with stereotypes of victims and perpetrators. We supported our hypothesis with four studies using various contexts, sources of perceived prototypicality, due-process prioritization, and samples (students from New Zealand, Ns = 137 and 114; Mechanical Turk workers from the United States; Ns = 260 and 336).

Judicial Review of Public Health Powers Since the Start of the COVID-19 Pandemic: Trends and Implications.

During the COVID-19 pandemic, officials in the United States at all levels of government utilized their legal authorities to impose a wide range of measures designed to control the spread of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2; the causative agent of COVID-19), including shutting down businesses, limiting the size of gatherings, requiring masking, and mandating vaccination. These orders and regulations were challenged in court cases that resulted in more than 1000 judicial decisions. Common claims were based on alleged procedural and substantive due process violations, violations of religious liberty, and violations of officials' scope of authority. In more than three fourths of the decisions, the court refused to grant the plaintiffs the relief sought. However, plaintiffs found success in several notable cases, especially in federal court. These recent decisions, as well as broader prepandemic trends, have important implications for public health officials' exercise of their public health powers, especially when those exercises implicate religious liberty. In this legal environment, officials may need to rely more on the powers of persuasion than on their legal authority alone. (Am J Public Health. 2023;113(3):280-287. https://doi.org/10.2105/10.2105/AJPH.2022.307181).

Falling through the cracks: Failing to identify compromised Miranda abilities for defendants with limited cognitive capacities.

Custodial suspects must be informed of their Miranda rights (Miranda v. Arizona, 1966) prior to police questioning. Since this landmark decision, scholars have rigorously studied Miranda comprehension and reasoning among vulnerable groups including those with intellectual disabilities (ID). However, the focus on ID has left arrestees with limited cognitive capacities (i.e., LCCs with IQs between 70 and 85) entirely overlooked. The current dataset addressed this oversight using a large (N = 820) sample of pretrial defendants who had completed the Standardized Assessment of Miranda Abilities (SAMA). Traditional (i.e., ID and no-ID) criterion groups were first analyzed with the standard error of measurement (SEM) removed. Second, a nuanced three-group framework included defendants with LCCs. Results indicate that LCC defendants are vulnerable to impaired Miranda comprehension (i.e., limited recall of the Miranda warning and deficits in Miranda-related vocabulary knowledge). Not surprisingly, their waiver decisions were often impaired by crucial misconceptions (e.g., seeing the investigating officers as beneficently on their side). The practical implications of these findings were underscored with respect to Constitutional safeguards for this critically important group, who have appeared to fall through the cracks in the criminal justice system.

Taking the next step in Miranda evaluations: Considering racial trauma and the impact of prior police contact.

By law, before interrrogating a suspect who is in custody, the police should inform them of their Miranda rights-the rights against self-incrimination and to an attorney. When a suspect or defendant waives their Miranda rights, a judge ultimately determines whether the waiver was legal. In making this determination, the judge employs the totality of the circumstances (TOC) analysis, which includes factors related to the individual defendant as well as the environment in which they waived their rights. Frequently, forensic psychologists evaluate a defendant to offer courts a clinical opinion about the defendant's ability to understand and appreciate their Miranda rights and to provide other TOC information. These evaluations are referred to as Miranda evaluations. Using Miranda evaluations as an illustration, this article describes how the critical, yet often overlooked, concepts of racial trauma and vicarious and direct prior police contacts should routinely be considered as part of forensic evaluations. After providing a succinct overview of the relevant legal issues related to Miranda rights and of the existing guidelines for conducting Miranda evaluations, we discuss the psychological impact of racial trauma and prior vicarious and direct police contacts. We provide case examples to illustrate how evaluators can consider the impact of racial trauma and prior police contact when conducting Miranda evaluations. This article serves as a practical guide for understanding how and why-in the context of their lived experiences-suspects may waive their Miranda rights. Finally, we recommend how to improve policy and research to better capture issues related to racial trauma and prior police contacts. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Reshaping Insanity in Pakistani Law: The Case of Safia Bano.

This Article analyzes the 2021 judgment of the Supreme Court of Pakistan in the case of Mst. Safia Bano v. Home Department, Government of Punjab. The case has garnered significant local and international attention due to the Court's ruling that a death sentence may not be carried out on a defendant who has a mental illness. Setting the case against the backdrop of Pakistan's Islamic and colonial contexts, this article argues that the Supreme Court has reshaped the insanity defense in Pakistani law by placing the determination of a defendant's mental state mainly in the hands of medical professionals. However, the Court's reliance on medical professionals and the subsequent downplaying of the "moral capacity" element of the insanity defense-a determination of law made by courts-has created an obstacle for courts to punish offenders more stringently in future cases due to the popular belief that mental health professionals are ill-equipped to answer broader questions of justice for victims and society. The article recommends that this issue can be remedied by establishing an objective legal test for insanity that considers Islamic law, Pakistani precedent, and advances in medical science.

Potential Effects of Dobbs v. Jackson Women's Health on Civil Commitment Law.

Since the publication of the U.S. Supreme Court's decision in Dobbs v Jackson Women's Health in June of 2022, much attention has been paid to the direct effects of that decision on reproductive health care for pregnant or potentially pregnant individuals; and to the potential effects of the Court's approach in Dobbs to other established precedent related to privacy and autonomy, such as rights to contraception and marriage equality. This Article will explore another potential negative consequence of Dobbs; its potential effect on the constitutional parameters of the law of civil commitment and involuntary medication of the mentally ill.The foundational Supreme Court case establishing the parameters of the State's right to involuntarily commit an individual to a mental institution was decided only two years after Roe v. Wade. In 1975, the Supreme Court in O'Connor v Donaldson held that an individual has a liberty interest in "prefer[ring] one's home to the comforts of an institution," and that a State could not, "without more," confine a non-dangerous individual. The two-prong test of requiring a showing of both mental illness and dangerousness to one's self or to others has remained the cornerstone of civil commitment law ever since.The language and analysis of O'Connor is similar to that of Roe, the abortion rights case overturned by Dobbs. In particular, the grounding of the right to avoid civil commitment in the individual liberty and privacy interests are common themes in the two cases. The current Court, in its decision in Dobbs, has cast substantial doubt on the continued vitality of that analysis; and one can easily imagine a reconceptualization of O'Connor along the lines of Dobbs that substantially alters the requirements for civil commitment. In particular, the reliance in Dobbs and other recent Supreme Court opinions on historical precedent as a linchpin of originalist analysis could lead the Court to search for justifications in colonial or 19th-century mental health practices, time periods which predate modern psychiatric science.This Article will explore the parallels in approach between Roe and O'Connor, and will suggest ways in which the post-Dobbs Supreme Court majority might disrupt the civil commitment status quo, including potential expansion of civil commitment or other detention of pregnant individuals for the protection of the fetus; and possible relaxation of the dangerousness requirement for civil commitment articulated in O'Connor.

Freedom, Rights, and Vaccine Refusal: The History of an Idea.

We analyzed how activists opposed to vaccination have used arguments related to freedom, liberty, and individual rights in US history. We focused on the period from the 1880s through the 1920s, when the first wave of widespread and sustained antivaccination activism in this country occurred. During this era, activists used the language of liberty and freedom most prominently in opposition to compulsory vaccination laws, which the activists alleged violated their constitutionally protected rights. Critics attacked vaccination with liberty-based arguments even when it was not mandatory, and they used the language of freedom expansively to encompass individuals' freedom to choose their health and medical practices, freedom to raise their children as they saw fit, and freedom from the quasicoercive influence of scientific and medical experts and elite institutions. Evidence suggests that in recent years, vaccine refusal has increasingly been framed as a civil right. We argue that this framing has always lain at the heart of resistance to vaccination and that it may prove consequential for the rollout of COVID-19 vaccines. (Am J Public Health. 2022;112(2):234-241. https://doi.org/10.2105/AJPH.2021.306504).