In this thesis, it is postulated that a discrete body of health care law (HCL) can potentially offer more benefits to patients by providing protection for their rights and improving healthcare delivery as a result of making healthcare professionals and workers more aware of their legal duties towards patients than is the case where a field of HCL is absent. The emergence of a discrete body of HCL in England and Wales has not received a great deal of attention in the academic literature; there has not, as of yet, been any thorough study of the questions of how and why this relatively new field of law emerged three decades ago. This thesis addresses this gap in the literature and explores those attractive elements of HCL in the law of England and Wales that may be emulated by a jurisdiction like Ghana, which is seeking to develop this field of the law. A combination of legal history and empirical legal research methodologies are deployed to unpack the development of HCL in England and Wales as a response to the quest for patient empowerment in healthcare and the need to recognise the voice of society in mediating ethical dilemmas generated by rapid advances in medicine. The characteristics of HCL and rationale for its emergence in England and Wales are used as a basis of comparison within a functional comparative analytical framework in order to explore the need for the development of HCL in Ghana, as well as any lessons that may be drawn from the former.

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This thesis examines Poor Law administration in the urban industrial union of Preston, Lancashire, from the introduction of the Poor Law Amendment Act in the region in 1837 to the eve of the Lancashire Cotton Famine in 1861. For many years historiography has emphasised that, despite the attempt to engender a greater degree of uniformity through unionisation and the creation of a London based central authority, diversity was a defining characteristic of relief administration at local level under the New Poor Law just as it had been under the Old. Local studies are therefore essential to understanding how the Poor Law operated in practice, and this thesis answers repeated calls for more of them. Lancashire has received little empirical attention from welfare historians for the period after 1837, particularly at the level of individual unions, and the study therefore primarily seeks to shed new light on how policy was formed and relief provided at local level in a region that was both the most industrialised in the country and located within the heartland of the anti-Poor Law movement. It is argued that policy and practice in Preston union, like any union, was shaped by a number of broad interconnected variables, the nature and relative importance of which were each determined by local circumstances. Isolated local studies, however, can only tell us so much. Thus, the thesis seeks to draw wider and more significant conclusions by setting Preston union within a broader regional and sub-regional framework. The approach reflects recent historiography which has argued that, in spite of local differences, Poor Law administration varied considerably by region, with a particularly marked distinction having been drawn between an inclusive, perhaps generous, south and east and a less inclusive, perhaps harsh, north and west. Most research in this area has focussed on the Old Poor Law, and this study questions whether, and the extent to which, such distinctions endured into the New. The thesis challenges the notion that spatial patterns of relief at regional level indicate relative levels of generosity. It argues, instead, that socio-economic conditions were chiefly responsible for observable differences at the regional and sub-regional levels, with the durability of the makeshift economy important in the case of the former. Further, it argues that variation at all levels occurred within rather narrow parameters, and that the Poor Law fundamentally served much the same purpose across the country.

The objective of this study are: to examine the right of public participation in decision making under EIA law in Malaysia; to examine the existing limitations of public participation in decision making procedures under EIA; to examine the practice of public participation in EIA procedures; to examine public awareness of EIA and its implementation; to assess the importance of constitutional measures supporting public participation in environmental decision-making; and to examine prospects for law reform and changes in EIA law and planning procedures to improve both the level of public participation in EIA and the quality of decision making. This study adopted qualitative research. This involves at least seven data sources, which are Malaysian planning authorities, Departments of Environment (DoE), public in selected affected areas, Malaysian Non-Governmental Organisations (NGOs), EIA reports, statutes and law cases. The interview method has been used to generate data from the planning authorities, DoE, public and NGOs; and content analysis has been used while examining the EIA reports, statutes and law cases. This study identified significant lack of provision regarding right to access to information, ignorance of the EIA laws as well as its procedures on part of the public, inappropriate structured provision on right to public participation in EIA laws and restricted right to access to justice in environmental matters. It identified five significant limitations to the right to public participation; uncertainty of the EIA procedures and their uncertain legal status, limited access to information on EIA report, strict rule of standing, complexity of federal-state relationship, and lack of awareness among the public in Malaysia. In addition, this study found ignorance of the concept of ‘environmental rights’ on part of the decision makers and the public. This study concludes by highlighting the issues that need further investigation and proposes practical suggestions to the problems.

This thesis examines the causes behind why England and Sweden, as European Union (EU) Member States that share a higher concern for animal welfare, suffer similar financial drawbacks and a decrease of their farmers’ competitive strength, in spite of their fundamentally different regulatory approaches to transposing EU law. This complex situation is investigated by tracing the issue to its origin: the inherent tension stemming from the dual classification of the animals in EU primary law as both sentient beings and tradable goods. Farm animal welfare is regulated by minimum harmonising EU Directives, which permit Member States to implement stricter domestic regulatory standards. This thesis argues that these stricter standards, while being zoocentrically important in terms of enabling a higher level of farm animal welfare, also have a substantial negative economic impact upon the affected farmers, due to the higher input costs. The issue arising is that minimum Directives effectively negate the competitive strength of the farmers in ‘stricter’ Member States, as their domestic produce competes directly against imported products from Member States whose national legislation is closer to the minimum standard established by the EU Directives. This thesis critiques this situation as untenable and submits that the farmers’ competitive strength in stricter Member States can be improved by a shift in consumer purchasing behaviour, achieved by a programme that raises public awareness. The research outcome is a recommendation of the introduction of an EU-wide farm animal welfare labelling policy, one that would allow consumers to distinguish high-welfare products from low-welfare ones, where the elevated price commanded by the former would offset the higher costs incurred in their production. The benefits of this solution are that it facilitates increased competitiveness within the EU’s internal market, while maintaining and promoting higher farm animal welfare standards.

The regulation of food is a contested domain (Ansell and Vogel, 2006). Who should bear responsibility for manufacture, distribution, sale and supply and consumption of the food we consume is one of the overriding political questions of our time. The legal, moral and political authority for the regulation of food faces challenges and is subject to intense negotiation. This study sets out to explore one small part of this multifaceted and global debate. The regulation of nutrition and health claims represents a concentrated area of the broader treatise. Nutrition and health claims are common in commercial communications used in the promotion of food. The use of such claims is strictly controlled by the Nutrition and Health Claims (England) Regulation 2007 and much has been written about the rationale for the Regulation. By contrast, the study of the enforcement of the Regulation is relatively neglected. The original contribution to knowledge made by this work is the finding that the enforcement of the regulation relies on the application of the broad discretion allowed to local authority enforcers and this results in variances in enforcement style. Notwithstanding such differences in style, one clear theme emerged: that enforcers largely deploy an accommodative approach based on advice rather than a deterrent approach reliant on prosecution. The study adopts a qualitative methodology with semi-structured interviews of those responsible for the enforcement of the law, namely trading standards officers and environmental health officers to assess their views and attitudes. It was found that factors affecting the application of the discretion ranged from the local priorities of the authority and the availability of resources to effectively control the use of such claims. While the discretion allowed for authorities to respond to the particular needs of their community, it makes for a ‘postcode lottery’ in differences in the way in which the same claims that are used across multiple authorities are enforced. It was found that in common with other legislation where enforcement is ceded to local authorities, the system of enforcement would benefit from greater consistency of practice.

The emergence of a harm reduction approach for drug users has prompted extensive debate in many countries. However, in Malaysia the pertinent issues regarding the bases of such an approach and its consonance with the criminal justice approach have received little attention. This thesis examines the justifications for the harm reduction approach in Malaysia, its compatibility with the existing criminal justice approach and ways of reconciling both approaches in the event of conflicts between them within a socio-legal sphere of analysis. Building on philosophical and scientific judgements, this thesis argues that Malaysia should implement the harm reduction approach and argues that it is congruent with public health ethics, utilitarianism, human rights protection and the Islamic principles of ‘hajiyyat’ (needs), ‘darurah’ (necessity) and ‘al-∂arar al-ashaddyuzalu bi’l-∂arar al-akhaff’(tolerating a lesser harm to eliminate a greater one). The approach also fits in with the abstinence orientation adopted within drug prohibition policy and the confines of the international drug control conventions. The Methadone Maintenance Therapy (MMT) and Needle and Syringe Exchange Programme (NSEP) harm reduction measures are further justified by their efficacy and cost-effectiveness in decreasing drug use and HIV pathogen transmission. This thesis also argues that any alleged unintended adverse consequences of harm reduction are limited or absental together. Moreover, with regard to the issue of compatibility between the harm reduction and criminal justice approaches, this thesis emphasises that there are significant theoretical and practical conflicts between the two approaches as they are currently understood and practised in Malaysia. The tensions arises principally from law enforcement practices, predominantly the street-level policing activities, reflecting the lack of commitment of criminal justice actors to the harm reduction strategy, despite the existence of government initiatives to support harm reduction. The thesis suggests important options for reconciling both approaches, particularly at a conceptual level. Finally, this thesis argues for incorporating the harm reduction approach as an important component of overall drug policy under a sustained prohibitionist framework.

This thesis will argue that it is crucial for the courts in clinical negligence claims to play a proactive role in ensuring effective standards in medicine and to provide adequate redress if these standards are not met. I will argue that the courts are, and always have been, the ultimate arbiters of the standard of care in clinical negligence and that it is only right and proper for this to be so. There was a considerable period when the English courts seemingly abdicated responsibility to the clinicians, and failed in carrying out even the most rudimentary checks as to the credibility of expert witnesses. Many commentators blamed the direction to the jury given by McNair J in Bolam. Yet Bolam of itself did not offer any sort of privilege to doctors. Other powerful factors were acting on the judiciary of this period, skewing the way in which the courts set the standard of legally acceptable medical care. The fear of defensive medicine, the special status ascribed to clinical knowledge and the presumed particularly altruistic nature of its proponents. That the courts now have the authority to set the appropriate standard of care in clinical negligence is not a particularly contentious claim. But the Bolitho decision, in and of itself, will not be sufficient impetus to ensure that such unjustified weight is not accorded to the profession’s own views again. Bolitho does no more than restore the true meaning of Bolam.There have also in the past decade been changes to clinical professional practice largely led by the medical profession themselves. An increase in evidence based medicine including the usage of clinical guidelines provides a framework for a more assertive judiciary less likely to fall back into deference. In order to provide comprehensive and effective redress within the modern NHS the existence and extent of various institutional primary direct duties of care must be determined. In the increasingly complex healthcare system both commissioners and providers of healthcare must owe a duty to ensure care is taken. The courts must not compromise from an irreducible standard of reasonable care, despite the resource issues facing institutions. A distorted interpretation of Bolam must not be permitted to be revived when the institutional duty is invoked.

This research stems from a normative concern about environmental justice and about how people, particularly those facing environmental threats, can become involved in policy making around environmental issues or have their concerns represented within the policy making process. Within Europe, there is increasing concern about a democratic deficit and a perceived gap between policy makers and citizens. In this context, the role ofNGOs is increasingly becoming important but there are concerns that NGO engagement in the EU policy process may weaken democratic policy making with regard to how the gap is bridged between policy makers and those affected by policies. The research has explored how and why NGOs engage with the EU policy making process around environmental issues. By asking questions about how NGOs prioritise environmental issues, the practices they undertake and the outcomes from their activity, the research assesses the role of NGOs in representing environmental issues within the EU policy process, and how their activity may promote or constrain the achievement of environmental justice in Europe. The research is based on a case study of the Via Baltica road corridor through Poland and the Baltic States, part of the Trans-European Transport Network. Interviews were carried out along the corridor and in Brussels with key stakeholders, including representatives from environmental NGOs and policy makers. The research found that, along the Via Baltica, NGOs have played a role in raising environmental issues at all levels of policy making and have the ability to engage with policy makers in proactive ways. However their concerns are biased in favour of nature protection and they do not represent the views of local residents in their activities. Moreover the opportunities for engagement and the nature of EU policy making impacts on the way that NGOs can engage with the policy process. Therefore whilst NGOs could, in principle, promote environmental justice in the EU, the structures they operate within and the practices adopted at different scales limit their ability to do so.

The growing evidence that humanity has entered the Anthropocene raises significant concerns over the existential survival of individuals, states, and of life on Earth itself. In response to the increasingly global nature of environmental problems, international environmental law (IEL) has emerged to facilitate collective efforts by states to mitigate ecological harm. In more recent times, the role of IEL has centred on addressing the balance between development, economic growth, and the need to protect the environment for future generations. In light of mounting evidence over the role of environmental degradation and the negative impact of humanity’s activities on the Earth, concerns over how such destruction can exacerbate conflict and undermine security, development, and economic growth have been raised by the United Nations Security Council and other international forums. The increasing associations between environment and security in international circles and by states poses the questions of how states perceive the ‘environment’ and for what reasons do they protect it? This thesis examines the extent to which this convergence between environment and security alters the way in which the international community seek to protect the environment, and in turn, what this suggests about their perception of the environment. Drawing on ecofeminist theory to develop an analytical framework, it examines the preparatory reports and outcome texts from eight environmental regimes in relation to three areas of international environmental law-making. It examines who participates in the development of IEL in order to reveal any tensions between the principle of participation included in sustainable development, and the exclusionary practices in some environmental areas that are closely connected to the environment and national interests. It then considers the justifications for the integration of other non-environmental considerations, such as development, economic, security, and technology into IEL, and their influence on states’ perception of the environment. The thesis concludes that despite the broader participation by NSAs in the development of IEL, changes in states’ priorities over time, and the growing convergence between security and environment, the western anthropomorphic perception of the environment prevails in law-making at an international level.