Voices of the vulnerable: Exploring the livelihood strategies, coping mechanisms and their impact on food insecurity, health and access to health care among Syrian refugees in the Beqaa region of Lebanon.

Lebanon has approximately one million Syrian refugees (SR) registered with the United Nations High Commission on Refugees (UNHCR) and an unknown number of unregistered SR, who cannot benefit from formal assistance. This study aimed to examine the livelihoods, coping strategies, and access to healthcare among SR based on registration status and accompanying formal assistance. A mixed-method approach with more emphasis on the qualitative design was adopted. A purposive convenient sampling approach was used to recruit SR from informal tented settlements (ITS) in the Beqaa region in Lebanon. Data collection included 19 focus group discussions (FGDs) that were conducted with participants, who were further divided into three groups: registered refugees with assistance, registered without assistance and unregistered. Twelve in-depth interviews were conducted with key informants from humanitarian organizations. All interviews and FGDs were audio recorded, transcribed, and thematically analyzed. SR were highly dependent on formal assistance when received, albeit being insufficient. Regardless of registration status, refugees resorted to informal livelihood strategies, including informal employment, child labor, early marriage, and accruing debt. Poor living conditions and food insecurity were reported among all SR. Limited healthcare access and high out-of-pocket costs led to limited use of antenatal care services, prioritizing life-threatening conditions, and resorting to alternative sources of healthcare. Severity of these conditions and their adverse health consequences were especially pronounced among unregistered refugees. Our findings shed light on the economic and health disparities among marginalized SR, with the lack of registration and formal assistance increasing their vulnerability. More tailored and sustainable humanitarian programs are needed to target the most vulnerable and hard-to-reach groups.

The United Nations Sustainable Development Goals: The Ethic and Ethos of Holistic Nursing.

Holistic nursing is founded on the values of integrality and the awareness of whole-people and whole-system interconnectedness. These concepts are foundational to the broader global health agendas and initiatives of our time, which seek to improve human, animal, and planetary health. The United Nations 2030 Agenda for Sustainable Development represents the most remarkable transnational initiative in history: a 15-year plan (2015-2030) rallying the efforts of all countries, governments, and concerned citizens worldwide to foster human-planet thriving and survival. The purpose herein is to substantiate the United Nations 2030 Agenda as a holistic nursing priority and theory-practice opportunity for current and future professional maturation. This article provides a background of the 17 Sustainable Development Goals (SDGs), a discussion regarding their relevance to holistic nursing, and an explanation of the essential nature of partnerships in attaining each of these "Global Goals." We link the discussion of the SDGs directly to the American Holistic Nurses Association's Core Values and identify implications for practice, education, research, and policy. Holistic nursing is ideally situated throughout the health care system and in the broader global context to advocate and advance the SDGs.

Coercive care and human rights; a complex juxtaposition - part 1.

OBJECTIVE: To explore the clinical implications associated with the United Nations Convention on the Rights of Persons with Disabilities (UN-CRPD), and coercive practice. CONCLUSIONS: Both human rights and clinical perspectives are necessary in the management of the mentally ill.

Social Responsibility and the State's Duty to provide Healthcare: An Islamic Ethico-Legal Perspective.

The United Nations Educational, Scientific and Cultural Organization's (UNESCO) Declaration on Bioethics and Human Rights asserts that governments are morally obliged to promote health and to provide access to quality healthcare, essential medicines and adequate nutrition and water to all members of society. According to UNESCO, this obligation is grounded in a moral commitment to promoting fundamental human rights and emerges from the principle of social responsibility. Yet in an era of ethical pluralism and contentions over the universality of human rights conventions, the extent to which the UNESCO Declaration can motivate behaviors and policies rests, at least in part, upon accepting the moral arguments it makes. In this essay I reflect on a state's moral obligation to provide healthcare from the perspective of Islamic moral theology and law. I examine how Islamic ethico-legal conceptual analogues for human rights and communal responsibility, huquq al-'ibad and fard al-kifayah and other related constructs might be used to advance a moral argument for healthcare provision by the state. Moving from theory to application, I next illustrate how notions of human rights and social responsibility were used by Muslim stakeholders to buttress moral arguments to support American healthcare reform. In this way, the paper advance discourses on a universal bioethics and common morality by bringing into view the concordances and discordances between Islamic ethico-legal constructs and moral arguments advanced by transnational health policy advocates. It also provides insight into applied Islamic bioethics by demonstrating how Islamic ethico-legal values might inform the discursive outputs of Muslim organizations.

UNITED NATION'S RESOLUTION ON ELIMINATION OF FEMALE GENITAL RITUAL: A LEGITIMATE RESPONSE TO A HUMAN RIGHTS PROBLEM OR WHAT?

A recent United Nations' (U.N.) Resolution, "Intensifying Global Efforts for the Elimination of Female Genital Mutilations," urging all countries to enact legislation outlawing female circumcision or female genital ritual (FGR) signals a disturbingly new frontier in the polemic surrounding the ancient cultural practice. Never before has the apex global institution lent its imprimatur to a project whose foundation is profoundly muddled in uncertainties and murkiness. That the Resolution received an instantaneous and near-universal acclaim as a necessary protective weapon against supposed assault on the human rights of women is not news. After all, aside from essentially validating extant legislative frameworks in several countries, the proclamation fits seamlessly with decades-long agitations of activists, scholars and media pundits of one stripe or the other. What is absurd--indeed, the real news--is continued neglect of calls for a rethinking of the criminalization fervor currently gripping the world, for a reassessment of the evidence trumpeted by abolitionists as justificatory of their unbridled interference in what practicing communities revere as a sacred cultural rite. Relying on the premise that claims regarding harmful impact of FGR, the fulcrum upon which eradication forces depend for their activism, cannot be substantiated, this paper argues that prohibitory regimes based thereon, whether at the U.N. or country level, is per se a violation of the human rights of the women purportedly sought to be protected. Human rights (including, in this case, its self-appointed "apostles"), cannot, as a popular Igbo maxim admonishes, become "outsiders who wept louder than the bereaved." This is the prism from which this paper analyzes the on-going supranational crusade to suppress FGR. It is a critique of extant FGR legal and policy regimes, an instance of which is the U.N. Resolution, as unrepresentative of legitimate advancement of human rights.

Las conductas adictivas: análisis crítico y propuestas para su prevención / Additive behaviors: critical analysis and proposals for prevention

Se realiza un análisis crítico de la situación actual de las conductas adictivas, a partir de los informes más recientes emitidos por la Organización de las Naciones Unidas (ONU), la Organización Mundial de la Salud (OMS), la Organización Panamericana de la Salud (OPS) y la Comisión Global de Políticas de Drogas, haciendo énfasis en los datos más relevantes y las principales consecuencias para el bienestar humano. Se sugieren algunos enfoques hacia los cuales se deben dirigir los esfuerzos para lograr mejores resultados y se indican algunas propuestas dentro del campo de la Reducción de la Demanda, específicamente para lograr una prevención más eficaz mediante variantes conceptuales y clasificatorias que permitan un diagnóstico precoz, en la etapa que peligra el estilo de vida saludable del ser humano, para lograr intervenciones tempranas que eviten el desarrollo de la enfermedad(AU)

It is made a critical analysis of the current situation of addictive behaviors, from the most recent reports issued by the United Nations Organization (UNO), World Health Organization (WHO), Pan American Health Organization (PAHO) and the Global Drug Policy, focusing on the most important and major implications for human welfare. Some approaches are suggested which should lead efforts to achieve better results and some proposals are indicated in the field of demand reduction, specifically to achieve a more effective prevention through conceptual variants and qualifiers that will allow an early diagnosis in the jeopardizing stage of a healthy lifestyle of human beings to achieve early intervention to prevent development of disease(AU)

Supra-Earth affairs.

The United Nations briefly considered the issue of extra-terrestrial intelligence at the 32nd session of the General Assembly in 1977. As a result, the Office of Outer Space Affairs was tasked to prepare a document on issues related to 'messages to extra-terrestrial civilizations', but this area has not been followed through in more recent times. This discussion paper describes the United Nations' activities in the field of near-Earth objects in some detail, and suggests that this might be used as a model of how Member States could proceed with dealing with this issue in case the existence of extra-terrestrial life/intelligence is established.

UNESCO's activities in ethics.

UNESCO is an intergovernmental organization with 193 Member States. It is concerned with a broad range of issues regarding education, science and culture. It is the only UN organisation with a mandate in science. Since 1993 it is addressing ethics of science and technology, with special emphasis on bioethics. One major objective of the ethics programme is the development of international normative standards. This is particularly important since many Member States only have a limited infrastructure in bioethics, lacking expertise, educational programs, bioethics committees and legal frameworks. UNESCO has recently adopted the Universal Declaration on Bioethics and Human Rights. The focus of current activities is now on implementation of this Declaration. Three activities are discussed that aim at improving and reinforcing the ethics infrastructure in relation to science and technology: the Global Ethics Observatory, the Ethics Education Programme and the Assisting Bioethics Committees project.

UNESCO, "universal bioethics," and state regulation of health risks: a philosophical critique.

The United Nations Educational, Scientific, and Cultural Organization's (UNESCO) Universal Declaration on Bioethics and Human Rights announces a significant array of welfare entitlements--to personal health and health care, medicine, nutrition, water, improved living conditions, environmental protection, and so forth--as well as corresponding governmental duties to provide for such public health measures, though the simple expedient of announcing that such entitlements are "basic human rights." The Universal Declaration provides no argument for the legitimacy of the sweeping governmental authority, taxation, and regulation to create and impose such "rights." As this paper explores that some action promotes a purported good, such as "health," does not thereby make the action morally permissible. Just as there are moral limits on legitimate personal actions, there are also moral limits on legitimate governmental actions to promote purported goods, including health. A core question of any governmental regulation, therefore, is whether it is a legitimate application of moral political authority or an unauthorized act of state coercion. Pace UNESCO's wide-ranging assertions, this paper argues that promoting health only falls within the legitimate authority of governments in very narrowly defined circumstances. As the paper critically explores, at stake are foundational moral and political questions concerning the limits of governmental authority to intervene in the consensual interaction of persons. Imposing such duties on others, including citizens of a state through regulatory activity and taxation, must be justified, nonarbitrary, and demonstrably within the limits of moral political authority. UNESCO's assertions do not meet this burden of proof.

The UNESCO Declaration on Bioethics and Human Rights: a canon for the ages?

The UNESCO Universal Declaration on Bioethics and Human Rights of 2005 purports to articulate universal norms for bioethics. However, this document has met with mixed reviews. Some deny that the elaboration of universal bioethics norms is needed; some deny that UNESCO has the expertise or authority to articulate such norms; some regard the content of the UNESCO document as too vague or general to be useful; and some regard the document as a cog in the effort of like-minded cosmopolitans to codify their particular moral intuitions in international law. This issue examines the potential merits and pitfalls of the Universal Declaration on Bioethics and Human Rights.

Promotion of children's rights and prevention of child maltreatment.

In medical literature, child maltreatment is considered as a public-health problem or an issue of harm to individuals, but less frequently as a violation of children's human rights. Public-health approaches emphasise monitoring, prevention, cost-effectiveness, and population strategies; protective approaches concentrate on the legal and professional response to cases of maltreatment. Both approaches have been associated with improvement in outcomes for children, yet maltreatment remains a major global problem. We describe how children's rights provide a different perspective on child maltreatment, and contribute to both public-health and protective responses. Children's rights as laid out in the UN convention on the rights of the child (UNCRC) provide a framework for understanding child maltreatment as part of a range of violence, harm, and exploitation of children at the individual, institutional, and societal levels. Rights of participation and provision are as important as rights of protection. The principles embodied in the UNCRC are concordant with those of medical ethics. The greatest strength of an approach based on the UNCRC is that it provides a legal instrument for implementing policy, accountability, and social justice, all of which enhance public-health responses. Incorporation of the principles of the UNCRC into laws, research, public-health policy, and professional training and practice will result in further progress in the area of child maltreatment.

Ethical rhetoric: genomics and the moral content of UNESCO's "universal" declarations.

Genomic research is an expanding and subversive field, leaking into various others, from environmental protection to food production to healthcare delivery, and in doing so, it is reshaping our relationship with them. The international community has issued various declaratory instruments aimed at the human genome and genomic research. These soft law instruments stress the special nature of genomics and our genetic heritage, and attempt to set limits on our activities with respect to same, as informed by the human rights paradigm. This paper examines the primary thrust and, more importantly, the joint value position of the Universal Declaration on the Human Genome and Human Rights and the Universal Declaration on Bioethics and Human Rights, concluding that, though important legal instruments from the human rights paradigm, these instruments, or rather the values contained therein, must find a more influential hard law voice and a broader policy environment.

UNESCO Global Ethics Observatory: database on ethics related legislation and guidelines.

The Database on Ethics Related Legislation and Guidelines was launched in March 2007 as the fourth database of the UNESCO Global Ethics Observatory system of databases in ethics of science and technology. The database offers a collection of legal instruments searchable by region, country, bioethical themes, legal categories and applicability to specific articles of the UNESCO Universal Declaration on Bioethics and Human Rights and International Declaration on Human Genetic Data. This paper discusses the background and rationale for the database and its role as a consultative and comparative resource hub for the study of ethics related legal instruments across the world, with the purpose of informing and inspiring relevant stakeholders on the implementation of the principles contained within the UNESCO declarations on bioethics.

Whose dignity? Resolving ambiguities in the scope of "human dignity" in the Universal Declaration on Bioethics and Human Rights.

In October 2005, the United Nations Educational, Scientific and Cultural Organization adopted the Universal Declaration on Bioethics and Human Rights (UDBHR). A concept of central importance in the declaration is that of "human dignity". However, there is lack of clarity about its scope, especially concerning the question of whether prenatal human life has the same dignity and rights as born human beings. This ambiguity has implications for the interpretation of important articles of the delcaration, including 2(c), 4, 8, 10 and 11. The paper applies relevant provisions of the UDBHR to specific cases, addresses problems of internal consistency and considers attempts at clarifying the scope of "human dignity" by the negotiating parties. An analysis of the important relationship between the UDBHR and the Universal Declaration of Human Rights, to which the UDBHR refers in its title and elsewhere, shows that because of a crucial emphatic asymmetry, a broad reading according to which the UDBHR must be understood to ascribe human rights and dignity to prenatal life is untenable. However, the view that the UDBHR confers human rights and dignity on humans from the moment of birth onwards is robust and defensible. This conclusion is important for a proper understanding of the declaration and its use, as stated in Articles 1(2) and 22, the latter urging states ".. to give effect to the principles .. in this declaration". Similarly, it has implications for the use of the declaration in the wider context of bioethics-related law and policy, as well as in academic and other discussions where increasing reference to the UDBHR is likely.

Global bioethics: did the universal declaration on bioethics and human rights miss the boat?

This paper explores the evolution of the Universal Declaration on Bioethics and Human Rights (UDBHR), which was adopted by the United Nations Educational, Scientific and Cultural Organization (Unesco) in 2005. While the draft UDBHR generated controversy among bioethicists, the process through which it evolved excluded mainstream bioethicists. The absence of peer review affects the declaration's content and significance. This paper critically analyses its content, commenting on the failure to acknowledge socioeconomic and other factors that impede its implementation. The UDBHR outlines ideal standards but fails to provide guidance that can be readily applied in different settings. It strives for universality but does not contribute to understanding of universal or global bioethics.