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The courts of England and Wales permit applicants in 1980 Hague Convention child abduction proceedings also to bring concurrent applications for the return of the child to their state of habitual residence based on a summary welfare assessment, which can be issued and heard alongside the Hague application. Given the different nature of these two applications, having them heard concurrently raises a number of challenges for the parties in terms of the evidence required and for the court in terms of the analytical process being undertaken. This article explores the nature of the two applications, the reasons why they might be brought concurrently, and the challenges that can arise in such cases.

Environmental flows are critical for balancing societal water needs with that of riverine ecosystems; however, data limitations often hinder the development of predictive relationships between anthropogenic modifications to streamflow regimes and ecological responses – these relationships are the basis for setting regional water policy standards for rivers. Herein, we present and describe a comprehensive dataset of modeled hydrologic alteration and consequences for native fish biodiversity, both mapped at the stream-reach resolution for the conterminous U.S. Using empirical observations of reference conditions and anthropogenically altered streamflow at over 7000 stream gauges, we developed a predictive model of hydrologic alteration, which was extended to >2.6 million stream reaches. We then used a previous nationwide assessment of ecological responses to hydrologic alteration to predict fish biodiversity loss in stream reaches resulting from streamflow modification. Validation efforts suggested hydrologic alteration models had satisfactory performance, whereas modeled ecological responses were susceptible to compounded errors. The dataset could ameliorate regional data deficits for setting environmental flow standards while providing tools for prioritizing streamflow protection or restoration.Measurement(s)hydrologic alteration, human alteration of streamflow regimes • fish biodiversityTechnology Type(s)Random forest • Quantile regression techniquesFactor Type(s)human disturbances in streams (land use, dam storage, water use)Sample Characteristic - OrganismFreshwater fishSample Characteristic - EnvironmentstreamSample Characteristic - Locationcontiguous United States of America

IN November 2008, Greek Law No. 3719/2008, Reforms Concerning the Family, Children and Society, came into force. Amongst its provisions, it created state-recognised partnerships between two adults of different sexes called \"civil unions\" ('σύmuφωνο συmubetaίωσης'). Civil unions were designed to offer couples who did not wish to marry an alternative, more flexible legal framework for their relationships. The legal consequences of civil unions include the regulation of property rights, paternity, parental responsibility, inheritance and maintenance payments in the event that the union be dissolved. There was a particular focus in the Law's explanatory report on the protection of children born outside of marriage, and of women (particularly mothers) who might be left with inadequate support after lengthy periods of non-marital cohabitation. Same-sex couples were excluded from the scope of civil unions, despite passionate debate during and after the parliamentary process about this issue.

We read with interest the extended essay published from Riisfeldt and are encouraged by an empirical ethics article which attempts to ground theory and its claims in the real world. However, such attempts also have real-world consequences. We are concerned to read the paper’s conclusion that clinical evidence weakens the distinction between euthanasia and normal palliative care prescribing. This is important. Globally, the most significant barrier to adequate symptom control in people with life-limiting illness is poor access to opioid analgesia. Opiophobia makes clinicians reluctant to prescribe and their patients reluctant to take opioids that might provide significant improvements in quality of life. We argue that the evidence base for the safety of opioid prescribing is broader than that presented, restricting the search to palliative care literature produces significant bias as safety experience and literature for opioids and sedatives exists in many fields. This is not acknowledged in the synthesis presented. By considering additional evidence, we reject the need for agnosticism and reaffirm that palliative opioid prescribing is safe. Second, palliative sedation in a clinical context is a poorly defined concept covering multiple interventions and treatment intentions. We detail these and show that continuous deep palliative sedation (CDPS) is a specific practice that remains controversial globally and is not considered routine practice. Rejecting agnosticism towards opioids and excluding CDPS from the definition of routine care allows the rejection of Riisfeldt’s headline conclusion. On these grounds, we reaffirm the important distinction between palliative care prescribing and euthanasia in practice.

Changes in family structures, demographics, social attitudes and economic policies over the last sixty years have had a large impact on family lives and correspondingly on family law.

Changes in family structures, demographics, social attitudes and economic policies over the last 60 years have had a large impact on family lives and correspondingly on family law. The Second Edition of this Handbook draws upon recent developments to provide a comprehensive and up-to-date global perspective on the policy challenges facing family law and policy round the world. The chapters apply legal, sociological, demographic and social work research to explore the most significant issues that have been commanding the attention of family law policymakers in recent years. Featuring contributions from renowned global experts, the book draws on multiple jurisdictions and offers comparative analysis across a range of countries. The book addresses a range of issues, including the role of the state in supporting families and protecting the vulnerable, children’s rights and parental authority, sexual orientation, same-sex unions and gender in family law, and the status of marriage and other forms of adult relationships. It also focuses on divorce and separation and their consequences, the relationship between civil law and the law of minority groups, refugees and migrants, and the movement of family members between jurisdictions along with assisted conception, surrogacy and adoption. This advanced-level reference work will be essential reading for students, researchers and scholars of family law and social policy as well as policymakers in the field.

Relocation cases are disputes between separated parents which arise when one parent proposes to move to a new geographic location with their child and the other parent objects to the proposal. Relocation disputes are widely recognised as being amongst the most difficult cases facing family courts, and the law governing them is increasingly a cause for debate at both national and international levels. In Relocation Disputes: Law and Practice in England and New Zealand, Rob George looks at the different ways in which the legal systems of England and New Zealand currently deal with relocation cases. Drawing on case law, literature and the views of legal practitioners in the two jurisdictions, Relocation Disputes represents a major contribution to our understanding of the everyday practice of relocation cases. The empirical data reported in this book reveal the practical differences between the English and New Zealand approaches to relocation, along with a detailed analysis of the pros and cons of each system as seen by judges, lawyers and court experts who deal with these cases in practice. This analysis leads to detailed criticisms and lessons that can be learnt, together with practical suggestions about possible reforms of relocation law.

UK policymakers, clinicians and public wish to see improvements in end-of-life care (EoLC). However, healthcare professionals' skills and knowledge to deliver high-quality care are often lacking. Since May 2012, palliative care staff in an inner-city tertiary hospital have run a 2-day Transforming End of Life Care (TEoLC) course to improve EoLC confidence, and competence among hospital and community staff. To evaluate course participants' self-rated confidence, competence and knowledge of EoLC topics. A before-and-after design using self-completion questionnaires, precourse and postcourse. 14 self-assessment questions examined confidence, understanding and knowledge of EoLC topics. Mean change scores and paired t tests were calculated and free-text responses analysed thematically. 236 staff members completed the course between May 2012 and April 2014. 42% worked in hospitals and 55% in the community; the most frequent staff roles were qualified nurses (49%), senior nurses (16%) and general practitioners (15%). All 14 self-assessment topics improved significantly (p<0.001); most improved was 'understanding and implementing Fast Track discharge'. Qualitative data showed increased knowledge and confidence in EoLC, particularly in communication, commitment to team work and holistic care. Overall, 217 (92%) participants would recommend the course and 215 (98%) indicated it would influence their practice. The TEoLC course improved participants' self-rated confidence, competence and knowledge in EoLC. Findings have utility beyond the UK in light of the international policy recommendations to improve the palliative care skills of generalist healthcare providers.

claudregnard@stoswaldsuk.org Hurley and colleagues’ promotion of the proposed assisted dying bill in England and Wales ignores the obstacles.1 In last year’s BMA survey, a majority of doctors were unwilling to prescribe the necessary drugs.2 Will we end up like Oregon, where a tiny proportion of doctors prescribe (one writing 31 prescriptions in 2020)?3 Every legislature has shortened or removed cooling off periods and expanded their criteria beyond a six month prognosis, some allowing or currently discussing assisted deaths in people with mental illness, learning disability, and autism and in children. Updated 14 Sep 2021. https://www.bma.org.uk/advice-and-support/ethics/end-of-life/physician-assisted-dying/physician-assisted-dying-survey 3 Oregon Health Authority. Oregon Death with Dignity Act annual reports. https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Pages/ar-index.aspx 4 Willis D George R. Conscientious objection and physician-assisted suicide: a viable option in the UK?

Recent papers in BMJ Support and Palliative Care concerning advance care plans (ACP) offer empirical evidence that helps us to understand how ACP are, and should be, applied.1 2 They are welcome and timely as critics often argue that palliative medicine sometimes values opinion over evidence.However, even in medicine, some things do not need evidence as proof: indeed, their value may be clear despite the evidence. ACP is an example, properly done, it captures a unique narrative. Rationality and professionalism are the justification: personhood, respect for autonomy, confidentiality, consent are all inherent to healthcare.