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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.

Most legal systems in the West allow for involuntary treatment of mental illness, usually on the basis that without such treatment the person would be a danger to themselves or others. While historically the mental health law jurisdiction has been a protective one, it has become increasingly influenced by civil rights and international human rights law, which privilege the value of autonomy and the right to personal liberty.In this regard, an important principle that has developed is that decisions about treatment for mental illness must be the \"least restrictive alternative\" available. This may mean, for example, that a person is supported to make a decision on treatment for their mental illness, according to evolving practices of \"supported decision-making,\" so that their legal capacity is still recognized. If involuntary treatment is required, the \"least restrictive\" approach demands that the liberty and integrity of the person be respected to the greatest extent possible.The Mental Health Act 2016 (Qld) (\"MHAQ\") prescribes that decision-making on non-consensual treatment should preferably be done according to what it calls the \"less restrictive way.\" However, the \"less restrictive way\" is defined as decision-making by patients under advance directives, and also by substitute decision-makers, including by attorneys or guardians not appointed by the patient, usually a family member. The MHAQ states that these arrangements are distinguished from and prioritized over what it calls \"involuntary treatment and care,\" where the decision for non-consensual treatment is made by the treating team.However, we argue that these arrangements are not in fact \"less restrictive\" of the person\'s autonomy, but are less accountable forms of decision-making. Decision-making by treating teams under involuntary treatment provisions is subject to higher levels of transparency and accountability. In Australian states these decisions are reviewed regularly by a specially constituted, independent mental health tribunal. By contrast, treatment decisions made under the \"less restrictive way\" are not even defined as constituting involuntary treatment, and are outside the scope of the tribunal\'s review.In the case of decision-making by advance directive, we acknowledge that this is widely considered to be \"less restrictive\" of a person\'s right to legal capacity and autonomy. However, in these cases, the patient may actually be refusing treatment at the time the advance directive is relied upon. This raises serious questions as to whether such \"voluntary\" admissions and treatment should not be subject to the same oversight and accountability as involuntary ones. Patients have a right to less restrictive forms of decision-making, but when deprived of their liberty, they also have a right to adequate safeguards established by law.The term \"less restrictive\" in the MHAQ is largely misplaced and misleading. In the case of advance directives, it deflects attention from the potentially restrictive nature of the treatment and the lack of accountability. Even more problematically, the privileging of private substitute decision-making under the less restrictive way ignores the real risk of abuse and undue influence within the personal and family sphere. We argue that the \"less restrictive way\" under the MHAQ is a step backwards for the rights of patients, in that it shifts power to family on the risky assumption that decision-making by these less supervised individuals is more likely to uphold human rights. We believe that this reflects a pre-feminist assumption that the informal, family, private sphere is nearly always safe. This is a contentious assumption, which nevertheless underpins much unproblematized thinking and advocacy on supported decision-making. This issue also highlights the need for further elucidation and discussion on what least restrictive means in the context of involuntary treatment for mental illness.

We investigated the relationships between political beliefs regarding two aspects of the right-left distinction (cultural and economic) and the acceptance of the pandemic restrictions using variable-centred and person-centred approaches. The community sample consisted of 305 participants. Four groups of the restrictions were considered. Religious fundamentalism predicted positively the acceptance of the restrictions associated with the limitations of labour rights and those limiting civil rights without a direct impact on safety. Anti-welfare negatively predicted the acceptance of the restrictions regarding social distancing and those limiting civil rights and increasing safety. These associations were discussed in relation to basic needs and values which motivate persons who endorse right-wing or left-wing political views. The latent profile analysis revealed three profiles of political beliefs, which were termed \"Conservative Statists,\" \"Liberal Laissez-fairists,\" and \"Conservative Laissez-fairists.\" The profiles differed in terms of acceptance of the pandemic restrictions, and the patterns of these relationships were different for particular groups of restrictions.

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The racial health equity implications of the Trump administration\'s response to the COVID-19 pandemic.
We focus on four key health care policy decisions made by the administration in response to the public health emergency: rejecting a special Marketplace enrollment period, failing to use its full powers to enhance state Medicaid emergency options, refusing to suspend the public charge rule, and failing to target provider relief funds to providers serving the uninsured.
In each case, the administration\'s policy choices intensified, rather than mitigated, racial health inequality. Its choices had a disproportionate adverse impact on minority populations and patients who are more likely to depend on public programs, be poor, experience pandemic-related job loss, lack insurance, rely on health care safety net providers, and be exposed to public charge sanctions.
Ending structural racism in health care and promoting racial health care equity demands an equity-mindful approach to the pursuit of policies that enhance-rather than undermine-health care accessibility and effectiveness and resources for the poorest communities and the providers that serve them.

Published decisions by federal and state appellate courts impact health care risk management in a number of ways, including overruling precedents, explaining and clarifying new laws and regulations, describing new and novel rules, describing new performance standards, and describing new civil rights.

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