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We conducted a systematic review of randomised controlled trials (RCT) of increased intake of arachidonic acid (ARA) on fatty acid status and health outcomes in humans. We identified twenty-two articles from fourteen RCT. Most studies were conducted in adults. These used between 80 and 2000 mg ARA per d and were of 1–12 weeks duration. Supplementation with ARA doses as low as 80 mg/d increased the content of ARA in different blood fractions. Overall there seem to be few marked benefits for adults of increasing ARA intake from the typical usual intake of 100–200 mg/d to as much as 1000 mg/d; the few studies using higher doses (1500 or 2000 mg/d) also report little benefit. However, there may be an impact of ARA on cognitive and muscle function which could be particularly relevant in the ageing population. The studies reviewed here suggest no adverse effects in adults of increased ARA intake up to at least 1000–1500 mg/d on blood lipids, platelet aggregation and blood clotting, immune function, inflammation or urinary excretion of ARA metabolites. However, in many areas there are insufficient studies to make firm conclusions, and higher intakes of ARA are deserving of further study. Based on the RCT reviewed, there are not enough data to make any recommendations for specific health effects of ARA intake.
The early years of the Review, then called the Bulletin International des Sociétés de la Croix-Rouge, provide numerous insights into the International Committee of the Red Cross (ICRC), which edited the journal. Since the ICRC was very small in those days and without support staff, one learns a great deal, especially about Gustave Moynier, who led the organization and carried out most of the editing duties at the Bulletin. The reader can trace the role of religious and other motivations, attitudes toward colonialism, the evolving nature of the International Red Cross and Red Crescent Movement and the ICRC's place therein, and complex relations with States. This early era, as richly recorded in the journal, stimulates a number of questions about further research into ICRC and Red Cross history.
BACKGROUND: Metabolomics technology has the potential to revolutionize how we screen, diagnose, and treat cancer, as well as improve upon existing cancer molecular tests that may not sufficiently capture the complexity of most malignancies. In this study, we explore the clinical potential of metabolomics analysis in the diagnosis and risk-stratification of brain tumors. METHODS: To test the hypothesis that brain tumor type and survival could be predicted with metabolomics, we analyzed the pre-operative serum and urine samples of patients with glioblastoma (GBM), oligoastrocytoma (OA2), meningioma (M1) and compared them to healthy controls. (HC). Sera from immune-deficient NOD-SCID mice xenografted with human GBM brain tumor initiating cells were also studied. RESULTS: Metabolomics analysis of patient samples was able to accurately differentiate GBM, OA2, M1 and HC (p = 2.3 x 10-26). Subsequently, a prediction model developed and validated internally was able to diagnose GBM with a sensitivity of 86.7% and specificity of 93.8%, and distinguish whether a GBM patient possess O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation (p = 7.4 x 10-10). Within the MGMT methylated group, the model was able to predict longevity (p = 3.25 x 10-4). The model was also able to predict survival irrespective of MGMT methylation status (p = 2.9 x 10-6). CONCLUSIONS: In this study, we demonstrate that metabolomic analysis of patient biofluids can identify brain tumors, distinguish brain tumor subtypes, and independently predict MGMT status as well as longevity among GBM patients. Metabolomics analysis may facilitate non-invasive diagnosis of aggressive brain tumours.
My preface to the first edition explains the objectives of this book, and they have not changed. My preface to the second edition explains the considerations that guide revisions, and they have not changed either. As before, revisions seek both to clarify the presentation and to incorporate recent developments. In particular I have now added some brief case studies to provide more specificity to certain rights in political context. My overall approach, hence the structure of the book, remains unchanged.
From the origins of this work as a gleam in the author's eye, the tension between personal rights and the workings of the state system of world affairs has been highlighted. If anything, the new edition emphasizes this tension even more. It is now even clearer that when states perceive a serious threat to their interests, above all their physical security, it becomes more difficult to get serious attention to human rights, especially the rights of those perceived as enemies. Moreover, when ruling elites elevate perceived challenges to the level of existential threats, sometimes to the nation but often just to the nature of their rule, serious attention to human rights suffers. Complicating analysis is the fact that some non-state actors see the existing situation as so objectionable that unrestricted violence is justified. This then feeds into a downward spiral of animosity and violence that tends to push human rights to the margins of public policy. Pursuit of victory in total war is not a mindset conducive to human rights.
Still, such is the power of the idea of human rights, defined to include humanitarian law, that states continue to profess their commitment to at least some of those standards, even as their record of compliance is often far short of what it should be. And armed non-state actors who attack civilians and kill prisoners face an uphill journey as they try to explain why they should be considered the new legitimate elite with the right to rule. The Arab Spring of 2011, with its demand for more democracy and other human rights, was a rejection of the militancy of Al Qaeda and other Islamist violent actors.
This book has clearly shown the extent to which human rights has become a routine part of international relations. Michael Ignatieff has captured the trend succinctly but brilliantly: “We are scarcely aware of the extent to which our moral imagination has been transformed since 1945 by the growth of a language and practice of moral universalism, expressed above all in a shared human rights culture.” The language and practice of universal human rights, and of its first cousin, regional human rights, has been a redeeming feature of a very bloody and harsh twentieth century.
But the journalist David Rieff reminds us of a more skeptical interpretation of universal human rights. “The universalizing impulse is an old tradition in the West, and, for all the condemnations that it routinely incurs today, particularly in the universities, it has probably done at least as much good as harm. But universalism easily declines into sentimentalism, into a tortured but useless distance from the particulars of human affairs.” Or, to drive the same point home with a more concrete example, whereas virtually all states formally endorse the abstract principles of human rights in peace and war, “Combatants are as likely to know as much about the laws of war as they do about quantum mechanics.”
The international law of human rights is based on liberalism, but the practice of human rights all too often reflects a realist world. A classical example was provided by the situation in Syria from 2011: the Assad security forces and their allies killed and otherwise repressed those demanding more human rights and democracy; and various states such as Israel, Turkey, and the United States were reluctant to get deeply involved, fearing a complicated quagmire. (In the midst of its bloody repression, Syria was at least blocked from sitting on the UN Human Rights Council.) State narrow interests rather than personal rights often prevail, interpersonal equality often gives way to disrespect for – if not hatred of – “others,” violent conflict is persistent, and weak international institutions are easily demonstrated.
It is a type of liberal progress in keeping with Ignatieff's view that we now recognize the enslavement and other exploitation of the persons in the Congo river basin between about 1460 and 1960 as a violation of their human rights.
In this chapter we examine more closely the evolving process for applying universal human rights standards on a global basis. We inquire whether there is now more commitment to liberalism, as shown through institutionalized procedures to protect human rights.
International law has traditionally been clearer about “What?” than “Who?” The law has emphasized what legal rules apply in different situations. It has frequently not explicitly addressed who is authorized to make authoritative judgments about legal compliance. By default this means that states remain judge and jury in conflicts involving themselves – a principle accepted by no well-ordered society. Certainly the global law on human rights and humanitarian affairs has traditionally been characterized by decentralized decision making leading to much ambiguity about compliance. As this author concluded some time ago, “Most states, in negotiating human rights agreements, do not want authoritative international means of protection.” Many states have asserted an apparently liberal commitment to internationally recognized human rights (including humanitarian law for armed conflicts). But states have often elevated national independence, particularly the supremacy of national policy making, over the realization of universal human rights. States have wanted to retain the authority to delay or opt out of human rights commitments, for whatever reason.
Is this conventional wisdom still valid? This chapter will show that, first, global enforcement of human rights, in the form of international court judgments and other forms of direct international responsibility for the application of human rights standards, is still a relatively rare event. Direct protection by international agencies exists, but not often. Neither the International Court of Justice, nor other international courts, nor the UN Security Council frequently assumes direct responsibility in seeing that universal human rights norms prevail over competing values. This is so especially outside Europe. There may be some change under way on this point in the early twenty-first century, particularly for smaller or weaker states. But the generalization still holds, especially for the more powerful. The global international community does not often frontally and flagrantly override state sovereignty in the name of human rights despite the 2005 norm of an international responsibility to protect (R2P).
At the same time, states generally find themselves enmeshed in global governance. By their own consent, they find themselves part of international legal regimes that generate diplomatic pressure to conform to human rights standards.
The world may be a smaller place in the light of communication and travel technology, but it is still a large planet when it comes to effective international governance. Given the approximately 6 billion persons and the more than 190 states that existed at the turn of the twenty-first century, and given the weakness of global organizations like the United Nations, it was both logical and sometimes politically feasible to look to regional organizations for the advancement of human rights. This chapter will show that regional developments for human rights were truly remarkable for a time in Europe, delicately progressive in the Western Hemisphere, embryonic in Africa, and otherwise weak. The key to the effective regional protection of human rights is not legal drafting, but underlying political culture, political will, and political acumen. One sees this clearly in the light of Brexit, the 2016 British decision to leave the European Union, in large part because of resentment about the deep intrusion of regional authority into traditional national affairs. In Europe where there are considerable cases and other regional human rights decisions to analyze, I provide a summary analysis. In the Western Hemisphere with substantial case law and other important regional decisions only recently, I provide mostly political analysis of underlying conditions but some attention to legal factors. I treat Africa briefly because of lack of major impact through regional arrangements.
After World War II, significant US foreign aid to Europe in the form of the Marshall Plan encouraged regional cooperation, especially of an economic nature. Most West European elites endorsed this approach at least to some degree, both in pursuit of economic recovery and to defend traditional western values in the face of Soviet-led communism. One result was the creation of the Council of Europe (CE) with its strong focus on human rights. Separately, owing to reluctance of the UK to integrate fully with the rest of Western Europe, one had the development of the European Communities, which more or less evolved into the European Union (EU). By the start of the twenty-first century it was evident that this bifurcation, while it had “worked” to a considerable degree, was not a completely happy situation. As European international integration proceeded, the contradictions of bifurcation were salient as never before.
It is quite remarkable that the notion of human rights has played such a large role in western history, and now in international relations since 1945, and yet no one has been able to definitively settle questions about the origins and “true” nature of these rights. Despite continuing debate over such philosophical matters, the international community – mostly through the United Nations – has agreed on a modern version of human rights. States, the most important actors in that community, who supposedly follow “realist” principles of harsh self-interest, have used international law and organization to adopt “liberal” standards requiring attention to individual and collective human rights. Internationally recognized human rights, as social construct, are a fact of international relations.
A philosophy of rights?
We do not lack for differing theories about human rights. Even among western philosophers there is great variation. For Edmund Burke, the concept of human rights was a monstrous fiction. For Jeremy Bentham, it was absurd to base human rights on natural rights, because “Natural rights is simple nonsense … nonsense upon stilts.” The contemporary philosopher Alasdair MacIntyre tells us there are no such things as human rights; they are similar to witches and unicorns and other figments of the imagination. Karl Marx, for that matter, was not born in Beijing. He too was western, both by birth and by principal area of concern. At the risk of oversimplifying his many and not always consistent writings, one can say that he regarded many civil rights as inherently good and tactically helpful in achieving socialism, while regarding property rights as contributing to the social ills of the modern world.
John Locke has been subjected to many interpretations. In a dominant strain of western political philosophy, he seems to say that natural law provides human rights as property rights – owned by each individual. Human rights are moral rights that no public authority can transgress. Individuals, in his liberal view, are equal and autonomous beings whose natural rights predate national and international laws. A primary purpose of public authority is to secure these rights in legal practice.Attracta Ingram tells us, on the other hand, that human rights are not property rights that derive fromnatural law. They are constructed in a political process featuring self-government, not discovery of metaphysical principles. There are other constructivist or analytical theories of human rights.
While intergovernmental agencies and private transnational groups dealing with human rights proliferate, one central key to progressive developments remains states and their foreign policies. As we have already seen, IGOs, from the UN through the OAS to the Organization for Security and Cooperation in Europe, have extensive human rights programs. Independent international officials for these organizations generate some influence. But it is usually state members of these IGOs that take the most important decisions, and it is primarily states that are the targets of reform efforts. Likewise, as we will see in Chapter 7, NGOs such as Amnesty International, Human Rights Watch, and Physicians for Human Rights, among others, are highly active in human rights matters and generate some influence. But, still, it is states that approve treaties and their monitoring mechanisms, states that sometimes manipulate foreign assistance in relation to rights, states that (may or may not) arrest war criminals – either singly or via international organizations such as NATO. NGOs mainly pressure states to do the right thing.
This chapter looks at human rights and state foreign policy in comparative perspective. It begins with a short discussion of three prominent mechanisms states can and do – at least sometimes – employ to influence another government's human rights policies: diplomatic, economic, and military means. Different approaches may be taken in different situations, as states usually calculate the instruments available, the expected effect of the action taken, anticipated reactions – and above all the costs to themselves of trying to advance human rights abroad. This is followed by a focus on the United States, the most important actor in international relations early in the twenty-first century. I show that the USA has a particular slant to its foreign policy on rights, and that Washington is often more prone to preach to others than to take international rights standards very seriously in its own policies. Clearly, the USA is highly selective when and how it pushes for rights abroad. The chapter then provides a comparative analysis of human rights in the foreign policies of some other states that either are liberal democracies or aspire to be so. I show that most differ from the US approach in one way or another, due to a varying combination of history and political culture, geo-political position, and perceived national interests.
My preface to the third edition was written at the time of the Arab Spring, with its popular demand for more democracy and human rights, but before its widespread failure. One can note the reinstitution of military rule in Egypt, humanitarian disaster in Syria, and chaos in Libya. Five years after 2011, there are ample reasons to be cautious if not pessimistic about the future of human rights. This is not only because of developments in the Arab-Islamic world, but also because of clear repressive trends in important states like China and Russia. Even in the West, almost every democratic government was under pressure from nativist and xenophobic forces hostile to – or at the least indifferent to – the notion of universal human rights. Many persons felt threatened by international forces, often described as socio-economic globalization. In addition, the prevalence of terrorism in much of Asia, Africa, and the Middle East, and its occasional occurrence in the West, created a political climate conducive to violation of many human rights in the name of national security. Counter-terrorism policies led at times to enforced disappearances, torture, administrative detention, and trial in military commissions offering “rough justice.”
Broad feelings of alienation and insecurity are not conducive to protection of human rights. Yet defense of the individual, his integrity and her dignity, is most needed precisely in those times of stress. It is easy to be in favor of human rights in times of peace and prosperity. The challenge is to respect the fundamental dignity and autonomy of persons in times of violence and economic distress. This means finding some workable and relatively humane blend of national security, economic prosperity, sustainable development, and human rights. This is what international law requires and this is what many governments profess to endorse. But making the law on the books into the law in reality is no easy path – especially given the insecurities and competitions inherent in the nation-state system of world affairs.
The objective of the fourth edition is finding the right synthesis between positive and negative developments in the quest for a more rights-protective world. All governments go through the motions of paying lip service to this goal. All states have accepted the 1949 Geneva Conventions designed mainly to protect human dignity in war. At the United Nations, the acceptance rate of most human rights treaties is about 70 percent.
This fourth edition of David P. Forsythe's successful textbook provides an authoritative and timely analysis of the place of human rights in an age of upheaval in international politics. Human rights standards are examined at the global, regional and national levels, with separate chapters on transnational corporations and advocacy groups. Completely updated and revised, the fourth edition takes account of new sources and recent scholarship, as well as recent events, such as the Syrian war, the rise of ISIS, refugee flows, South Sudan crises, and the resurgence of nationalism. A new chapter has been added on the media and human rights, covering both traditional and social media. Examining attempts to protect human rights by various actors, such as the United Nations, the European Union, transnational corporations, and the media, the book stresses that the open-ended fate of universal human rights depends on human agency in this context. Containing further reading suggestions and discussion questions, this textbook is a vital resource for courses on human rights in an international context.
We saw in Chapter 7 that the international law of human rights was directed mainly to public authorities like states and their governments, but that private non-profit actors like human rights advocacy groups helped shape the rights discourse and action. In this chapter I will show that for-profit private actors like transnational corporations have a tremendous effect on persons in the modern world, for good or ill. For the first fifty years after the adoption of the United Nations Charter and Universal Declaration of Human Rights, these business enterprises mostly fell outside the mainstream debate about the promotion and protection of internationally recognized human rights. This was so despite the fact that the leaders of the German firm I. G. Farben and other business leaders had faced legal justice at the Nuremberg Trials (second round, US jurisdiction) for their role in criminal behavior.
This general situation was changing in the early twenty-first century. Attention to transnational corporations and human rights constitutes an important dimension in the international discourse on human rights. Non-profit human rights groups, along with the media and particularly consumer organizations and movements, are targeting the corporations. The result is renewed pressure on public authorities, especially states, to adopt norms and policies ensuring that business practices contribute to, rather than contradict, internationally recognized human rights. The corporations themselves are under considerable pressure to pay attention to human rights, although there remain formidable obstacles to a broad corporate social responsibility that includes human rights.
It has been long recognized that business enterprises that operate across national boundaries have an enormous impact on the modern world. If we compare the revenues of the twenty-five largest transnational corporations (TNCs) with revenues of states, as in Table 8.1, we see that economic significance.
The world's 200 largest TNCs are incorporated in just ten states, as shown in Table 8.2, above all in the United States and Japan. This means, of course, that if one could affect the national policies of these TNCs in this small number of states, one could greatly affect TNCs’ global impact.
Beyond macro-statistics, it is clear that with regard to the internationally recognized right to health, and if we take the case of the HIV/AIDS pandemic in Africa and other places, the role of drug companies (often claiming intellectual property rights) is central.
After gross violations of human rights, what is one to do? This is the subject of transitional justice, a growth industry for intellectuals and policy makers after the Cold War. Should one prosecute individuals in international courts, or in hybrid or special courts, or in national courts? Should one avoid courts and rely on truth commissions, or bar violators from public office, or just move on to concentrate on building a rightsprotective state in the future rather than looking back via criminal prosecution? There are many complexities facing those interested in international criminal justice – meaning those interested in whether to prosecute individuals against the background of international human rights and humanitarian norms. Beyond punishment of evildoers, one needs to keep in mind other possible goals of transitional justice: deterring future atrocities, bringing psychological closure to victims and/or relatives, producing reconciliation among divided communities, building a rights-protective polity in the future, adjusting to the lingering power of elements of the old regime.
In the last decade of the twentieth century the United Nations created two international criminal courts, the first in almost fifty years. Moreover a new International Criminal Court (ICC) came into legal existence in July 2002. Furthermore, special courts were created in the aftermath of atrocities in Sierra Leone, East Timor, Kosovo, and Cambodia, while a new court was created by the interim government of Iraq after the US invasion and occupation of 2003 to try Saddam Hussein and his lieutenants. The United Kingdom agreed that the former dictator of Chile, Augusto Pinochet, could be extradited to Spain to stand trial there for torture. The Security Council authorized a special court in response to a political assassination in Lebanon, although that was more political theatre than expectation of effective criminal justice.
In the abstract it is hard to disagree with the proposition that those who commit gross violations of internationally recognized standards pertaining to genocide, war crimes, and crimes against humanity should face criminal justice. The principle of R2P, already noted as adopted by the UN in 2005, adds ethnic cleansing to this list of major violations (but without changing the subject matter jurisdiction of existing courts).
By now it should be clear that states, acting frequently through international organizations and/or diplomatic conferences, produce the international law of human rights by concluding treaties and developing customary law. The resulting law obligates states, primarily. In Chapter 6 we examined state foreign policy against the background of the international law of human rights. But private actors can be important at both ends of this process, affecting legislation and implementation.
This chapter starts with an analysis of non-governmental organizations and their advocacy of human rights ideas, which is directed both to the creation and application of human rights norms. Probably the best known of these groups is Amnesty International, but which over time may have lost some of its former status. This analysis is eventually set within the confines of social movements. Such actors push for more liberalism in the form of human rights protection in international relations. The chapter then turns to those private groups that are mostly called relief or development agencies, or sometimes PVOs (private voluntary agencies) or VOLAGs (voluntary agencies). A classic example is Oxfam. These private actors are crucial especially for grassroots action that directly or indirectly attends to social and economic rights. Most can be said to be liberal or pragmatic liberal actors, in that they emphasize policies for the betterment of individuals under legal norms, rather than emphasizing the collective national interests of states as pursued through the application of power. Chapter 8 addresses private for-profit actors, commonly called multinational or transnational corporations when they act across national borders.
Private advocacy for human rights
There are perhaps 250 private organizations consistently active across borders that take as their reason for being (raison d’être) the advocacy of some part of the international law of human rights and/or humanitarian affairs on a global basis.2 From this group a handful have the requisite budget, contacts, expertise, and reputation to get the global traditional media and major governments to pay them at least periodic attention across a range of issues and situations: Amnesty International (AI), Human Rights Watch (HRW), the International Commission of Jurists, the International Federation for Human Rights, the International Committee of the Red Cross, Human Rights First, Lawyers Without Borders, Doctors Without Borders, Physicians for Human Rights, Anti-Slavery International, PEN (Poets, Essayists, Novelists), Article 19 (devoted to freedom of expression), etc.
Human rights are widely considered to be those fundamental moral rights of the person that are necessary for a life with human dignity. Human rights are thus means to a greater social end, and it is the legal system that tells us at any given point in time which rights are considered most fundamental in society. Even if human rights are thought to be inalienable, a moral attribute of persons that public authorities should not contravene, rights still have to be identified – that is, constructed – by human beings and codified in the legal system. While human rights have a long history in theory and even in spasmodic practice, it was the American and French revolutions of the eighteenth century that sought to create national polities based on broadly shared human rights. Despite the rhetoric of universality, however, human rights remained essentially a national matter, to be accepted or not, until 1945 when they were recognized in global international law.
This book is about the evolution and status of human rights in international relations at the start of the twenty-first century. Thus this extended essay is about the effort to liberalize international relations – to make international relations conform to the liberal prescription for the good society. In the classical liberal view, the good society is based on respect for the equality and autonomy of individuals, which is assured through the recognition and application of the fundamental legal rights of the person. In this book liberalism is a synonym for attention to personal rights. But in international relations it has been widely believed that the state, not the individual, is the basic unit. And the core principle has been said to be state sovereignty and non-interference in the domestic affairs of states. In this book realism is a synonym for attention to state interests – foremost among which is security – and state power. The subject of international human rights thus projects liberalism into a realist world – a world dominated for several centuries by states and their collective interests.
When it comes to the dissemination of news, traditionally one spoke of hot and cool media. That referred to televised and print journalism. In the past, such was the influence of the CBS evening news that President Lyndon Johnson supposedly said that when anchor Walter Cronkite became critical of US policies in Vietnam in 1968, he knew he had lost the support of Middle America. In contemporary times one has to also speak of social media in which every person might be considered a private journalist – choosing what to disseminate as newsworthy “fact” and to whom. In 2016, various individuals in Aleppo used social media to keep the world informed about conditions there in the midst of the bloody Syrian war. In 2009, various individuals in Iran kept the rest of the world informed about the Green Revolution which sought more democracy there, especially via Twitter, despite electronic jamming by the regime.
It was well known, witness the ample case law on the subject, that traditional media activity involved a host of human rights questions centered on freedom of belief and expression, and of privacy. The same now is true for social media. Indeed, individual use of the internet has expanded the list of thorny human rights questions not only for individuals, but also for those for-profit corporations like Facebook and Google who saw themselves initially not as members of the media, but as technology or software companies. They are at least quasi-media actors, however, because increasingly a high percentage of persons with internet access get their news, or fake news, from such electronic platforms – either singularly or in combination with television. What circulates on Facebook, Google, and Twitter – and similar media actors – reaches billions of persons, which is precisely why these actors are at the center of discussion, debate, and legal and political action about their policies. What they allow to circulate or block is enormously important. Whether they cooperate with governmental spying programs is also hugely important.
It was obviously the case that traditional media could be important in drawing attention to human rights violations. This occurred as far back as the nineteenth century, when print journalism helped push Britain and other Western governments into interventions in response to Balkan atrocities during Ottoman rule.