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Britten and Pears regarded their relationship as a ‘marriage’ and described it as such as early as 1943. Although comfortable with using this term privately, they were aware of the legal prohibition and social stigma that prevented them from proclaiming their partnership openly. And yet throughout their nearly forty years together they made no immediate secret among their circle of friends and relatives about living their lives as a couple. As this essay suggests, theirs was a special case, in that they lived their relationship with relative openness among those who knew them. Works such as the Michelangelo Sonnets and Canticle I were a declaration of sorts about the nature of their relationship, although it was not until after the composer’s death that Pears commented overtly in an interview about their love for one another. A decade after the decriminalisation of homosexual acts in the UK, and with social discussion on homosexuality widening, Pears believed that his and Britten’s marriage need no longer be regarded as a secret.
As drug policies pertaining to cannabis use become more liberalised, the prevalence of cannabis use in pregnancy could increase. However, there is limited guidance available for clinicians. This paper presents a narrative review of literature published in the past 16 years (2006–2021) to (a) address the impact of legalisation and decriminalisation on the risks, ethics and support of women who use cannabis during pregnancy and (b) develop guidance for clinicians.
Both national and international trends suggest increased use of cannabis over the past decade, while the risks of cannabis use for recreational or medicinal purposes in pregnancy remain unmitigated.
This review confirmed that the recommendation of cannabinoid-based products for pregnant and breast-feeding women is currently premature. More research is needed to address safety concerns. We discussed navigating ethical concerns and suggest targeted management strategies for clinicians treating pregnant women who choose to use cannabis.
There are few topics that divide public opinion as sharply as the use of psychoactive substances and it is easy to see why. Substance use is complex and can be examined from numerous perspectives, including legal, health, economic, cultural and ethical. These varying approaches can lead to a range of different conclusions. Here we explore some of the common approaches adopted towards drug policy and suggest a number of principles, which may inform a psychiatrist's own view.
Whilst it remains a criminal activity to solicit sex publicly in the UK, it has become increasingly popular to configure sex workers as ‘vulnerable’, often as a means of foregrounding the significant levels of violence faced by female street sex workers. Sex work scholars have highlighted that this discourse can play an enabling role in a moralistic national policy agenda which criminalises and marginalises those who sell sex. Yet multiple and overlapping narratives of vulnerability circulate in this policy arena, raising questions about how these might operate at ground level. Drawing on empirical data gathered in the development of an innovative local street sex work multi-agency partnership in Leeds, this article explores debates, discourses and realities of sex worker vulnerability. Setting applied insights within more theoretically inclined analysis, we suggest how vulnerability might usefully be understood in relation to sex work, but also highlight how social justice for sex workers requires more than progressive discourses and local initiatives. Empirical findings highlight that whilst addressing vulnerability through a local street sex work multi-agency partnership initiative, a valuable platform for shared action on violence in particular can be created. However, an increase in fundamental legal and social reform is required in order to address the differentiated and diverse lived experiences of sex worker vulnerability.
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