Hasil untuk "Medical philosophy. Medical ethics"

Lucas França Garcia, Daniele Fernanda Felipe, Márcia Santana Fernandes et al.

Resumo Este artigo analisa a evolução histórica das regulamentações éticas brasileiras sobre pesquisas envolvendo seres humanos, discutindo as Resoluções do Conselho Nacional de Saúde 1/1988, 196/1996, 466/2012, 510/2016 e a Lei 14.874/2024. Trata-se de pesquisa documental qualitativa com abordagem histórico-crítica, comparando os marcos regulatórios nacionais com as principais diretrizes internacionais de ética em pesquisa. Observa-se que, apesar do avanço jurídico trazido pela nova lei, persistem críticas significativas, especialmente quanto à proteção dos participantes e à independência dos comitês de ética em pesquisa. Conclui-se que a nova regulamentação necessita de ajustes para corrigir lacunas relacionadas à burocratização dos processos e à autonomia das instâncias éticas brasileiras. Recomenda-se simplificar procedimentos administrativos, fortalecer a independência dos comitês de ética em pesquisa e do Sistema Nacional de Ética em Pesquisa e alinhar a legislação brasileira às melhores práticas internacionais, assegurando, assim, proteção efetiva e contínua aos participantes de pesquisas.

Peter D. Young, Katherine M. Sahan

Abstract Background Healthcare professionals have ethical duties to provide information according to conceptions of the doctor-patient relationship, and one way this responsibility is established in practice is by UK guidance on shared decision making. Non-invasive prenatal testing (NIPT) is a relatively new prenatal screening test offered by the UK National Health Service (NHS) since 2021. Since NIPT has different characteristics when compared to other prenatal screens and tests—such as the combined test and amniocentesis—it is not clear how information should be offered in a pre-test consultation. Key to answering this question is to understand more about the HCP-patient relational dynamics surrounding the offer of NIPT. Previous studies have focused on the woman’s role in this; the views and attitudes of pregnant women about decision making in the offer of NIPT has been interrogated elsewhere. However, little attention has been given to the views and attitudes of healthcare professionals (HCPs) and how those views might shape the dynamics of how NIPT is offered and how the decision-making process goes. Methods This study carried out qualitative interviews with 20 UK HCPs who offered NIPT and/or provided counselling for NIPT. Findings from the interviews were analysed and themes were developed about how HCPs reported they offered NIPT and their reasons for this. Results HCPs say they conveyed information about the nature of NIPT to women when offering the test. This includes how HCPs say they described the risks of NIPT, their views about clarifying the non-diagnostic nature of NIPT, how they explained NIPT accuracy to women, and how they stressed that decisions about test options were up to the patient. HCPs also reported how they distinguished NIPT from other screens and tests and described NIPT as a different category of screening test. Furthermore, many HCPs say they either provided predetermined information to patients or reported being patient-led in the offer. Conclusions This study explores how HCPs reported the offer of NIPT and also how they thought the offer should go, by giving their reasons for what they report. This indicates their normative sense of which information ought to be given (that is, what they believed was critical to provide for decision making). It also indicates which aspects within the offer they believed should be emphasised or played down. The accounts reported here of HCPs’ experiences raise questions about how information should be provided to women in the offer of NIPT. This might help us establish better practices of informing women who use NIPT. Results of this study have a number of implications for the ethics of prenatal testing in practice. Firstly, they indicate a need for better guidance and education about how to discuss certain informational aspects within the offer such as NIPT characteristics and statistics. Secondly, they show that aspects of the current offer may be value-laden, and the way HCPs counsel patients about NIPT may be insufficiently patient-led. More research in this area might tell us whether different guidance or educational opportunities ought to be developed to help HCPs discuss NIPT and its characteristics. Clinical trial number Not applicable.

Radu-Mihai DUMITRESCU

In a context marked by clinical complexity and systemic pressures, the integration of the humanities into medical professional education is becoming increasingly relevant. This paper explores, through a narrative review and a bibliometric analysis of the literature (2000-2025, PubMed), the contributions of the humanities to medical education, clinical practice and public health. Findings reveal thematic recurrence around five major areas: narrative medicine and empathy, ethical and moral reasoning, cultural competence, clinical communication and professional well-being. Results show that students exposure to literature, philosophy, arts and social sciences significantly improves empathy, critical reflection, emotional resilience and understanding of the patient experience. The bibliometric analysis also confirmed the coherence and interdependence of these themes, highlighting an emerging core of interdisciplinary research between narrative medicine, clinical ethics and global health. Key recommendations include: the systematic introduction of humanities courses in the medical curriculum, the development of integrated thematic modules throughout clinical training, institutional support for continuing reflective education, and the encouragement of collaboration between medical and humanities disciplines. In conclusion, the humanities provide an essential underpinning for the preparation of competent, empathic and competent medical professionals adapted to contemporary challenges. An integrative educational approach, centred on the human dimensions of practice, is fundamental for a more ethical, equitable and sustainable health system.

Satendra Singh

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Benjamin Chin-Yee

ABSTRACT:Generalizations in medical research can be informative, but also misleading. Building on recent work in the philosophy of science and ethics of communication, I offer a novel analysis of common generalizations in clinical trials as generics in natural language. Generics, which express generalizations without terms of quantification, have attracted considerable attention from philosophers, psychologists, and linguists. My analysis draws on probabilistic and contextual features of generics to diagnose how these generalizations function and malfunction across communicative contexts in medicine. Given a high risk of misinterpretation ("slippage"), I recommend avoidance of generic claims about medical interventions in public contexts, exemplified by clinical trials and medical research more generally. Generics should only be used with vigilance in private contexts, exemplified by the physician–patient encounter. My analysis provides tools to support vigilance when communicating with generics, suggests new norms for public science communication, and raises deeper questions in the ethics of clinical communication.

Aviad E. Raz, J. Minari, S. Schicktanz et al.

Department of Sociology and Anthropology, Ben-Gurion University of the Negev, Beer-Sheba, Israel, Uehiro Research Division for iPS Cell Ethics, Center for iPS Cell Research and Application (CiRA), Kyoto University, Kyoto, Japan, Department of Medical Ethics and History of Medicine, University Medical Center Göttingen, Göttingen, Germany, Department of Ethics and Political Philosophy and Interdisciplinary Hub on Digitalization and Society, Radboud University, Nijmegen, Netherlands, Institute of Biological Chemistry, and Bioethics Network Ethucation, Medical University Innsbruck, Innsbruck, Austria

Eti Muharremi, Gentian Vyshka

The Yalta Conference of 1945 brought together three of the most influential leaders of the 20th century: Franklin D. Roosevelt, Joseph Stalin and Winston Churchill. Surprisingly, all three leaders would go on to suffer strokes after the conference. This manuscript examines the health status of these leaders during and after the Yalta Conference, the factors that contributed to their strokes (including the role of hypertension), and other modifiable risk factors present in each one of them, and the impact of their declining health on their countries and the world. Roosevelt's demise, prior to the conclusion of the war, triggered a leadership transition during a critical moment in history, while Churchill and Stalin's passing shaped the early Cold War era. A veil of secrecy shrouded the health conditions of these pivotal leaders. “The Big Three” made considerable efforts to hide their health conditions from both the press and the public at large.Understanding the health of political leaders is crucial as it can affect their decision-making abilities and the course of history. The fates of Roosevelt, Stalin and Churchill serve as important reminders of the potential consequences of poor health in the highest echelons of political power.

E Archer, R Turner

Background. The concept of empathy in students has gained significant attention in medical education. Whether implementing formal educational interventions to promote long-term and effective empathy levels leads to sustained increased empathy levels in students, is however less clear. Objectives. The study aimed to evaluate the trajectory of medical students’ self-perceived empathy levels during their 6-year MB ChB degree. Methods. A longitudinal, prospective study was conducted over 4 years. A cohort of 292 medical students was invited to participate. Participants completed the Jefferson Scale of Empathy for Students (JSE-S) at three intervals during their studies. The students attended two workshops related to empathic patient interactions during this time. The JSE-S mean score by age and gender was compared, making use of a linear regression model. Results. A total of 119 students completed the study. Students’ total empathy levels were similar during the first and the last measuring point (110), but there was a significant rise in the intermediate measuring point (113.3). When the male and female cohorts’ scores were interpreted separately, both genders demonstrated a similar pattern to the total score, although females’ JSE-S scores were higher than the males. Conclusion. The results of the study confirm that educational interventions can increase students’ self-perceived empathy levels; however, we suggest that students require reinforcement and multiple opportunities to practise and observe empathic communication with patients to sustain high levels of empathy. Follow-up sessions to specifically target the promotion of empathy should be implemented; otherwise the long-term effect of educational interventions might be limited.

Neda Yavari, Fariba Asghari, Zahra Shahvari et al.

It appears that up until now, no comprehensive tool has been developed to assess medical students’ attitudes toward the different dimensions of professionalism. The present study aimed to develop a comprehensive quantitative tool to evaluate medical students’ attitudes toward professionalism. This study consisted of two phases: The first phase was item generation and questionnaire design based on literature review and a qualitative survey. The qualitative data were extracted from 49 semi-structured individual interviews and one focus group discussion. In the second phase, the questionnaire was developed and its face, content, and structure validity and reliability were evaluated. To measure the construct validity of the questionnaire, a cross-sectional study was conducted on 354 medical students at different academic levels at Isfahan University of Medical Sciences. The final questionnaire was loaded on five factors. The factors accounted for 43.5% of the total variance. Moreover, Cronbach's alpha was 0.84 for the total scale, and the interclass correlation coefficient was 0.77 for the test-retest reliability. The 17-item questionnaire measuring medical students’ professional attitude had acceptable validity and reliability and can be adopted in other studies on physicians’ and medical students’ professional attitudes.

Alberto Molina-Pérez, D. Rodríguez-Arias, J. Delgado-Rodríguez et al.

a Ethical Legal and Psychosocial Aspects of organ Transplantation (ELPAT), a section of the European Society for Organ Transplantation (ESOT) b FiloLab-UGR Scientific Unit of Excellence, Department of Philosophy I, Faculty of Philosophy, University of Granada, Campus Cartuja s/n, 18011 Granada, Spain c University Hospital of Canary Island, University of La Laguna, Tenerife, Spain d Institute of Pharmaceutical Science, King's College London, United Kingdom e Department of Philosophy, Faculty of History and Philosophy, Babes-Bolyai University of Cluj, Cluj, Romania f Institute for Health Research, University of Bedfordshire, Luton, England, United Kingdom g Dutch Transplant Foundation, Department of Public Information & Education, Leiden, the Netherlands h Dutch Transplant Foundation, Department of Policy, Leiden, the Netherlands i Department of Medical Ethics and History of Medicine, University Medical Center Göttingen, Göttingen, Germany

Ali Sahebi, Siamak Moayedi, Mohamad Golitaleb

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Euzebus C. Ezugwu, Pauline E. Osamor, David Wendler

Abstract Background Sickle cell anemia (SCA) is a major genetic disease with the greatest burden in sub-Saharan Africa. To try to help reduce this burden, some churches in Nigeria conduct premarital sickle cell hemoglobin screening and refuse to conduct weddings when both individuals are identified as carriers of sickle cell trait. Main body This paper explores the ethical challenges involved in such denials. We assess whether churches have the right to decline to marry adults who understand the risks and still prefer to get married, and whether couples should be denied church weddings based on the risk that their child may suffer from sickle cell anemia. We examine the moral and ethical dimensions of such denials and explore the underlying socio-cultural context involving the purpose of marriage and the meaning of the wedding ceremony in societies where premarital screening is one of the few tools available to reduce the risk of having children with SCA. The potential role of the church is also examined against the background of church beliefs, the duty of the church to its members and its role in reducing the suffering of its members and /or their children. Conclusion We argue that the church should impose these burdens on couples only if doing so promotes a sufficiently compelling goal and there is no less burdensome way to achieve it. We then argue that the goal of reducing the number of individuals in Nigeria who have SCA is compelling. However, testing earlier in life offers a less burdensome and potentially even more effective means of achieving this goal. This suggests that, advocating for earlier screening and helping to support these programs, would likely better promote the church’s own goals of helping its parishioners, increasing the number of church weddings, and reducing the burden of SCA in Nigeria.

Teresa Honrubia Fernández

Durante los primeros 6 meses de 2017 se desarrolló un encendido debate sobre el caso de un niño inglés con una enfermedad rara y muy grave. Charlie Gard permaneció 9 meses en una unidad de cuidados intensivos paralizado, sometido a ventilación mecánica y con una función neurológica en constante deterioro. Mientras, en la prensa especializada y en los medios de comunicación general se desarrollaba un debate sobre quien tenía que tomar la decisión de retirar o continuar con los tratamientos de soporte vital y cuáles eran los criterios que había que utilizar para tomarla. En este artículo, analizamos estos y otros problemas éticos y sugerimos que, para tomar las mejores decisiones, se ha ido evolucionando de los intentos de definir la futilidad y determinar quién decide, hacia el concepto de tratamientos potencialmente inapropiados y el recurso a estrategias de toma de decisiones compartidas.

A. Malik, C. Foster

R. Peels, M. Blaauw

Maasoumeh Barkhordari-Sharifabad, Tahereh Ashktorab, Foroozan Atashzadeh-Shoorideh

In the nursing profession, leadership plays a significant role in creating motivation and thus enabling nurses to provide high quality care. Ethics is an essential component of leadership qualifications and the ethical leader can help create an ethical atmosphere, offer ethical guidance, and ensure the occupational satisfaction of personnel through prioritizing moralities. However, some issues prevent the implementation of this type of leadership by nursing leaders. The aim of this study was to identify and describe some problems and obstacles in ethical leadership faced by nursing leaders, and to help them achieve more accurate information and broader perspective in this field. The present study was conducted using a qualitative approach and content analysis. A total of 14 nursing managers and educators were selected purposefully, and deep and semi-structured interviews were conducted with them. Content analysis was performed using an inductive approach. Three main categories were obtained after data analysis: ethical, cultural and managerial problems. “Ethical problems” pertain to doubt in ethical actions, ethical conflicts and ethical distress; “cultural problems” include organizational and social culture; and “managerial problems” are connected to organizational and staff-related issues. Nursing leaders put forth various aspects of the problems associated with ethical leadership in the clinical setting. This style of leadership could be promoted by developing suitable programs and providing clear-cut strategies for removing the current obstacles and correcting the organizational structure. This can lead to ethical improvement in nursing leaders and subsequently the nurses.

D J McQuoid-Mason

The question has been asked as to whether doctors attending sexual-offence victims have to notify sexual-offence suspects that their patients who were forced to have unprotected sexual intercourse are HIV-positive. It is submitted that the common law requires doctors to warn endangered third parties where such persons may suffer injury as a result of interactions with their patients, and that this applies to patients who have tested positive for HIV. The ethical rules of the Health Professions Council of South Africa also require doctors to breach the confidentiality rule against the consent of their patients who have tested HIV-positive, where the sexual partner of a patient is known, and after counselling such patients still refuse to allow disclosure – provided there is no risk of consequential harm to such patients. The dilemma of doctors treating HIV-positive patients is sometimes resolved where, in terms of the Criminal Law (Sexual Offences and Related Matters) Amendment Act No. 32 of 2007, a court order for the compulsory testing of the suspect has been obtained and the suspect knows his or her HIV status. Recommendations are made for what doctors should do in such cases.

Zahra Nasrollahi

the term “spirituality” has been proposed to denote the notion of intellectuality. Actually, the former has been derived from the Latin words “spiritus” (means breath) and “spirare” (means inhaling or breathing). Given the Latin translations of the New Testament, the term “spiritualis” or spiritual person is an individual whose life is dominated or influenced by the Holy Spirit or God (1).

Leandri Hattingh

Managed health care in South Africa is faced with complex moral challenges, where different stakeholders appeal to different ethics principles to guide decision making. The traditional bio-medical ethics principles of beneficence, non-maleficence and respect for autonomy are typically emphasised in clinical practice, while third party funders appeal to the principle of justice to guide the allocation of limited, pooled resources. Health care professionals working in managed care are particularly exposed to these conflicts, vis-à-vis incongruence between the ethics guidelines from their professional bodies and the legislation pertaining to managed care. Common understanding of the claims and responsibilities of each of the stakeholders may promote a more coherent, sustainable health care system.Â

Maia Winkel

Afghanistan, Chad, South Sudan, Myanmar, Somalia, the Democratic Republic of Congo, Yemen, and Sudan - these are eight countries in which armed forces – be it in a national capacity or in de facto rebel militia - regularly and mercilessly exploit hundreds of thousands of children.[i] A quick internet search for images of child soldiers turns up thousands of pictures of hardened children with vacant stares holding machine guns; something alarming but not unexpected, in the thousands of photographs that appear, not a single child smiles. These are children because of their chronological ages - ranging from as young as five years old to seventeen - not because of how they behave, what they do, how they think. With their childhoods quickly ripped away, these individuals are often given guns and ordered to kill or to die; ruthless violence becomes endemic to their lives. With a current estimated count of 250,000 child soldiers (possibly as high as 300,000), something must be done to preserve these children’s innocence, as well as to prevent future aggression and hostility that this indoctrination is engendering. [ii] [iii] So, who is to blame for this ongoing crisis? The governments, the children, or the rebel leaders who put youths to use for their own cause? In 2007, The United Nations Children’s Fund (UNICEF), published The Paris Principles, wherein “The Principles recognise that, in situations of armed conflict, States and armed groups are the primary actors responsible for the protection of civilians in their effective control and that if they are unable or unwilling to meet all of their humanitarian responsibilities directly they are charged with enabling the provision of humanitarian action by impartial actors.” [iv] While blameworthiness and responsibility are major components of exploiting youth as child soldiers and accountability must be expected of those responsible, the immediate focus should not be only on blaming the responsible parties, but rather, that there should be a global aim of addressing the more pressing issues of prevention of violence, rehabilitation from the damage caused by severe indoctrination, and reintegration into a non-violent world. To understand the degree to which child soldiers are exploited, we must first clarify the roles into which these children are generally forced. According to The Paris Principles, a child “associated with armed forces or armed groups,” is defined as “any person below 18 years of age who is or who has been recruited or used by an armed force or armed group in any capacity, including but not limited to children, boys and girls, used as fighters, cooks, porters, messengers, spies or for sexual purposes. It does not only refer to a child who is taking or has taken a direct part in hostilities.” [v] Therefore, the at-risk group is clearly much larger than that comprised by the sadly iconic gun-toting children; as such, “child soldier” describes a number of functions that these children are expected to perform, many of which inappropriate for people of any age, but especially for young children, and which are carried out regardless of the children’s lack of maturity and inability to understand and give consent. To realize the gravity of ethical corruption regarding this human rights violation, we must first discuss several motives for why young children are regularly kidnapped and coerced by armed forces into becoming child soldiers. Firstly, it does not require much effort to steal these children away from their families. Entire communities are constantly terrorized with individual and collective punishment – with frequent murderous raids, kidnappings, mass rape, wanton destruction, and threats of violent annihilation - if they fail to surrender a given number of children to these forces. At the various, early stages of development during which these children are captured, they still rely on authority figures to understand the ways of the world; therefore, they can be easily influenced. Often under the effects of drugs forced upon them by their captors, these children can undergo frightful transformations with regards to moral understanding, appropriate social behavior, and sense of self, in relation to others. The physical, emotional, and psychological malleability and susceptibility to indoctrination - and the subsequent harmful consequences - are often sufficient to desensitize these child soldiers to the atrocities they witness and commit. Furthermore, young children do not have the capacity to understand the gravity and finality of death, the mental and emotional capacity to comprehend the meaning of their actions - whether self-intended or when ordered to do so - or the willpower to resist the authority that coerces them into committing such despicable and vile actions.[vi] Moving Forward In response to this widespread, terrible crisis, on March 6, 2014, the United Nations publicly announced its most recent goal: “to end the recruitment and use of children in Government forces in conflict by 2016. Secretary-General Ban Ki-moon stressed that children should be armed with pens and textbooks, not guns.” [vii] The Secretary-General’s Annual Report on Children and Armed Conflict, named eight countries in which armed forces recruit and use children as soldiers. As previously noted, they are: Afghanistan, Chad, South Sudan, Myanmar, Somalia, Democratic Republic of Congo, Yemen, and Sudan. [viii] As of June 2013, the first six nation states listed had agreed to collaborate with the United Nations to reduce the recruitment and exploitation of children as soldiers. [ix] Discussions with the governments of Yemen and Sudan have already occurred and, according to the United Nations, the two are expected to sign action plans, as well. However, the fact that authorities in these countries have been complicit in the commission of grave crimes against their own children, in addition to having poorly functioning democratic institutions devoted to safeguarding human rights, makes their public pronouncements questionable. Worse still, the ostensible cooperation with the United Nations has been consistently used as a foil against exposure and criticism. Revisiting an earlier question, when government security forces recruit and employ child soldiers for use in armed conflict, upon whose shoulders does the responsibility lie to rescue and protect these broken youths? I agree with the spirit of the Paris Principles that stipulate that in situations of armed conflict it is primarily the responsibility of the states and armed groups to provide the public with humanitarian protection and aid. However, it is certainly unrealistic to expect the violators to become human rights enforcers. Therefore, when child soldiers comprise a significant component of armed forces, who then is to be held responsible for the action of these young killers and what can be done when innocent children become mechanical murderers? To what degree, if at all, should child soldiers be held accountable for their actions? Here, we must consider the mental state and capacity of child soldiers – in both an emotional and psychological sense. In evaluating issues of moral responsibility, we cannot ignore the context in which the child soldiers operate; we must take into account what exactly is at stake, how the children interpret and internalize violent experiences that surround them, how cognitively aware these children are of their actions and the ensuing consequences, what their state of cognizance is (i.e., drugged, drunk, brainwashed), and how much physical and psychological trauma can be endured before an individual’s moral sense and personal dignity collapse. With their lives torn asunder, these children are robbed of their innocence and of their trust in humanity; what remains is a generation of deeply scarred minds and souls. As hundreds of thousands of child soldiers are currently being used, there are crucial issues that demand our immediate attention: protecting children by preventing future exploitation, rehabilitating the psychologically, physically, and emotionally damaged children, and reintegrating the youth into protective, rehabilitative, and healthy societies. There must be a collective, universal effort to end this exploitation of children and save them from witnessing and taking part in human rights atrocities. Although the attitude is commendable, I am wary that the action plans between countries with child soldiers and the United Nations represent noncommittal efforts on both sides. I am not advocating for foreign invasion into these countries, however appeals of nonmaleficence and justice to these national forces will only fall on deaf ears. I worry that this trusting reliance on this illusion of cooperation will inevitably lead to the betrayal and abandonment of the victims, the damaged children; particularly since child soldiers are often ostracized from their families and home communities as a result of the atrocities they are forced to commit. In hopes of rehabilitating rescued child soldiers - reversing as much emotional and mental damage as possible - we need to collectively engage in a prolonged, involved educational and therapeutic intervention; ideally, these efforts would involve support from people within the communities most affected by this crisis, so as to restore a sense of worth to these children. When approaching this difficult task of rehabilitation, a key concept that must be honestly confronted is that what has happened cannot be undone. This sensitive issue must be addressed in a supportive environment in which the youths should neither be punished for their previous actions nor be exonerated. Instead, we should help them to understand the significance of their actions, explaining how they may not have had the discretion to refuse to participate in acts of brutality. Realizing the devastating effects of the conditions into which child soldiers are forced, I believe these children should be rescued, protected, and rehabilitated. In our most vulnerable, exposed state, we cannot always be accountable for our actions. For these often kidnapped children, the integrity of the self, willpower, and sense of agency are compromised; instead, these internal structures have been distorted and overwhelmed by violent ideology and action. I do not believe their actions can truly be classified as decisions because exploited and abused child soldiers have limited capacity with respect to making informed decisions. It is crucial to bear in mind that they do not have the intellectual and emotional maturity to comprehend the meaning of their newly assigned identities and ascribed roles. Furthermore, the range of severe emotional and psychological trauma that these youths experience often serves to blind them from the horrors of violence, their actions, and the human rights violations they regularly commit. They behave in the manner in which they have been treated and taught, where violence is an acceptable, standard part of everyday life. Only once the world succeeds in eradicating child exploitation in situations of armed conflict and rehabilitating and reintegrating rescued child soldiers - challenging goals, at the very least - should we turn our focus to assigning blame and retribution. REFERENCES [i] War Child. http://www.warchild.org.uk/issues/child-soldiers [ii] Ibid. [iii] Amnesty International. “Hidden Scandal, Secret Shame: Torture and Ill-Treatment of Children.” Published December 8, 2000. Index Number: ACT 40/038/2000. http://www.amnesty.org/en/library/info/ACT40/038/2000/en [iv] The United Nations Children’s Fund (UNICEF), The Paris Principles: Principles and Guidelines on Children Associated with Armed Forces or Armed Groups. Published 2007, Section 1.6 http://www.unicef.org/emerg/files/ParisPrinciples310107English.pdf [v] Ibid, Section 2.1. [vi] Child Soldiers International. http://child-soldiers.org/ [vii] The United Nations Office of the Special Representative for Children and Armed Conflict. “UN Unveils Global Campaign to End Use of Child Soldiers in Government Forces By 2016.” Published March 6, 2014. http://childrenandarmedconflict.un.org/12078/ [viii] The United Nations General Assembly Security Council, Children and Armed Conflict: Report of the Secretary-General, 2012. [ix] Supra, War Child.