article 22 case study

Preventive Detention Laws in India, Article 22, Meaning, Significance

Preventive detention is detaining a person in order to prevent a situation of crime that a person can possibly commit. Check all about Preventive Detention Laws in India & Article 22 of Constitution.

Table of Contents

Preventive Detention Meaning

Preventive detention is detaining a person in order to prevent a situation of crime that a person can possibly commit. In other words, preventive detention is an administrative action on the grounds of the suspicion that some wrong actions may be done by the person concerned which will be prejudicial to the state.

Supreme Court on Preventive Detention

It’s worth noting that the Indian Supreme Court has laid down certain guidelines for the use of preventive detention laws, such as the requirement for a judicial review of the detention within a specified period of time, the right to legal representation, and the right to be informed of the grounds for detention. These guidelines aim to ensure that preventive detention laws are used in a fair and just manner and to prevent abuses of power by the government.

In Alijav v. District Magistrate, Dhanbad, the Supreme Court held that while preventative detention does not involve an offence, criminal procedures do involve penalising a person for an offence they had committed.

In Ankul Chandra Pradhan v. Union of India, case Supreme Court held that the goal of preventative detention is not to punish but rather to stop them from doing anything that may jeopardise the security of the state.

The Constitution of India gives the Parliament the authority to enact rules governing preventive detention where they are necessary for national security, foreign policy, or defence. Parliament has sole authority over legislation.

Read about: List of Chief Justice of India

Preventive Detention Laws in India

Preventive Detention laws in India refers to the provisions of Indian law that allow for the detention of individuals without trial, in order to prevent them from committing an act that would pose a threat to public order or national security. In India, preventive detention laws are governed by various acts. These laws give the government broad powers to detain individuals deemed to be a threat to national security or public order for a specified period of time, without the need for trial or charge.

The provisions regarding preventive detention in India are governed by Article 22. Persons who are detained or arrested are protected by this article. Therefore, Article 22 does not apply before the arrest or imprisonment of a person or group of people; it only does so later. It should be observed that Articles 21 and 22 work well together in this situation.

A person can be put in custody for two reasons. One is if an individual has committed a crime. Second when an individual has the potential to commit a crime in the future. The custody arising out of the latter is preventive detention under which, an individual is deemed likely to commit a crime. Laws made by the government on it are,

Preventive Detention Act, 1950. Expired in 1969.
Maintenance of Internal Security Act (MISA), 1971. Repealed in 1978.
National Security Act (NASA), 1980.
Terrorist and Disruptive Activities (Prevention) Act (TADA), 1985. Repealed in 1995.
Prevention of Terrorism Act (POTA), 2002. Repealed in 2004.
Unlawful Activities (Prevention) Act (UAPA), 1967, as amended in 2004, 2008, 2012 and 2019. etc

Read about: Article 14 of Indian Constitution

Article 22 of Indian Constitution


Article 22	This article provides for the protection of the life and personal liberty of individuals and lays down the procedure for preventive detention. According to this article, no person can be detained without being informed of the grounds for such detention, and no person can be detained for more than three months without a judicial review.
Article 22(2)	This clause requires the state to provide for a judicial review of the detention within a period of five weeks from the date of detention unless the individual is otherwise released earlier.
Article 22(3)	This clause allows for the detention of individuals without a trial in certain circumstances, such as when a state of emergency has been declared.
Article 22(4)	This clause provides that any person who is detained under preventive detention laws has the right to be represented by a legal practitioner of their choice, and has the right to be informed of the grounds for their detention.
Article 22(5)	This clause requires the government to keep a record of all detentions and to place this record before both houses of Parliament.

Read about: Article 15 of Indian Constitution

Types of Detention

Punitive Detention: This type of imprisonment is used to punish a person for an offence they committed after being found guilty in court. It occurs under any ordinary law.

Preventive Detention: It is to hold someone in custody without a court trial and conviction. Its goal is to deter someone from committing an offence in the near future rather than to punish them for a prior offence. As a result, it is purely based on suspicion and is merely a precaution.

gives the following rights to an individual who is arrested or detained under an ordinary law:

A person in custody has a right to be told of the reason(s) for one’s arrest at the moment of arrest. so that he can prepare for the trial, make his own defence, or ask for bail. Police cannot prevent an arrested individual from meeting with or consulting with the counsel of their choice. like a lawyer, a counsellor, etc In the Hussainara Khatoon case, the Supreme Court ruled that “one accused has the right to obtain free legal representation from the state if he cannot afford a lawyer.”

Article 22 second part ensures protection for an individual who has been arrested or detained under a preventive detention law. The protection has been ensured to both citizens as well as aliens and includes the following:

The detention of a person cannot exceed three months unless the advisory board reports sufficient cause for extended detention. Judges of a are part of this Board. : The grounds of detention should be communicated to the detente. Although, the facts considered to be against the public interest should not be revealed. The detente should be afforded an opportunity to make representation against the detention order.

Article 22 also authorises the Parliament to prescribe

Read More: Article 16 of Indian Constitution

Preventive Detention Act 1950

It was enacted to strengthen human detention in instances involving state conditions, such as national defence, the maintenance of peace and public order, and foreign affairs.
The Act was challenged in the court of law in the matter of AK Gopalan versus The State of Madras, where it was cleared by the court that an individual’s freedom did not qualify as ensured under Article 21.
A narrow view has been adopted by the Supreme Court of Articles 21 and 22, which refused to consider whether there were any flaws in the legal method.
The Supreme Court in the Maneka Gandhi case significantly widened and interpreted the term “personal liberty” to its widest degree.
The higher court held that Article 21 does not preclude Article 19 and that any legislation depriving a citizen of personal liberty must pass the scrutiny of both Articles 21 and 19.

Preventive Detention UPSC

The laws governing preventative detention need to be revised or modified in order to comply with the Right to Life and Liberty since they are not totally fair and reasonable. Some detractors compare a security to the fundamental tenant of human rights. India is a large nation with extensive borders and a variety of identities, and as a result, the neighbouring nations are hostile to it. These security-related laws, rules, and practices have the responsibility of protecting India’s sovereignty, independence, and dignity under these circumstances.

Read about: Article 19 of Indian Constitution

Sharing is caring!

What is mean by preventive detention?

Preventive detention is detaining a person in order to prevent a situation of crime that a person can possibly commit.

What are the types of detention?

The detention is to two types Punitive and Preventive detention.

For how much a time one can be detained under Preventive detention?

Period of detention under preventive detention is three months.

What is Article 22 in Indian Constitution?

Under Article 22, No person who is arrested shall be detained in custody without being informed, as soon as may be, of the grounds for such arrest nor shall he be denied the right to consult, and to be defended by, a legal practitioner of his choice.

What is Punitive Detention?

Punitive detention is used to punish a person for an offence they committed after being found guilty in court and receiving a judgment.

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Constitution of India

Protection Against Arrest and Detention in Certain Cases

(1) No person who is arrested shall be detained in custody without being informed, as soon as may be, of the grounds for such arrest nor shall he be denied the right to consult, and to be defended by, a legal practitioner of his choice.

(2) Every person who is arrested and detained in custody shall be produced before the nearest magistrate within a period of twenty-four hours of such arrest excluding the time necessary for the journey from the place of arrest to the court of the magistrate and no such person shall be detained in custody beyond the said period without the authority of a magistrate.

(3) Nothing in clauses (1) and (2) shall apply—

(a) to any person who for the time being is an enemy alien; or

(b) to any person who is arrested or detained under any law providing for preventive detention.

(4) No law providing for preventive detention shall authorise the detention of a person for a longer period than three months unless—

(a) an Advisory Board consisting of persons who are, or have been, or are qualified to be appointed as, Judges of a High Court has reported before the expiration of the said period of three months that there is in its opinion sufficient cause for such detention: Provided that nothing in this sub-clause shall authorise the detention of any person beyond the maximum period prescribed by any law made by Parliament under sub-clause (b) of clause (7); or

(b) such person is detained in accordance with the provisions of any law made by Parliament under sub-clauses (a) and (b) of clause (7).

(5) When any person is detained in pursuance of an order made under any law providing for preventive detention, the authority making the order shall, as soon as may be, communicate to such person the grounds on which the order has been made and shall afford him the earliest opportunity of making a representation against the order.

(6) Nothing in clause (5) shall require the authority making any such order as is referred to in that clause to disclose facts which such authority considers to be against the public interest to disclose.

(7) Parliament may by law prescribe—

(a) the circumstances under which, and the class or classes of cases in which, a person may be detained for a period longer than three months under any law providing for preventive detention without obtaining the opinion of an Advisory Board in accordance with the provisions of sub-clause (a) of clause (4);

(b) the maximum period for which any person may in any class or classes of cases be detained under any law providing for preventive detention; and

Article 22, Constitution of India 1950

Provided that nothing in this sub-clause shall authorise the detention of any person beyond the maximum period prescribed by any law made by Parliament under sub-clause (b) of clause (7); or

Draft Article 15A (Article 22) was debated on 15 and 16 September 1949 . It was not part of the Draft Constitution 1948. Instead, the Chairman of the Drafting Committee proposed to insert the following as Draft Article 15A:

’15A. (1) No person who is arrested shall be detained in custody without being informed, as soon as may be, of the grounds for such arrest nor shall he be denied the right to consult a legal practitioner of his choice.

(3) Nothing in this article shall apply- (a) to any person who for the time being is an enemy alien; or (b) to any person who is arrested under any law providing for preventive detention; Provided that nothing in sub-clause (b) of clause (3) of this article shall permit the detention of a person for a longer period than three months unless- (a) an Advisory Board consisting of persons who are or have been or are qualified to be appointed as judges of a High Court has reported before the expiration of the said period of three months that there is in its opinion sufficient cause for such detention, or (b) such person is detained in accordance with the provisions of any law made by Parliament under clause (4) of this article.

(4) Parliament may by law prescribe the circumstances under which and the class or classes of cases in which a person who is arrested under any law providing for preventive detention may be detained for a period longer than three months and also the maximum period for which any such person may be so detained.’

The Draft Article provided safeguards for arrested or detained persons, but also carved out exceptions for persons subject to preventive detention.

The Chairman of the Drafting Committee stated that Draft Article 15A was introduced to compensate for the dropping of the due process clause from Draft Article 15 ( Article 21 ). He declared this new Draft Article turned statutory safeguards for detainees into constitutional guarantees, thereby protecting personal liberty from arbitrary action.

Some members felt the Draft Article did not go far enough. One member proposed a series of amendments, one of which gave the accused the right to be defended by a lawyer of their choice. He argued that this was necessary to bring the Draft Article in line with the existing statutory provisions. This was accepted by the Assembly.

Other members were concerned about the lack of safeguards for preventively detained persons. Several wanted to reduce the permissible time period for this detention, to periods ranging from two months to fifteen days to twenty four hours. One member wanted to extend the right to be informed of grounds for one’s arrest to such detainees, arguing that this would restrain police officers from indiscriminately arresting people. All of these amendments were rejected by the Assembly.

Members also pointed out that the provisions relating to the Advisory Board were vague and did not contain guidelines for its functioning or safeguards for the rights of detained persons. In response to these concerns, the Chairman proposed to amend clause (4) to give Parliament the power to frame laws setting out the procedure to be followed by the Advisory Board. This was accepted by the Assembly.

The amended Draft Article was adopted on 16 September 1949.

Safeguard Against Arbitrary Arrest and Detention- Article 22

Legal Blogs
October 28, 2022

Introduction

One such fundamental right which forms an integral part of the right to freedom is Article 22 of the Indian constitution which ensures all persons protection against arrest and detention in certain cases. Therefore, this fundamental right is available to both citizens and non-citizens just the same against any arrest or detention made against them by a capricious or arbitrary exercise of power.

The importance of the article as an indispensable part of the fundamental rights can be seen by the presence of this right in the International Covenant on Civil and Political Rights in the form of Article 9(1) of the covenant and the Universal Declaration of Human Rights in the form of article 9 of the declaration, both of which highlight the rights and safeguards of an individual against any form of arbitrary arrest and detention made against him by any type of executive or non-judicial power. The international recognition of this right makes it an important and basic feature in the chapter of human liberties and its safeguards.

Rights of arrested persons under ordinary law

Clauses (1) and (2) of article 22 guarantee four rights for a person who is arrested for any offense under ordinary law. These rights are available to both citizens and non-citizens except for the persons arrested and detained under the preventive detention laws who are covered by clauses 4 to 7 of the article.

The following are the basic rights guaranteed to the qualified persons under clauses (1) and (2):

Right to be informed of the grounds of arrest

Article 22(1) states that every arrested person who is detained in authoritative custody shall have the right to be informed of the grounds on which such an arrest is made against him. Every person who is arrested and detained in the custody of any authorised authority has the right to be informed of the reasons so as to facilitate him to make an application for bail or file a writ of habeas corpus.

This is important as it also allows the person arrested to prepare his defence with a view to enable him to represent himself lawfully. The clause is in the nature of a directive to the arresting authority to reveal the grounds of the arrest to the person.

The court in the case of Tarapada De v. State of West Bengal [1] held that the words “as soon as may be” used in the article means as nearly as is reasonable in the circumstances of a particular case. If the grounds of the arrest are delayed to be informed then it must be justified by reason.

Therefore, the arrested person must be informed of the grounds as a matter of right.

Right to be defended by a lawyer of his own choice

Article 22(1) gives an arrested person the right to consult or be defended by a legal practitioner or a lawyer of his own choice with the objective to represent himself before the court. Prior to Maneka Gandhi’s case the view was that the court was not bound to provide the help of a lawyer unless a request was made. But after the ruling of the Supreme Court in Maneka Gandhi’s [2] case and a series of cases following that case, it is clear that the courts will be bound to provide the assistance of a lawyer arrested under ordinary law also.

In the case of Mohammed Amir Kasab alias Abu Mujahid v. State of Maharashtra [3] the arrested person was a Pakistani who was offered the services of a lawyer upon his arrest as per the article. But having refused the same and the services of any Indian lawyer he sought a lawyer from his home country. Thereafter he again made a request for a lawyer upon being denied help from his home country which he was provided immediately. Therefore, his constitutional right was upheld under article 22(1).

Resolution of the bar council not to defend some persons in criminal cases-

In the case of A.S.Mohammed Rafi v. State of Tamil Nadu [4] the bar association of Coimbatore had passed a resolution that no member of the Coimbatore bar should defend the arrested policeman in a case. The Supreme Court in this case held that the resolutions of several bar associations throughout the country that they will not defend a particular person or persons in a particular criminal case are wholly illegal, against all traditions of the bar, and against professional ethics.

Every person, however, wicked, depraved, vile, degenerate, perverted, loathsome, execrable, vicious, or repulsive he may be regarded by society has a right to be defended in a court of law and correspondingly it is the duty of the lawyer to defend him. [5]

Right to be produced before a magistrate

Article 22(2) strikes the right balance between the interest of justice and the arrested person by giving him the right of being presented as a matter of legal compulsion before the court of the nearest magistrate within twenty-four hours of such arrest.

The article also keeps in view the realistic aspects of things by excluding the time required for conveyance from the place of arrest to the magistrate to make it more effective and applicable in the social scene. Therefore, every arrested person has the right to be presented before the magistrate within 24 hours of his arrest as a matter of his fundamental right.

No detention beyond 24 hours except by an order of a magistrate

Article 22(2) safeguards the arrested person from the viciousness of the police by giving him the right of not being allowed to be kept in their custody beyond the stated limit except with prior permission or under the authority of the magistrate. If the arrested person has to be kept in custody beyond the limit then he shall be kept in judicial custody and not police custody.

The expression “arrest and detention” in article 22 (2) does not apply to a person arrested under a warrant but to a person arrested by an executive or non-judicial order for an accusation of a crime, quasi-crime nature, or some act prejudiced to the security of the state. The judicial arrests are not included to fulfill the absence of judicial mind in case of executive arrests which is already present in these arrests.

In the case of State of Punjab v. Ajaib Singh and Another [6] it was held that the Abducted Person (Recovery and Restoration) Act 1949 under which an abducted person could be arrested and delivered to the officer-in-charge of the nearest camp as valid by the reason that the said arrest does not constitute the “arrest and detention” because the person was not accused of a criminal offense.

Article 22(3) provides for the exceptions in the applicability of the provisions of article 22 (1) and (2). The safeguards provided under the above two clauses are not available to these persons as a matter of exception:

(a)A person who is an enemy alien for the time being

(b)A person who has been arrested and detained under the laws of preventive detention

An enemy alien may however seek the protection of Articles 22 (4) and (5) when he is arrested under the preventive detention laws but subject to the law passed by the parliament. The second category exception is given to make room for the special arrest made under laws of preventive detention the rights of whose arrest is given in the latter part of the article.

Preventive Detention Laws

Meaning: Article 22(4) to (7) covers the provisions regarding the procedure which is to be followed when a person is arrested and detained under any law of preventive detention. There is no authorized definition of preventive detention in Indian law but it is defined in contra-distinction to the word ‘punitive’.

While the objective of punitive laws is to punish a person who has already committed an offence the objective of preventive detention is not to punish a person who has already done something but to intercept or prevent him from doing something which may be reasonably suspected of harming the society or endangering the security of the government.

Necessity: Though the concept of preventive detention laws is considered an anti-democratic concept it still finds its place in the constitution of India as opposed to other countries like the United States or the UK. The necessity of this provision was highlighted by Patanjali Shastri, in the case of A.K.Gopalan v. State of Madras [7] as a sinister feature to prevent the abuse of the freedom provided by the constitution by anti-social and subversive elements which pose a risk to the democracy and integrity of the Indian republic.

History: The history of this law can be studied through various acts which were passed by the legislator during the course of its timeless existence:

Preventive Detention Act 1950: The act was a temporary measure that was passed to give the central and the state government to detain a person under this law who possess a risk which is prejudiced to the security of India, defence of India, its relations with other nations, maintenance of public order and maintenance of services and essentials which are necessary for the community. Destined to lapse on 1 st April 1951 the act lapsed on December 31 st , 1969.
Maintenance of Internal Security Act, 1971: The Preventive Detention Law was revived in the form of the Maintenance of Internal Security Act, 1971(MISA) in less than two years after the lapse of the previous act.
Prevention of Black Marketing and Maintenance of Supplies of Essential Commodities Act, 1980: MISA was repealed in 1978. But in less than two years the preventive detention law was revived in the form of the Prevention of Black Marketing and Maintenance of Supplies of Essential Commodities Act, 1980. The act was enacted with the objective to curb black marketing and hoarding of essential commodities.
National Securities Act, 1982: The president passed the National Security Ordinance in 1980 which later on replaced the act, providing for preventive detention of persons responsible for inciting and initiating communal or caste riots which pose a serious risk to the security of the state. In the case of A.K.Roy v. Union of India [8] , the Supreme Court upheld the validity of this act and refused the notion of it being vague or arbitrary in nature.
Terrorist and Disruptive Activities (Prevention) Act, 1987 (TADA): The act was enacted with the objective to curb terrorism in the country, and the view of the same granted sweeping powers to the State Governments. There was widespread misuse of these powers and to curb the same the Supreme Court in the case of Kartar Singh v. State of Punjab [9] limited the scope of its interpretation.

Constitutional safeguards against the laws of preventive detention

Though the constitution has inculcated the preventive detention laws against the generic democratic notions it has also balanced it to reduce the harshness and arbitrary service of these laws. The constitution has provided safeguards by placing importance on the legislative powers conferred on the legislature. This is also one of the reasons why article 22 has been included in the chapter on guaranteed rights. Article 22 (4) to (7) provides the following safeguards to a person arrested and detained under the laws of preventive detention:

Review by the advisory board

Prior to the Constitution (44th amendment) Act, 1978- Article 22(4) (a) provided that no person can be detained for a period of more than three months under the preventive detention law unless an advisory board constituted of a person who is or had been qualified to be a High Court judge has before the term of three months have expired given their opinion that the cause of the detention is justified.

If the advisory board holds the detention unjustified then the government is bound to revoke the order and in a parallel scenario, the detaining authority has the right to decide the period of detention.

But in the latter case, the detention cannot extend for an indefinite period and can only be up to the maximum period prescribed by any law passed by the parliament for that class of detenu under sub-clause (b) of clause (7).

Under clause 7(a) any law providing for the detention longer than three months without the prior approval of the advisory board needs to specify the class or classes of detenu it applies to and the circumstances of such applicability. The procedure of detention under clause 4 is subject to the provisions of clause 7 which also provides the inquiry procedure of the advisory board.

Since the amendment has yet to be enforced the above provisions still apply. The amendment aimed to change the maximum period of detention without the reference of the advisory board from 3 to 2 months, changed the composition of the advisory board to a chairman and two members appointed upon the recommendation of the Chief Justice of the appropriate high court and abolished clause 7(a) that is the power of the parliament to make laws for detention beyond three months without reference of the advisory board.

Communication of the grounds of detention to the detenu

Article 22(5) gives the detenu two basic rights:

(a)The authority making the detention must as soon as may be furnished the grounds which led to the subjective satisfaction of the detaining authority to detain that person.

(b)The authority must give the detenu the earliest opportunity of representation by giving him sufficient particulars to enable him to do the same.

In the case of Kubic Darusz v. Union of India [10] the court held that merely explaining the grounds verbally without giving it in writing in a language understood by him where the detenu does not know good English does not serve the purpose of article 22(5) and hence it is important for the communication to be clear and easily understandable by the detenu to make it a valid communication.

The grounds supplied to the detenu must also not be vague, irrelevant and non-existence the presence of any of the above would vitiate the order of detention.

In the case of Subhash Popatlal Dave v. Union of India [11] it was held that under clause 5 the grounds of detention are to be served to the detenu after his detention. Therefore, the State is under no obligation to provide the grounds prior to the arrest and detention.

In the case of Huidrom Konungjao Singh v. State of Manipur [12] , it was held that the State also has the authority to pass an order of detention against a person already in custody provided that upon the challenge of such an order the state shall prove that it was fully aware of the fact that the detenu was already in custody and there are reasonable grounds to believe prejudice.

Detenu’s right to representation

The absence of any constitutional provision regarding the detenu’s right of representation prior to the order of detention makes it obvious that the detenu’s representation is considered after the confirmation of the order of detention. The detenu must be furnished with the basic facts, material, and all the documents which were considered by the detaining authority in making the decision of detention.

These shall be given to the detenu as soon as possible to allow him the opportunity of earliest representation and to keep a check on the arbitrary and capricious exercise of power by the detaining authority.

The detaining authority is under a procedural compulsion to inform the detenu while serving the order of detention of his right to make a representation and also to be heard by the advisory board and the failure to do so would vitiate the detention.

In the case of Prem Lata Sharma v. District Magistrate, Mathura [13] the court vitiated the detention order when the detaining authority refused to send the representation of the detenu to the central government on the grounds that this amounts to the infringement of the detenu’s right under clause 5 of article 22.

Though there is no specified time limit for the disposal of the representation of the detenu by the central government, it is bound to consider it as expeditiously as possible and any unnecessary delay in the same will render the detention illegal.

During a period of emergency, the President has the right to suspend the fundamental right of people and the detenu has no locus standi to question the grounds or reasons of his detention.

Article 22(6) provides for exceptions to Article 22(5). Under clause 6 if the act of furnishing the detenu with the facts of his detention is against the interest of the public then the detain authority is at the liberty of refraining from furnishing the same.

In the case of Puran Lal Lakhan Lal v. Union of India [14] , it was held that both the obligation to furnish the particulars and the duty to consider whether the disclosure of facts is against the public interest are vested in the detaining authority and no one else.

Subjective satisfaction of detaining authority

The preventive detention laws make it clear that the power of detention is to be exercised to the subjective satisfaction of the detaining authority. The courts normally do not interfere with the decisions of the detaining authority whether the grounds are sufficient or not. But this does not mean that it is completely immune to judicial scrutiny.

The courts have justified the application of judicial mind by saying that subjective satisfaction is precedent to the exercise of a power of the Executive and they can examine whether the authority has arrived at the requisite satisfaction for the order of detention. This is done to ensure that the exercise of power is not bad. The subjective satisfaction of the detaining authority can be challenged on the grounds of mala fide, vagueness, irrelevant or non-existence or mechanical application of mind.

In the case of A.D.M. Jabalpur v. S. Shukla [15] the court held that even if the detenu makes out a prima facie case that the detention was mala fide the affidavit of the authority will be the answer and the inquiry will be closed. The courts cannot insist on the production of the file or hold that the case of the detenu stands unrebutted by the reason of non-disclosure of grounds of arrest.

The effect of the case was that the courts were barred from examining the question of mala fide of the order of detention or ultra vires character of the order of detention. This decision was overturned in the case of A.K.Gopalan v. State of Madras . [16]

Article 22 is not a complete code

At one time article 22 was considered a complete code in itself the validity of the preventive detention laws was decided within the four corners of this code.

In the case of A.K.Gopalan v. State of Madras [17] , it was held that a detenu cannot claim the freedom guarantee under article 19(1)(d)if it is infringed by the detention and that the validity of the detention shall not be tested by the reasonableness of the restriction imposed on the freedom to a movement nor on the ground that his personal liberty is infringed under article 21 otherwise than according to the procedure established by law. This has now been shown wrong in the case of R.C.Cooper v. Union of India [18]

In the case of Maneka Gandhi v. Union of India [19] , it was held that the law relating to preventive detention must not only satisfy the requirements of Article 22 but also the requirements of Article 21 of the Constitution. In other words the procedure prescribed under the preventive detention law must be reasonable and just and fair under Articles 14 , 19, and 21 of the Constitution.

It is high time the legislators recognise the overriding arbitrariness and corruption in the use and issue of the orders of preventive detention. Though the courts feel the requirement of the same in the constitution it is time we establish stricter and stable laws for the proper and efficient application of these laws in the societal setup. Article 22 can pave the way but we still have a long road to walk. Under the current societal setup where the crimes behind the bars have increased with the inhuman treatment of the people arrested and detained in police custody, it is time for us to go beyond this article and put in place more balanced and better checks.

References:

[1] AIR 1951 SC 174

[2] Maneka Gandhi v. Union of India, AIR 1978 SC 597

[3] AIR 2012 SC 3565

[4] AIR 2011 SC 308

[5] INDIAN KANOON, https://indiankanoon.org/doc/1355688/ , last viewed on 9 th October 2022.

[6] 1953 AIR 10, 1953 SCR 254

[7] AIR 1950 SC 27

[8] AIR 1982 SC 710

[9] (1994) 3 SCC 569

[10] (1990) 1 SCC 568

[11] AIR 2012 SC 3370

[12] AIR 2012 SC 2002

[13] AIR 1998 SC 2212

[14] AIR 1958 SC 163

[15] AIR 1976 SC 1207

[16] AIR 1950 SC 27

[17] Ibid note 16

[18] AIR 1970 SC 564

[19] AIR 1978 SC 597

This article has been submitted by Krithika Mittal, a student at Lovely Professional University, Punjab.

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Article 22 of the Indian Constitution

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Nitya Khare , a 2nd -Year Student of LNCT University, has written this Article on “Article 22 of the Indian Constitution” .

Table of Contents

Introduction

India is the largest democracy in the world and owing to its status it is important that its constitution uphold the basic essence of democracy as a whole. The constitution does so by protecting the most basic civic and human liberties of its citizens in the form of the fundamental rights as enshrined in Part III of the Indian Constitution. One such fundamental right which forms an integral part of the right to freedom is Article 22 of the Indian Constitution. It ensures all person protection against arrest and detention in certain cases. Therefore, this fundamental right is available to both citizens and non-citizens just the same against any arrest or detention made against them by a capricious or arbitrary exercise of power.

The importance of the article as an indispensable part of the fundamental rights can be seen by the presence of this right in the International Covenant on Civil and Political Rights in the form of Article 9(1) of the covenant and the Universal Declaration of Human Rights in the form of Article 9 of the declaration. Both of these highlight the rights and safeguards of an individual against any form of arbitrary arrest and detention made against him by any type of executive or non-judicial power. The international recognition of this right makes it an important and basic feature in the chapter of human liberties.

Article 22 of the Indian Constitution was included as part of the original Constitution, which was adopted in 1949. The article is based on similar provisions in other constitutions. Such as the Fifth and Sixth Amendments in the United States Constitution and Article 5 of the European Convention on Human Rights.

It lays down the framework for the governance of the country and protects the rights and freedoms of citizens. This article is part of the fundamental rights chapter of the Constitution. It lays down the rights that are guaranteed to the citizens of India. The fundamental rights are considered to be the most essential rights of citizens and are protected by the Constitution.

Article 22 is a crucial provision that lays down the procedures that must be followed by the state when a person is arrested. It also mentions the rights of the arrested person, which are to be protected by the state.

The article lays down the rights of arrested persons. Also, the procedures to be followed by the authorities when someone is arrested. It includes the following provisions:

Rights of arrested persons under ordinary law

Article 22(1) and (2) guarantee four rights for a person who is arrested for any offense under ordinary law. These rights are available to both citizens and non-citizens except for the persons arrested and detained under the preventive detention laws who are covered by clauses 4 to 7 of the article.

The following are the basic rights guaranteed to the qualified persons under clauses (1) and (2)

Right to be informed of the grounds of arrest

Article 22(1) of Indian Constitution states that every arrested person who is detained in authoritative custody shall have the right to be informed of the grounds on which such an arrest is made against him. Every person who is arrested and detained in the custody of any authorized authority has the right to be informed of the reasons so as to facilitate him to make an application for bail or file a writ of habeas corpus.

This is important as it also allows the person arrested to prepare his defense with a view to enable him to represent himself lawfully. The clause is in the nature of a directive to the arresting authority to reveal the grounds of the arrest to the person.

Therefore, the arrested person must be informed of the grounds as a matter of right.

Right to be defended by a lawyer of his own choice

Article 22(1) gives an arrested person the right to consult or be defended by a legal practitioner or a lawyer of his own choice with the objective to represent himself before the court. Prior to Maneka Gandhi’s case, the view was that the court was not bound to provide the help of a lawyer unless a request was made. But after the ruling of the Supreme Court in Maneka Gandhi’s [2] case and a series of cases following that case, it is clear that the courts will be bound to provide the assistance of a lawyer arrested under ordinary law also.

Resolution of the bar council not to defend some persons in criminal cases-

In the case of A.S. Mohammed Rafi v. State of Tamil Nadu [4] the bar association of Coimbatore had passed a resolution that no member of the Coimbatore bar should defend the arrested policeman in a case. The Supreme Court in this case held that the resolutions of several bar associations throughout the country that they will not defend a particular person or persons in a particular criminal case are wholly illegal, against all traditions of the bar, and against professional ethics.

Every person, however, wicked, depraved, vile, degenerate, perverted, loathsome, execrable, vicious, or repulsive he may be regarded by society has a right to be defended in a court of law. Correspondingly it is the duty of the lawyer to defend him.

Right to be produced before a magistrate

The article also keeps in view the realistic aspects of things by excluding the time required for conveyance from the place of arrest to the magistrate to make it more effective and applicable in the social scene. Therefore, every arrested person has the fundamental right to be presented before the magistrate within 24 hours of his arrest.

No detention beyond 24 hours except by an order of a magistrate

Article 22(2) of Indian Constitution safeguards the arrested person from the viciousness of the police by giving him the right of not being allowed to be kept in their custody beyond the stated limit except with prior permission or under the authority of the magistrate. If the arrested person has to be kept in custody beyond the limit then he shall be kept in judicial custody and not police custody.

The expression “arrest and detention” in Article 22(2) does not apply to a person arrested under a warrant but to a person arrested by an executive or non-judicial order for an accusation of a crime, quasi-crime nature, or some act prejudiced to the security of the state. The judicial arrests are not included to fulfill the absence of judicial mind in case of executive arrests which is already present in these arrests.

In the case of State of Punjab v. Ajaib Singh and Another [5] it was held that the Abducted Person (Recovery and Restoration) Act 1949 under which an abducted person could be arrested and delivered to the officer-in-charge of the nearest camp as valid by the reason that the said arrest does not constitute the “arrest and detention” because the person was not accused of a criminal offense.

Article 22(3)

It says that “(3) Nothing in clauses (1) and (2) shall apply (A) to any person who for the time being is an enemy alien. (B) to any person who is arrested or detained under any law providing for preventive detention.”

This means no individual arrested can be kept in custody for more than a period determined by the magistrate.

Article 22 (4)

“(4) No law providing for preventive detention shall authorize the detention of a person for a longer period than three months unless (a) an Advisory Board consisting of persons who are, or have been, or are qualified to be appointed as, Judges of a High Court has reported before the expiration of the said period of three months that there is in its opinion sufficient cause for such detention.”

It defines that no law provides preventive detention for a period not more than three months. Unless an Advisory Board of a qualified judge of the High Court.

Article 22(5)

“(5) When any person is detained in pursuance of an order made under any law providing for preventive detention, the authority making the order shall, as soon as may be, communicate to such person the grounds on which the order has been made and shall afford him the earliest opportunity of making a representation against the order.”

The detained individual should be aware of the grounds for his detention. Also, be given an opportunity of making a representation against his/her case.

Article 22(6)

“(6) Nothing in clause (5) shall require the authority making any such order as is referred to in that clause to disclose facts which such authority considers to be against the public interest to disclose.”

Exceptions to these rules are enemies and Aliens.

Article 22(7)

“(7) Parliament may by law prescribe

(b) the maximum period for which any person may in any class or classes of cases be detained under any law providing for preventive detention; and

(c) the procedure to be followed by an Advisory Board in an inquiry under sub-clause (a) of clause ( 4 ) Right against Exploitation.”

This clause has subclauses a, b, and c. Where Parliament has the sole power to increase or decrease the detained period above three months. Also, decide the procedure for arrest and detention given by the Advisory Board.

Objectives of Article 22 of the Indian Constitution

To prevent arbitrary arrest and detention.
To ensure that citizens are informed of the grounds for arrest,
To protect the right to legal representation.
To prevent prolonged detention without trial.
To ensure fair and humane treatment in custody
To provide a check on the power of the state

What is detention?

There are two types of detentions

Punitive detention is a detention after a trial.

Preventive detention is without trial. A person can be detained only on grounds of suspicion. Hence, the rights of a person arrested in this manner get governed by preventive detention laws.

Punitive Detention

Clause 1 of Article 22 of the Indian Constitution delineates two major provisions. Firstly, the fundamental right of every arrestee to know the grounds of their arrest or detention. Secondly, the fundamental right of every arrestee to have a legal representation of choice. It includes not only legal consultation but also legal defense.

Joginder Kumar v. The State of Uttar Pradesh [6]

In this case, Chief Justice M. Venkatachalliah expounded on Clause 1 of Article 22, wherein he held that even if the arrest under the power and authority of a law enforcement agency is lawful, it should be pursued if and only if the preliminary investigation of the alleged complaint reasonably satisfies the law enforcement agency about the genuineness of the complaint, also, the law enforcement agency must justify the grounds of the arrest to the arrestee.

Shri D. K. Basu & Anr. v. The State of Uttar Pradesh & Anr [7]

This is the leading case that bolsters Clause 1of Article 22, wherein the two-judge divisional bench (Justice K. Singh and Justice A. S. Anand) clutched two major guidelines:

a) Any person who has an active interest in the welfare of the arrestee has the right to be informed about the arrest and the subsequent place of custodial detention.

b) The arrestee must sign an ‘Arrest Memo’ prepared by the on-scene police officer that mentions the reason, date, and time of the arrest.

It is worth noting Section 50, Clause 1 of the Code of Criminal Procedure, 1973, upholds the aforementioned provision. Wherein the arrestee is entitled to know the particulars of the crime for which the person is being arrested.

The 10th point given by the divisional bench allows the arrestee to consult a lawyer of their choice during the interrogation. This is enshrined within Clause 1 as the fundamental right of an arrestee to consult a legal practitioner.

Hussainara Khatoon & Ors. v. The State of Bihar & Anr. [8]

In this case, Justice P. N. Bhagwati highlighted a situation where an under-trial prisoner is placed behind bars for years at an end. Wherein the detention time extends beyond the maximum number of years the said individual would have been awarded if found guilty for the offense by the court of law due to the financial constraints of the individual.

The court observed that it is the failure of the Criminal Justice System where the poverty of the individual keeps them from not only producing the designated bail amount but also acquiring a lawyer to represent them in a court of law. In light of the non-speedy disposal of cases. The Supreme Court called the aforementioned plight of the financially weak under-trial prisoners a violation of their Fundamental Right to Life and Personal Liberty under Article 21 of the Indian Constitution, wherein the prisoners are unnecessarily detained for long durations.

This case highlights the constitutional right of getting a speedy trial. It expounds on the fundamentalism in providing free legal aid to the economically weak to truly champion Article 22(1). Wherein legal representation must be made fundamentally available to all citizens of India.

Maneka Gandhi v. Union of India [9]

It is worth mentioning that in this case, a seven-judge constitutional bench opined that the procedure established by law under which the Fundamental Right of Life and Personal Liberty is being withheld by the state must be reasonable, fair, and just. In light of the aforementioned violation, the Supreme Court of India held that spending longer than the required time in prison while awaiting a trial without proper legal representation is not a reasonable procedure. Additionally, the court of law directed the state to provide free legal aid at its own cost to the economically weak and deprived sections of society.

It is the absolute obligation of the Magistrate to provide a lawyer at the expense of the state to an unrepresented individual before the commencement of the trial. Moreover, it is the constitutional duty of the Magistrate and the state to provide a lawyer as soon as the arrestee is arrested even if the arrestee does not ask for legal representation in virtue of either refusal or silence. [10]

Although Clause 1 of Article 22 of the Indian Constitution provides for the Fundamental Right of Legal Consultation and Defense. The lawyer cannot be present at every stage of the custodial interrogation while accosting the law enforcement officers. [11] A lawyer’s duties are limited to representing the arrestee in judicial proceedings (defense) and providing legal counsel in legal matters. For eg: bail applications, legal consequences of certain confessions, etc. It does not include the duty to interfere in the interrogative questioning of the arrestee by law enforcement agencies. [12]

Moreover, Article 22(2) elucidates that an arrestee must be produced before the Magistrate within twenty-four hours of the arrest. The period of custodial detention cannot extend beyond twenty-four hours without presenting the arrestee before the nearest district Magistrate.

Provision of Cr.P.C.

One can postulate that the Code of Criminal Procedure, 1973 (CrPC, 1973) and the Indian Penal Code, 1860 (IPC, 1860) explicate the constitutional provisions to punish the misuse of power and authority to violate the rights and freedoms of citizens of India that have been conferred by the Constitution of India. Although Section 57 of the CrPC, 1973, strengthens the constitutional provision of not extending custodial detention beyond twenty-four hours without a special order of the magistrate. The provision for extending the twenty-four period of punitive detention is not mentioned in the constitution.

Section 167(2)(b) of the CrPC, 1973, allows the district Magistrate who has jurisdiction of the case to extend the period of custodial detention to fifteen days if and only if two pivotal conditions are met. (A) The arrestee is produced before the jurisdictional district Magistrate whilst in punitive detention. (B) If the investigation by the law enforcement agency is not complete within the first twenty-four hours of the arrest (Clause 1) and not only the law enforcement agency (the police) but also the district Magistrate have well-founded, reasonable grounds to keep the arrestee in custodial detention (Clause 2). The former condition cements the fundamental right of an arrestee or a detainee to be produced before a district Magistrate. Additionally, the latter condition bolsters Clause 2 of Article 22, wherein the district Magistrate has the sole authority to extend the punitive detention of an individual.

The State of Punjab v. Ajaib Singh & Anr. [13]

In this landmark judgment of a five-judge constitutional bench (Chief Justice M. P. Sastri, Justice S. R. Das, Justice B. K. Mukherjea, Justice V. Bose, and Justice N. H. Bhagwati). The court held that the action of physically recovering an individual without any actual accusation of commission of a punitive offense of criminal or quasi-criminal nature and handing the same individual to the custody of the nearest police station does not come under the ambit of ‘arrest’ within Clause 1 and 2 of Article 22 of Indian Constitution.

A. K. Roy v. Union of India & Anr. [14]

In this case, Chief Justice Y. V. Chandrachud dismantled Clause 2 of Article 22 of Indian Constitution, where he posited that an arrestee or a detainee under preventive custodial detention is denied the Fundamental Right of being defended by a legal practitioner of choice. Clause 3, Sub-Clause B revokes the Fundamental Right of Legal Representation under Clause 1.

An Alien Enemy is any individual that is either a subject of a foreign state that is at war with India or an Indian citizen that either voluntarily resides within or trades with the aforementioned state. Sub-Clause A of Clause 3 bars an Alien Enemy from the provisions under Clauses 1 and 2 of Article 22.

Preventive Detention Laws

A person can be put in jail/custody for two reasons. One is that he has committed a crime. Another is that he has the potential to commit a crime in the future. The custody arising out of the latter is preventive detention. As in this, a person is deemed likely to commit a crime. Thus Preventive Detention is done before the crime has been committed.

Preventive detention is also known as the ‘necessary evil’ of the Constitution as it can be steered in various directions. It can be put to use in various scenarios, not all being just and reasonable. It is the most contentious part of fundamental rights. The provision only mentions the rights people could exercise when they are detained. But it speaks nothing about any specific grounds or necessary provisions of detention. It thus gives enormous power to the authorities to twist the tool of preventive detention however and whenever they please. This has proved to be a way in which the freedom of the masses has been immensely curbed and continues to be so.

The necessity of such a provision

The aim of the constitution framers to bring such provision into existence was to prevent people from disrupting the peace and stability of the society. People were detained to prevent them from undermining the sanctity of the constitution, endangering the security of the state, disturbing relations of India with foreign powers, or hindering the maintenance of public order.

India follows preventive detention even in times of peace when there is no threat posed to its national security. So it is one of the main reasons for imposing and implementing provisions of preventive detention. While no other nation has this proposition during peacetime.

The Preventive Detention Acts

There have been a few acts in history that have been framed by law in order to fill in the gaps and provide provisions for detention.

Terrorist and Disruptive Activities (Prevention) Act, 1987 (TADA)

This law was an anti-terrorism law that gave wide power to the authorities for dealing with national terrorism and socially disruptive activities. This Act provided that a person can be detained for up to 1 year without formal charges or trial. A detainee can be in custody for up to 60 days without being produced in front of a magistrate. Also, such a person may be produced by the executive magistrate who is not answerable to the high court. This Act allowed the authorities to withhold the identities of witnesses and secret trials. The police were given enhanced powers for the detention of suspects. The Act shifted the burden of proof on the accused. It led to the abuse of this Act and adverse effect on the democracy of the country. This Act is now repealed.

National Security Act, 1980 [15]

The purpose of this Act was to provide for preventive detention laws and matters connected therewith. The authorities, through this Act, obtain the power to detain any person who poses a threat to the security of the nation in any prejudicial manner. They can also detain any foreigner and regulate their presence in the country. Under this Act, an individual can be detained without a charge for up to 12 months if the authorities are satisfied that the person is a threat to national security. The detainee can neither impose compulsion for knowing the grounds of detention nor can get a lawyer during the trial. The NSA has repeatedly come under criticism for the way it is used by the police. The Act differs from normal detention as it abrogates all rights available to the detainee in normal circumstances.

Prevention of Terrorism Act (POTA), 2002

This Act aimed at strengthening anti-terrorism laws in India. This Act replaced TADA. It defined what activities could constitute a terrorist act and who a terrorist was. Also to ensure no violation of human rights and misuse of power, certain safeguards were installed within the Act. The provisions were all similar to the ones provided in TADA. Right after the enactment of this Act, it was alleged that this law was grossly abused. Hence government repealed it after two short years.

Constitutional Safeguards against Preventive Detention Laws

Article 22 further deals with certain rights which are provided in case of preventive detention.

(a) Review by Advisory Board:

Clause 4 of the article states that no law framed for preventive detention gives authority to detain any person for more than 3 months. Unless; an advisory board reports a sufficient cause for such detention. The people on the advisory board should be equally qualified as that of a judge of the high court. The report needs to be submitted before the expiration of said 3 months.

(b) Communication of grounds of detention to detainee:

Clause 5 of the article states that any authority while detaining any person under the law providing for preventive detention shall communicate the grounds of detention to the person as soon as possible. The ground of detention should have a rational connection with the object which the detainee is prevented from attaining. The communication should provide all the material facts related to the ground. It should not be a mere statement of facts.

(c) No obligation of authority:

The detaining authority is under no obligation to provide the grounds of detention to the detainee prior to his arrest. But is advised to do so at the earliest thereby providing an opportunity for representation to the detainee as well.

A person already in custody can be detained when there are reasonable and sufficient causes to do so. The focal problem is that in cases of preventive detention, there is no way to check whether the cause of detention is just and reasonable until it is presented to the advisory board which is applicable after the stretch of 3 months.

(d) Detinue’s Right of Representation:

Clause 5 of the article also states that the grounds of the detention should be communicated as soon as possible in order to enable the right of representation to the person. The authority providing the detention order shall afford to the person the earliest opportunity of making a representation against the order.

Conservation of Foreign Exchange, Prevention of Smuggling Activities Act (COFEPOSA), 1974, and Article 22(5)

This Act was brought into force in 1974. It gave wide powers to the executive to detain individuals on the apprehension of their involvement in smuggling activities. Section 3 of this Act is shared with clause 5 of Article 22 of Indian Constitution. It states that the ground of detention should be communicated to the detainee within a minimum of five or a maximum of fifteen days. In no case should it be delayed beyond fifteen days. It must be completely furnished to the detainee, including all the facts. It should not be only a bare recital of the grounds. Any lapse within this provision would render the detention order void. This Act still stands valid.

No time limit prescribed for disposal of representation:

It does not provide any information about the method of dealing or disposing of the representation made by the detainee. It just extends to providing the right of representation. There is no further description or time limit assigned for the end result of the representation made. Which can be inferred as a means to keep lingering the issue at hand and aid in the wrongful detention of the person.

Exception under Article 22(6) of Indian Constitution

Clause 6 of the article is similar in nature to clause 3 as it stands as an exception to clause 5. It states that the detaining authority is not mandatorily required to disclose any such facts which it considers to be against the public interest to disclose. This clause does not mention any other specifications or details within the topic. Hence it is regarded as the utmost arbitrary and regressive. It has no solid basis or reasoning to resonate with the ‘against the public interest’ phrase. It can be arbitrary to any extent.

Subjective satisfaction of the detaining authority

Clause 7 of the article is the most regressive of all clauses. It authorizes the parliament to describe the circumstances and categories of cases where the detention of a person may be extended beyond three months without the opinion of the advisory board. It can also regulate the maximum period for which anyone may be detained under laws providing for preventive detention. The parliament also exercises hold on the methodology applied by the advisory board in the inquiry of detention cases. This clause provides for detention in cases of subjective satisfaction of the authority, where the element of ‘subjective satisfaction’ can be unjust and biased in any and every possible situation thus making it a piece of equipment to mask the legally and morally wrong detentions.

Hence, this clause provides complete subjectivity and authority to the government. Which is the cause of arbitrary and unjust cases of wrongful detention. The authorities are in a position enough to tweak the facts and circumstances of the case to project it fair. There is no antidote for the protection of such misery. This clause is the focal reason for criticism and misuse of this provision.

Article 22 of the Indian Constitution is a vital provision that ensures the protection of arrested persons in India. It lays down the rights and procedures that must be followed by the state in cases of arrest and detention. However, there are still instances where the rights of arrested persons are violated in practice. To address these issues, there need to be greater awareness and accountability mechanisms in place to ensure compliance with the article.

Also Read: UAPA – Why and How it is a stringent law. Click Here!

[1] AIR 1951 SC 174

[2] Maneka Gandhi v. Union of India, AIR 1978 SC 597

[3] AIR 2012 SC 3565

[4] AIR 2011 SC 308

[5] 1953 AIR 10, 1953 SCR 254

[6] (1994) 4 SCC 260

[7] (1997) 1 SCC 416

[8] (1979) 3 SCR 169

[9] (1978) 2 SCR 621

[10] The State of Madhya Pradesh v. Shobharam & Ors., AIR SC 1910 (1966)

[11] Nandini Satpathy v. Dani (P.L.) & Anr, 3 SCR 608 (1978)

[12] Poolpandi Etc. v. Superintendent, Central Excise & Ors., 3 SCR 247 (1992)

[14] (1982) 2 SCR 272

[15] Nandlal Bajaj v. State of Punjab and Another, (1981), AIR 2041

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The constitution of India, art. 22
Shah Ishfaq, Preventive detention Legal service India. (2019)
J.N. Pandey, The constitutional law of India,154,155 (Central Law Agency, Allahabad, 10th edn., 1980)
Naman Jain, Rowlatt Act in disguise: The Preventive Detention laws in India, The Law Blog, (2020)
Ravi Nitesh, Democracy is not about detention and suppressing dissent, The Kashmir Times, 8/11/2020, available at http://www.kashmirtimes.com/newsdet.aspx?q=104284,
The constitution of India, art. 19
J.N. Pandey, The constitutional law of India,154,155 (Central Law Agency, Allahabad, 10th edn., 1980)
Harshit Sharma, Preventive Detention: An Evil Of Article 22 , Journal on contemporary issues of law, VOL.3 ISSUE 11 (2017)

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Safeguards against Arbitrary Arrest and Detention

Part i: detained under an ordinary law.

Clauses (1) and (2) of Article 22 guarantee four rights on a person who is arrested for any offence under an ordinary law-

The right to be informed ‘as soon as may be’ of ground of arrest’.
The right to consult and to be represented by a lawyer of his own choice.
The right to be produced before a magistrate within 24 hours.
The freedom from detention beyond the said period except by the order of the magistrate.

The above fundamental rights guaranteed to arrested persons by clauses (1) and (2) of Article 22 are available to both citizens and non-citizens and not to persons arrested and detained under any law providing for preventive detention.

The rights to be informed of grounds of arrest

It is necessary to enable the arrested person to know the grounds of his arrest and to prepare for his defence.
Article 22(1) is in the nature of a directive to the arresting authorities to disclose the grounds of arrest of a person immediately.
If the ground of arrest is delayed, it must be justified by ‘reasonable circumstances.
This right of being informed of the grounds of arrest is not dispensed with by offering to make bail to the arrested person.

Right to be defended by a lawyer of his own choice

In Hussainara Khatoon vs Home Secretary, State of Bihar,1979 case, the SC held that its is the constitutional right of every accused person who is unable to engage a lawyer, to have free legal services provided to him by the State and the State is under constitutional duty to provide a lawyer to such person if the needs of justice so require. If free legal services are not provided, the trial itself may be vitiated as contravening Article 21 .

Right to be produced before a magistrate

The arrested person must be produced before the Magistrate within 24 hours of his arrest.

No Detention beyond 24 hours except by order of the Magistrate

The expression ‘arrest and detention’ in Articles 22(1) and (2) was held not to apply to a person arrested under a warrant issued by the court on criminal or quasi-criminal complaint or under security proceedings.
It was designed to give protection against the act of the Executive or order of non-judicial authorities and applies to a person who has been accused of a crime or of offence of criminal or quasi-criminal nature or some act prejudicial to the State or public interest.
Clause (3) of Article 22 provides two exceptions to the rule contained in clauses (1) and (2).
It provides that the rights given to arrested person under clauses (1) and (2) are not available to following persons:
An enemy alien
A person arrested and detained under Preventive Detention law

Part II: Preventive Detention

Meaning of Preventive Detention

It involves the detainment (containment) of a person in order to keep him/her from committing future crimes and/or from escaping future prosecution.

Article 22 (3) (b) of the Constitution allows for preventive detention and restriction on personal liberty for reasons of state security and public order.

Safeguards against arrest or detention made under a law providing for preventive detention [articles 22(4) to (7)]

Clauses (4) to (7) of Article 22 contain the procedural requirements which are to be complied with when a person is detained under a law providing for preventive detention. These are as follows-

No detention beyond three months unless such detention is approved by the Advisory Board.
The detaining authority must communicate, as soon as may be, to the detenu, the grounds for such detention.
The detenu must be afforded the earliest opportunity of making a representation against the order of detention.
No detention beyond the maximum period prescribed under a law made by Parliament under Clause 7(a).

Article 22(7)(a) provides: “Parliament may by law prescribe the circumstances under which and the class or classes of cases in which, a person may be detained for a period longer than three months under any law for consideration providing for preventive detention without obtaining the opinion of an il a final decision Advisory Board in accordance with the provisions of sub-clause (a) of clause (4).

Purpose of the Preventive detention

In the case of Mariappan vs. The District Collector and Others , the Court held that the aim of detention and its laws is not to punish anyone but to stop certain crimes from being committed.

Safeguards against the misuse of power of Detention

Every case of preventive detention must be authorised by the law and not at the will of the executive.
In fact, the Preventive detention cannot extend beyond a period of 3 months.
Every case of the preventive detention must be placed before an Advisory Board composed of the Judges of the High Court (or persons qualified for Judges of the High Court)
In fact, the case must be presented before the Advisory Board approx. within 3 months.
A continued detention after 3 months must have consent of the Advisory Board.
In fact, the person will be given the opportunity to afford the earliest opportunity to make a representation against preventive detention.
No person can be detained indefinitely.

Preventive Detention – Issues:

Arbitrariness: Police decisions on whether a person poses a threat are not tested in court by leading evidence or evaluated by legally educated individuals.
Violation of human rights: Quite frequently, there is no trial (up to three months), no periodic review, and no legal representation for the imprisoned person.
Abuse: It lacks any procedural safeguards to decrease detainees’ vulnerability to torture and discriminatory treatment, as well as to prohibit authorities from utilising preventative detention for subversive purposes.
Suppression tool: In the lack of adequate protections, preventative detention has been used inappropriately, notably against Dalits and minorities .
It is strange that the framers of our Constitution, who were once victims of the tyranny of preventative detention laws, opted to extend powers to governments to establish such laws under the Constitution.
Section 50 of the Criminal Procedure Code (CRPC) states that everyone detained must be notified of the reason for their arrest and has the right to bail. In actuality, though, obtaining bail is not an easy procedure.

Muntazir Ahmad Bhat v. UT of J&K (2021)

The Bench stated that while violent behaviour is not new, today’s extremism, radicalism, and terrorism in their full expression have taken on a new character and represent tremendous challenges to the civilised world. As a result, to keep an eye on the detainees’ illicit conduct, the Bench rejected the plea of freeing a preventive detenuee.

Abhayraj Gupta v. Superintendent, Central Jail, Bareilly

The Allahabad High Court quashed a detention order issued against a murder suspect by exercising powers under the National Security Act, 1980, stating that if a person is in custody and there is no imminent possibility of his release, the power of preventive detention should not be exercised. In considering the detention order issued against the petitioner, the Court noted that the detention order contained a blatant assertion that if the petitioner is released on bond, he may engage in criminal activity again.

Guidelines given by the Supreme C ourt:

The detention of an individual under preventive detention law should be based on apprehensions that the concerned person is a threat to “public order” affecting the community at large. Mere ‘law and order’ problems such as indulging in cheating or criminal breach of trust would not be sufficient.
The state should not arbitrarily use preventive detention to deal with all “law and order” problems, which could be dealt with by ordinary law.
In all such cases, the court must ask one question in deciding its legality, i.e., was the ordinary law of the land sufficient to deal with the situation? If the answer is in the affirmative, the detention order will be illegal.
Moreover, preventive detention must fall within the four corners of Article 21 (due process of law). It must be read with Article 22 (safeguards against arbitrary arrest and detention) and the statute in question.

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Make Your Note

SC Judgement on Preventive Detention

04 Aug 2021
GS Paper - 2
Judgements & Cases
Fundamental Rights

Why in News

Recently, the Supreme Court (SC) ruled that a preventive detention order can only be passed if the detenu is likely to adversely affect the maintenance of public order.

The SC also gave direction to governments and to other courts, for dealing with detention under preventive detention.
However, a Preventive Detention Order can only be passed if his activities adversely affect or are likely to adversely affect the maintenance of public order.
Contravention of law, such as indulging in cheating or criminal breach of trust, certainly affects ‘law and order’.
However, before it can be said to affect ‘public order’, it must affect the community or the public at large.
Direction to the Government: The State should not arbitrarily resort to “preventive detention” to deal with all and sundry “law and order” problems, which could be dealt with by the ordinary laws of the country.
Was the ordinary law of the land sufficient to deal with the situation? If the answer is in the affirmative, the detention order will be illegal.
For example, the court said two drunks fighting on a road was a law and order problem, and not ‘public disorder’. The solution here was not preventive detention.
If the power of preventive detention is not narrowed down to limits, the right to liberty will become nugatory (of no value or importance).
Therefore, Preventive detention must fall within the ambit of Article 21 (due process of law) and read with Article 22 (safeguards against arbitrary arrest and detention) and the statute in question.

White Collar Crime vs Blue Collar Crime

These crimes are characterized by deceit, concealment, or violation of trust.
Examples of white-collar crimes include securities fraud, corporate fraud, and money laundering, Ponzi and pyramid schemes, etc.
White-collar crime has been associated with the educated and affluent.
The term was first coined in 1949 by sociologist Edwin Sutherland.
Blue Collar Crime: These crimes are primarily small scale, for immediate beneficial gain to the individual or group involved in them.
This can also include personal related crimes that can be driven by immediate reaction, such as during fights or confrontations.
These crimes may include Narcotic production or distribution, sexual assault, theft, burglary, assault or murder.

Preventive Detention

Punitive detention is to punish a person for an offence committed by him after trial and conviction in a court.
Preventive detention, on the other hand, means detention of a person without trial and conviction by a court.
Article 22 has two parts— the first part deals with the cases of ordinary law and the second part deals with the cases of preventive detention law.

Note: The 44 th Amendment Act of 1978 has reduced the period of detention without obtaining the opinion of an advisory board from three to two months. However, this provision has not yet been brought into force, hence, the original period of three months still continues.

Preventive Detention Act, 1950. Expired in 1969.
Maintenance of Internal Security Act (MISA), 1971. Repealed in 1978.
Conservation of Foreign Exchange and Prevention of Smuggling Activities Act (COFEPOSA), 1974.
National Security Act (NSA), 1980.
Prevention of Blackmarketing and Maintenance of Supplies of Essential Commodities Act (PBMSECA), 1980.
Terrorist and Disruptive Activities (Prevention) Act (TADA), 1985. Repealed in 1995.
Prevention of Illicit Traffic in Narcotic Drugs and Psychotropic Substances Act (PITNDPSA), 1988.
Prevention of Terrorism Act (POTA), 2002. Repealed in 2004.
No democratic country in the world has made preventive detention as an integral part of the Constitution as has been done in India.
The governments sometimes use such laws in an extra-judicial power. Also, there remains a fear of arbitrary detentions.

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How to Write Case Reports and Case Series

Ganesan, Prasanth

Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India

Address for correspondence: Dr. Prasanth Ganesan, Medical Oncology, 3 rd Floor, SSB, Jawaharlal Institute of Postgraduate Medical Education and Research, Dhanvantari Nagar, Puducherry - 605006, India. E-mail: [email protected]

Received March 13, 2022

Received in revised form April 10, 2022

Accepted April 10, 2022

This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Case reports are considered the smallest units of descriptive studies. They serve an important function in bringing out information regarding presentation, management, and/or outcomes of rare diseases. They can also be a starting point in understanding unique associations in clinical medicine and can introduce very effective treatment paradigms. Preparing the manuscript for a case report may be the first exposure to scientific writing for a budding clinician/researcher. This manuscript describes the steps of writing a case report and essential considerations when publishing these articles. Individual components of a case report and the “dos and don'ts” while preparing these components are detailed.

INTRODUCTION

A case report describes several aspects of an individual patient's presentation, investigations, management decisions, and/or outcomes. This is a type of observational study and has been described as the smallest publishable unit in medical literature.[ 1 ] A case series involves a group of patients with similar presentations or treatments. In modern medicine [ Figure 1 ], these publications are categorized as the “lowest level of evidence”.[ 2 ] However, they serve several essential functions. For example, there are rare diseases where large, randomized trials, or even observational studies may not be possible. Medical practice, in these conditions, is often guided by well-presented case reports or series. There are situations where a single case report has heralded an important therapy change.[ 3 ] Further, case reports are often a student's first exposure to manuscript writing. Hence, these serve as training for budding scholars to understand scientific writing, learn the process of manuscript submission, and receive and respond to reviewer comments. This article explains the reasons why case reports are published and provides guidance for writing such type of articles.

WHY ARE CASE REPORTS PUBLISHED?

A case report is often published to highlight the rarity of a particular presentation. However, it may be of much more value if it also informs some aspects of management. This could be in the form of rare expressions of a common disease so that clinicians who read will be aware and can consider additional possibilities and differential diagnoses when encountering similar situations. A new form of evaluation of a patient, either to facilitate the diagnostics or to improve understanding of the disease condition, may stimulate a case report. Novel treatments may be tried, and the results might be necessary to disseminate. This may be encountered either in rare diseases or conditions where treatment options are exhausted. Moreover, randomized trials report outcomes of a group and often do not inform about the individual patient. [ Table 1 ] describes a few examples of case reports/case series which have had a remarkable impact on medical practice.

ETHICAL ISSUES

If there is a possibility of patient identification from the report, it is mandatory to obtain informed consent from the patient while approval from the institutional ethics committee (IEC) may also be needed depending on institutional policies.[ 7 ] If identifying information is absent (or if suitable steps are taken to remove identifying information or hide the identity, (such as by covering the eyes), it may still be required by some journals to obtain ethics committee approval for certain types of case reports. If a case series involves retrospective chart review, “waiver-of-consent” may be sought from the ethics committee. Indian Ethical Guidelines do not separately address this issue in case reports.[ 8 ] The Committee on Publication Ethics has described best practices for journals when publishing case reports which also gives links to model consent forms.[ 9 ]

HOW TO START?

If you are a beginner and you have identified an interesting case which you want to report, the first step would be to sit with your team and discuss the aspects of the case you want to highlight in your publication.[ 10 ] Do a literature search and try to summarize available information before writing the draft. It would also be a good idea to understand which journal you are targeting; this will assist in determining the number of figures, the word limits, and ethical requirements (such as informed consent). Discussions with senior faculty about the authors and their order should also be done at this point to avoid issues later. For a beginner, it would be a good practice to present the case in the department or in an institutional scientific forum before writing up the manuscript.

COMPONENTS OF a CASE REPORT

A case report usually has the following sections: an abstract, a brief introduction, the actual description of the case, and finally, the discussion which highlights the uniqueness of the case and includes a conclusion statement. Many journals these days publish case reports only as a letter to editor; in such cases, an abstract is not usually required.

The title must be informative about the problem being reported. It may refer to the particular issue being highlighted in the report, or it may refer to the educational aspect of that particular report. Catchy titles are often used by authors to trigger interest among the readers and make them want to read the article. Authors may remember to use titles which will help people locate the article when searching the literature.

When writing a title, it may be best to avoid terms such as “case report,” “review of literature,” “unique,” “rare,” “first-report”; these do not add value to the presentation.

Introduction

This must introduce the condition and clearly state why the case report is worth reading. It may also contain a brief mention of the current status of the problem being described with supporting references.

Describing the case

The case must be presented succinctly, in a chronological order, clearly highlighting the salient aspects of the case being reported. Relevant negative findings may be provided. For example, if a case is being reported for elaborating a new type of treatment, then more attention must be given to treatment aspects (e.g., name of the drug, dosage, schedule, dose modifications, or the type of surgery, duration, and type of anesthesia) after briefly describing the presentation and diagnostics. The idea is that the reader must be able to apply the treatment in his/her practice if required.

However, if the case is being presented for diagnostic rarity/unusual clinical features/pathological aspects, then more attention must be given to these aspects. For example, if the emphasis is on tissue pathology, then the description must include details about tissue processing, types of stains, and immunohistochemistry details.

Figures and tables

Figures, as in any publication, should be self-explanatory. A properly constructed figure legend can be used for describing certain aspects of the case much better than long-winded text in the main manuscript. This will also help to reduce the word count in the main manuscript. If there are multiple figures (e.g., follow-up radiology series and response to treatment images), these can be combined as [ Figure 1 ]a, [ Figure 1 ]b, [ Figure 1c ] or [ Figure 1 ]a, [ Figure 1 ]b, [ Figure 1 ]c, [ Figure 1d ]. This will help conform to the figure number limits prescribed by the journal. While preparing the figures, one must ensure that the quality of the art/photograph is not compromised. Further, patient identifying features must be masked, unless necessary to show.

Tables are usually not part of case reports but may be used. One example is presenting the baseline investigations in a tabular format which can facilitate assimilation as well as reduce the word count. Tables are more often used in case series. The most common is a type of table where the features of all the cases included are summarized with each row referring to an individual patient. This usually works for a series of up to ten patients; beyond that, the table may become crowded and difficult to understand. Tables may also be used in the discussion section to summarize related, published reports to date.

Discussion including review

A case report may help to alter the approach to patient management in the clinic or it may even stimulate original research evaluating a new treatment. Thus, the discussion must summarize the unique aspects of the case (why is the case different?) and the essential learning points/implications (how will it change management?/What further research needs to be done?). In addition to stating the differences from existing literature, the discussion should also attempt to explain these differences.

If the condition or treatment approach being focused on is sufficiently rare, reviewing all available cases published until that point is critical. This review may be presented in a table with each case described briefly. A more nuanced study might attempt to summarize the relevant demographics and clinical details of the various cases published to date in the form of a table (e.g., median age, gender distribution, and survival outcomes).

CASE SERIES - WHAT IS DIFFERENT?

There is no formal definition as to what is case series and what would be considered a retrospective cohort study. In general, a case series comprises <10 cases; beyond that, it may be feasible to apply formal statistics and may be considered a cohort study.

Both case reports and case series are descriptive studies. Case series must have similar cases and hence the inclusion must be clearly defined. The interventions must be documented in a way that is reproducible and follow-up of each individual in the report must be available. Although formal statistical analyses are usually not a part of case series, authors may attempt to summarize baseline demographic parameters using descriptive statistics.

ABSTRACT OF a CASE REPORT

As explained earlier, a few journals do not require abstracts for case report submissions. When required, one should try to highlight the salient aspects of the case presented and the reason for the publication within the abstract word limit, which may be as short as 100–200 words. Spend time and effort in writing a good abstract as this is a portion which is usually read by the editor during manuscript screening and may have implications for whether the article progresses to the next stage of editorial processing.

REFERENCES IN a CASE REPORT

One may only cite key references in a case report or series as there is limited scope for elaborate literature search. Most journals have a limit of 10–15 references for case reports; when publishing as a letter to editor (or correspondence), the allowed reference limit may be even lower (five or less for some journals).

CHOOSING THE RIGHT JOURNAL

Many journals have recently stopped publishing case reports and series. This is often an attempt by journals to optimize their resources (space and reviewer time) to attain the highest possible impact. Although this is unfortunate, it is a reality which must be acknowledged. Nonetheless, the advent of online-only journals has led to more options for aspiring authors. Some journals accept case series, whereas others have “sister” journals created to accept case reports and other, less definitive, contributions to the literature.[ 11 ] It is an important exercise to study all available journals accepting case reports of the type being written. The case report must be tailored to the journal's requirements. Many journals may charge an article processing fee; author(s) must consider whether they are willing to pay and publish. Some of these may be predatory journals; authors must be wary of them and scrupulously avoid publishing in such journals as they can permanently stain the publication records of a researcher.

PUBLISHING THE CASE REPORT/SERIES AS a LETTER TO EDITOR/IMAGE SERIES

When the matter to be conveyed is very minimal or is being published mainly for its rarity, letters to editor may be an alternate route to publish case report data. Interesting images may be published in the form of “images” series which is now a part of many journals. The flexibility of web-based publishing also allows interesting videos to be published online.

GUIDELINES FOR CASE REPORTS

There are guidelines which help authors in the preparation and submission of case reports. The CAse REports (CARE) checklist is one such popular guideline. It provides a “checklist” and other resources for authors that can help navigate the process of writing a case report, especially when a person is doing it for the first time.[ 12 ]

AUTHORSHIP IN CASE REPORTS

Although there are no separate guidelines for authorship in “case reports,” general authorship rules follow that for any manuscript. “Gift” authorship must be avoided. All authors must have contributed to the creation of the manuscript in addition to being involved in some aspect of care of the patient being reported. Authorship order should be ideally predecided based on mutual consensus.

CONCLUSIONS

A case report is a useful starting point for one's scientific writing career. There are useful online resources which describe the steps for a newbie writer.[ 13 14 ] [ Table 2 ] summarizes the important components to follow and understand when writing case reports. Although many frontline journals have reduced their acceptance of case reports, these publications continue to serve an essential scientific and academic role.

Financial support and sponsorship

Conflicts of interest.

There are no conflicts of interest.

Case reports; manuscript writing; case series; references

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Continuing to enhance the quality of case study methodology in health services research

Shannon l. sibbald.

1 Faculty of Health Sciences, Western University, London, Ontario, Canada.

2 Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

3 The Schulich Interfaculty Program in Public Health, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

Stefan Paciocco

Meghan fournie, rachelle van asseldonk, tiffany scurr.

Case study methodology has grown in popularity within Health Services Research (HSR). However, its use and merit as a methodology are frequently criticized due to its flexible approach and inconsistent application. Nevertheless, case study methodology is well suited to HSR because it can track and examine complex relationships, contexts, and systems as they evolve. Applied appropriately, it can help generate information on how multiple forms of knowledge come together to inform decision-making within healthcare contexts. In this article, we aim to demystify case study methodology by outlining its philosophical underpinnings and three foundational approaches. We provide literature-based guidance to decision-makers, policy-makers, and health leaders on how to engage in and critically appraise case study design. We advocate that researchers work in collaboration with health leaders to detail their research process with an aim of strengthening the validity and integrity of case study for its continued and advanced use in HSR.

Introduction

The popularity of case study research methodology in Health Services Research (HSR) has grown over the past 40 years. 1 This may be attributed to a shift towards the use of implementation research and a newfound appreciation of contextual factors affecting the uptake of evidence-based interventions within diverse settings. 2 Incorporating context-specific information on the delivery and implementation of programs can increase the likelihood of success. 3 , 4 Case study methodology is particularly well suited for implementation research in health services because it can provide insight into the nuances of diverse contexts. 5 , 6 In 1999, Yin 7 published a paper on how to enhance the quality of case study in HSR, which was foundational for the emergence of case study in this field. Yin 7 maintains case study is an appropriate methodology in HSR because health systems are constantly evolving, and the multiple affiliations and diverse motivations are difficult to track and understand with traditional linear methodologies.

Despite its increased popularity, there is debate whether a case study is a methodology (ie, a principle or process that guides research) or a method (ie, a tool to answer research questions). Some criticize case study for its high level of flexibility, perceiving it as less rigorous, and maintain that it generates inadequate results. 8 Others have noted issues with quality and consistency in how case studies are conducted and reported. 9 Reporting is often varied and inconsistent, using a mix of approaches such as case reports, case findings, and/or case study. Authors sometimes use incongruent methods of data collection and analysis or use the case study as a default when other methodologies do not fit. 9 , 10 Despite these criticisms, case study methodology is becoming more common as a viable approach for HSR. 11 An abundance of articles and textbooks are available to guide researchers through case study research, including field-specific resources for business, 12 , 13 nursing, 14 and family medicine. 15 However, there remains confusion and a lack of clarity on the key tenets of case study methodology.

Several common philosophical underpinnings have contributed to the development of case study research 1 which has led to different approaches to planning, data collection, and analysis. This presents challenges in assessing quality and rigour for researchers conducting case studies and stakeholders reading results.

This article discusses the various approaches and philosophical underpinnings to case study methodology. Our goal is to explain it in a way that provides guidance for decision-makers, policy-makers, and health leaders on how to understand, critically appraise, and engage in case study research and design, as such guidance is largely absent in the literature. This article is by no means exhaustive or authoritative. Instead, we aim to provide guidance and encourage dialogue around case study methodology, facilitating critical thinking around the variety of approaches and ways quality and rigour can be bolstered for its use within HSR.

Purpose of case study methodology

Case study methodology is often used to develop an in-depth, holistic understanding of a specific phenomenon within a specified context. 11 It focuses on studying one or multiple cases over time and uses an in-depth analysis of multiple information sources. 16 , 17 It is ideal for situations including, but not limited to, exploring under-researched and real-life phenomena, 18 especially when the contexts are complex and the researcher has little control over the phenomena. 19 , 20 Case studies can be useful when researchers want to understand how interventions are implemented in different contexts, and how context shapes the phenomenon of interest.

In addition to demonstrating coherency with the type of questions case study is suited to answer, there are four key tenets to case study methodologies: (1) be transparent in the paradigmatic and theoretical perspectives influencing study design; (2) clearly define the case and phenomenon of interest; (3) clearly define and justify the type of case study design; and (4) use multiple data collection sources and analysis methods to present the findings in ways that are consistent with the methodology and the study’s paradigmatic base. 9 , 16 The goal is to appropriately match the methods to empirical questions and issues and not to universally advocate any single approach for all problems. 21

Approaches to case study methodology

Three authors propose distinct foundational approaches to case study methodology positioned within different paradigms: Yin, 19 , 22 Stake, 5 , 23 and Merriam 24 , 25 ( Table 1 ). Yin is strongly post-positivist whereas Stake and Merriam are grounded in a constructivist paradigm. Researchers should locate their research within a paradigm that explains the philosophies guiding their research 26 and adhere to the underlying paradigmatic assumptions and key tenets of the appropriate author’s methodology. This will enhance the consistency and coherency of the methods and findings. However, researchers often do not report their paradigmatic position, nor do they adhere to one approach. 9 Although deliberately blending methodologies may be defensible and methodologically appropriate, more often it is done in an ad hoc and haphazard way, without consideration for limitations.

Cross-analysis of three case study approaches, adapted from Yazan 2015

Dimension of interest	Yin	Stake	Merriam
Case study design	Logical sequence = connecting empirical data to initial research question Four types: single holistic, single embedded, multiple holistic, multiple embedded	Flexible design = allow major changes to take place while the study is proceeding	Theoretical framework = literature review to mold research question and emphasis points
Case study paradigm	Positivism	Constructivism and existentialism	Constructivism
Components of study		“Progressive focusing” = “the course of the study cannot be charted in advance” (1998, p 22) Must have 2-3 research questions to structure the study
Collecting data	Quantitative and qualitative evidentiary influenced by:	Qualitative data influenced by:	Qualitative data research must have necessary skills and follow certain procedures to:
Data collection techniques
Data analysis	Use both quantitative and qualitative techniques to answer research question	Use researcher’s intuition and impression as a guiding factor for analysis	“it is the process of making meaning” (1998, p 178)
Validating data		Use triangulation	Increase internal validity Ensure reliability and increase external validity

The post-positive paradigm postulates there is one reality that can be objectively described and understood by “bracketing” oneself from the research to remove prejudice or bias. 27 Yin focuses on general explanation and prediction, emphasizing the formulation of propositions, akin to hypothesis testing. This approach is best suited for structured and objective data collection 9 , 11 and is often used for mixed-method studies.

Constructivism assumes that the phenomenon of interest is constructed and influenced by local contexts, including the interaction between researchers, individuals, and their environment. 27 It acknowledges multiple interpretations of reality 24 constructed within the context by the researcher and participants which are unlikely to be replicated, should either change. 5 , 20 Stake and Merriam’s constructivist approaches emphasize a story-like rendering of a problem and an iterative process of constructing the case study. 7 This stance values researcher reflexivity and transparency, 28 acknowledging how researchers’ experiences and disciplinary lenses influence their assumptions and beliefs about the nature of the phenomenon and development of the findings.

Defining a case

A key tenet of case study methodology often underemphasized in literature is the importance of defining the case and phenomenon. Researches should clearly describe the case with sufficient detail to allow readers to fully understand the setting and context and determine applicability. Trying to answer a question that is too broad often leads to an unclear definition of the case and phenomenon. 20 Cases should therefore be bound by time and place to ensure rigor and feasibility. 6

Yin 22 defines a case as “a contemporary phenomenon within its real-life context,” (p13) which may contain a single unit of analysis, including individuals, programs, corporations, or clinics 29 (holistic), or be broken into sub-units of analysis, such as projects, meetings, roles, or locations within the case (embedded). 30 Merriam 24 and Stake 5 similarly define a case as a single unit studied within a bounded system. Stake 5 , 23 suggests bounding cases by contexts and experiences where the phenomenon of interest can be a program, process, or experience. However, the line between the case and phenomenon can become muddy. For guidance, Stake 5 , 23 describes the case as the noun or entity and the phenomenon of interest as the verb, functioning, or activity of the case.

Designing the case study approach

Yin’s approach to a case study is rooted in a formal proposition or theory which guides the case and is used to test the outcome. 1 Stake 5 advocates for a flexible design and explicitly states that data collection and analysis may commence at any point. Merriam’s 24 approach blends both Yin and Stake’s, allowing the necessary flexibility in data collection and analysis to meet the needs.

Yin 30 proposed three types of case study approaches—descriptive, explanatory, and exploratory. Each can be designed around single or multiple cases, creating six basic case study methodologies. Descriptive studies provide a rich description of the phenomenon within its context, which can be helpful in developing theories. To test a theory or determine cause and effect relationships, researchers can use an explanatory design. An exploratory model is typically used in the pilot-test phase to develop propositions (eg, Sibbald et al. 31 used this approach to explore interprofessional network complexity). Despite having distinct characteristics, the boundaries between case study types are flexible with significant overlap. 30 Each has five key components: (1) research question; (2) proposition; (3) unit of analysis; (4) logical linking that connects the theory with proposition; and (5) criteria for analyzing findings.

Contrary to Yin, Stake 5 believes the research process cannot be planned in its entirety because research evolves as it is performed. Consequently, researchers can adjust the design of their methods even after data collection has begun. Stake 5 classifies case studies into three categories: intrinsic, instrumental, and collective/multiple. Intrinsic case studies focus on gaining a better understanding of the case. These are often undertaken when the researcher has an interest in a specific case. Instrumental case study is used when the case itself is not of the utmost importance, and the issue or phenomenon (ie, the research question) being explored becomes the focus instead (eg, Paciocco 32 used an instrumental case study to evaluate the implementation of a chronic disease management program). 5 Collective designs are rooted in an instrumental case study and include multiple cases to gain an in-depth understanding of the complexity and particularity of a phenomenon across diverse contexts. 5 , 23 In collective designs, studying similarities and differences between the cases allows the phenomenon to be understood more intimately (for examples of this in the field, see van Zelm et al. 33 and Burrows et al. 34 In addition, Sibbald et al. 35 present an example where a cross-case analysis method is used to compare instrumental cases).

Merriam’s approach is flexible (similar to Stake) as well as stepwise and linear (similar to Yin). She advocates for conducting a literature review before designing the study to better understand the theoretical underpinnings. 24 , 25 Unlike Stake or Yin, Merriam proposes a step-by-step guide for researchers to design a case study. These steps include performing a literature review, creating a theoretical framework, identifying the problem, creating and refining the research question(s), and selecting a study sample that fits the question(s). 24 , 25 , 36

Data collection and analysis

Using multiple data collection methods is a key characteristic of all case study methodology; it enhances the credibility of the findings by allowing different facets and views of the phenomenon to be explored. 23 Common methods include interviews, focus groups, observation, and document analysis. 5 , 37 By seeking patterns within and across data sources, a thick description of the case can be generated to support a greater understanding and interpretation of the whole phenomenon. 5 , 17 , 20 , 23 This technique is called triangulation and is used to explore cases with greater accuracy. 5 Although Stake 5 maintains case study is most often used in qualitative research, Yin 17 supports a mix of both quantitative and qualitative methods to triangulate data. This deliberate convergence of data sources (or mixed methods) allows researchers to find greater depth in their analysis and develop converging lines of inquiry. For example, case studies evaluating interventions commonly use qualitative interviews to describe the implementation process, barriers, and facilitators paired with a quantitative survey of comparative outcomes and effectiveness. 33 , 38 , 39

Yin 30 describes analysis as dependent on the chosen approach, whether it be (1) deductive and rely on theoretical propositions; (2) inductive and analyze data from the “ground up”; (3) organized to create a case description; or (4) used to examine plausible rival explanations. According to Yin’s 40 approach to descriptive case studies, carefully considering theory development is an important part of study design. “Theory” refers to field-relevant propositions, commonly agreed upon assumptions, or fully developed theories. 40 Stake 5 advocates for using the researcher’s intuition and impression to guide analysis through a categorical aggregation and direct interpretation. Merriam 24 uses six different methods to guide the “process of making meaning” (p178) : (1) ethnographic analysis; (2) narrative analysis; (3) phenomenological analysis; (4) constant comparative method; (5) content analysis; and (6) analytic induction.

Drawing upon a theoretical or conceptual framework to inform analysis improves the quality of case study and avoids the risk of description without meaning. 18 Using Stake’s 5 approach, researchers rely on protocols and previous knowledge to help make sense of new ideas; theory can guide the research and assist researchers in understanding how new information fits into existing knowledge.

Practical applications of case study research

Columbia University has recently demonstrated how case studies can help train future health leaders. 41 Case studies encompass components of systems thinking—considering connections and interactions between components of a system, alongside the implications and consequences of those relationships—to equip health leaders with tools to tackle global health issues. 41 Greenwood 42 evaluated Indigenous peoples’ relationship with the healthcare system in British Columbia and used a case study to challenge and educate health leaders across the country to enhance culturally sensitive health service environments.

An important but often omitted step in case study research is an assessment of quality and rigour. We recommend using a framework or set of criteria to assess the rigour of the qualitative research. Suitable resources include Caelli et al., 43 Houghten et al., 44 Ravenek and Rudman, 45 and Tracy. 46

New directions in case study

Although “pragmatic” case studies (ie, utilizing practical and applicable methods) have existed within psychotherapy for some time, 47 , 48 only recently has the applicability of pragmatism as an underlying paradigmatic perspective been considered in HSR. 49 This is marked by uptake of pragmatism in Randomized Control Trials, recognizing that “gold standard” testing conditions do not reflect the reality of clinical settings 50 , 51 nor do a handful of epistemologically guided methodologies suit every research inquiry.

Pragmatism positions the research question as the basis for methodological choices, rather than a theory or epistemology, allowing researchers to pursue the most practical approach to understanding a problem or discovering an actionable solution. 52 Mixed methods are commonly used to create a deeper understanding of the case through converging qualitative and quantitative data. 52 Pragmatic case study is suited to HSR because its flexibility throughout the research process accommodates complexity, ever-changing systems, and disruptions to research plans. 49 , 50 Much like case study, pragmatism has been criticized for its flexibility and use when other approaches are seemingly ill-fit. 53 , 54 Similarly, authors argue that this results from a lack of investigation and proper application rather than a reflection of validity, legitimizing the need for more exploration and conversation among researchers and practitioners. 55

Although occasionally misunderstood as a less rigourous research methodology, 8 case study research is highly flexible and allows for contextual nuances. 5 , 6 Its use is valuable when the researcher desires a thorough understanding of a phenomenon or case bound by context. 11 If needed, multiple similar cases can be studied simultaneously, or one case within another. 16 , 17 There are currently three main approaches to case study, 5 , 17 , 24 each with their own definitions of a case, ontological and epistemological paradigms, methodologies, and data collection and analysis procedures. 37

Individuals’ experiences within health systems are influenced heavily by contextual factors, participant experience, and intricate relationships between different organizations and actors. 55 Case study research is well suited for HSR because it can track and examine these complex relationships and systems as they evolve over time. 6 , 7 It is important that researchers and health leaders using this methodology understand its key tenets and how to conduct a proper case study. Although there are many examples of case study in action, they are often under-reported and, when reported, not rigorously conducted. 9 Thus, decision-makers and health leaders should use these examples with caution. The proper reporting of case studies is necessary to bolster their credibility in HSR literature and provide readers sufficient information to critically assess the methodology. We also call on health leaders who frequently use case studies 56 – 58 to report them in the primary research literature.

The purpose of this article is to advocate for the continued and advanced use of case study in HSR and to provide literature-based guidance for decision-makers, policy-makers, and health leaders on how to engage in, read, and interpret findings from case study research. As health systems progress and evolve, the application of case study research will continue to increase as researchers and health leaders aim to capture the inherent complexities, nuances, and contextual factors. 7

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Constitution

Article 22 : significant or paradoxical

This article has been written by Badal Singh.

Table of Contents

Introduction

“There is nothing more foreign to a civilized and democratic system than to preventive detention.”

– Robert Bourassa

The Constitution of India carries the conscience of the Constitution-makers and the common people, reflects the form of society that needs to be adopted, the rules to be followed, the obligations to be performed and the rights to be enjoyed without any sort of interference and disruptions. Among the rights granted by the supreme authority of the nation, the fundamental rights are the basic and prime ones that can be enjoyed by each citizen of the state and any infringement of these rights are subject to judicial review. There are exceptions to these wherein the state can suspend any of them in matters of state security, the sovereignty of the nation or for the maintenance of the public order. The problem arises when the private and basic human rights of the individual are infringed and a very serious question as to what extent the state can interfere in the life and rights granted to the individual arises.

India being the largest democracy grants liberty to its individual through Article 21 and 22 in the form of personal liberty and preventive detention. The rights granted in Article 21 and 22 of the Constitution are the ones that face the maximum heat of being infringed. The right to life and personal liberty granted by Article 21 of the Constitution goes hand in hand with Article 22 as both talks about the liberties provided to the citizen and some of the exceptional circumstances under which these rights are unavailable or restricted.

Liberty is itself the gift of the law and may by law (be) forfeited or abridged. This statement by Justice A.N Ray sums up the meaning and scope of liberty provided to an individual in India. When required, the state can restrict liberty up to any extent as it may deem valid, but only through the correct and ethical interpretation of the law. Whether the interpretation is fit or not, whether appropriate scrutiny has been done over the impediment of such rights, or whether the restriction is arbitrary in nature is a matter of great apprehension.

Article 22 of the Indian constitution deals with the Protection from Arrest and Detention. The first part of this article confers certain rights to the individual such as the knowledge of ground of arrest, right to consult and to be defended by a legal practitioner, right to be produced before the magistrate within 24 hours of arrest (excluding the journey time) and right to be released after 24 hours unless the magistrate authorizes further detention. These rights aren’t granted to an alien or a person detained under the preventive detention laws. The second part deals with such preventive detention laws and is mentioned in the sub-clause 3 of Article 22 .

This article acts as a boon for the stakeholders to prohibit activities that could disturb the peace of the nation or would be dangerous for the sovereignty of the nation. At the same time, the stakeholders can use the same laws to oppress the voices and wrongdoings, thus curbing the freedom of speech and expression granted by the constitution. Thus, this article of the Constitution being so significant can also be paradoxical and a matter of debate.

Article 22: Perks, Provisions and Repercussions.

After 300 years of the devastating and dismal British era, India gained independence on 15 August 1947 and nearly after 3 years of independence, with the deeds of the constituent assembly, the constitution of India was framed and adopted by the people of India. The Constitution of India, the largest written text of its kind, is the supreme law of land and consists of all the provisions through which law and order is maintained within the state and in state affairs. The Constitution also envisages six different types of fundamental rights within itself. Among those fundamental rights, the right to preventive arrest and detention is given in Article 22 of the Indian Constitution. The crux of the given Article is that no person shall be denied the ground of his arrest and his right to consult a legal practitioner isn’t exhausted as well.

The Article also stipulates a time period of 24 hours (excluding the travel period) within which the arrested individual needs to be presented before the magistrate and no person should be kept in custody beyond the said period without the authority from the magistrate. But there are certain exceptions given in the article and under such circumstances, individuals can’t avail the existing rights under the first and second section of the article. Section 3 of the article says that these rights can’t be availed by enemy aliens or the individuals detained under the preventive detention laws.

Also, Section 151 of the Criminal Procedure Code, 1971 grants a police officer the right to a police officer without the order of a magistrate or even without a warrant letter, merely on a suspicion that an individual is in a position or condition to commit a crime. Now, we need to focus on what preventive detention laws are, and what are the significances and consequences of such laws.

Preventive detention laws are the set of rules and statutes that allow the state and its authorities to detain an individual or a group of them under suspicion that the individual would commit any cognizable offence under the law and would be a threat to the sovereignty of the state, instability of the society or dismantling of the public order.

The arrest under such provisions of the preventive detention laws is known as “preventive arrest”. Preventive detention laws are generally designed to grant the state swift decisions during times of emergency and dire need. The importance of these laws was understood and upheld by the constituent assembly as they considered these laws proficient enough to be included in the ambit of fundamental rights.

But the authorities granted to the state and its agencies isn’t absolute and is subject to certain conditions and speculations. Section 4 of the article states that no person under the provision of preventive detention laws can be detained for more than 3 months unless it is so prescribed by an advisory board consisting of persons eligible of being a judge of high courts, provided that nothing in this sub-clause shall authorize the detention of any person beyond the maximum period prescribed by any law made by Parliament under sub-clause (b) of clause (7); or if such person is detained in accordance with the provisions of any law made by Parliament under subclauses (a) and (b) of clause (7).

Also, the authority detaining an individual has the duty to inform and make available a legal representative available as per clause 5.

The law seems quite a crystal clear and transparent in nature. But it is not what it looks like and there arises a lot of debates on the provisions envisaged in clause 7 of article 22. It provides the powers to the parliament to make the laws in case the detention is more than the prescribed period of three months and the absence of a recommendation by the advisory committee.

According to the same, it is the parliament that decides the extent of time that an individual can be detained, under the preventive detention laws and also the procedure followed by the advisory committee is to be decided by the parliament. This gives absolute power to the parliament. Sometimes, it can take arbitrary decisions that can be against the consensus of the public at large. It can infringe with the right to speech and expression and right to life and personal liberty of individuals, even without committing any offence and only if he/she goes against the will or expectation of the ruling party in the state.

In this way, a single clause of Article 22 can lead to the dismantling of the golden trilogy , i.e., the rights granted to an individual under Article 14,19 and 21 of the Indian constitution. The authorities can even deny the grounds of an arrest taking an excuse as the fact being against the public order as per clause 5 of Article 22. Democracy as said by Lincoln is a form of government of the people, by the people and for the people. The whole crux of democracy lies within the people living in the state and the rights they enjoy without any kind of interference or infringement.

The arbitrary laws which infringe such rights without any reasonableness or rational nexus between the act committed by the individual and the sanctions faced by him, act as a blot on democracy and degrades the notion as to why democracy is practised.

Preventive Detention Laws: history and developments

The constitution provides the framework through the help of which the rule of law within a state is followed and made to follow. Apart from the constitution, there are certainly other sources of legislation such as the IPC, CrPC and CPC which deal with the criminal and civil justice system of the country. Laws vary according to their nature. Some of them are enabling whereas the remaining are restrictive.

Preventive detention laws are generally restrictive in nature and curb the rights to freedom of speech, movement, expression and liberty. These laws authorize the state with the power to detain an individual without filing a case by anyone or without any offence being committed by that specific individual.

These detentions are protective in nature and allow the state and the concerned authorities to prevent the crime from being committed. If the state has a presumption that an individual could be a threat to the peace and stability of the society and there exists no other applicable means to prevent such mishap, the state as per the law made and envisaged by the parliament in consensus with the concerned articles of the constitution, can arrest and detain an individual without a trial for a reasonable time limit as discussed above.

The history of preventive detention in India dates back to the colonial era. During the regime of the East India Company in India, laws such as the Rowlett Act (1919), Bengal Criminal Amendment Ordinance and Defense of India Act, 1939, envisaged the provisions of preventive detention. These acts allowed the authorities to detain anyone on just a mere suspicion and no reasonable nexus needed to be established between the arrest and reasoning behind the arrest.

The British regime used these provisions to oppress the protestors and the revolutionaries to a much greater extent. These laws provided a pathway for dictatorship in prevention of maintaining the rule of law. Whenever things went opposite to that of what the Britishers expected, they would take the support of such stringent and arbitrary legislations to hide behind and contravene the rights of the common individuals. Primarily designed to have strict control over the unruly elements of the society, these laws during the British regime created a legal escape for the contemporary authorities, for all the wrong deeds and violations of basic rights.

After independence, the drafters of the constitution had many discussions and debates about whether the preventive detention laws would be included or not. The assembly with a common consensus agreed to include provisions related to preventive detention in the fundamental rights of the constitution as they deemed its inclusion necessary for the protection of the sovereignty of the nation and avoid any kind of hostility or mishap.

The first preventive detention law in India was passed in February 1950 by the parliament of India. This law lasted for a time period of 21 years, i.e., till 1971, and then was abolished. Before being abolished, the applicability of this case was observed in the A.K Gopalan v. State of Madras.

In the end, the validity of this case was upheld by the supreme court, with the exclusion of some of the provision. Afterwards, the country formulated a lot of preventive detention laws in different stages of post-development but the provisions that were provided in such rules were almost similar.

The Unlawful Activities Prevention Act (UAPA) was another preventive detention law implemented in 1967. This act provides for provisions that help in dealing with the terror activities and curb the actions that pose a threat to the sovereignty of the state. The act has been amended multiple times as per the need of reinforcement in relation with the situation of the society.

The last amendment which took place recently in the year 2019, gave the government to declare an individual a terrorist on mere suspicion by the officials believing it to be so. Initially, the provision was only for the groups and organizations which came under the ambit of terrorism. Also, after the Prevention of Terror Activities Act (POTA) and Terror and Disruptive Activities Act (TADA) was repealed, their provisions were included in the UAPA through an amendment done in the year 2004. This made UAPA an act with stringent regulations that the authority could use in cases such as the terror attack that occurred on 26th November 2007. But the same act can be used by the state to impose arbitrary restrictions on individuals without much scope of justice and judicial trials.

Another preventive detention law that has been in the public eye in recent times is the Public Safety Act of Jammu and Kashmir. Designed for action against the timber smugglers within Jammu and Kashmir, this Act was introduced by Sheikh Abdullah in the year 1978. And in the contemporary situation, after the abrogation of Article 370 from the Constitution, it was his son Farookh Abdullah who had to face the heat of this provision.

He was detained by the NDA government under suspense that letting him free would initiate riots and conflicts in the state of Kashmir, leading to chaos in the society and internal disturbance within the nation. But was his and Mehbooba Mufti’s detention ethical? Rather than ethical, the question that needs to be raised and scrutinized is whether the detention was valid as per the doctrine of justice and was the detention not in violation of the basic fundamental rights that are needed to be abided by. These questions arise in the context of all the existing preventive detention laws different parties portray differently, sometimes conflicting opinions.

Preventive detention law: a matter of contention

No subject matter is universally accepted with the same reasoning. The facts and point of views differ from person to person. Each of them carries definite reasoning and connects it with a reasonable nexus to support their point of view. The thing that has to be paid attention to is whether the reasoning that has been provided is valid and feasible with respect to the present scenario of the society.

Also, the counter-arguments provided by the party against, should also be considered and the prominent should be implemented in the behaviour and in the working mechanism of the society. The same is the situation regarding the preventive detention laws’ inclusion amongst the governing statutes.

The virtuous and the intellects of society don’t have the same opinion regarding such laws. Some think that these laws are just a few arbitrary provisions that the state and its authorities use to curb the rise of any expressive thoughts that could be derogatory for the existing sovereigns or to halt the exercise of basic fundamental rights of an individual if he does anything in contrary of what is just and beneficial for the existing rulers and democrats.

These people just believe that these laws are against the basic doctrine of the Constitution. Laws are from and for people, and not the people are from laws. And such stringency that disallows and disdains such freedom of life, liberty, expression and equality of citizens shouldn’t be declared valid.

The absence and flout of such laws in the advanced foreign nations like England and other European nations provides advocacy to the views of the individuals who are against the preventive detention laws. Since these provisions provide for arrest and sanctions against individuals without even the commencement of crime, they are not in correspondence with the norms of the Constitution.

This is not how justice ought to be delivered and is against the public policy and norms of humanity. Mihir Desai , a senior advocate says that these preventive detention laws allow the state to carve out exceptions for its lawlessness.

The state can to curb any existing dissent or dissenters, charge individuals under such laws, which otherwise they wouldn’t have been able to, through any other source. Therefore, some people believe that such laws don’t stand any chance of existence and are outdated and against the terms of democracy.

Amidst such dissenting opinions regarding the preventive detention laws, there are a considerable number of people who think preventive detention laws are a very vital set of legislations that help in preserving and protecting the sovereignty of the nation and its people. India, being a multi-religious, multi-ethnic and multi-cultural country, consists of people of different faiths, carrying diverse identity and following varieties of norms and traditions. And when any contradiction arises, it gives rise to conflict amongst the groups.

Therefore, Indian society is always vulnerable to riots and religious conflicts. To avoid such mishaps, it is vital for the state to have stringent provisions to control and prohibit the commencement of any sort of disservice. Also, terrorism is one of the major areas of concern for India and the government spends a huge part of the annual part in safeguarding the country from terrorists and terror activities.

Preventive detention laws provide a helping hand to prevent such activities before occurrence and thus maintain the peace and stability within the state.

The supreme court in the case of AlijanMian v. District Magistrate, Dhanbad set forward a difference between criminal proceedings and crime. It stated that criminal proceedings refer to punishing a person who has committed a crime, but preventive detention in itself isn’t a crime.

In Anil Dey v. State of West Bengal , the Supreme Court held that “the veil of subjective satisfaction of the detaining authority cannot be lifted by the courts with a view to appreciate its objective sufficiency”. Although the courts “cannot substitute their own opinion for that of the detaining authority by applying an objective test to decide the necessity of detention for a specified purpose, they do review whether the satisfaction is “honest and real, and not fanciful and imaginary”. It is thus advised by the court to the judicial authorities to use its virtue while detaining anyone under any law and such detainment can always be the subject of review and objectivity tests of the court.

Article 22, although not perfect and ideal, was included in the Constitution after tons of debates and arguments among the members of the constituent assembly. The Constitution provides for basic freedoms to each of its citizens and they are provided with the rights to enjoy those freedoms without any infringement. But these rights are to be enjoyed to an extent only up to which the rights of others aren’t infringed.

Therefore, one must have mutual respect for the rights granted to others as well. Similarly, the state must also portray respect to the rights which have been granted by the rule of law to the citizens.

But sometimes for the sake of preservation of rights of a huge mass, the state should also have the rights to curb some of the rights granted to some of the individuals, specifically those individuals who have the capacity to disturb the mechanism of the society. Preventive detention is equally important for the nation as the other essential laws. It is a wicked sine non qua.

It is like a medicine with some side effects, but if the body has to be maintained in proper working condition, then it must be accepted with its side effects. The provisions of these laws are held up by the supreme court and it has found it justifiable on each and every ground. The only ground that creates controversies is the unjust and irrational use of such provisions by the state for personal benefits.

But what about a country where thousands of individuals each year are detained without a just justification by the authorities and an effective trial? The role of the judiciary comes into the picture under such scenarios. Also, the effectiveness and transparency of the advisory committee that decides on the further detention of the individual is equally important. Any kind of corruption would lead to the monopoly of the state. As said earlier, preventive detention is a hard pill to swallow. And it is actually a way to protect the rights of the public at large, even if the rights of some individuals have to be infringed.

The Constitution of India, 1950
The Criminal Procedure Code, 1973

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IAS Questions
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What Is The Article 22

What is the Article 22?

Article 22 of the Indian constitution talks about the protection of life and personal liberty .

Explore The Ultimate Guide to IAS Exam Preparation

Download the e-book now.

About Article 22:

It deals with the protection against arrest and detention in certain cases.
This article is applicable to both citizens and non-citizens.
This provision extends certain procedural safeguards for individuals in case of an arrest.
The idea behind this right is to prevent arbitrary arrests and detention.
The article provides the following safeguards:
Article 22(1) – Any person who is in custody has to be informed as to why he has been arrested. Further, he cannot be denied the right to consult an advocate.
Article 22(2) – The arrested individual should be produced before a judicial magistrate within 24 hours of his arrest.
Article 22(3) – Nothing in clauses ( 1 ) and ( 2 ) shall apply (a) to any person who for the time being is an enemy alien; or (b) to any person who is arrested or detained under any law providing for preventive detention
These safeguards are, however, not applicable to
Enemy aliens
People arrested under preventive detention law.

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Hertz CEO Kathryn Marinello with CFO Jamere Jackson and other members of the executive team in 2017

Top 40 Most Popular Case Studies of 2021

Two cases about Hertz claimed top spots in 2021's Top 40 Most Popular Case Studies

Two cases on the uses of debt and equity at Hertz claimed top spots in the CRDT’s (Case Research and Development Team) 2021 top 40 review of cases.

Hertz (A) took the top spot. The case details the financial structure of the rental car company through the end of 2019. Hertz (B), which ranked third in CRDT’s list, describes the company’s struggles during the early part of the COVID pandemic and its eventual need to enter Chapter 11 bankruptcy.

The success of the Hertz cases was unprecedented for the top 40 list. Usually, cases take a number of years to gain popularity, but the Hertz cases claimed top spots in their first year of release. Hertz (A) also became the first ‘cooked’ case to top the annual review, as all of the other winners had been web-based ‘raw’ cases.

Besides introducing students to the complicated financing required to maintain an enormous fleet of cars, the Hertz cases also expanded the diversity of case protagonists. Kathyrn Marinello was the CEO of Hertz during this period and the CFO, Jamere Jackson is black.

Sandwiched between the two Hertz cases, Coffee 2016, a perennial best seller, finished second. “Glory, Glory, Man United!” a case about an English football team’s IPO made a surprise move to number four. Cases on search fund boards, the future of malls, Norway’s Sovereign Wealth fund, Prodigy Finance, the Mayo Clinic, and Cadbury rounded out the top ten.

Other year-end data for 2021 showed:

Online “raw” case usage remained steady as compared to 2020 with over 35K users from 170 countries and all 50 U.S. states interacting with 196 cases.
Fifty four percent of raw case users came from outside the U.S..
The Yale School of Management (SOM) case study directory pages received over 160K page views from 177 countries with approximately a third originating in India followed by the U.S. and the Philippines.
Twenty-six of the cases in the list are raw cases.
A third of the cases feature a woman protagonist.
Orders for Yale SOM case studies increased by almost 50% compared to 2020.
The top 40 cases were supervised by 19 different Yale SOM faculty members, several supervising multiple cases.

CRDT compiled the Top 40 list by combining data from its case store, Google Analytics, and other measures of interest and adoption.

All of this year’s Top 40 cases are available for purchase from the Yale Management Media store .

And the Top 40 cases studies of 2021 are:

1. Hertz Global Holdings (A): Uses of Debt and Equity

2. Coffee 2016

3. Hertz Global Holdings (B): Uses of Debt and Equity 2020

4. Glory, Glory Man United!

5. Search Fund Company Boards: How CEOs Can Build Boards to Help Them Thrive

6. The Future of Malls: Was Decline Inevitable?

7. Strategy for Norway's Pension Fund Global

8. Prodigy Finance

9. Design at Mayo

10. Cadbury

11. City Hospital Emergency Room

13. Volkswagen

14. Marina Bay Sands

15. Shake Shack IPO

16. Mastercard

17. Netflix

18. Ant Financial

19. AXA: Creating the New CR Metrics

20. IBM Corporate Service Corps

21. Business Leadership in South Africa's 1994 Reforms

22. Alternative Meat Industry

23. Children's Premier

24. Khalil Tawil and Umi (A)

25. Palm Oil 2016

26. Teach For All: Designing a Global Network

27. What's Next? Search Fund Entrepreneurs Reflect on Life After Exit

28. Searching for a Search Fund Structure: A Student Takes a Tour of Various Options

30. Project Sammaan

31. Commonfund ESG

32. Polaroid

33. Connecticut Green Bank 2018: After the Raid

34. FieldFresh Foods

35. The Alibaba Group

36. 360 State Street: Real Options

37. Herman Miller

38. AgBiome

39. Nathan Cummings Foundation

40. Toyota 2010

Home / clat pg / Landmark Judgements on Article 20 of the Indian Constitution

Landmark judgements on article 20 of the indian constitution.

Introduction

State of Rajasthan v. Mohan Lal

Introduction

Article 20 of the Constitution of India constitutes a pivotal fundamental right, safeguarding the rights of accused individuals and convicts. This post contains summary of landmark judgements on Article 20.

Article 20 encompasses three crucial provisions:

Article 20(1) pertains to ex-post facto laws, preventing retroactive legal consequences for past actions, and distinguishing between the prospective and retrospective nature of laws;

Article 20(2) establishes the principle of double jeopardy, safeguarding against multiple prosecutions or penalties for the same offense; and

Article 20(3) ensures the right against self-incrimination, empowering individuals to abstain from providing potentially self-damaging testimony. Collectively, these principles fortify a just legal framework, preserving individual rights and equitable treatment within the Indian legal system.

Landmark Judgements on Article 20

Here is a summary of landmark judgements on Article 20 of the Indian Constitution :

Sajjan Singh v. State of Punjab

Section 5(3) of the Prevention of Corruption Act, addressing disproportionate income cases, necessitates individuals to substantiate the legitimacy of assets that appear exceedingly disproportionate to their earnings.

In this context, the pivotal concern emerges regarding the compliance of such a provision with the safeguards enshrined in Article 20 of the Constitution. In a legal challenge posed by Sajjan Singh, who cited the law’s enactment in 1947 subsequent to a 1948 search operation, while asserting the accumulation of disproportionate assets since 1920, the core contention centers on the prospect of retrospective imposition of liability.

However, the Court’s ruling pivoted on Article 20(1)’s principle, which guards against retroactively intensifying penalties or liabilities. The Court discerned the distinction between altering the burden of proof, as outlined in Section 5(3), and augmenting legal ramifications.

Conclusively, the Court determined that the obligation to provide pre-1947 asset receipts did not constitute a retrospective imposition of liability, as it pertained solely to the evidentiary aspect and did not enhance punitive consequences, aligning with the interpretation that such evidentiary shifts lay outside the scope of Article 20(1).

Ratanlal v. State of Punjab

In a case involving a sixteen-year-old boy who trespassed on private property and committed a molestation offense, he was initially found guilty, resulting in imprisonment and a fine.

The subsequent enactment of the Prohibition of Offenders Act, specifying that those under twenty-one be sent to juvenile facilities, raised a Supreme Court question on retroactivity. The Government cited Article 20, barring harsher retroactive punishment.

The Court, led by Justice Subba Rao, emphasized the law’s benevolent intent and extended it ex-post-facto, mitigating punishment. Therefore, article 20(2) was invoked, clarifying “double jeopardy” concerns.

Kedar Nath v. State of Bengal

The Hon’ble Supreme Court of India emphasized that legislative acts characterizing actions as criminal offenses along with their corresponding penalties inherently operate on a prospective basis.

Applying such laws retrospectively, as cautioned by the Court, would run counter to the safeguards enshrined in Article 20 (1) of the Indian Constitution. This principle serves to protect individuals from facing punitive measures for actions committed prior to the establishment of the relevant legal provisions, thereby upholding the fundamental principles of justice and fairness integral to the constitutional framework.

Maru Ram etc v. Union of India

The Court’s discerning observation pertained to the encompassing scope of Article 20 (1), elucidating that it encompasses a pivotal tenet preventing the imposition of penalties more severe than those in force at the commencement of an offence.

This principle safeguards individuals from facing heightened retrospective punishments, underscoring the imperative of maintaining consistency between the legal consequences applicable at the time of the offense and any subsequent alterations to the penalty framework.

By adhering to this principle, the Court reinforces the foundational elements of fairness, proportionality, and legal certainty within the Indian legal system.

Maqbool Hussain v. State of Bombay

In this specific case, an individual was found in possession of a certain quantity of gold, which was in violation of the prevailing local law. The customs authority seized the gold, and subsequently, the person faced prosecution in a criminal court.

The central issue before the court revolved around the concept of Double Jeopardy, wherein it had to determine whether this sequence of events constituted a violation of the principle. The court was tasked with evaluating whether the individual could be subjected to multiple legal actions and penalties for the same offence of possessing illicit gold, given that both the confiscation by customs and the subsequent criminal prosecution were implicated.

Selvi v. State of Karnataka

The Supreme Court ruled that the mandatory application of certain scientific techniques—namely, narcoanalysis, polygraph examination, and the Brain Electrical Activation Profile (BEAP)—possesses a ‘testimonial’ nature, thereby invoking the safeguards of Article 20(3) of the Constitution.

The techniques involved include polygraph tests for lie detection, narcoanalysis which administers truth serum to elicit responses while in a semi-conscious state, and brain mapping which analyzes brain signals during recollection.

The primary defense against their challenge was that these measures don’t entail voluntary statements but rather scientific procedures akin to blood tests. However, Selvi’s judgment rejected this analogy, deeming the techniques not comparable to neutral blood tests.

Instead, they were likened to oral testimonies as answers are elicited via devices, directly involving the accused, in contrast to blood tests which remain impartial and detached.

State of Rajasthan v. Mohan Lal

The Narcotics, Drugs and Psychotropic Substances Act held relevance in the present case, where a contention arose that Article 20 of the Constitution exclusively prohibits the imposition of penalties or convictions based on ex post facto legislation, but does not extend to restraining the trial or prosecution process itself.

Furthermore, it was contended that a trial conducted utilizing a distinct procedural framework from the one in force at the time of the offense does not necessarily adhere to the same limitations, and thus cannot be deemed constitutionally invalid.

This perspective underscores the nuanced interpretation of Article 20 within the context of the mentioned Act, highlighting the balance between safeguarding individual rights against retrospective punishment and maintaining the constitutional integrity of trial procedures that may evolve over time.

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The Woman Behind Freud’s First Case Study

The case of anna o. showed that psychoanalysis worked. did freud tamper with it.

There is perhaps no one more devoted to the cause than a convert, and there is no one more violent toward it than a person who has lost their faith. The faithful turned faithless take up the act of crusade, but in reverse: new atheists confronting the world with secular eyes, children who learn that their parents aren’t omnipotent. They have suffered the loss of an organizing principle, the very thing they built their life around. Now, they may seek revenge on the object that caused an earlier delusion. The commitment doesn’t end—it just takes on new guises.

Beyond the reactions of former lovers and former zealots, we see this in the history of psychoanalysis, perhaps because the practice attracts and demands those same qualities of immersion and devotion. Many have justly loved psychoanalysis, and many have justly despaired of it. This includes the very founders of rational emotive behavioral therapy and cognitive behavioral therapy, who brought about a sea change in mental health care, and the critics Frederick Crews, Jeffrey Masson, and Philip Rieff, who turned against Freud even after he had been unthroned as king of the twentieth century. This hatred can feel quasi-personal, aimed at the originator, their father figure, Sigmund Freud.

This loss of faith looms over Gabriel Brownstein’s book, The Secret Mind of Bertha Pappenheim: The Woman Who Invented Freud’s Talking Cure . On its face, the book is a study of the first analytic patient (although she didn’t exactly receive psychoanalytic treatment), Bertha Pappenheim. Pappenheim, who was treated by Freud’s mentor Josef Breuer in Vienna, was the subject of one of Breuer’s case studies and was much discussed by Freud throughout his own career. The book’s stated aim is to offer a full portrait of someone flattened and circulated as a specimen. For Pappenheim is best known by another name—Anna O.—and is best known not as her full person, who left a legacy of feminist and activist patronage, but as the world’s most famous hysteric.

But quietly, this is also a book about the birth and death of psychoanalysis—which is to say that the narrative of Freud’s ascendance and betrayal is the engine that drives the book. Brownstein argues, sometimes contradictorily, that Freud’s brilliance and his drive to make his way as a medical doctor propelled him to tamper with Bertha’s story.

Given that Pappenheim’s stunning cure is the origin story of psychoanalysis, Brownstein seeks to denigrate the whole endeavor on these grounds. If the Anna O. case was a fraud, so, too, would the cure be that she discovered.

Hysteria, much like psychoanalysis, has a storied past, one with a powerful crescendo followed by a caesura. Though the term “hysteric” is now assumed in common speech to be either a pejorative epithet, synonymous with performative hyper-emotionality ( he was hysterical ), or a historical diagnosis made up by misogynistic doctors (like, some argue, Breuer and Freud), the condition was once quite common. For the uninitiated, hysteria is an illness where the body speaks, where neurotic symptoms appear in and on it. It was treated by an array of cures, from gynecological massage (prescribed orgasm), hypnotism, rest, and drugging, to change of scenery, and, yes, for a very few patients, starting in the late nineteenth century, Breuer and Freud’s cathartic method. This eventually became psychoanalysis. This was, it must be said, a treatment that seems preferable to the other options.

Bertha Pappenheim was in many ways a typical hysterical patient, and an extraordinary woman. When she went to see Breuer in 1880, she presented with the typical hysterical complaints: partial paralysis, disturbances of appetite and language, pain. She couldn’t recall her native German and only spoke in English. She wouldn’t drink water. She had fallen ill while nursing her father, and her condition deteriorated upon his death. She was treated both in her home and in an asylum, often with high doses of drugs. What marks her case as special is that Pappenheim was the first person on Earth to be treated by the cathartic method, in large part because she invented it. Anytime you hear someone say “talking cure,” they’re using the very term Pappenheim ascribed to the yearslong experiment she undertook, morning and night, with her doctor. As she chattered on, as she engaged in the “chimney sweeping” of her mind—so the story goes—she felt better.

Freud and Breuer went on to co-write the groundbreaking Studies on Hysteria , published in 1895. The two doctors, one senior and one junior, open the book with a co-written introduction and end it with a pair of stand-alone essays (Freud’s undermining Breuer’s) in which the nascent theories of repression, defense, catharsis, and abreaction first appear. Each supplied case material of hysteric women treated by this nascent cathartic method. Freud wrote up four cases, and Breuer only contributed the case of Pappenheim, now disguised and named “Anna O.” The two detailed the symptoms of their patients and how each was aided, if not outright cured, by this new talking protocol.

In Breuer’s write-up of Anna O., which only runs about 25 pages, he elaborates on the case study, telling his readers how ill Anna was, when, and why. He then goes on to describe his therapeutic practice of sitting with her at night, and how, while Anna O. was under hypnosis, the two came to “develop a therapeutic technique” of linking each of her symptoms to the moment it appeared. The water she will not drink, for instance, is linked to a moment she saw her English ladies’ companion let a little dog drink from her glass. After the connection is revealed under hypnosis, Breuer tells us, Anna O. drinks water once more. The process repeated until there were no symptoms left, and Anna O.’s mental state presumably returned to normal.

The problem is—and basically all historians of psychoanalysis agree on this point—that even though Breuer and Freud reported a miracle cure, Anna O. didn’t get better. In fact, she got worse and was put in a sanatorium. The question is why. Brownstein, following the anti-Freud tradition, attributes this failure to the treatment. Freud, of course, attributed this failure to the person who offered the treatment—Breuer—not because he couldn’t cure her, but because he didn’t finish doing so.

Like all origin myths, the case has been subject to endless interpretation and reinterpretation. Even the original case study is retrospective: Breuer didn’t write up the Anna O. case at the time of treatment. He did so at Freud’s urging, so that the two might document this new technique of psychotherapy. Anna O. thus became the first patient of psychoanalysis only after the fact, and even though her treatment has just about nothing in common with psychoanalysis today, she is celebrated as such. Freud then revised the case multiple times across his life (in private letters, then in publications in 1910 and 1914), often to diminish Breuer’s role in the origin of psychoanalysis. This is in part due to what Freud thought of privately as Breuer’s failure: When Anna O. showed Breuer she had transferred onto him—by fantasizing about having his baby—Breuer ran away. Breuer could have invented psychoanalysis had he stayed in the room—but he didn’t dare. And thus Anna remained ill, but, in Freud’s understanding, psychoanalysis was not at fault.

Once Freud died, others revised the case in their own ways. Stacks of books can be called up in any research library by those who either defend or revile Freud—and nearly all of them, at one point, turn to Anna O. These studies often seek to collate and correlate Breuer’s flattened write-up of the case with historical reality, trying to reconstruct both Anna O.’s illness and her medical treatment. Some are feminist rereadings of the case, arguing that Anna O. was sick with patriarchy; others center squarely on Freud’s obsession with the case, excavating his letters about Anna O. to various ends.

What’s plain as day: Pappenheim has become the Rorschach test for the field. What we see in her case tends to be run through our feelings about psychoanalysis. The great historian of psychoanalysis John Forrester has argued that the baby that Anna O. spoke of wanting to have with Breuer was psychoanalysis—something she conceived with Breuer, even though he wouldn’t stick around and take responsibility for it. Anti-Freudian Mikkel Borch-Jacobsen sees Anna O.’s case as entirely fabricated, a young woman taken in by her handsome doctor and given huge quantities of drugs; if she invented psychoanalysis, she was the first to be duped by it. As the late Peter Gay observed, “There are contradictions and obscurities in successive versions of the case, but this much is more or less beyond dispute: In 1880, when Anna O. fell ill, she was twenty-one.”

But because very little besides Breuer’s documents is known of her life at the time of treatment, we project what we want onto her, and we can, for her history is a mere fragment. That we continue to do so makes exquisite sense: Psychoanalysis teaches us we must go back to our origins to go forward. And the treatment of Anna O. by Breuer is one way—a decent way—to conceptualize the start of Freud’s theory of mind.

Brownstein’s main critique of Freud’s use of Anna O. is this: that he took her case for his own material ends (though, by the same token, we might ask after Brownstein’s book advance). Freud was a broke young doctor; he needed to get married, and, to do so, he needed to press Breuer into writing Studies on Hysteria so that he could practice this new treatment with a kind of paternal authorization, styling himself as a doctor of “the cathartic method of J. Breuer.”

Brownstein agrees with anti-Freudians like Borch-Jacobsen and Crews that Anna O.’s treatment was a dismal failure. And even though that would make the lie—that Anna O. was cured—Breuer’s, Brownstein argues it was Freud who metaphorically had a gun to his mentor’s head and forced him to write it. More softly, Brownstein argues that Anna O. obscures Bertha Pappenheim, whom Brownstein now promises to deliver to us. Here’s the problem: Brownstein wants to make Freud the (very) bad guy of a story that had little to do with him, even if he had a great deal to do with the case becoming a story. So much so that Brownstein treats the possibility of Freud seeing Bertha Pappenheim at a party years after the treatment as corroborating evidence for some kind of misdeed.

Brownstein thus rewrites up the notorious case, with his chatty, negative asides and interpretations taking center stage. His first close reading from the book is, appropriately, from the first page. He argues that, though Studies purports to be “about the sex lives and sex drives of young bourgeois women,” it “begins by announcing that, for the purposes of propriety, any discussion of their actual intimate lives will be avoided.” Brownstein argues that this is a cover—that Breuer and Freud are maliciously withholding evidence for their theory because there isn’t any and because the doctors wanted to appear respectable. But if we read the first page of Studies , here’s what Breuer and Freud actually wrote: “It would be a grave breach of confidence to publish material of this kind, with the risk of patients being recognized and their acquaintances becoming informed of facts which were confided only to the physician.” There is a deep truth to what Freud and Breuer argue: They were working in a small coterie of largely wealthy Viennese Jewish patients. Everyone knew one another (hence, the great possibility of Freud running into Pappenheim). If you circulated reports of the ills of a young woman’s “marriage bed” or lack thereof, it would have meant no father would refer his daughter to Breuer or Freud, let alone the greater ethical considerations Brownstein says are gestured to half-heartedly.

Elsewhere, Brownstein accuses Freud of having a faulty memory and disguising the patient (despite the authors’ own opening warning to the reader not to go looking for biographical information of Pappenheim). To cover over the lack of details about her, Brownstein freely narrativizes the case, turning it into a historical fiction. At other times, Brownstein seems furious that Freud tends to write beautifully—Brownstein takes this as a sign of fudging the facts—while he then turns to close reading it like a literary critic.

By the end, we know from Brownstein that we’re supposed to find Breuer largely unobjectionable, but in the grips of a young Freud. The cardinal sin for Brownstein, though, is that Anna O. wasn’t made better. (Brownstein believes that she was in fact suffering from a functional neurological disorder, a contemporary diagnosis that overlaps with hysteria.) She was transported back to the asylum, so ill that Breuer reportedly told Freud his beloved patient might be better off dead, so that she might be free of suffering. Yet we might pause and say something did indeed happen in that treatment: Pappenheim was ultimately able to recover enough. By 1889, at 29 years of age, she was able not only to get out of bed, to talk, but to work in a soup kitchen. From this year on, she published—first anonymously and then pseudonymously, under the name Paul Berthold. Soon, Pappenheim was finally known not as Anna O., not as Berthold, but as herself. She also became famous as herself, a powerful, feminist leader, founding the Jewish Women’s Association and centralizing Jewish women’s organizing toward both employment and charity.

Why a book about Bertha Pappenheim now? One answer: With its claim that it will deliver readers Pappenheim in full, Brownstein’s book sits on that ever-expanding shelf of nonfiction books that seek to tell the stories of women who have been relegated to the margins of history, returning them to their larger, unobfuscated import. The book, too, in trying to bring Pappenheim’s story up to the present by rediagnosing her with functional neurological disorder, joins the book market for explorations of contested illness. Yet this book isn’t exactly proper to either of these subgenres. Instead, we might make sense of it as a work of backlash: Just as a range of analysts and writers have turned once more to Freud (as The New York Times proclaimed in an article not quite aptly titled “Not Your Daddy’s Freud”), so have others returned to maligning him. Brownstein has offered us, perhaps, the first book of the Freud Wars 2.0.

Brownstein, in fact, inherits the role of Freud skeptic from an earlier generation. His father, Dr. Shale Brownstein, was a prominent New York psychiatrist and psychoanalyst with a Rolodex of famous patients. Sometime in the 1980s, Dr. Brownstein became disillusioned with psychoanalysis and became an anti-Freudian—though we are never quite told why. One night, when Brownstein went to visit his father, he found him in his underwear, speaking wildly. The subject: Bertha Pappenheim. His father held a thick envelope filled with scientific and historic papers, newspaper clippings, reviews of books, and his own essay on the subject.

His father gave him the manila envelope. The younger Brownstein went home to Brooklyn, and the next day his father was dead. As if in a novel, Brownstein then becomes fixated on the envelope and its contents only to discover he has misplaced it. His own book is as much an attempt to decipher his father’s theory about Bertha Pappenheim as to understand his father’s turn against Freud. Brownstein makes clear that his father was a devoted doctor, and treated queer luminaries in downtown New York, including Peter Hujar and Richard Serra. Dr. Brownstein tended to babies with HIV in the 1980s who languished otherwise in their cots, when others wouldn’t dare go near. Dr. Brownstein gave everything to psychoanalysis, but then something changed. We don’t quite know what, but his father became so disillusioned that he burned all 24 volumes of Freud’s Standard Edition .

Was it the homophobia of mainstream psychoanalysis that rightfully made him repudiate his training? Was it indeed the legacy of Anna O.? I wish we knew what Brownstein felt as he wrestled with Freud via his father. As author and son, Brownstein is overwhelmed by the research subject he must now try to understand and, more importantly, terribly overwhelmed by the pain of being alive when life is most brutal. Shortly after his father’s death, his wife is diagnosed with terminal pancreatic cancer, and when the global pandemic arrives, Brownstein must weather it without them.

While Brownstein seemingly hates Freud, he, like many others, can’t escape him. Early in the book, he disparages two Freudian terms: “secondary gain,” which can be described as the unconscious advantage patients acquire through their illness (stereotyped here as attention), and “ la belle indifférence ,” a calm character in the face of crisis. But toward the book’s close, Brownstein suddenly tips his hand: He comes to a form of self-understanding through these concepts. In not getting treated for a heart problem, he says he has a case of la belle indifférence . In writing the book, he self-analyzes, he can be understood as having a case of secondary gain—after all, Brownstein was quite literally paid for producing it.

But Brownstein uses these concepts defensively—to show his reader he is in on the joke. The book itself, more movingly, is a testament to yet another set of Freudian concepts: the return of the repressed, as evidenced by his return to the use of Freud; working through (here, loss of his father, his wife); and, indeed, sublimation. Writing the book then might be an act of Freudian sublimation; it is also an act of devotion.

Hannah Zeavin is an assistant professor of history at UC Berkeley. She is the author of The Distance Cure: A History of Teletherapy .

Tom Van Lent who resigned from the Everglades Foundation in February 2022.

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Powerful qtl mapping and favorable allele mining in an all-in-one population: a case study of heading date.

These authors equally contributed to this work

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Pengfei Wang, Ying Yang, Daoyang Li, Zhichao Yu, Bo zhang, Xiangchun Zhou, Lizhong Xiong, Jianwei Zhang, Yongzhong Xing, Powerful QTL mapping and favorable allele mining in an all-in-one population: a case study of heading date, National Science Review , 2024;, nwae222, https://doi.org/10.1093/nsr/nwae222

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The multiparent advanced generation intercross (MAGIC) population is characterized with great potentials in power and resolution of QTL mapping, but SNP-based GWAS does not fully play its potential. In this study, a MAGIC population of 1021 lines was developed from four Xian and four Geng varieties from 5 subgroups of rice. A total of 44,000 genes showed functional polymorphisms among eight parents, including frameshift variations or premature stop codon variations, which provides the potential to map almost all genes of the MAGIC population. Principal component analysis results showed that the MAGIC population had a weak population structure. A high-density bin map of 24,414 bins was constructed. Segregation distortion occurred in the regions possessing the genes underlying genetic incompatibility and gamete development. SNP-based association analysis and bin-based linkage analysis identified 25 significant loci and 47 QTLs for heading date, including 14 known heading date genes. The mapping resolution of genes is dependent on genetic effects with offset distances of less than 55 kb for major effect genes and less than 123 kb for moderate effect genes. Four causal variants and noncoding structure variants were identified to be associated with heading date. Three to four types of alleles with strong, intermediate, weak, and no genetic effects were identified from eight parents, providing flexibility for the improvement of rice heading date. In most cases, japonica rice carries weak alleles, and indica rice carries strong alleles and nonfunctional alleles. These results confirmed that the MAGIC population provides the exceptional opportunity to detect QTLs, and its use is encouraged for mapping genes and mining favorable alleles for breeding.

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Introduction
Conclusions
Article Information

ADHD indicates attention-deficit/hyperactivity disorder; CVD, cardiovascular disease.

a Controls were derived from the same base cohort as the cases; thus, a case with a later date of CVD diagnosis could potentially serve as a control for another case in the study.

Crude odds ratios (ORs) were based on cases and controls matched on age, sex, and calendar time. Adjusted ORs (AORs) were based on cases and controls matched on age, sex, and calendar time and adjusted for country of birth, educational level, somatic comorbidities (type 2 diabetes, obesity, dyslipidemia, and sleep disorders), and psychiatric comorbidities (anxiety disorders, autism spectrum disorder, bipolar disorder, conduct disorder, depressive disorder, eating disorders, intellectual disability, personality disorders, schizophrenia, and substance use disorders).

The solid lines represent the adjusted odds ratios, and the shaded areas represent the 95% CIs. In restricted cubic splines analysis, knots were placed at the 10th, 50th, and 90th percentiles of ADHD medication use.

eTable 1. International Classification of Diseases (ICD) Codes from the Swedish National Inpatient Register

eTable 2. Type of Cardiovascular Disease in Cases

eTable 3. Risk of CVD Associated With ADHD Medication Use Across Different Average Defined Daily Doses

eTable 4. Risk of CVD Associated With Cumulative Duration of Use of Different Types of ADHD Medications

eTable 5. Sensitivity Analyses of CVD Risk Associated With Cumulative Use of ADHD Medications, Based On Different Cohort, Exposure, and Outcome Definitions

eFigure. Risk of CVD Associated With Cumulative Use of ADHD Medications, Stratified by Sex

Data Sharing Statement

Long-Term ADHD Medications and Cardiovascular Disease Risk JAMA Medical News in Brief December 26, 2023 Emily Harris
Long-Term Cardiovascular Effects of Medications for ADHD—Balancing Benefits and Risks of Treatment JAMA Psychiatry Editorial February 1, 2024 Samuele Cortese, MD, PhD; Cristiano Fava, MD, PhD

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Zhang L , Li L , Andell P, et al. Attention-Deficit/Hyperactivity Disorder Medications and Long-Term Risk of Cardiovascular Diseases. JAMA Psychiatry. 2024;81(2):178–187. doi:10.1001/jamapsychiatry.2023.4294

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Attention-Deficit/Hyperactivity Disorder Medications and Long-Term Risk of Cardiovascular Diseases

1 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
2 Unit of Cardiology, Heart and Vascular Division, Department of Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
3 School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
4 Department of Applied Health Science, School of Public Health, Indiana University, Bloomington
5 Department of Psychological and Brain Sciences, Indiana University, Bloomington
Editorial Long-Term Cardiovascular Effects of Medications for ADHD—Balancing Benefits and Risks of Treatment Samuele Cortese, MD, PhD; Cristiano Fava, MD, PhD JAMA Psychiatry
Medical News in Brief Long-Term ADHD Medications and Cardiovascular Disease Risk Emily Harris JAMA

Question Is long-term use of attention-deficit/hyperactivity disorder (ADHD) medication associated with an increased risk of cardiovascular disease (CVD)?

Findings In this case-control study of 278 027 individuals in Sweden aged 6 to 64 years who had an incident ADHD diagnosis or ADHD medication dispensation, longer cumulative duration of ADHD medication use was associated with an increased risk of CVD, particularly hypertension and arterial disease, compared with nonuse.

Meaning Findings of this study suggest that long-term exposure to ADHD medications was associated with an increased risk of CVD; therefore, the potential risks and benefits of long-term ADHD medication use should be carefully weighed.

Importance Use of attention-deficit/hyperactivity disorder (ADHD) medications has increased substantially over the past decades. However, the potential risk of cardiovascular disease (CVD) associated with long-term ADHD medication use remains unclear.

Objective To assess the association between long-term use of ADHD medication and the risk of CVD.

Design, Setting, and Participants This case-control study included individuals in Sweden aged 6 to 64 years who received an incident diagnosis of ADHD or ADHD medication dispensation between January 1, 2007, and December 31, 2020. Data on ADHD and CVD diagnoses and ADHD medication dispensation were obtained from the Swedish National Inpatient Register and the Swedish Prescribed Drug Register, respectively. Cases included individuals with ADHD and an incident CVD diagnosis (ischemic heart diseases, cerebrovascular diseases, hypertension, heart failure, arrhythmias, thromboembolic disease, arterial disease, and other forms of heart disease). Incidence density sampling was used to match cases with up to 5 controls without CVD based on age, sex, and calendar time. Cases and controls had the same duration of follow-up.

Exposure Cumulative duration of ADHD medication use up to 14 years.

Main Outcomes and Measures The primary outcome was incident CVD. The association between CVD and cumulative duration of ADHD medication use was measured using adjusted odds ratios (AORs) with 95% CIs.

Results Of 278 027 individuals with ADHD aged 6 to 64 years, 10 388 with CVD were identified (median [IQR] age, 34.6 [20.0-45.7] years; 6154 males [59.2%]) and matched with 51 672 control participants without CVD (median [IQR] age, 34.6 [19.8-45.6] years; 30 601 males [59.2%]). Median (IQR) follow-up time in both groups was 4.1 (1.9-6.8) years. Longer cumulative duration of ADHD medication use was associated with an increased risk of CVD compared with nonuse (0 to ≤1 year: AOR, 0.99 [95% CI, 0.93-1.06]; 1 to ≤2 years: AOR, 1.09 [95% CI, 1.01-1.18]; 2 to ≤3 years: AOR, 1.15 [95% CI, 1.05-1.25]; 3 to ≤5 years: AOR, 1.27 [95% CI, 1.17-1.39]; and >5 years: AOR, 1.23 [95% CI, 1.12-1.36]). Longer cumulative ADHD medication use was associated with an increased risk of hypertension (eg, 3 to ≤5 years: AOR, 1.72 [95% CI, 1.51-1.97] and >5 years: AOR, 1.80 [95% CI, 1.55-2.08]) and arterial disease (eg, 3 to ≤5 years: AOR, 1.65 [95% CI, 1.11-2.45] and >5 years: AOR, 1.49 [95% CI, 0.96-2.32]). Across the 14-year follow-up, each 1-year increase of ADHD medication use was associated with a 4% increased risk of CVD (AOR, 1.04 [95% CI, 1.03-1.05]), with a larger increase in risk in the first 3 years of cumulative use (AOR, 1.08 [95% CI, 1.04-1.11]) and stable risk over the remaining follow-up. Similar patterns were observed in children and youth (aged <25 years) and adults (aged ≥25 years).

Conclusions and Relevance This case-control study found that long-term exposure to ADHD medications was associated with an increased risk of CVDs, especially hypertension and arterial disease. These findings highlight the importance of carefully weighing potential benefits and risks when making treatment decisions about long-term ADHD medication use. Clinicians should regularly and consistently monitor cardiovascular signs and symptoms throughout the course of treatment.

Attention-deficit/hyperactivity disorder (ADHD) is a common psychiatric disorder characterized by developmentally inappropriate inattentiveness, impulsivity, and hyperactivity. 1 , 2 Pharmacological therapy, including both stimulants and nonstimulants, is recommended as the first-line treatment for ADHD in many countries. 1 , 3 The use of ADHD medication has increased greatly in both children and adults during the past decades. 4 Although the effectiveness of ADHD medications has been demonstrated in randomized clinical trials (RCTs) and other studies, 5 , 6 concerns remain regarding their potential cardiovascular safety. 7 Meta-analyses of RCTs have reported increases in heart rate and blood pressure associated with both stimulant and nonstimulant ADHD medications. 5 , 7 - 9

As RCTs typically evaluate short-term effects (average treatment duration of 75 days), 7 it remains uncertain whether and to what extent the increases in blood pressure and heart rate associated with ADHD medication lead to clinically significant cardiovascular disease (CVD) over time. Longitudinal observational studies 10 - 12 examining the association between ADHD medication use and serious cardiovascular outcomes have emerged in recent years, but the findings have been mixed. A meta-analysis 13 of observational studies found no statistically significant association between ADHD medication and risk of CVD. However, the possibility of a modest risk increase cannot be ruled out due to several methodological limitations in these studies, including confounding by indication, immortal time bias, and prevalent user bias. Additionally, most of these studies had an average follow-up time of no more than 2 years. 13 , 14 Thus, evidence regarding the long-term cardiovascular risk of ADHD medication use is still lacking.

Examining the long-term cardiovascular risk associated with ADHD medicine use is clinically important given that individuals with a diagnosis of ADHD, regardless of whether they receive treatment, face an elevated risk of CVD. 15 Additionally, a substantial proportion of young individuals with ADHD continues to have impairing symptoms in adulthood, 16 necessitating prolonged use of ADHD medication. Notably, studies have indicated a rising trend in the long-term use of ADHD medications, with approximately half of individuals using ADHD medication for over 5 years. 17 Furthermore, evidence is lacking regarding how cardiovascular risk may vary based on factors such as type of CVD, type of ADHD medication, age, and sex. 13 Therefore, there is a need for long-term follow-up studies to address these knowledge gaps and provide a more comprehensive understanding of the cardiovascular risks associated with ADHD medication use. This information is also crucial from a public health perspective, particularly due to the increasing number of individuals receiving ADHD medications worldwide. 4

This study aimed to assess the association between cumulative use of ADHD medication up to 14 years and the risk of CVD by using nationwide health registers in Sweden. We hypothesized that longer cumulative use of ADHD medication would be associated with increased CVD risk. In addition, we aimed to examine whether the associations differ across types of ADHD medication, types of CVD, sex, and age groups.

We used data from several Swedish nationwide registers linked through unique personal identification numbers. 18 Diagnoses were obtained from the National Inpatient Register, 19 which contains data on inpatient diagnoses since 1973 and outpatient diagnoses since 2001. Information on prescribed medications was retrieved from the Swedish Prescribed Drug Register, which contains all dispensed medications in Sweden since July 2005 and includes information on drug identity based on the Anatomical Therapeutic Chemical (ATC) classification, 20 dispensing dates, and free-text medication prescriptions. Socioeconomic factors were obtained from the Longitudinal Integrated Database for Health Insurance and Labour Market studies. 21 Information on death was retrieved from the Swedish Cause of Death Register, 22 which contains information on all deaths since 1952. The study was approved by the Swedish Ethical Review Authority. Informed patient consent is not required for register-based studies in Sweden. The study followed the Reporting of Studies Conducted Using Observational Routinely Collected Health Data–Pharmacoepidemiological Research ( RECORD-PE ) guideline. 23

We conducted a nested case-control study of all individuals residing in Sweden aged 6 to 64 years who received an incident diagnosis of ADHD or ADHD medication dispensation 15 between January 1, 2007, and December 31, 2020. The diagnosis of ADHD ( International Statistical Classification of Diseases and Related Health Problems, Tenth Revision [ ICD-10 ] code F90) was identified from the National Inpatient Register. Incident ADHD medication dispensation was identified from the Swedish Prescribed Drug Register and was defined as a dispensation after at least 18 months without any ADHD medication dispensation. 24 Baseline (ie, cohort entry) was defined as the date of incident ADHD diagnosis or ADHD medication dispensation, whichever came first. Individuals with ADHD medication prescriptions for indications other than ADHD 25 and individuals who emigrated, died, or had a history of CVD before baseline were excluded from the study. The cohort was followed until the case index date (ie, the date of CVD diagnosis), death, migration, or the study end date (December 31, 2020), whichever came first.

Within the study cohort, we identified cases as individuals with an incident diagnosis of any CVD (including ischemic heart diseases, cerebrovascular diseases, hypertension, heart failure, arrhythmias, thromboembolic disease, arterial disease, and other forms of heart disease; eTable 1 in Supplement 1 ) during follow-up. For each case, the date of their CVD diagnosis was assigned as the index date. Using incidence density sampling, 26 up to 5 controls without CVD were randomly selected for each case from the base cohort of individuals with ADHD. The matching criteria included age, sex, and calendar time, ensuring that cases and controls had the same duration of follow-up from baseline to index date. Controls were eligible for inclusion if they were alive, living in Sweden, and free of CVD at the time when their matched case received a diagnosis of CVD, with the index date set as the date of CVD diagnosis of the matched case ( Figure 1 ). Controls were derived from the same base cohort as the cases. Thus, a case with a later date of CVD diagnosis could potentially serve as a control for another case in the study. 26

The main exposure was cumulative duration of ADHD medication use, which included all ADHD medications approved in Sweden during the study period, including stimulants (methylphenidate [ATC code N06BA04], amphetamine [ATC code N06BA01], dexamphetamine [ATC code N06BA02], and lisdexamfetamine [ATC code N06BA12]) as well as nonstimulants (atomoxetine [ATC code N06BA09] and guanfacine [ATC code C02AC02]). Duration of ADHD medication use was derived from a validated algorithm that estimates treatment duration from free text in prescription records. 25 The cumulative duration of ADHD medication use was calculated by summing all days covered by ADHD medication between baseline and 3 months prior to the index date. The last 3 months before the index date were excluded to reduce reverse causation, as clinicians’ perception of potential cardiovascular risks may influence ADHD medication prescription. This time window was chosen because routine psychiatric practice in Sweden limits a prescription to a maximum 3 months at a time. 27 Individuals with follow-up of less than 3 months were excluded.

We conducted conditional logistic regression analyses to estimate odds ratios (ORs) for the associations between cumulative durations of ADHD medication use and incident CVD. Crude ORs were adjusted for all matching variables (age, sex, and calendar time) by design. Adjusted ORs (AORs) were additionally controlled for country of birth (Sweden vs other), highest educational level (primary or lower secondary, upper secondary, postsecondary or postgraduate, or unknown; individuals aged <16 years were included as a separate category), and diagnoses of somatic (type 2 diabetes, obesity, dyslipidemia, and sleep disorders) and psychiatric comorbidities (anxiety disorders, autism spectrum disorder, bipolar disorder, conduct disorder, depressive disorder, eating disorders, intellectual disability, personality disorders, schizophrenia, and substance use disorders; eTable 1 in Supplement 1 ) before baseline. The association between cumulative ADHD medication use and incident CVD was assessed using both continuous and categorical measures (no ADHD medication use, 0 to ≤1, 1 to ≤2, 2 to ≤3, 3 to ≤5, and >5 years). To capture potential nonlinear associations, we used restricted cubic splines to examine ADHD medication use as a continuous measure throughout follow-up. 28 The associations were examined in the full sample and stratified by age at baseline, that is, children or youth (<25 years old) and adults (≥25 years old). Furthermore, to evaluate the association with dosage of ADHD medication, we estimated the risk of CVD associated with each 1-year increase in use of ADHD medication across different dosage groups categorized by the average defined daily dose (DDD; for instance, 1 DDD of methylphenidate equals 30 mg) during follow-up. 29

In subgroup analyses, we examined the associations between ADHD medication use and specific CVDs, including arrhythmias, arterial disease, cerebrovascular disease, heart failure, hypertension, ischemic heart disease, and thromboembolic disease (eTable 1 in Supplement 1 ). Additionally, we investigated the associations with CVD risk for the most commonly prescribed ADHD medications in Sweden, ie, methylphenidate, lisdexamfetamine, and atomoxetine, while adjusting for other ADHD medication use. We also examined sex-specific associations.

To further examine the robustness of our findings, we conducted 4 sensitivity analyses. First, we restricted the sample to ever users of ADHD medication to reduce unmeasured confounding between ADHD medication users and nonusers. Second, we assessed ADHD medication exposure over the entire follow-up period without excluding the 3 months prior to the index date. Third, to capture fatal cardiovascular events, we additionally included death by CVD in the outcome definition. Finally, we constructed a conditional logistic regression model that adjusted for propensity scores of ADHD medication use. Data management was performed using SAS, version 9.4 (SAS Institute Inc) and all analyses were performed using R, version 4.2.3 (R Foundation for Statistical Computing).

The study cohort consisted of 278 027 individuals with ADHD aged 6 to 64 years. The incidence rate of CVD was 7.34 per 1000 person-years. After applying exclusion criteria and matching, the analysis included 10 388 cases (median [IQR] age at baseline, 34.6 (20.0-45.7) years; 6154 males [59.2%] and 4234 females [40.8%]) and 51 672 matched controls (median [IQR] age at baseline, 34.6 [19.8-45.6] years; 30 601 males [59.2%] and 21 071 females [40.8%]) ( Figure 1 and Table 1 ). Median (IQR) follow-up in both groups was 4.1 (1.9-6.8) years. Among the controls, 3363 had received a CVD diagnosis after their index dates. The most common types of CVD in cases were hypertension (4210 cases [40.5%]) and arrhythmias (1310 cases [12.6%]; eTable 2 in Supplement 1 ). Table 1 presents the sociodemographic information and somatic and psychiatric comorbidities in cases and controls. In general, cases had higher rates of somatic and psychiatric comorbidities and a lower level of educational attainment compared with controls.

A similar proportion of cases (83.9%) and controls (83.5%) used ADHD medication during follow-up, with methylphenidate being the most commonly dispensed type, followed by atomoxetine and lisdexamfetamine. Longer cumulative duration of ADHD medication use was associated with an increased risk of CVD compared with nonuse (0 to ≤1 year: AOR, 0.99 [95% CI, 0.93-1.06]; 1 to ≤2 years: AOR, 1.09 [95% CI, 1.01-1.18]; 2 to ≤3 years: AOR, 1.15 [95% CI, 1.05-1.25]; 3 to ≤5 years: AOR, 1.27 [95% CI, 1.17-1.39]; and >5 years: AOR, 1.23 [95% CI, 1.12-1.36]) ( Figure 2 ). The restricted cubic spline model suggested a nonlinear association, with the AORs increasing rapidly for the first 3 cumulative years of ADHD medication use and then becoming stable thereafter ( Figure 3 ). Throughout the entire follow-up, each 1-year increase in the use of ADHD medication was associated with a 4% increased risk of CVD (AOR, 1.04 [95% CI, 1.03-1.05]), and the corresponding increase for the first 3 years was 8% (AOR, 1.08 [95% CI, 1.04-1.11]). We observed similar results when examining children or youth and adults separately ( Figure 2 ). The restricted cubic spline model suggested a similar nonlinear association, with higher AORs in children or youth than in adults, but the 95% CIs largely overlapped ( Figure 3 ). Furthermore, similar associations were observed for females and males (eFigure in Supplement 1 ). The dosage analysis showed that the risk of CVD associated with each 1 year of ADHD medication use increased with higher average DDDs. The risk was found to be statistically significant only among individuals with a mean dose of at least 1.5 times the DDD (eTable 3 in Supplement 1 ). For example, among individuals with a mean DDD of 1.5 to 2 or less (eg, for methylphenidate, 45 to ≤60 mg), each 1-year increase in ADHD medication use was associated with a 4% increased risk of CVD (AOR, 1.04 [95% CI, 1.02-1.05]). Among individuals with a mean DDD >2 (eg, for methylphenidate >60 mg), each 1-year increase in ADHD medication use was associated with 5% increased risk of CVD (AOR, 1.05 [95% CI, 1.03-1.06]).

When examining the risk for specific CVDs, we found that long-term use of ADHD medication (compared with no use) was associated with an increased risk of hypertension (AOR, 1.72 [95% CI, 1.51-1.97] for 3 to ≤5 years; AOR, 1.80 [95% CI 1.55-2.08] for >5 years) ( Table 2 ), as well as arterial disease (AOR, 1.65 [95% CI, 1.11-2.45] for 3 to ≤5 years; AOR, 1.49 [95% CI 0.96-2.32] for >5 years). However, we did not observe any statistically significant increased risk for arrhythmias, heart failure, ischemic heart disease, thromboembolic disease, or cerebrovascular disease ( Table 2 ). Furthermore, long-term use of methylphenidate (compared with no use) was associated with an increased risk of CVD (AOR, 1.20 [95% CI, 1.10-1.31] for 3 to ≤5 years; AOR, 1.19 [95% CI, 1.08-1.31]) for >5 years; eTable 4 in Supplement 1 ). Compared with no use, lisdexamfetamine was also associated with an elevated risk of CVD (AOR, 1.23 [95% CI, 1.05-1.44] for 2 to ≤3 years; AOR, 1.17 [95% CI, 0.98-1.40] for >3 years), while the AOR for atomoxetine use was significant only for the first year of use (1.07 [95% CI 1.01-1.13]; eTable 4 in Supplement 1 ).

In sensitivity analyses, we observed a similar pattern of estimates when the analysis was restricted to ever users of ADHD medications. Significantly increased risk of CVD was found when comparing ADHD medication use for 1 year or less with use for 3 to 5 or less years (AOR, 1.28 (95% CI, 1.18-1.38) or for use for more than 5 years (AOR, 1.24 [95% CI, 1.13-1.36]) (eTable 5 in Supplement 1 ). When assessing ADHD medication use across the entire follow-up period, and compared with no use, the pattern of estimates was similar to the main analysis (3 to ≤5 years: AOR, 1.28 [95% CI, 1.18-1.39]; >5 years: AOR, 1.25 [95% CI, 1.14-1.37]) (eTable 5 in Supplement 1 ). The analysis that included cardiovascular death as a combined outcome also had results similar to the main analysis. Moreover, when adjusting for propensity scores of ADHD medication use, the findings remained consistent (eTable 5 in Supplement 1 ).

This large, nested case-control study found an increased risk of incident CVD associated with long-term ADHD medication use, and the risk increased with increasing duration of ADHD medication use. This association was statistically significant both for children and youth and for adults, as well as for females and males. The primary contributors to the association between long-term ADHD medication use and CVD risk was an increased risk of hypertension and arterial disease. Increased risk was also associated with stimulant medication use.

We found individuals with long-term ADHD medication use had an increased risk of incident CVD in a dose-response manner in the first 3 years of cumulative ADHD medication use. To our knowledge, few previous studies have investigated the association between long-term ADHD medication use and the risk of CVD with follow-up of more than 2 years. 13 The only 2 prior studies with long-term follow-up (median, 9.5 and 7.9 years 30 , 31 ) found an average 2-fold and 3-fold increased risk of CVD with ADHD medication use compared with nonuse during the study period, yet 1 of the studies 30 included only children, and participants in the other study 31 were not the general population of individuals with ADHD (including those with ADHD and long QT syndrome). Furthermore, both studies were subject to prevalent user bias. Results from the current study suggest that the CVD risk associated with ADHD medication use (23% increased risk for >5 years of ADHD medication use compared with nonuse) is lower than previously reported. 30 , 31 Furthermore, we observed that the increased risk stabilized after the first several years of medication use and persisted throughout the 14-year follow-up period.

The association between ADHD medication use and CVD was significant for hypertension and arterial disease, while no significant association was observed with other types of cardiovascular events. To our knowledge, only 1 previous study 12 has examined the association between ADHD medication use and clinically diagnosed hypertension, and it found an increased risk, although the increase was not statistically significant. Furthermore, increased blood pressure associated with ADHD medication use has been well documented. 7 , 9 One study 32 found that blood pressure was mainly elevated during the daytime, suggesting that the cardiovascular system may recover at night. However, the cross-sectional nature of that study cannot preclude a long-term risk of clinically diagnosed hypertension associated with ADHD medication use. We also identified an increased risk for arterial disease. To date, no previous study has explored the association between ADHD medication use and arterial disease. A few studies have reported that ADHD medication may be associated with changes in serum lipid profiles, but the results were not consistent. 33 , 34 Further research is needed on the potential implications of ADHD medications for individuals’ lipid profiles. We did not observe any association between ADHD medication use and the risk of arrhythmias. A recent systematic review of observational studies of ADHD medication use reported an elevated risk of arrhythmias, but the finding was not statistically significant. 13 A review of RCTs also found that the use of stimulants was associated with an average increase in heart rate of 5.7 beats/min, 9 but no evidence of prolonged QT interval or tachycardia was found based on electrocardiograms. 7 Additionally, it is worth noting that some individuals receiving ADHD medications might be prescribed antiarrhythmic β-blockers to alleviate palpitation symptoms, thus potentially attenuating an association between ADHD medications and arrhythmias. Nevertheless, the absence of an association between ADHD medication use and clinically diagnosed arrhythmias in the present study does not rule out an increased risk for mild arrhythmias or subclinical symptoms, as palpitations and sinus tachycardia are not routinely coded as arrhythmia diagnoses. Further research is necessary to replicate our findings.

Regarding types of ADHD medication, findings of the present study suggest that increasing cumulative durations of methylphenidate and lisdexamfetamine use were associated with incident CVD, while the associations for atomoxetine were statistically significant only for the first year of use. Previous RCTs have reported increased blood pressure and heart rate with methylphenidate, lisdexamfetamine, and atomoxetine, 5 , 35 , 36 but the mechanisms behind these adverse effects are still a topic of debate; there might be differences in cardiovascular adverse effects in stimulants vs nonstimulants. 37

We found that the association between cumulative duration of ADHD medication use and CVD was similar in females and males. Previous investigations exploring sex-specific association found higher point estimates in females, although the differences were not statistically significant. 13 Research has indicated that females diagnosed with ADHD may demonstrate different comorbidity patterns and potentially have different responses to stimulant medications compared with males. 38 - 40 Therefore, additional studies are needed to explore and better understand the potential sex-specific differences in cardiovascular responses to ADHD medications.

A strength of this study is that data on ADHD medication prescriptions and CVD diagnoses were recorded prospectively, so the results were not affected by recall bias. The findings should, however, be interpreted in the context of several limitations. First, our approach for identification of patients with CVD was based on recorded diagnoses and there could be under ascertainment of cardiovascular diagnoses in the registers used. This means that some controls may have had undiagnosed CVD that did not yet require medical care, which would tend to underestimate associations between ADHD medication use and CVD. Second, exposure misclassification may have occurred if patients did not take their medication as prescribed. This misclassification, if nondifferential, would tend to reduce ORs such that the estimates we observed were conservative. Third, while we accounted for a wide range of potential confounding variables, considering the observational nature of the study and the possibility of residual confounding, we could not prove causality. It is possible that the association observed might have been affected by time-varying confounders. For example, other psychotropic medications and lifestyle factors could have affected both ADHD medication use and the occurrence of cardiovascular events. 41 , 42 Confounding by ADHD severity is also a potential factor to consider, as individuals with more severe ADHD symptoms may have more comorbidities and a less healthy lifestyle, which could affect the risk of CVD. Fourth, the study did not examine the risk of CVD among individuals with preexisting CVD. Individuals with preexisting CVD represent a distinct clinical group that requires careful monitoring; thus, evaluating the risk among them necessitates a different study design that carefully considers the potential impact of prior knowledge and periodic monitoring. Finally, the results by type of ADHD medication and type of CVD need to be replicated by studies with larger sample sizes.

The results of this population-based case-control study with a longitudinal follow-up of 14 years suggested that long-term use of ADHD medication was associated with an increased risk of CVD, especially hypertension and arterial disease, and the risk was higher for stimulant medications. These findings highlight the importance of carefully weighing potential benefits and risks when making treatment decisions on long-term ADHD medication use. Clinicians should be vigilant in monitoring patients, particularly among those receiving higher doses, and consistently assess signs and symptoms of CVD throughout the course of treatment. Monitoring becomes even more crucial considering the increasing number of individuals engaging in long-term use of ADHD medication.

Accepted for Publication: August 29, 2023.

Published Online: November 22, 2023. doi:10.1001/jamapsychiatry.2023.4294

Corresponding Authors: Zheng Chang, PhD ( [email protected] ) and Le Zhang, PhD ( [email protected] ), Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, 171 65 Stockholm, Sweden.

Author Contributions: Dr Zhang and Prof Chang had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Zhang, Johnell, Larsson, Chang.

Acquisition, analysis, or interpretation of data: Zhang, Li, Andell, Garcia-Argibay, Quinn, D'Onofrio, Brikell, Kuja-Halkola, Lichtenstein, Johnell, Chang.

Drafting of the manuscript: Zhang.

Critical review of the manuscript for important intellectual content: All authors.

Statistical analysis: Zhang, Li.

Obtained funding: Larsson, Chang.

Administrative, technical, or material support: Garcia-Argibay, D'Onofrio, Kuja-Halkola, Lichtenstein, Chang.

Supervision: Andell, Lichtenstein, Johnell, Larsson, Chang.

Conflict of Interest Disclosures: Dr Larsson reported receiving grants from Takeda Pharmaceuticals and personal fees from Takeda Pharmaceuticals, Evolan, and Medici Medical Ltd outside the submitted work. No other disclosures were reported.

Funding/Support: This study was supported by grants from the Swedish Research Council for Health, Working Life, and Welfare (2019-01172 and 2022-01111) (Dr Chang) and the European Union’s Horizon 2020 research and innovation program under grant agreement 965381 (Dr Larsson).

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Data Sharing Statement: See Supplement 2 .

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CDK Global calls cyberattack that crippled its software platform a "ransom event"

By Megan Cerullo

Edited By Anne Marie Lee

Updated on: June 25, 2024 / 9:06 AM EDT / CBS News

CDK Global is now calling the cyberattack that took down its software platform for its auto dealership clients "a ransom event."

In a note to clients Saturday, CDK for the first time acknowledged that the hackers that made its dealer management system, or DMS, unavailable to clients for days , are demanding a ransom to restore its systems.

"Thank you for your patience as we recover from the cyber ransom event that occurred on June 19th," CDK said in a memo to clients on Saturday, according to a copy of the email obtained by CBS MoneyWatch .

CDK added in the note that it has started restoring its systems and expects the process of bringing major applications back online "to take several days and not weeks."

Beware of phishing

In its memo, the company also warned car dealerships to be alert to phishing scams, or entities posing as CDK but who are in fact bad actors trying to obtain proprietary information like customers' passwords.

A CDK spokesperson told CBS MoneyWatch that it is providing customers "with alternate ways to conduct business" while its systems remain inoperative.

The cybercriminals behind the CDK attack are linked to a group called BlackSuit, Bloomberg reported on Monday, citing Allan Liska of computer security firm Recorded Future. In a June 21 story , the media outlet also said the hackers were demanding tens of millions of dollars and that CDK planned to pay the ransom.

Liska didn't immediately respond to a request for comment. CDK itself hasn't pointed to any group behind the attack on its system that has disrupted car dealerships across the U.S. since last week. Companies targeted in ransomware schemes are often reluctant to disclose information in the midst of negotiations with hackers on a payment.

"When you see an attack of this kind, it almost always ends up being a ransomware attack," Cliff Steinhauer, director of information security and engagement at the National Cybersecurity Alliance, told the Associated Press. "We see it time and time again unfortunately, [particularly in] the last couple of years. No industry and no organization or software company is immune."

"Doing everything manually"

The hack has left some car dealers unable to do business altogether, while others report using pen and paper, and even "sticky notes" to record transactions.

Tom Maoli, owner of Celebrity Motor Car Company, which operates five luxury car dealerships across New York and New Jersey, on Monday told CBS MoneyWatch his employees "are doing everything manually."

"We are trying to keep our customers happy and the biggest issue is the banking side of things, which is completely backed up. We can't fund deals," he said.

Asbury Automotive Group, a Fortune 500 company operating more than 150 new car dealerships across the U.S., in a statement on Monday said the attack has "adversely impacted" its operations and has hindered its ability to do business. Its Koons Automotive dealerships in Maryland and Virginia, however, which don't rely on CDK's software, have been able to operate without interruption, the company said.

Ransomware attacks are on the rise. In 2023, more than 2,200 entities, including U.S. hospitals, schools and governments were directly impacted by ransomware, according to Emisoft , an anti-malware software company. Additionally, thousands of private sector companies were targeted. Some experts believe that the only way to stop such attacks is to ban the payment of ransoms, which Emisoft said would lead bad actors to "quickly pivot and move from high impact encryption-based attacks to other less disruptive forms of cybercrime."

Earlier this year, the U.S. Department of State offered $10 million in exchange for the identities of leaders of the Hive ransomware gang, which since 2021 has been responsible for attacks on more than 1,500 institutions in over 80 countries, resulting in the theft of more than $100 million.

Cybersecurity and Infrastructure Security Agency
Cyberattack

Megan Cerullo is a New York-based reporter for CBS MoneyWatch covering small business, workplace, health care, consumer spending and personal finance topics. She regularly appears on CBS News 24/7 to discuss her reporting.

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Things to know about the gender-affirming care case as the Supreme Court prepares to weigh in

FILE - A flag supporting LGBTQ+ rights decorates a desk on the Democratic side of the Kansas House of Representatives during a debate, March 28, 2023, at the Statehouse in Topeka, Kan. The U.S. Supreme Court agreed Monday to consider whether a Tennessee ban on gender-affirming care for minors is constitutional. (AP Photo/John Hanna, File)

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The U.S. Supreme Court said Monday that it will hear arguments on the constitutionality of state bans on gender-affirming care for transgender minors.

The issue has emerged as a big one in the past few years. While transgender people have gained more visibility and acceptance in many respects, half the states have pushed back with laws banning certain health care services for transgender kids.

Things to know about the issue:

What is gender-affirming care?

Gender-affirming care includes a range of medical and mental health services to support a person’s gender identity, including when it’s different from the sex they were assigned at birth.

The services are offered to treat gender dysphoria, the unease a person may have because their assigned gender and gender identity don’t match. The condition has been linked to depression and suicidal thoughts.

Gender-affirming care encompasses counseling and treatment with medications that block puberty, and hormone therapy to produce physical changes. Those for transgender men cause periods to stop, increase facial and body hair, and deepen voices, among others. The hormones used by transgender women can have effects such as slowing growth of body and facial hair and increasing breast growth.

Gender-affirming care can also include surgery, including operations to transform genitals and chests. These surgeries are rarely offered to minors .

What laws are states passing?

Over the past three years, 26 Republican-controlled states have passed laws restricting gender-affirming care for minors. Most of the laws ban puberty blockers, hormone treatment and surgery for those under 18. Some include provisions that allow those already receiving treatment to continue.

The laws also make exceptions for gender-affirming treatments that are not part of a gender transition, such as medications to stop breast growth in boys and excessive facial hair in girls.

One of the laws — in Arkansas — was nixed by a federal court and is not being enforced.

Meanwhile, at least 14 Democratic-controlled states have adopted laws intended to protect access to gender-affirming care.

The gender-affirming care legislation is a major part of a broader set of laws and policies that has emerged in Republican-controlled states that rein in rights of transgender people. Other policies, adopted in the name of protecting women and girls, bar transgender people from school bathrooms and sports competitions that align with their gender.

What have courts said so far?

Most of the bans have faced court challenges, and most are not very far along in the legal pipeline yet.

The law in Arkansas is the only one to have been struck down entirely, but the state has asked a federal appeals court to reverse that ruling.

The 6th U.S. Circuit Court of Appeals, one step below the Supreme Court, last year ruled that Kentucky and Tennessee can continue to enforce their bans amid legal challenges. The high court has agreed to hear the Tennessee case in the term that starts later this year.

The U.S. Supreme Court in April ruled that Idaho can enforce its ban while litigation over it proceeds. A lower court had put it on hold.

What does the medical community think?

Every major U.S. medical group, including the American Academy of Pediatrics and the American Medical Association, has opposed the bans and said that gender-affirming treatments can be medically necessary and are supported by evidence.

But around the world, medical experts and government health officials are not in lockstep. Some European countries in recent years have warned about overdiagnosis of gender dysphoria.

In England, the state-funded National Health Service commissioned a review of gender identity services for children and adolescents, appointing retired pediatrician Dr. Hilary Cass to lead the effort. The final version of the Cass Review , published in April, found “no good evidence on the long-term outcomes of interventions to manage gender-related distress.”

England’s health service stopped prescribing puberty blockers to children with gender dysphoria outside of a research setting, following recommendations from Cass’ interim report.

The World Professional Association for Transgender Health and its U.S. affiliate issued a statement in May saying they’re deeply concerned about the process, content and consequences of the review, saying it “deprives young trans and gender diverse people of the high-quality care they deserve and causes immense distress and harm to both young patients and their families.”

blue and orange image of the Capitol building with text "Project 2025"

Research/Study Research/Study

Inside Project 2025's attack on reproductive rights: IVF

Special Programs Abortion Rights & Reproductive Health

Written by Sophie Lawton , Jacina Hollins-Borges & John Knefel

Published 06/24/24 1:30 PM EDT

At least 22 partner organizations of Project 2025, a coalition of over 100 conservative groups looking to staff the next potential administration of former President Donald Trump, have publicly criticized in vitro fertilization, according to a Media Matters review.

Project 2025 is organized by conservative think tank The Heritage Foundation, and has laid out a radical plan for governance during a second Trump term. The initiative's wide-ranging policy proposals are laid out in its “ Mandate for Leadership ,” a staunchly anti-choice document. Although the Mandate itself doesn’t mention IVF, Heritage has published several pieces opposing the procedure and celebrated a ruling by the Alabama Supreme Court that extended de facto personhood rights to frozen embryos, severely curtailing access to IVF. After abrupt political backlash , Alabama’s governor passed a law protecting IVF providers from legal liability, which some Project 2025 partner organizations have criticized for rendering the original “fetal personhood” ruling moot.

The organizations and individuals associated with Project 2025 who oppose IVF have raised various objections, none of which are scientifically or medically sound. Some opponents, for example, have elided the difference between the legal definition of “viable” — like that used by Louisiana, which has the most restrictive anti-IVF laws in the country — and the medical definition. Louisiana allows IVF but prohibits the destruction of embryos, forcing fertility clinics to ship them to other states for storage. These organizations will often point out that despite this law, Louisiana has more babies born through IVF than Alabama, though they fail to mention that both states have some of the lowest rates of IVF births in the country.

Similarly, some partner organizations have suggested following European countries' leads in regulating IVF, several of them naming Italy as a suitable example. Italy once had laws classifying embryos as living people and severely regulating IVF procedures; all of them were repealed after IVF became more difficult to access and less likely to succeed.

Other Project 2025 associates have argued that IVF is a form of eugenics or that it will lead to cloning or extreme forms of genetic modification and experimentation. Still others have baselessly claimed that IVF is underregulated, ignoring the multiple federal and state guidelines and licensing requirements that providers must meet.

For the full report on Project 2025's attack on reproductive rights, click here .

Select a Partner Organization

The heritage foundation, alabama policy institute, alliance defending freedom, the american conservative, american family association, american principles project, americans united for life, amac action, california family council, concerned women for america, discovery institute, eagle forum, ethics and public policy center, family policy alliance, family research council, independent women’s forum, dr. james dobson family institute, liberty university, media research center, mississippi center for public policy, students for life of america, susan b. anthony pro-life america, turning point usa.

In a post to X, The Heritage Foundation appeared to express support for the Alabama IVF ruling, writing, “FACT: The Alabama Supreme Court decision does not threaten access to IVF,” and claiming that the decision “reassures parents” that frozen embryos will be safer. [Twitter/X, 3/7/24 ]
Senior legal fellow Thomas Jipping wrote that the Alabama Supreme Court ruling on embryos that imperiled IVF “got it right” and further suggested that abortion should not be legal. Jipping also denied the ruling is “an attack on IVF technology itself ... or could have revolutionary ripple effects,” belittling “the media, politicians, and activists” who discussed the ruling’s consequences. He concluded that while this case was about destroyed embryos, “causing the death of an unborn child by abortion is legal [in] more than half of the United States.” [The Heritage Foundation, 4/2/24 ]

The Heritage Foundation's Emma Waters has written extensively against assisted reproductive technologies, particularly IVF and surrogacy. Her opposition draws on unsubstantiated concerns about possible harms to children who lack access to both biological parents and on biblical teaching about proper procreation. [Media Matters, 3/1/24 , 4/2/24 ]

In a March article titled “Why the IVF Industry Must Be Regulated,” Waters laid out policy recommendations that would impose heavy medical restrictions on IVF and make the procedure more difficult for couples to access and harder for facilities to perform. [Media Matters, 3/19/24 ]

In an article describing her biblical reasoning for not supporting IVF, Waters argued that it is important for Protestants specifically to “take a firm and authoritative stance on reproductive technology” because “Protestants necessarily hold a central place in America’s political and institutional life.” [The Heritage Foundation, 1/24/24 ]

Waters celebrated the Alabama Supreme Court ruling on IVF, calling it “an unqualified victory” and claiming “parents should be grateful that their embryos will receive greater protection.” In another piece on the ruling, Waters suggested states adopt stricter laws around IVF procedures, like those that exist in some European countries. [The Heritage Foundation, 2/27/24 , 2/28/24 ]

In a 2023 article, Waters complained about a California bill that would allow single parents or same-sex couples to access IVF through their health care service plans, stating, “No amount of technology or health insurance coverage can alter God’s created order.” She also claimed that allowing more widespread use of IVF procedures would create a “human trafficking market.” [The Heritage Foundation, 6/20/23 ]

Waters repeated her complaints about LGBTQ couples using IVF and other assisted reproductive technologies in another article titled “Radical ‘Right to Build Families Act’ Would Unleash IVF and Commercial Surrogacy.” In the article, Waters claimed that “the pro-abortion and the LGBTQ coalitions” are pushing assisted reproductive technologies, writing that both coalitions “have been quite hostile to the rights of children and the unborn.” [The Heritage Foundation, 1/13/23 ]

In an interview with the Family Policy Alliance, Alabama Policy Institute president and CEO Stephanie Smith claimed, “The Alabama Supreme Court ruled — correctly, in our opinion — that those embryos were children and should be treated as children under our wrongful death statutes.” Referencing Louisiana’s strict IVF laws, she went on to suggest new parameters that would make the treatment more difficult to receive. [YouTube, 2/29/24, 2/29/24 ]

API released a joint statement with Susan B. Anthony Pro-Life America criticizing Alabama’s stop-gap measure to protect providers of IVF from criminal charges. The statement said, “It is unacceptable the Alabama Legislature has advanced a bill that falls short of pro-life expectations and fails to respect the dignity of human life.” [The New York Times, 2/28/24 ]

In an article titled, “In IVF case, Alabama Supreme Court protects life from conception,” Alliance Defending Freedom senior counsel Denise Burke claimed the Alabama ruling was “a victory for life and the rights of parents.” Burke argued, “Cases like this one demonstrate that being pro-life entails more than just protecting unborn children from abortion.” [Alliance Defending Freedom, 3/18/24 ]

In a statement, Burke called the Alabama ruling “a tremendous victory” for “unborn children created through assisted reproductive technology.” [The New York Times, 2/22/24 ]

An article in the American Conservative by contributor Carmel Richardson claimed IVF is helping the “LGBT movement” distort the meaning of family. Richardson wrote, “To limit the baby-making industry is to give hard answers to those who would like a chicken in every pot and a baby in every lesbian, gay, bisexual, and transgender arm.” Richardson later disparaged IVF for allowing even a “transgender pedophile” to have a child. [The American Conservative, 3/1/24 ]

Contributor Christopher Brunet argued in a piece titled, “A personal IVF story” that he “should be allowed to condemn IVF” because “while one may born as the result of a rape, for example, it does not mean that they can’t condemn rape.” Brunet called IVF “the hope and despair of professional women in middle management” and “propaganda against nature, persuading a generation of collegiate women that they're not losing fertility every day after they turn 20.” Brunet also admonished Republicans for caving to pressure to support IVF, writing, “Just as there is now no going back on IVF, there is also no going back on gay marriage, civil rights, demographic replacement.” [The American Conservative, 2/28/24 ]

Them Before Us President Katy Faust published a story in The American Conservative titled “Alabama sets the stage for a Supreme Court fight over IVF,” in which she praised the Alabama ruling and claimed Louisiana has similar guidelines about embryos. Faust claimed these laws “protect children from their rampant destruction at the hands of #BigFertility” and called on conservatives to “not only challenge the baby-taking industry, but the baby-making industry.” [The American Conservative, 2/24/24 ]

In a call to action against Mississippi’s “anti-life” bill HB 1688, American Family Association claimed the bill would grant an “unrestricted right to destroy unborn children” through procedures such as IVF. The organization called it a “very bad amendment” and asked readers to contact their local lawmakers about the bill. HB 1688 would protect the right to assisted reproductive procedures in Mississippi. [American Family Association, 3/8/24 ; Mississippi Today, 3/7/24 ]

In a second call to action against Mississippi’s HB 1688, AFA Vice President Walker Wildmon stated that the bill “creates an unrestricted right to destroy unborn children as part of very broadly defined ‘treatments or procedures.’” [American Family Association, 3/11/24 ]

On his podcast At The Core , Wildmon claimed, “The ruling in Alabama had to do with wasting embryos, or dumping embryos or discarding” and went on to state “eyes are being opened to how much of a disregard as a culture we’ve had for babies with this IVF discussion.” [American Family Radio, At The Core , 2/28/24 ]

In a Facebook live panel hosted by AFA about the Alabama IVF ruling, Wildmon claimed, “An embryo is a baby,” and stated, “IVF is not being threatened here.” [Facebook, American Family Association Action, 3/1/24 ]

American Principles Project President Terry Schilling tweeted about IVF: “If America isn’t careful, we could actually create a government backed institution of buying and selling human beings. Which, I thought, we decided long ago was wrong.” American Principles Project previously tweeted a statement by Schilling where he told Republicans to “come up with reasonable policy” and that “they should come up with what they actually believe and support and stand for.” [Twitter/X, 3/7/24 , 2/27/24 ]

In a February statement posted to its website, Americans United for Life praised Sen. Cindy Hyde-Smith (R-MS) for blocking legislation that would protect the right to reproductive treatments. The statement claimed that “embryonic children are typically treated as property rather than persons” and that there is a “near-total lack of patient health and safety regulations and meaningful regulatory oversight” in the IVF industry. [Americans United for Life, 2/28/24 ]

Chief legal counsel for AUL Steve Aden spoke with The Washington Post, criticizing Trump’s statement about IVF treatments and stating that “the ethical approach to IVF is to ensure that human lives are not wantonly created and destroyed in the process.” The Post also highlights the “model legislation to limit the number of embryos created per IVF cycle” that AUL previously drafted. [The Washington Post, 2/24/24 ]

In 2022, Aden compared IVF treatments to “eugenics,” telling The Guardian he considers “most” kinds of IVF “untenable in a culture that respects all human life.” [The Guardian, 5/12/22 ]

In a piece on the Association of Mature American Citizens Action website, author John Moor suggested giving the Alabama Supreme Court credit for “having the courage” to make the ruling limiting IVF. He went on to compare a “preborn child” to people who “fall under a government protected characteristic,” claiming the government protects individuals from discrimination “based on age, mental capacity and appearance like skin color” and therefore should protect embryos as well. [AMAC Action, 3/18/24 ]

On Instagram, the California Family Council claimed, “By the numbers the IVF Industry is responsible for the loss of more embryonic life every year than the abortion industry.” [Instagram, 3/6/24 ]

In a statement on its website, the CFC claimed there are “grave moral concerns inherent to IVF,” and, “We cannot ignore the plight of our embryonic brothers and sisters.” The statement heavily doubled down on the idea that embryos are humans and advocated for the adoption of laws like those regulating IVF in Louisiana and countries like Germany, Italy, France, Poland, New Zealand, and Australia. [California Family Council, 3/8/24 ]

In 2023, CFC attacked a California bill it claimed “would require employers to provide insurance plans that cover all nonexperimental fertility treatments, including … for a surrogate hired by any couple or single person.” The CFC statement criticized the bill for expanding fertility treatments to include LGBTQ families, stating, “Children have the natural right to their biological father and mother, and they suffer tremendously in every area of life when this right is infringed upon.” [California Family Council, 6/19/23 ]

Valerie Bynog, a legislative strategist for Concerned Women for America Legislative Action Committee, wrote in a blog on the organization’s website, “An embryo … is a living being.” Bynog criticized the American IVF industry for not having laws like “many European countries” that have “common sense regulations” around IVF. [Concerned Women for America, 2/29/24 ]

Discovery Institute Chair and Senior Fellow Wesley J. Smith wrote in 2017 that IVF is lacking the “moralistic restriction” of only being used by infertile married couples, and referred to the treatment as “positive eugenics.” [Discovery Institute, 10/27/17 ]

Smith previously wrote in 2013 that IVF opens the door for “polyamorous threesomes or lesbian couples” to have children and claimed it must be stopped. He also claimed, “We already know that children born via IVF have poorer health outcomes than children conceived naturally,” and compared IVF treatments to cloning animals. [Discovery Institute, 9/26/13 ]

In a statement on its website, Eagle Forum claimed, “Other states and countries are performing IVF in ethical ways,” referencing Louisiana and European countries, and claimed Louisiana’s IVF regulations “clearly haven’t deterred fertility clinics.” The statement attacked Sen. Tammy Duckworth’s (D-IL) Access to Family Building Act, saying it expands reproductive protections too widely to include “not only IVF, but cloning, gene editing, experimentation on embryos, commercial surrogacy, ‘designer babies’, and more,” and that it removes “religious conscience protections” around IVF. [Eagle Forum, 2/29/24 ]

Appearing as a guest on a Facebook live panel hosted by the American Family Association, Eagle Forum executive director Becky Gerritson claimed the Alabama ruling “did not stop IVF, it did not regulate IVF” and told the panel that Eagle Forum is “promoting and pushing” more regulation of the IVF industry. [Facebook, American Family Association Action, 3/1/24 ]

The Ethics and Public Policy Center published a piece on its website by fellow Patrick Brown in which he claimed that Republicans are making “a mistake” by criticizing the Alabama ruling and called for Republicans to refuse “broad progressive legislation that would make access to IVF an ‘individual right.’” Brown pushed back on calls for IVF to be an individual right, claiming that it has “weakened” the “family as an institution,” and suggested policy that would cover IVF for only “legally married couples using their own sperm and egg.” He also called the Alabama ruling a “modest” case against IVF. [Ethics and Public Policy Center, 3/2/24 ]

EPPC President Ryan Anderson published a piece titled, “The truth about Alabama’s ruling on IVF” wherein he claimed that “the media … falsely claimed IVF was about to be banned— and Republicans fell for the claim.” Anderson’s whole piece referred to IVF embryos as “frozen embryonic children” and called IVF “morally and emotionally fraught.” [Ethics and Public Policy Center, 2/28/24 ]

EPPC fellow Andrew Walker criticized Christians and pro-life Americans for not having a stronger stance against IVF. He called IVF “morally problematic” for taking sexual intercourse out of conception, breaking a “holy and inviolable seal,” and for creating embryos that won’t be used, claiming, “In Christian language, these embryos are our neighbors.” [Ethics and Public Policy Center, 2/28/24 ]

EPPC fellow Aaron Kheriaty wrote a piece for Newsweek titled “After Alabama ruling, it's time for a serious look at the ethics of the IVF industry,” in which he claimed that “there is no morally just solution” for modern IVF treatments. [Newsweek, 2/29/24 ]

In a Family Policy Alliance podcast, Director of Public Policy Joseph Kohm stated, “Each of those fertilized embryos that are frozen is a unique human life,” before praising the Alabama Supreme Court for addressing the issue of IVF. [YouTube, 2/29/24 ]

Family Research Council President Tony Perkins told The Associated Press that the Alabama Supreme Court’s decision was “a beautiful defense of life.” [The Associated Press, 2/23/24 ]

On X, Perkins asserted that Sen. Tammy Duckworth’s (D-IL) bill protecting reproductive services was “an overreach designed to advance the Democrats’ radical, Frankensteinian agenda.” He also claimed the bill would legalize “creation of animal-human hybrids (‘chimeras’)” and “trafficking and destruction of human embryos.” In a later post, Perkins pushed for more “IVF safeguards.” [Twitter/X, 2/28/24 , 2/28/24 ]

On his podcast, Washington Watch, Perkins claimed Duckworth’s bill “raises numerous moral and bioethical issues that go far beyond ensuring the IVF issue” and again claimed it would allow the creation of human-animal hybrids. [YouTube, Washington Watch, 2/28/24 ]

On the Independent Women’s Forum’s She Thinks Podcast, Natural Womanhood editor Grace Emily Stark argued that “all across the board people, even medical professionals, have this really inflated idea of how successful IVF is that does not match reality.” [Independent Women’s Forum, She Thinks Podcast , 2/17/23 ]

On the High Noon podcast, IWF senior fellow Emily Jashinsky argued, “The pro-life movement should lead with the reality that there is a way for IVF to be done ethically where you’re not discarding embryos.” Later, host Inez Stepman asked: “Do we really want to live in a world where we’re eugenically selecting babies, where we are commodifying the act of pregnancy?” [Independent Women’s Forum, High Noon , 2/28/24 ]

IWF cross-posted an article originally written for Fox News by IWF visiting fellow Emma Waters, warning that “AI will fuel disturbing ‘build-a-child’ industry.” Waters claimed: “Seventy-five percent of IVF clinics in the U.S. offer genetic testing. This allows parents to create multiple embryos and select the one that matches their preferred sex and eye, hair, and skin color.” She added: “They can also gauge if a child will develop certain health problems. In one controversial case, deaf parents tried to create a child who would inherit their deafness. Of course, clinics destroy the unwanted embryos.” [Independent Women’s Forum, 8/4/23 ]

In a Q&A post on the Dobson Digital Library, James Dobson declared that he is “strongly opposed to the practice of creating fertilized eggs from ‘donors’ outside the immediate family (this would include the donation of sperm or eggs from a brother or sister of the husband and wife wishing to conceive),” because such activity would be to “play God.” Dobson added that IVF is “less problematic” if “all the fertilized eggs are inserted into the uterus (i.e., no ova are wasted or disposed of after fertilization.” He also argued that implanting an already existing frozen embryo is akin to “adoption.” [Dobson Digital Library, accessed 4/2/24 ]

Liberty University posted a summary of a law school panel discussion on reproductive rights after the Dobbs decision, highlighting comments from The Justice Foundation’s Allan Parker on “how to advance that victory [Dobbs] by abolishing in vitro fertilization to protect frozen eggs that have already been fertilized, which he explained is an expansion of the idea that life begins at conception.” Parker said: “I think we need more scholarly research and more public education (on this topic) before the Supreme Court is willing to accept the argument that the right to life under the constitution protects life from the moment of conception.” He added, “It takes time to change culture. But we need to do the historical research, get the education about it to where the judges, based on the appropriate case with the appropriate evidence, will be comfortable making that judicial determination.” [Liberty University, 2/14/24 ]

Media Research Center’s Tierin-Rose Mandelburg responded to the Alabama Supreme Court decision in a blog post, writing, “This is a good thing. Regardless of whether a child is conceived naturally or by artificial implantation, that child has value and has sanctity and deserves to be treated as such. Throwing embryos away should be considered murder, as, now in Alabama, it is.” Mandelburg’s blog began with the line, “Sweet Home Alabama just got even sweeter for babies.” [NewsBusters, 2/19/24 ]

Media Research Center’s Jorge Bonilla argued that the mainstream media’s response to Alabama’s ruling was disingenuous and simply a cover to advocate for abortion rights, writing, “The panic point for the media is the Court’s grant of personhood to human embryos.” “Such a finding, were it to be upheld by the United States Supreme Court, drives a dagger into efforts to codify Roe,” he continued. He later added: “Personhood, even if not uttered out loud, is the whole ball game and the media know it. It’s hard to imagine the liberal media caring too much about IVF except that these stories enable advocacy for a Roe restoration. Personhood gets in the way of that.” [NewsBusters, 2/23/24 ]

Similar to the Heritage Foundation, the Mississippi Center for Public Policy argued more than a decade ago in support of a proposed “personhood amendment” to the state’s constitution, claiming it was “unlikely” to “be used to justify a ban on in vitro fertilization (IVF).” MCPP added: “IVF procedures can be performed without destroying human embryos, and therefore would still be permissible under Initiative 26. As is currently being done in many cases, any excess embryos not implanted in the womb could be frozen and implanted later or adopted out to other parents.” [Mississippi Center for Public Policy, 11/3/11 ]

Students for Life of America argued that a “consistent, intellectually-honest stance holds that human life begins at conception/fertilization,” and views discarding embryos as “a human rights violation,” claiming that the current process of IVF encourages “targeted killing” based on “undesirable traits” and “leads to eugenics.” [Students for Life of America, 1/27/22 , 4/21/22 , 2/23/24 ]

In a blog post, Students for Life of America prepared supporters to discuss IVF by raising the argument that “more die from IVF than abortion.” [Students for Life America, 2/23/24 ]

Susan B. Anthony Pro-Life America has advocated against federal bills drafted to protect IVF after the Alabama ruling. SBA Pro-Life America argued against Rep. Nancy Mace’s (R-SC) non-binding resolution that states “strong support” for IVF, arguing that it “leaves no room for reasonable laws like the one in Louisiana that for decades has protected human embryos while also allowing IVF.” The organization also heavily criticized Sen. Tammy Duckworth’s (D-IL) bill, saying it “would even codify a right to human cloning and genetic engineering of human embryos.” [Susan B. Anthony Pro-Life America, 2/28/24 , POLITICO, 2/27/24 ]

Turning Point USA’s Alex Clark, who frequently criticizes fertility care and birth control, has written about her changing stance on IVF, concluding in 2022 that IVF is not “really any different than an early abortion.” [Turning Point USA, 8/11/22 , 8/29/22 ; Media Matters, 6/11/23 , 2/14/23 ]

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IMPORTANT EXAMS

Protection Against Arrest and Detention in Certain Cases

Article 22, Constitution of India 1950

Safeguard Against Arbitrary Arrest and Detention- Article 22

Introduction

Rights of arrested persons under ordinary law

Right to be informed of the grounds of arrest

Right to be defended by a lawyer of his own choice

Right to be produced before a magistrate

No detention beyond 24 hours except by an order of a magistrate

Preventive Detention Laws

Constitutional safeguards against the laws of preventive detention

Review by the advisory board

Communication of the grounds of detention to the detenu

Detenu’s right to representation

Subjective satisfaction of detaining authority

Article 22 is not a complete code

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Article 22 of the Indian Constitution

Introduction

Rights of arrested persons under ordinary law

Right to be informed of the grounds of arrest

Right to be defended by a lawyer of his own choice

Resolution of the bar council not to defend some persons in criminal cases-

Right to be produced before a magistrate

No detention beyond 24 hours except by an order of a magistrate

Article 22(3)

Article 22 (4)

Article 22(5)

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Objectives of Article 22 of the Indian Constitution

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Joginder Kumar v. The State of Uttar Pradesh [6]

Shri D. K. Basu & Anr. v. The State of Uttar Pradesh & Anr [7]

Hussainara Khatoon & Ors. v. The State of Bihar & Anr. [8]

Maneka Gandhi v. Union of India [9]

Provision of Cr.P.C.

The State of Punjab v. Ajaib Singh & Anr. [13]

A. K. Roy v. Union of India & Anr. [14]

Preventive Detention Laws

The necessity of such a provision

The Preventive Detention Acts

Terrorist and Disruptive Activities (Prevention) Act, 1987 (TADA)

National Security Act, 1980 [15]

Prevention of Terrorism Act (POTA), 2002

Constitutional Safeguards against Preventive Detention Laws

(a) Review by Advisory Board:

(b) Communication of grounds of detention to detainee:

(c) No obligation of authority:

(d) Detinue’s Right of Representation:

Conservation of Foreign Exchange, Prevention of Smuggling Activities Act (COFEPOSA), 1974, and Article 22(5)

Exception under Article 22(6) of Indian Constitution

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