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This paper aims to examine advance decisions to refuse treatment (ADRTs) in the context of the COVID-19 (Coronavirus 2019) pandemic. This study considers the development of ADRTs, the lack of take up and confusion among the general public, clinicians and health and social care staff.

The paper is a conceptual piece that reflects on ADRTs in the particular context of COVID-19. It considers professional concerns and pronouncements on ADRTs.

ADRTs have a low take up currently. There is misunderstanding among public and professionals. There is a need for raising awareness, developing practice and a need to allay fears of misuse and abuse of ADRTs in clinical, health and social care settings.

The authors make recommendations that reflexive training and awareness become the norm in health and social care, that reform of ADRTs is undertaken to prevent misunderstandings and that the person becomes central in all decision-making processes.

This paper is original in considering ADRTs as a safeguarding issue from two perspectives: that of the person making the ADRT and being confident in respect for the decisions made; and that of clinicians and other professionals being reflexively aware of the need to accept advance decisions and not acting according to unconscious biases in times of crisis.

The purpose of this paper is to discuss how the province over time has addressed problems that are generic to many jurisdictions in assuring quality: level of aggregation, pooling, definition of new and continuing programs, scope of jurisdiction, role of governors, performance indicators, relationship to accreditation, programs versus credentials, benchmarking and isomorphism. The paper will pay particular attention to the balance between institutional autonomy in promoting quality and innovation in contrast to system-wide standards for assuring quality. The Province of Ontario has had some form of quality assurance since 1969. For most of the period since then, there were separate forms for undergraduate and graduate programs. Eligibility for public funding is based on the assurance of quality by a buffer body. In 2010, after two years of work, a province-wide task force devised a new framework.

The structure of the paper is a series of “problem/solution” discussions, for example, aggregation, pooling, isomorphism and jurisdiction.

Some problems are generic, for example, how to define a “new” program. Assuring quality and enhancing quality are fundamentally different in terms of process.

Although many of the problems discussed are generic, the paper is based on the experience of one jurisdiction.

The article will be useful in post-secondary systems seeking to balance autonomy and innovation with central accountability and standardization. It is particularly applicable to undifferentiated systems.

Implications for public policy are mainly about locating the most effective center of gravity between assuring quality and enhancing quality, and between promoting quality and ensuring accountability.

The approach of the discussion and analysis is novel, and the results portable.

In view of the vital and essential part which the trade of this country must necessarily play in the winning of the war and in safeguarding the peace, it is comforting to know that at last it is beginning to be realised in official quarters that the only way to resuscitate trade and provide a substantial proportion of exports in payment of indispensable imports is to remove restrictions and barriers and to allow trade its natural freedom as far as possible. The lamentable lack of foresight and the inefficiency shown, immediately following the outbreak of war, in imposing pools and controls in all kinds of trades, has already been responsible for the loss of vast sums of money by the commercial interests of the country, and the time has come when experimental hindrances of this kind must be resisted. A special correspondent of The Times, in an excellent article referring to the pooling system, observes that the disappearance of a trade name from shops and hoardings may not strike the ordinary man as really important. But the manufacturer who produces and advertises branded goods guarantees in effect that consumers are supplied with goods of a recognised quality and at a fixed price. To the maker pooling means the loss of whatever goodwill is vested in his name or trade‐mark, to establish which in public favour may have cost him many years of effort and a large investment. The goodwill of British industry and trade is in large measure the sum of goodwill earned by hundreds of separate commodities. The absorption of branded goods in a common pool confronts business men with a problem which they should examine here and now in preparation for the day when trade reverts to its function of satisfying the needs of people living at peace. The problem is to maintain their goodwill in the interval. Much the same difficulties will have to be met by other firms—and possibly by whole industries—which, though their products are not pooled, have turned over from fulfilling peace‐time demands to direct participation in the national war effort. There are clothing manufacturers whose output is needed for the Services. Some businesses find their occupation gone because their raw material—it may be timber—is not now freely available. The production of electricity and gas is restricted by rationing. As the Government ould not look with favour on campaigns to increase sales of gas or electricity, the industries which supply them cannot very well advertise in the ordinary way. But what, then, is to become of “Mr. Therm,” who has been built up so skilfully and at some considerable cost as a model public servant? Publicity seems to be the answer to this problem of keeping goodwill alive. The managing director of a leading motor manufacturing company has made it known that that is the policy which his firm intend to follow while they are exclusively occupied in building aero engines. They will keep their name before the public by advertising, and they believe all makers of British cars should do the same, whether they are at present turning out private cars or not. Advertising is included among the legitimate and, indeed, essential activities classed as business development work, and is allowed as a trade expense before profits are calculated for taxation. It would be well for firms to think carefully before letting all their normal expenditure on business development lapse in war‐time. Ordinary trade has a vital part to play in the war, if only because it is out of profits alone that the revenues needed for fighting can be found. Though the times are difficult, new opportunities and markets will present themselves. Markets hitherto served by Germany are to‐day open to the British manufacturer, if the requisite arrangements for export can be made. At home, with the life of the people going on, new habits are forming, and with them new requirements. The trader who puts forth his best efforts during war‐time is helping his country, not hampering it. It is for the Government to ease his way by removing needless obstructions to normal trade; it is for business men themselves to face their problems with initiative and energy.

The Howard Shuttering Contractors case throws considerable light on the importance which the tribunals attach to warnings before dismissing an employee. In this case the tribunal took great pains to interpret the intention of the parties to the different site agreements, and it came to the conclusion that the agreed procedure was not followed. One other matter, which must be particularly noted by employers, is that where a final warning is required, this final warning must be “a warning”, and not the actual dismissal. So that where, for example, three warnings are to be given, the third must be a “warning”. It is after the employee has misconducted himself thereafter that the employer may dismiss.

A distinction must be drawn between a dismissal on the one hand, and on the other a repudiation of a contract of employment as a result of a breach of a fundamental term of that contract. When such a repudiation has been accepted by the innocent party then a termination of employment takes place. Such termination does not constitute dismissal (see London v. James Laidlaw & Sons Ltd (1974) IRLR 136 and Gannon v. J. C. Firth (1976) IRLR 415 EAT).

Although a significant body of work has amassed that explores the antecedents, correlates, and consequences of employee turnover in organizations, little is known about how employees go about quitting once they have made the decision to leave. That is, after the decision to voluntarily quit their job is made, employees must then navigate through the process of planning for their exit, announcing their resignation, and potentially working at their company for weeks after their plans to resign have been made public. Our lack of understanding of the resignation process is important as how employees quit their jobs has the potential to impact the performance and turnover intentions of other organizational members, as well as to harm or benefit the reputation of the organization, overall. Moreover, voluntary turnover is likely to increase in the coming decades. In this chapter, we unpack the resignation process. Specifically, drawing from the communication literature and prior work on employee socialization, we develop a three-stage model of the resignation process that captures the activities and decisions employees face as they quit their jobs, and how individual differences may influence how they behave in each of these three stages. In doing so, we develop a foundation upon which researchers can begin to build a better understanding of what employees go through after they have decided to quit but before they have exited their organization for the final time.

Civil wrongdoings with consequent financial and other loss or damage to employers, employees and third parties may result in the course of various trade union activities. These day to day trade union activities take a variety of forms. The most common ones are inducement of breach of contract, conspiracy, trespass, nuisance, and intimidation. Each of these activities constitutes a tort which, unless the statutory immunities apply, would normally give rise at common law to an action for damages or, as is more frequent, enable the aggrieved party to obtain an injunction.

A pæan of joy and triumph which speaks for itself, and which is a very true indication of how the question of poisonous adulteration is viewed by certain sections of “the trade,” and by certain of the smaller and irresponsible trade organs, has appeared in print. It would seem that the thanks of “the trade” are due to the defendants in the case heard at the Liverpool Police Court for having obtained an official acknowledgment that the use of salicylic acid and of other preservatives, even in large amounts, in wines and suchlike articles, is not only allowable, but is really necessary for the proper keeping of the product. It must have been a charming change in the general proceedings at the Liverpool Court to listen to a “preservatives” case conducted before a magistrate who evidently realises that manufacturers, in these days, in order to make a “decent” profit, have to use the cheapest materials they can buy, and cannot afford to pick and choose; and that they have therefore “been compelled” to put preservatives into their articles so as to prevent their going bad. He was evidently not to be misled by the usual statement that such substances should not be used because they are injurious to health— as though that could be thought to have anything to do with the much more important fact that the public “really want” to have an article supplied to them which is cheap, and yet keeps well. Besides, many doctors and professors were brought forward to prove that they had never known a case of fatal poisoning due to the use of salicylic acid as a preservative. Unfortunately, it is only the big firms that can manage to bring forward such admirable and learned witnesses, and the smaller firms have to suffer persecution by faddists and others who attempt to obtain the public notice by pretending to be solicitous about the public health. Altogether the prosecution did not have a pleasant time, for the magistrate showed his appreciation of the evidence of one of the witnesses by humorously rallying him about his experiments with kittens, as though any‐one could presume to judge from experiments on brute beasts what would be the effect on human beings—the “lords of creation.” Everyone reading the evidence will be struck by the fact that the defendant stated that he had once tried to brew without preservatives, but with the only result that the entire lot “went bad.” All manufacturers of his own type will sympathise with him, since, of course, there is no practicable way of getting over this trouble except by the use of preservatives; although the above‐mentioned faddists are so unkind as to state that if everything is clean the article will keep. But this must surely be sheer theory, for it cannot be supposed that there can be any manufacturer of this class of article who would be foolish enough to think he could run his business at a profit, and yet go to all the expense of having the returned empties washed out before refilling, and of paying the heavy price asked for the best crude materials, when he has to compete with rival firms, who can use practically anything, and yet turn out an article equal in every way from a selling point of view, and one that will keep sufficiently, by the simple (and cheap) expedient of throwing theory on one side, and by pinning their faith to a preservative which has now received the approval of a magistrate. Manufacturers who use preservatives, whether they are makers of wines or are dairymen, and all similar tradesmen, should join together to protect their interests, for, as they must all admit, “the welfare of the trade” is the chief thing they have to consider, and any other interest must come second, if it is to come in at all. Now is the time for action, for the Commission appointed to inquire into the use of preservatives in foods has not yet given its decision, and there is still time for a properly‐conducted campaign, backed up by those “influential members of the trade” of whom we hear so much, and aided by such far‐reaching and brilliant magisterial decisions, to force these opinions prominently forward, in spite of the prejudice of the public; and to insure to the trades interested the unfettered use of preservatives,—which save “the trade” hundreds of thousands of pounds every year, by enabling the manufacturers to dispense with heavily‐priced apparatus, with extra workmen and with the use of expensive materials,—and which are urgently asked for by the public,—since we all prefer to have our foods drugged than to have them pure.

We have before us the recently‐issued Annual Report of the Local Government Board on the work done by the Local Authorities under the Sale of Food and Drugs Acts. While preserving the general form and arrangement of its predecessors, it shows that not only the Board itself, but the local authorities also, are coming to an increasing realisation of the importance of the subject. Six years ago we had occasion to point out some of the defects attaching to these reports, and to suggest various improvements that might be made in them. We felt, and expressed at the time our belief, that the Board was much handicapped by the form of quarterly reports imposed on the Public Analyst by the Food and Drugs Acts, and by the non‐existence of any machinery by which it could get together and collate the vast amount of information which those reports ought to, but do not, yield. Until the law is altered the present system must continue, but it is striking evidence of the lack of serious study spent on the matter that for want of effective coordination and control more than one‐half of what may be considered the real and permanent value of the Public Analyst's work goes into the waste‐paper basket. The work done by most Public Analysts as individuals is limited to some few hundreds of samples of any one article of food, but the combined expeperience of them all would in most cases — assuming it could be accurately ascertained—go far towards settling in a single year many of the thorny questions relative to standards and limits which are fought out at such great length and still greater cost to the community in the courts of law.