By analysing intelligence-gathering reform legislation this article discusses access to justice for communications interception by the intelligence and security services. In the aftermath of the Snowden revelations, sophisticated oversight systems for bulk communications surveillance are being established across the globe. In the Netherlands prior judicial consent and a binding complaint procedure have been established. However, although checks and balances for targeted communications interference have been created, accountability mechanisms are less equipped to effectively remedy indiscriminate interference. Therefore, within the context of mass communications surveillance programs, access to justice for complainants remains a contentious issue.
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Digital surveillance technologies using artificial intelligence (AI) tools such as computer vision and facial recognition are becoming cheaper and easier to integrate into governance practices worldwide. Morocco serves as an example of how such technologies are becoming key tools of governance in authoritarian contexts. Based on qualitative fieldwork including semi-structured interviews, observation, and extensive desk reviews, this chapter focusses on the role played by AI-enhanced technology in urban surveillance and the control of migration between the Moroccan–Spanish borders. Two cross-cutting issues emerge: first, while international donors provide funding for urban and border surveillance projects, their role in enforcing transparency mechanisms in their implementation remains limited; second, Morocco’s existing legal framework hinders any kind of public oversight. Video surveillance is treated as the sole prerogative of the security apparatus, and so far public actors have avoided to engage directly with the topic. The lack of institutional oversight and public debate on the matter raise serious concerns on the extent to which the deployment of such technologies affects citizens’ rights. AI-enhanced surveillance is thus an intrinsically transnational challenge in which private interests of economic gain and public interests of national security collide with citizens’ human rights across the Global North/Global South divide.
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Background: Follow‑up of curatively treated primary breast cancer patients consists of surveillance and aftercare and is currently mostly the same for all patients. A more personalized approach, based on patients’ individual risk of recurrence and personal needs and preferences, may reduce patient burden and reduce (healthcare) costs. The NABOR study will examine the (cost‑)effectiveness of personalized surveillance (PSP) and personalized aftercare plans (PAP) on patient‑reported cancer worry, self‑rated and overall quality of life and (cost‑)effectiveness. Methods: A prospective multicenter multiple interrupted time series (MITs) design is being used. In this design, 10 participating hospitals will be observed for a period of eighteen months, while they ‑stepwise‑ will transit from care as usual to PSPs and PAPs. The PSP contains decisions on the surveillance trajectory based on individual risks and needs, assessed with the ‘Breast Cancer Surveillance Decision Aid’ including the INFLUENCE prediction tool. The PAP contains decisions on the aftercare trajectory based on individual needs and preferences and available care resources, which decision‑making is supported by a patient decision aid. Patients are non‑metastasized female primary breast cancer patients (N= 1040) who are curatively treated and start follow‑up care. Patient reported outcomes will be measured at five points in time during two years of follow‑up care (starting about one year after treatment and every six months thereafter). In addition, data on diagnostics and hospital visits from patients’ Electronical Health Records (EHR) will be gathered. Primary outcomes are patient‑reported cancer worry (Cancer Worry Scale) and over‑all quality of life (as assessed with EQ‑VAS score). Secondary outcomes include health care costs and resource use, health‑related quality of life (as measured with EQ5D‑5L/SF‑12/EORTC‑QLQ‑C30), risk perception, shared decision‑making, patient satisfaction, societal participation, and cost‑effectiveness. Next, the uptake and appreciation of personalized plans and patients’ experiences of their decision‑making process will be evaluated. Discussion: This study will contribute to insight in the (cost‑)effectiveness of personalized follow‑up care and contributes to development of uniform evidence‑based guidelines, stimulating sustainable implementation of personalized surveillance and aftercare plans. Trial registration: Study sponsor: ZonMw. Retrospectively registered at ClinicalTrials.gov (2023), ID: NCT05975437.
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