Has Nick Clegg helped the case for a war crimes tribunal?

Clegg’s gaffe over the “illegal” war could strengthen case for involvement of the international cour

Nick Clegg raised more than a few eyebrows yesterday when he called the Iraq war "illegal" while standing in for David Cameron at PMQs.

Clegg might have made a habit of condemning the war while in opposition, but appeared to forget that his partners in government now include neocons such as George Osborne and Iain Duncan Smith, who voted in favour of the conflict. During a heated exchange with Jack Straw, he said:

Maybe [Straw] one day -- perhaps we will have to wait for his memoirs -- could account for his role in the most disastrous decision of all, which is the illegal invasion of Iraq.

The obvious issue is that he has highlighted a division in the coalition, but has Clegg also strengthened the case for legal action?

The Guardian today quotes senior lawyers wondering whether his statement is legally significant because it was made while speaking in the Commons:

Philippe Sands, professor of law at University College London, said: "A public statement by a government minister in parliament as to the legal situation would be a statement that an international court would be interested in, in forming a view as to whether or not the war was lawful."

The No 10 press office has done some hasty damage limitation. A spokesman said that Clegg had been speaking in his capacity as leader of the Liberal Democrats, rather than Deputy Prime Minister -- slightly odd, perhaps, given that he was standing at the despatch box, answering questions on behalf of the government at PMQs.

The coalition government has not expressed a view on the legality or otherwise of the Iraq conflict. But that does not mean that individual members of the government should not express their individual views. These are long-held views of the Deputy Prime Minister.

The issue of the war's legality has rumbled quietly on since 2003. My colleague Mehdi Hasan wrote in January that:

The New Statesman has learned from a senior legal source that not one member of Britain's new 12-justice Supreme Court believes that the war was lawful. One former law lord, Johan Steyn, has called on the Iraq inquiry to publish an interim report before the general election declaring the war illegal.

A recent Sunday Times poll showed that a quarter of the public wants to see Blair stand trial. The International Criminal Court's chief prosecutor even said in 2007 that he could "envisage" a scenario where this took place.

In theory, a senior minister negating the war's legal basis could add force to the argument for a tribunal, should the international court consider the case. But somehow -- particularly as it does not signify a change in the government's official position, and the Chilcot inquiry is not seeking to apportion blame on this point -- that seems distinctly unlikely.

Samira Shackle is a freelance journalist, who tweets @samirashackle. She was formerly a staff writer for the New Statesman.

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The surprising truth about ingrowing toenails (and other medical myths)

Medicine is littered with myths. For years we doled out antibiotics for minor infections, thinking we were speeding recovery.

From time to time, I remove patients’ ingrowing toenails. This is done to help – the condition can be intractably painful – but it would be barbaric were it not for anaesthesia. A toe or finger can be rendered completely numb by a ring block – local anaesthetic injected either side of the base of the digit, knocking out the nerves that supply sensation.

The local anaesthetic I use for most surgical procedures is ready-mixed with adrenalin, which constricts the arteries and thereby reduces bleeding in the surgical field, but ever since medical school I’ve had it drummed into me that using adrenalin is a complete no-no when it comes to ring blocks. The adrenalin cuts off the blood supply to the end of the digit (so the story goes), resulting in tissue death and gangrene.

So, before performing any ring block, my practice nurse and I go through an elaborate double-check procedure to ensure that the injection I’m about to use is “plain” local anaesthetic with no adrenalin. This same ritual is observed in hospitals and doctors’ surgeries around the world.

So, imagine my surprise to learn recently that this is a myth. The idea dates back at least a century, to when doctors frequently found digits turning gangrenous after ring blocks. The obvious conclusion – that artery-constricting adrenalin was responsible – dictates practice to this day. In recent years, however, the dogma has been questioned. The effect of adrenalin is partial and short-lived; could it really be causing such catastrophic outcomes?

Retrospective studies of digital gangrene after ring block identified that adrenalin was actually used in less than half of the cases. Rather, other factors, including the drastic measures employed to try to prevent infection in the pre-antibiotic era, seem likely to have been the culprits. Emboldened by these findings, surgeons in America undertook cautious trials to investigate using adrenalin in ring blocks. They found that it caused no tissue damage, and made surgery technically easier.

Those trials date back 15 years yet they’ve only just filtered through, which illustrates how long it takes for new thinking to become disseminated. So far, a few doctors, mainly those in the field of plastic surgery, have changed their practice, but most of us continue to eschew adrenalin.

Medicine is littered with such myths. For years we doled out antibiotics for minor infections, thinking we were speeding recovery. Until the mid-1970s, breast cancer was routinely treated with radical mastectomy, a disfiguring operation that removed huge quantities of tissue, in the belief that this produced the greatest chance of cure. These days, we know that conservative surgery is at least as effective, and causes far less psychological trauma. Seizures can happen in young children with feverish illnesses, so for decades we placed great emphasis on keeping the patient’s temperature down. We now know that controlling fever makes no difference: the fits are caused by other chemicals released during an infection.

Myths arise when something appears to make sense according to the best understanding we have at the time. In all cases, practice has run far ahead of objective, repeatable science. It is only years after a myth has taken hold that scientific evaluation shows us to have charged off down a blind alley.

Myths are powerful and hard to uproot, even once the science is established. I operated on a toenail just the other week and still baulked at using adrenalin – partly my own superstition, and partly to save my practice nurse from a heart attack. What would it have been like as a pioneering surgeon in the 1970s, treating breast cancer with a simple lumpectomy while most of your colleagues believed you were being reckless with your patients’ future health? Decades of dire warnings create a hefty weight to overturn.

Only once a good proportion of the medical herd has changed course do most of us feel confident to follow suit. 

This article first appeared in the 20 April 2017 issue of the New Statesman, May's gamble

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