Advance directives and the persistent vegetative state in Victoria: a human rights perspective

With advances in medical technology, it is now possible to sustain the life of a person in a persistent vegetative state (PVS) until a decision is made to withhold or withdraw life-sustaining treatment. Who makes that decision? Under the Medical Treatment Act 1988 (Vic) there is no legally enforceable right for a person to choose, in advance, what intervention that person will and will not accept if he or she ends up in a PVS. The best that can be achieved is that a person can appoint an agent who is empowered to refuse medical treatment on the person's behalf in the event of incompetence. It is suggested that this mechanism ignores two fundamental human rights: self-determination and the inherent right to dignity. This article proposes the development of an advance directive mechanism that provides for a person to refuse, in advance, specified intervention, thereby respecting fundamental human rights and alleviating the existing need for an agent to second-guess a person's desires and best interests.

Medico-legal decision making for incapacitated neonates

This thesis finds there is a need for greater transparency and objectivity in end-of-life decision making for extremely premature and critically ill infants. To achieve this objectivity, the allocation of finite public healthcare resources, and corresponding quality of life, should be a principal consideration in treatment decisions.

Critically impaired infants and end of life decision making : resource allocation and difficult decisions

Decisions to withdraw or withhold life-sustaining treatment are contentious, and offer difficult moral dilemmas to both medical practitioners and the judiciary. This issue is exacerbated when the patient is unable to exercise autonomy and is entirely dependent on the will of others.This book focuses on the legal and ethical complexities surrounding end of life decisions for critically impaired and extremely premature infants. Neera Bhatia explores decisions to withdraw or withhold life-sustaining treatment from critically impaired infants and addresses the controversial question, which lives are too expensive to treat? Bringing to bear such key issues as clinical guidance, public awareness, and resource allocation, the book provides a rational approach to end of life decision making, where decisions to withdraw or withhold treatment may trump other competing interests.The book will be of great interest and use to scholars and students of bioethics, medical law, and medical practitioners.

Historical evolution and modern implications of concepts of consent to, and refusal of, medical treatment in the law of trespass

Many mischiefs arise on the change of a maxim and rule of the Common Law, which those who altered it could not see when they made the change.

Medical and scientific authorship: a conflict between discipline rules and the law

When the results of medical collaborations are to be published, questions of authorship arise. Which members of the research team are to be acknowledged as authors of the paper? In what order are they to be acknowledged? Institutional rules will generally determine the attribution of authorship to members of the research team. However those rules are most unlikely to be consistent with the legal rules governing authorship and its attribution, most of which will apply regardless of a team’s adherence to institutional rules. This article examines the meaning of authorship in the medical community, and in the legal community under the copyright laws. It considers various formulations of the institutional rules governing authorship, as well as editorial practices. Through consideration of a hypothetical scenario, the consequences of the disparity between authorship norms in law and in medicine are elaborated.

Privacy law in Australia

This book begins by examining the nature and scope of the right to privacy and the moral basis and status: What is privacy? What interests does it affect and protect? Is there a justification for the right?
It discusses the relevant legal regime in all Australian jurisdictions. It covers the extent to which privacy has been protected under common law and equity and then weaves these principles into the statutory discussion of privacy. It focusses specifically on the most important areas of privacy protection - medical records, communications, criminal investigations and DNA, employment, territory, etc. Finally, it examines how the law may develop in the future.

The initiation and administration of drugs for advanced life support by critical care nurses in the absence of a medical practitioner

Current legislation does not permit the administration of first line resuscitation medications by suitably qualified Division 1 registered nurses (RNs) in the absence of a medical officer. This omission by the Drugs,  Poisons and Controlled Substances Act 1981 (Vic) and the Drugs, Poisons and The Controlled Substances Regulations 1995 (Vic) leaves many critical care nurses in a vulnerable legal position.

The primary aim of this study was to gauge the view of critical care nurses with respect to lobbying for change to the current legislation. In addition, the study aimed to explore and describe the educational preparation, practice perceptions and experiences of RNs working in critical care regarding cardiopulmonary resuscitation and the administration of first line advanced life support (ALS) medications in the absence of a medical officer. It was anticipated that data collected would demonstrate some of the dilemmas associated with the initiation and administration of ALS medications for practising critical care nurses and could be used to inform controlling bodies in order for them to gain an appreciation of the issues facing critical care nurses during resuscitation.

A mailout survey was sent to all members of the Victorian Branch of the Australian College of Critical Care Nurses (ACCCN). The results showed that the majority of nurses underwent an annual ALS assessment and had current ALS accreditation. Nurses indicated that they felt educationally prepared and were confident to manage cardiopulmonary resuscitation without a medical officer; indeed, the majority had done so. The differences in practice issues for metropolitan, regional and rural nurses were highlighted. There is therefore clear evidence to suggest that legislative amendments are appropriate and necessary, given the time critical nature of cardiopulmonary arrest. There was overwhelming support for ACCCN Vic. Ltd to lobby the Victorian government for changes to the law.

Twisting the knife: discrimination in the law

Of the many different variations that can occur in human sexual formation, transsexualism no doubt remains the least understood by the wider Australian community. As a consequence, the process of attaining human rights to legal status, privacy, dignity and freedom from discrimination for those who experience this unusual condition has been a slow and sometimes frustrating one. The article seeks to introduce the reader to some of the more recent developments in the international jurisprudence of transsexualism and the underlying medical evidence that has supported them. It also offers criticism of the belated attempt by the State of Victoria,  with the Births, Deaths & Marriages Registration (Amendment) Act 2004, to establish certain statutory rights in this regard. While the legislation was enacted with the stated and very laudable purpose of providing for the  correction of birth records on the Register of Births of those people with transsexualism who have altered their phenotypic sex by hormonal  medication and surgery, the article argues it has also served to remove other equally important rights already won and proposes that a final remedy will only be found, as on previous occasions, in the courts.

Discussing sex at work can be a costly business: Translating the science, language and law behind M v A & U (2007) QADT 8...

On 16 March 2007, in the matter of M v A & U [2007] QADT 8, the Anti-Discrimination Tribunal of Queensland found that a complaint of discrimination in the supply of goods and services had been made out by the complainant on two grounds: her female sex and lawful sexual activity. The decision would have been quite unremarkable except that ‘M’, as the complainant was known for the purposes of the hearing, is a woman of difference, one who had unusually arrived at her legal female state by completing the sex reassignment process now more commonly described as ‘sex affirmation’.

This article seeks to elaborate on the language and law of transsexualism used by the Tribunal. Its aim is to enhance practitioners’ understanding of the legal and social issues peculiar to those who affirm a sex opposite that first assigned to them so that those practitioners may better interpret the law to their clients. As the instant decision shows, the failure by an employer to take reasonable steps to avoid infringing the Anti-Discrimination Act 1991 (Qld), either on its own part or by the actions of its employees, can prove a costly business indeed.

The author offers a brief synopsis of the current medical viewpoint regarding transsexualism and reviews recent Australian legal developments in the jurisprudence. She reminds practitioners that the Anti-Discrimination Act 1991 (Qld) has since been further strengthened by the inclusion of ‘gender identity’ as a protected attribute, and concludes by proposing the existence of a heightened duty on the part of practitioners to ensure business clients are aware of the full extent of their legal obligations to not discriminate against employees or clients.

Euthanasia, morality and the law

"This book assesses the desirability of legalising euthanasia. From the ethical perspective, euthanasia raises many important issues including the right to life, the right to liberty, the avoidance of unnecessary pain, the appropriate allocation of medical resources, and the rights and duties of doctors. Other relevant considerations include the improving standard of palliative care and the "slippery slope" argument. The central arguments for and against euthanasia are evaluated against the background of the leading contemporary moral theories. The book seeks to cut through the rhetoric that has become a feature of the debate and asks whether there is a sound reason for denying the wishes of individuals who express their wish to die."

Causation in law and medicine

Causation is an issue that is fundamental in both law and medicine, as well as the interface between the two disciplines. It is vital for the resolution of a great many disputes in court concerning personal injuries, medical negligence, criminal law and coronial issues, as well as in the provision of both diagnoses and treatment in medicine. This book offers a vital analysis of issues such as causation in law and medicine, issues of causal responsibility, agency and harm in criminal law, causation in forensic medicine, scientific and statistical approaches to causation, proof of cause, influence and effect, and causal responsibility in tort law

Survey commentaries and analysis on Singapore biotechnology venture capital, intellectual and property regulatory law

The article presents survey commentaries and analysis on biotechnology venture capital, intellectual and property regulatory law in Singapore as of April 2006. The survey revealed that the financial sector and venture capitalists lack the ability to evaluate and understand biotechnology. Some major concerns for stakeholders are the lack of experience in the litigation of cases by Singaporean law firms and the lack of strategic management of portfolios for biomedical and pharmaceutical companies and the government. Stakeholders cited the need for Singaporean laws to be amended to accommodate developments in medical devices, herbal medicine, some biological areas and pre-clinical and clinical trials.