Advance Directives Refusing Treatment as an Expression of Autonomy: Do the Courts Practise What They Preach?

The principle of autonomy is at the heart of the right of a competent individual to make an advance directive that refuses life-sustaining medical treatment, and to have that directive complied with by medical professionals. That right is protected by both the common law and, to an extent, by legislation that has been enacted in the United Kingdom and many jurisdictions in Australia. The courts have a critical role in protecting that autonomy, both in those jurisdictions in which the common law continues to operate, and in those jurisdictions which are now governed by statute, and in which judicial determinations will need to be made about legislative provisions. The problem explored in this article is that while the judiciary espouses the importance of autonomy in its judgments, that rhetoric is frequently not reflected in the decisions that are reached. In the United Kingdom and Australia, there is a relatively small number of decisions that consider the validity and applicability of advance directives that refuse life-sustaining medical treatment. This article critically evaluates all of the publicly available decisions and concludes that there is cause for concern. In some cases, there has been an unprincipled evolution of common law principles, while in others there has been inappropriate adjudication through operational irregularities or failure to apply correct legal principles. Further, some decisions appear to be based on a strained interpretation of the facts of the case. The apparent reluctance of some members of the judiciary to give effect to advance directives that refuse treatment is also evidenced by the language used in the judgments. While the focus of this article is on common law decisions, reference will also be made to legislation and the extent to which it has addressed some of the problems identified in this article.

Dengue fever and el nino-southern oscillation in Queensland, Australia : a time series predictive model

Background It remains unclear over whether it is possible to develop an epidemic forecasting model for transmission of dengue fever in Queensland, Australia. Objectives To examine the potential impact of El Niño/Southern Oscillation on the transmission of dengue fever in Queensland, Australia and explore the possibility of developing a forecast model of dengue fever. Methods Data on the Southern Oscillation Index (SOI), an indicator of El Niño/Southern Oscillation activity, were obtained from the Australian Bureau of Meteorology. Numbers of dengue fever cases notified and the numbers of postcode areas with dengue fever cases between January 1993 and December 2005 were obtained from the Queensland Health and relevant population data were obtained from the Australia Bureau of Statistics. A multivariate Seasonal Auto-regressive Integrated Moving Average model was developed and validated by dividing the data file into two datasets: the data from January 1993 to December 2003 were used to construct a model and those from January 2004 to December 2005 were used to validate it. Results A decrease in the average SOI (ie, warmer conditions) during the preceding 3–12 months was significantly associated with an increase in the monthly numbers of postcode areas with dengue fever cases (β=−0.038; p = 0.019). Predicted values from the Seasonal Auto-regressive Integrated Moving Average model were consistent with the observed values in the validation dataset (root-mean-square percentage error: 1.93%). Conclusions Climate variability is directly and/or indirectly associated with dengue transmission and the development of an SOI-based epidemic forecasting system is possible for dengue fever in Queensland, Australia.

The National Aboriginal and Torres Strait Islander Women's Health Strategy

The National Aboriginal and Torres Strait Islander Women’s Health Strategy was launched at the Australian Women’s Health Network (AWHN) National Conference in Hobart on the 19 May 2010. It is important to note that this Strategy does not replace other national or State and Territory documents which identify priorities and needs. The aim is to supplement existing work and contribute to the new National Women's Health Policy (NWHP) being developed. This article will outline the process of the Strategy’s development and its uses for the future.

Don't sell social science short

The News of the Week article that reports on Senator Kay Bailey Hutchison (R-TX) questioning the need to fund social science research at the National Science Foundation is alarming and shortsighted ("Senate panel chair asks why NSF funds social sciences," 12 May, p. 829). Social science research is at the fundamental core of basic research and has much to contribute to the economic viability of the United States. Twenty years of direct and jointly funded social and ecosystem science research at Colorado State University's Natural Resource Ecology Laboratory has produced deep insights into environmental and societal impacts of political upheaval, land use, and climate change in parts of Africa, Asia, and the Americas. Beyond greatly advancing our understanding of the coupled human-environmental system, the partnership of social and ecosystem science has brought scientists and decision-makers together to begin to develop solutions to difficult problems.

Identifying child sexual abuse within school contexts : policy problems and solutions, and a landmark case

As a strategy to identify child sexual abuse, most Australian States and Territories have enacted legislation requiring teachers to report suspected cases. Some Australian State and non-State educational authorities have also created policy-based obligations to report suspected child sexual abuse. Significantly, these can be wider than non-existent or limited legislative duties, and therefore are a crucial element of the effort to identify sexual abuse. Yet, no research has explored the existence and nature of these policy-based duties. The first purpose of this paper is to report the results of a three-State study into policy-based reporting duties in State and non-State schools in Australia. In an extraordinary coincidence, while conducting the study, a case of failure to comply with reporting policy occurred with tragic consequences. This led to a rare example in Australia (and one of only a few worldwide) of a professional being prosecuted for failure to comply with a legislative duty. It also led to disciplinary proceedings against school staff. The second purpose of this paper is to describe this case and connect it with findings from our policy analysis.

Modeling crash types: New insights into the effects of covariates on crashes at rural intersections

Many studies focused on the development of crash prediction models have resulted in aggregate crash prediction models to quantify the safety effects of geometric, traffic, and environmental factors on the expected number of total, fatal, injury, and/or property damage crashes at specific locations. Crash prediction models focused on predicting different crash types, however, have rarely been developed. Crash type models are useful for at least three reasons. The first is motivated by the need to identify sites that are high risk with respect to specific crash types but that may not be revealed through crash totals. Second, countermeasures are likely to affect only a subset of all crashes—usually called target crashes—and so examination of crash types will lead to improved ability to identify effective countermeasures. Finally, there is a priori reason to believe that different crash types (e.g., rear-end, angle, etc.) are associated with road geometry, the environment, and traffic variables in different ways and as a result justify the estimation of individual predictive models. The objectives of this paper are to (1) demonstrate that different crash types are associated to predictor variables in different ways (as theorized) and (2) show that estimation of crash type models may lead to greater insights regarding crash occurrence and countermeasure effectiveness. This paper first describes the estimation results of crash prediction models for angle, head-on, rear-end, sideswipe (same direction and opposite direction), and pedestrian-involved crash types. Serving as a basis for comparison, a crash prediction model is estimated for total crashes. Based on 837 motor vehicle crashes collected on two-lane rural intersections in the state of Georgia, six prediction models are estimated resulting in two Poisson (P) models and four NB (NB) models. The analysis reveals that factors such as the annual average daily traffic, the presence of turning lanes, and the number of driveways have a positive association with each type of crash, whereas median widths and the presence of lighting are negatively associated. For the best fitting models covariates are related to crash types in different ways, suggesting that crash types are associated with different precrash conditions and that modeling total crash frequency may not be helpful for identifying specific countermeasures.

Improving road safety through deterrence-based initiatives : a review of research

The efficacy of road safety countermeasures to deter motorists from engaging in illegal behaviours is extremely important when considering the personal and economic impact of road accidents on the community. Within many countries, deterrence theory has remained a cornerstone to criminology and criminal justice policy, particularly within the field of road safety, as policy makers and enforcement agencies attempt to increase perceptions regarding the certainty, severity and swiftness of sanctions for those who engage in illegal motoring behaviours. Using the Australian experience (particularly the tremendous amount of research into drink driving), the current paper reviews the principles underpinning deterrence theory, the utilisation of the approach within some contemporary road safety initiatives (e.g., Random Breath Testing) as well as highlights some methods to enhance a deterrent effect. The paper also provides direction for future deterrence-based research, in particular, considering the powerful impact of non-legal sanctions, punishment avoidance as well as creating culturally embedded behavioural change.

IDOL

Idol is a collaborative performance work for vocal performer and dancers. The work explores movement and sound relative to a vocal interface called the eMic (Extended Microphone Interface Controller). The eMic is a gestural controller designed by the composer for live vocal performance an real-time processing. The process for generating the work involves the choreographer being provided an opportunity to experiment with gestures ad movement relative to the eMic interface. The choreographer explored the interface as an object,a prop, an instrument and as an extension of the body. the movement was then videoed and the data coming from the sensors simultaneously recorded. The data and the video were then used as part of the compositional process, allowing the composer to see what the performance looks like and to experiment with mapping strategies using the captured sensor data. This approach represents a new compositional direction for working with the eMic, in that previously the compositional process commenced at the computer, building processing patches and assigning parameters to eMic sensors. In order to play the composition, the body needed to adapt to 'playing' the instrument. This approach treats the eMic like a traditional instrument that requires the human body to develop a command over the instrument. Working with the movement as a starting point inverts the process using choreographic gestures as the basis for musical structures.

Factors contributing to ethical issues in project procurement planning : a case study in Malaysia

The construction industry plays a substantial role in a country’s national economy, irrespective of the country’s levels of economic development. The Malaysian Government has given a much needed boost to the country’s construction projects under the 9th Malaysian Plan where a total of 880 projects worth RM15billion (US$48billion) is to be tendered (The Star, 2006). However, Malaysia has not escaped the problems of project failure. In 2005, 17.3% of 417 Malaysian government contracts projects were considered “sick”. Project procurement is one of the most important stages of project delivery. Even though ethics in project procurement has been identified as one of the contributors to project failure, it has not been systematically studied before from the perspective of client in Malaysia. The aim of this paper is to present an exploration to the ethical issues in project procurement in Malaysian public sector projects. By exploring ethical issues from client perspective, this could provide an ethical standpoint for the project life cycle and could maintain a good affiliation between the clients and the customers. It is expected that findings from this review will be somewhat representative of other developing countries.

The multiliteracies classroom

Mary Kalantzis and Bill Cope write in the foreword: “The Multiliteracies Classroom demonstrates in convincing detail how powerful learning can be achieved. Along the way, the book seamlessly weaves cutting-edge theoretical ideas into the fabric of its narrative. In one moment, we hear the lilt of the accents of the children’s discussions. In another, this is connected to the theoretical intricacies of ‘discourse’, ‘heteroglossia’, ‘multimodality’, or ‘dialogic spaces’. We witness the triumphs of a teacher who, in Mills’ words, ‘did not regard literacy as an independent variable. Rather, she regarded it as inseparable from social practices, contextualized in certain political, economic, historic and ecological contexts. Kathy Mills has produced a masterpiece of qualitative research.”

Centrally supported online surveys for research at QUT

We describe the introduction, service growth, benefits and holistic support approach of a centrally supported universitywide online survey tool for researchers at QUT. The online survey service employs the Key Survey software, and has grown into a significant service for QUT researchers since being introduced in 2009. Key benefits of the approach include the ability of QUT to handle important issues relating to data such as security, privacy, integrity, archiving & disposal. The service also incorporates a workflow process that enhances the institution’s ability to ensure survey quality control through controlled approval and pilot testing before any survey is widely released. An important issue is that a tool like this can make it very easy to do very poor research very quickly while creating lots of data, due to the absence of a rigorous methodology designed to reduce errors and collect accurate, comprehensive, timely data. With this in mind, a holistic approach to service provision and support has been taken, which has included the introduction of an integrated system of seminars, tools and workshops to get researchers thinking about the quality of their research while becoming operational quickly. The system of seminars, workshops, checks and approvals we have put in place at QUT is designed to ensure better quality outcomes for QUT’s research and the individual researchers concerned.

Governmentality and the reflection of legal educators : assessment practices as a case study

This paper presents a conceptual framework, informed by Foucault’s work on governmentality, which allows for new kinds of reflection on the practice of legal education. Put simply, this framework suggests that legal education can be understood as a form of government that relies on a specific rationalisation and programming of the activities of legal educators, students, and administrators, and is implemented by harnessing specific techniques and bodies of ‘know-how’. Applying this framework to assessment at three Australian law schools, this paper highlights how assessment practices are rationalised, programmed, and implemented, and points out how this government shapes students’ legal personae. In particular, this analysis focuses on the governmental effects of pedagogical discourses that are dominant within the design and scholarship of legal education. It demonstrates that the development of pedagogically-sound regimes of assessment has contributed to a reformulation of the terrain of government, by providing the conditions under which forms of legal personae may be more effectively shaped, and extending the power relations that achieve this. This analysis provides legal educators with an original way of reflecting on the power effects of teaching the law, and new opportunities for thinking about what is possible in legal education.

A three year outcome evaluation of a theory based drink driving education program

This study reports on the impact of a "drink driving education program" taught to grade ten high school students. The program which involves twelve lessons uses strategies based on the Ajzen and Madden theory of planned behavior. Students were trained to use alternatives to drink driving and passenger behaviors. One thousand seven hundred and seventy-four students who had been taught the program in randomly assigned control and intervention schools were followed up three years later. There had been a major reduction in drink driving behaviors in both intervention and control students. In addition to this cohort change there was a trend toward reduced drink driving in the intervention group and a significant reduction in passenger behavior in this group. Readiness to use alternatives suggested that the major impact of the program was on students who were experimenting with the behavior at the time the program was taught. The program seems to have optimized concurrent social attitude and behavior change.

Copyrights and creative commons licensing : pedagogical innovation in a higher education media literacy classroom

This article examines the role of copyrights in contemporary media literacies. It argues that, provided they are ethical, young people’s engagement with text should occur in environments that are as free from restriction as possible. Discussion of open culture ecologies and the emergent education commons is followed by a theorisation of both literacy and copyrights education as forms of epistemology: that is, as effects of knowledge producing discourses and practices. Because Creative Commons licenses respect and are based on existing copyright laws, a brief overview of traditional copyrights for educators is first provided. We then describe the voluntary Creative Commons copyright licensing framework (“some rights reserved”) as an alternative to conventional “all rights reserved” models. This is followed by an account of a series of workshop activities on copyrights and Creative Commons conducted by the authors in the media literacy classes of a preservice teacher education program in Queensland, Australia. It provides one example of a practical program on critical copyrights approaches, which may be adapted and used by other school and higher education institutions.