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.

Factors contributing to successful public private partnership projects : comparing Hong Kong with Australia and the United Kingdom

Purpose: With the increasing interest in Public Private Partnership (PPP) there is a need to investigate the factors contributing to successful delivery of PPP projects. Design/methodology/approach: An empirical questionnaire survey was conducted in Hong Kong and Australia. The survey respondents were asked to rate eighteen factors which contribute to delivering successful PPP projects. Findings: The findings from this survey were further compared with the results achieved by a previous researcher (Li, 2003) in a similar survey conducted in the United Kingdom. The comparison showed that amongst the top five success factors ranked by Hong Kong respondents, three were also ranked highly by the Australians and British. These success factors included: ‘Commitment and responsibility of public and private sectors’; ‘Strong and good private consortium’; and ‘Appropriate risk allocation and risk sharing’. Originality/value: These success factors were therefore found to be important for contributing to successful PPP projects irrespective of geographical locations.

Dragline automation - a decade of development : shared autonomy for improving mining equipment productivity

Draglines are massive machines commonly used in surface mining to strip overburden, revealing the targeted minerals for extraction. Automating some or all of the phases of operation of these machines offers the potential for significant productivity and maintenance benefits. The mining industry has a history of slow uptake of automation systems due to the challenges contained in the harsh, complex, three-dimensional (3D), dynamically changing mine operating environment. Robotics as a discipline is finally starting to gain acceptance as a technology with the potential to assist mining operations. This article examines the evolution of robotic technologies applied to draglines in the form of machine embedded intelligent systems. Results from this work include a production trial in which 250,000 tons of material was moved autonomously, experiments demonstrating steps towards full autonomy, and teleexcavation experiments in which a dragline in Australia was tasked by an operator in the United States.

The role of the rule of law in virtual communities

There is a severe tendency in cyberlaw theory to delegitimize state intervention in the governance of virtual communities. Much of the existing theory makes one of two fundamental flawed assumptions: that communities will always be best governed without the intervention of the state; or that the territorial state can best encourage the development of communities by creating enforceable property rights and allowing the market to resolve any disputes. These assumptions do not ascribe sufficient weight to the value-laden support that the territorial state always provides to private governance regimes, the inefficiencies that will tend to limit the development utopian communities, and the continued role of the territorial state in limiting autonomy in accordance with communal values. In order to overcome these deterministic assumptions, this article provides a framework based upon the values of the rule of law through which to conceptualise the legitimacy of the private exercise of power in virtual communities. The rule of law provides a constitutional discourse that assists in considering appropriate limits on the exercise of private power. I argue that the private contractual framework that is used to govern relations in virtual communities ought to be informed by the values of the rule of law in order to more appropriately address the governance tensions that permeate these spaces. These values suggest three main limits to the exercise of private power: that governance is limited by community rules and that the scope of autonomy is limited by the substantive values of the territorial state; that private contractual rules should be general, equal, and certain; and that, most importantly, internal norms be predicated upon the consent of participants.

Local autonomy, tax morale, and the shadow economy

Policymakers often propose strict enforcement strategies to fight the shadow economy and to increase tax morale. However, there is an alternative bottom-up approach that decentralises political power to those who are close to the problems. This paper analyses the relationship with local autonomy. We use data on tax morale at the individual level and macro data on the size of the shadow economy to analyse the relevance of local autonomy and compliance in Switzerland. The findings suggest that there is a positive (negative) relationship between local autonomy and tax morale (size of the shadow economy).

Public-private partnerships in the promotion of sport and well-being : a governance model

This research focuses on exploring the links between sport, Indigenous self determination and deeper engagement within mainstream Australia especially with regard to the issue of promoting healthy lifestyles and the role of governance, through sport governance. Against all social, economic and health criteria Indigenous Australians are disadvantaged – despite government attention and financial input. It is well understood that education is a basis to better health, employment and lifestyle (Furneaux and Brown, 2008). However, many of the issues confronting Indigenous people have not responded to conventional government approaches based on program development and policy initiatives from single organisations (Ryan et al 2006). As a consequence, new approaches that both tap into the specific interests of Indigenous people and better engage them in the process of governance are required. The case material of the research focuses on the Australian Football League (AFL) Kickstart program.

Law autonomy and advance directives

The principle of autonomy underpins legal regulation of advance directives that refuse life-sustaining medical treatment. The primacy of autonomy in this domain is recognised expressly in the case law, through judicial pronouncement, and implicitly in most Australian jurisdictions, through enactment into statute of the right to make an advance directive. This article seeks to justify autonomy as an appropriate principle for regulating advance directives and relies on three arguments: the necessity of autonomy in a liberal democracy; the primacy of autonomy in medical ethics discourse; and the uncontested importance of autonomy in the law on contemporaneous refusal of medical treatment. This article also responds to key criticisms that autonomy is not an appropriate organising principle to underpin legal regulation of advance directives.

Sapporo World Window : urban interaction through public and private screens

This paper introduces Sapporo World Window, a screen-based application that is currently under development for the new underway passage at the centre of Sapporo City. There are ten large public screens installed in the space, displaying user-generated videos about various aspects of the city and a real-time map that visualises users’ interaction with the city. The application aims to engage the general public by functioning as a unique ‘point of connection’ for socio-cultural and technological interactions, making the space a lively social place where people can have meaningful experiences of interacting with people and places of Sapporo through mobile phones (keitai) and the public screens in the space. This paper first outlines the contextual background and key concept for the application’s design. Then the paper discusses the user interaction processes, technical specifications, and interface design, followed by the conclusions and outlook.

Public regulatory reform and management earnings forecasts in a low private litigation environment

We examine the impact of continuous disclosure regulatory reform on the likelihood, frequency and qualitative characteristics of management earnings forecasts issued in New Zealand’s low private litigation environment. Using a sample of 720 earnings forecasts issued by 94 firms listed on the New Zealand Exchange before and after the reform (1999–2005), we provide strong evidence of significant changes in forecasting behaviour in the post-reform period. Specifically, firms were more likely to issue earnings forecasts to pre-empt earnings announcements and, in contrast to findings in other legal settings, those earnings forecasts exhibited higher frequency and improved qualitative characteristics (better precision and accuracy). An important implication of our findings is that public regulatory reforms may have a greater benefit in a low private litigation environment and thus add to the global debate about the effectiveness of alternative public regulatory reforms of corporate requirements.

Increasing underwater vehicle autonomy by reducing energy consumption

In this paper, we concern ourselves with finding a control strategy that minimizes energy consumption along a trajectory connecting two given configurations. We develop an algorithm, based on our previous work with the time optimal problem, which provides implementable control strategies that are energy efficient. We find an interesting correlation between the duration of these trajectories and the optimal duration. We present the algorithm, control strategy and experimental results from our test-bed vehicle.

On location : the imagined private interior in public life

This paper reveals the interior landscapes of selected contemporary Australian films, such as The Caterpillar Wish and Bad Boy Bubby, to develop a number of thematic influences on the manner in which domestic and private lives are constructed through filmic imagination. The research uncovers the conditions that contribute to particular scenographic representations of the humble interiors that act as both backdrop and performer to subtle and often troubled narratives. Such readings are informed by the theoretical works of writer Gertrude Stein, among others, who explore the relationships between the scenographic third dimension and the fourth dimensional performance in the representation of narrative space. A further theoretical thread lies in Giuliana Bruno’s work on the tension between private and public filmic space, which is explored through the public outing of intensely private spaces generated through narratives framed by the specificities of found interiors. Beyond the interrogation of qualities of imagined filmic space is the condition whereby locations, once transformed by the event of movie making are consequently forever revised. These altered conditions subsequently reinvest the lives of those who return to the location with layered narratives of occupation. Situationally, the now reconverted interior performs as contributor to subsequent private inhabitation, even if only as imagined space. The possibility here is that the qualities of the original may be superimposed and recontextualised to invest post-produced interiors with the qualities of the other space as imagined. This reading of film space explores new theoretical design scenarios for imagined and everyday interior landscapes.

Student autonomy enhancing science learning : Observations from a Primary Connections implementation

This case study involved a detailed analysis of the changes in beliefs and teaching practices of teachers who adopted the Primary Connections program as a professional development initiative. When implementing an inquiry-based learning model, teachers observed that their students learnt more when they intervened less. By scaffolding open-ended nquiries they achieved more diverse, complex and thorough learning outcomes than previously achieved with teacher-led discussions or demonstrations. Initially, student autonomy presented erceived threats to teachers, including possible selection of topics outside the teachers’ science knowledge. In practice, when such issues arose, resolving them became a stimulating part of the earning for both teachers and students. The teachers’ observation of enhanced student learning became a powerful motivator for change in their beliefs and practices. Implications for developers of PD programs are (1) the importance of modeling student-devised inquiries, and (2) recognising the role of successful classroom implementation in facilitating change.