Gardner; re BWW: Victorian Supreme Court makes landmark Australian ruling on tube feeding

• The Victorian Supreme Court has decided that artificial nutrition and hydration provided through a percutaneous gastrostomy tube to a woman in a persistent vegetative state may be withdrawn.
• The judge ruled, in line with a substantial body of international medical, ethical and legal opinion, that any form of artificial nutrition and hydration is a medical procedure, not part of palliative care, and that it is a procedure to sustain life, not to manage the dying process.
• Thus, the law does not impose a rigid obligation to administer artificial nutrition or hydration to people who are dying, without due regard to their clinical condition. The definition of key terms such as “medical treatment”, “palliative care”, and “reasonable provision of food and water” in this case will serve as guidance for end-of-life decisions in other states and territories.
• The case also reiterates the right of patients, and, when incompetent, their validly appointed agents or guardians, to refuse medical treatment.
• Where an incompetent patient has not executed a binding advance directive and no agent or guardian has been appointed, physicians, in consultation with the family, may decide to withdraw medical treatment, including artificial nutrition or hydration, on the basis that continuation of treatment is inappropriate and not in the patient’s best interests. However, Victoria and other jurisdictions would benefit from clarification of this area of the law

Moving from voluntary euthanasia to non-voluntary euthanasia: equality and compassion

The recent Dutch law legalising active voluntary euthanasia will reignite the euthanasia debate. An illuminating method for evaluating the moral status of a practice is to follow the implications of the practice to its logical conclusion. The argument for compassion is one of the central arguments in favour of voluntary active euthanasia. This argument applies perhaps even more forcefully in relation to incompetent patients. If active voluntary euthanasia is legalised, arguments based on compassion and equality will be directed towards legalising active non-voluntary euthanasia in order to make accelerated termination of death available also to the incompetent. The removal of discrimination against the incompetent has the potential to become as potent a catch-cry as the right to die. However, the legalisation of non-voluntary euthanasia is undesirable. A review of the relevant authorities reveals that there is no coherent and workable "best interests" test which can be invoked to decide whether an incompetent patient is better off dead. This provides a strong reason for not stepping onto the slippery path of permitting active voluntary euthanasia.

Assessing sport management journals : a multi-dimensional examination

The rating of refereed journals has become important for academics and institutions as well as for sport management as a field of study. This paper argues that the dearth of a rating system in sport management works against the best interests of the development of the field. This paper presents a rating scheme for sport management journals, which replicates an earlier study of marketing journals, using weighted multi-dimensional perceptual ratings (Polonsky & Whitelaw, 2006). Forty-five senior sport management academics evaluated 13 journals on four criteria: journal prestige, contribution to theory, contribution to practice and contribution to teaching. Using the weighted scores of the four criteria for each journal and a supporting cluster analysis, four categories of journals were identified. The results of this study will assist academics as they argue the case for the quality of journals in which they publish. Further it facilitates evaluation of sport management journals in relation to one another on the basis of their overall ranking and their scores on the four individual criteria.

Child testimony in custody cases: a review

The authors provide a brief historical review of judicial trends in child custody placement. In contrast to the start of the 19th century, by its end, courts took into consideration children's best interests, maternal rights, and prevailing sex role ideologies. Statutory changes began to reflect similar concerns by the end of that century. Modern practices, relying on the best interests of the child standard, also include consistent consideration of children's preferences in making custody determinations. An important factor in this context is the accuracy with which a child describes domestic relations, especially in contested cases with contradictory allegations by parents. Research dealing with children's report accuracy and techniques to enhance it are reviewed, and a description of various practical considerations when questioning children is provided.

A theory of injustice: the flip side of the relocation coin in Australia

Problems attached to relocation cases in Australia because of geographical and cultural reasons - the best interests of the child principle inherently promotes injustice in relocation cases - operation of Part VII of the Family Law Act in the context of relocation cases - assessment of the best interests of the child principle in Australian relocation cases - responsibility of contact parents - reforming Australian law to promote an equality of interests.

Academic assessment of arts management journals: a multidimensional rating survey

The authors report the results of a journal rating survey assessing 14 publications dedicated to arts management and related topics. Establishing a rating scheme for journals is an important step in the professionalization of an academic field. The authors argue that the development of a rating system in arts management is in the best interests of the discipline. Academics used weighted multidimensional perceptual ratings to evaluate each journal’s prestige, contribution to theory, contribution to practice and contribution to teaching. Cluster analysis using these four criteria identified three classes of journals: A, B+ and B. The setting of standards serves to identify quality goals for academics and journal editors alike, thus enhancing the standing of arts management as a subdiscipline of management.

Child protection, risk assessment and blame ideology

In this article we use qualitative data drawn from a sample of child protection cases 10 demonstrate holV the process of al1ributing blame to parents and carers for child maltreatment is a sign!ficanr influence 011 decisionmaking,
sometimes to the detriment of assessing the flltllre safety of children. We foctls on two cases which both demonstrate how the process of apportioning blame can lead to decisions which might not be considered 10 be in the best interests of the children concerned. We conceptualise blame as an 'ideology' with its roots in the discourse of the 'risk society', pelpetuated and sustained by the technology of risk assessment. The concept of blame ideology is offered as an addition to theOlY which seeks 10 explain the influences on decision making in child protection practice.

The adverse effect of dummy auction bids on market value

The popularity of an auction as a means of selling residential real estate has increased markedly in recent years. The effectiveness of an auction program is heavily promoted by most real estate agents, claiming it to be the best means of attracting the best price from the highest bidder, It is based on the theory of gathering all buyers together at a publicised time, and then offering the property for sale to the open market.

In theory, the person most willing to buy the property will have the highest bid, supposedly agreeing at market value with the vendor (although above the vendor's reserve I. Unfortunately, the practice of dummy bidding has recently resurfaced and highlights serious flaws in the auction system, with hundreds of residential auctions conducted across Australia every weekend.

Clearly, it is in the vendor's best interests land the auctioneer's best interests, who is paid even more by the vendor if the price is higherl to achieve the highest offer from the last bidder. The tactic of dummy bids is designed to deceive genuine purchasers into a false sense of perception, where there appears to be more competition for the property than there actually exists.

This paper examines the auction process with the emphasis placed on the practice of dummy biding, It considers the broad implications for the definition of market value and also the overall residential market. Useful advice is also included for real estate valuers relying upon auction sale properties in their market analysis. As well as strongly supporting the auction concept, the authors suggest improvements to the overall auction process to ensure relevance to the definition of market value is maintained.

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.

Clinical, ethical and legal considerations in the treatment of newborns with non-ketotic hyperglycinaemia

Non-ketotic hyperglycinaemia (NKH) is a devastating neurometabolic disorder leading, in its classical form, to early death or severe disability and poor quality of life in survivors. Affected neonates may need ventilatory support during a short period of respiratory depression. The transient dependence on ventilation dictates urgency in decision-making regarding withdrawal of therapy. The occurrence of patients with apparent transient forms of the disease, albeit rare, adds uncertainty to the prediction of clinical outcome and dictates that the current practice of withholding or withdrawing therapy in these neonates be reviewed. Both bioethics and law take the view that treatment decisions should be based on the best interests of the patient. The medical-ethics approach is based on the principles of non-maleficence, beneficence, autonomy and justice. The law relating to withholding or withdrawing life-sustaining treatment is complex and varies between jurisdictions. Physicians treating newborns with NKH need to provide families with accurate and complete information regarding the disease and the relative probability of possible outcomes of the neonatal presentation and to explore the extent to which family members are willing to take part in the decision making process. Cultural and religious attitudes, which may potentially clash with bioethical and juridical principles, need to be considered.

A.R.T., surrogacy and legal parentage : a comparative legislative review

This is one of three Occasional Papers published by the Victorian Law Reform Commission as part of the Commission's work on assisted reproduction and adoption. A central issue which arises in the context of assisted reproduction is how to recognise and protect the best interests of children who are conceived through assisted reproduction. The three Occasional Papers deal with different aspects of this question. This Paper examines how laws in the other Australian states, and in the United States, United Kingdom and Canada regulate access to assisted reproduction, control the use of surrogacy and deal with issues relating to parentage of children conceived through assisted reproduction. Generally, this legislation gives priority to protecting the best interests of children, but the way in which this is done varies considerably.

Converting potential organ donors : a situational analysis of Australian physicians

This theory-building research suggests that the key to unlocking Australia's potential organ donor pool is to reduce the ethical ambiguity and legal uncertainty plaguing physicians' interepretation of the patients's best interests standard. This may generate a greater acceptance of organ donation as part of end-of-life patient care amongst our physicians.

Provocation in New South Wales : the need for abolition

Over the past two decades significant debate has emerged surrounding the operation of the partial defence of provocation. Such debates have led to its abolition in several Australian and international jurisdictions where Government and Law Commission bodies have argued that provocation has operated in a gender biased way that is no longer reflective of community values and expectations of justice. In contrast to the Australian states of Tasmania, Victoria and Western Australia, who have transferred consideration of provocation to sentencing, New South Wales (NSW) has retained provocation as a partial defence to murder. Drawing upon in-depth interviews conducted with legal stakeholders and an analysis of recent case law, this article considers whether the operation of provocation in NSW is still in the best interests of justice, and, specifically, whether in practice it privileges one gender above the other. This research concludes that the continued operation of provocation in NSW raises key issues surrounding the legitimisation of male violence against women, the denial and minimisation of the harm caused by lethal domestic violence, and the continued inability of the law to appropriately respond to women who kill in the context of prolonged family violence.

Gatekeeping parenthood : should the state play a role in determining eligibility criteria for assisted reproductive treatment?

The use of assisted reproductive treatment to conceive a child provides the opportunity for the state and/or medical practitioners to play a role in deciding who should or should not become a parent. This article explores the primary criteria used to "screen" people wishing to use assisted reproductive treatment and to exclude them from treatment in some circumstances. It argues that idiosyncratic judgment or general legal presumptions against treatment are not satisfactory, as they are unlikely to predict whether the best interests of a child born as a result of assisted reproductive treatment will be compromised. Rather, such judgments may serve to be discriminatory, and are often misinformed. The author suggests that the law and society should rather serve to support children and parents in need, and to protect existing children from actual suffering or risks of harm.

Accepting the unacceptable : patriarchal hegemony and child support arrangements

This research explored how low-income single mothers' child support decisions were based on the 'best interests of the child'. While mothers desired joint financial responsibility for children, poor payment outcomes made mothers financially dependent on the state and resulted in single mothers' coerced acceptance of unacceptable child support arrangements.