Exploring distributive justice in health care

The allocation of resources to providers and the way in which the resources are then prioritised to specific service areas and patients remain the critical ethical decisions which determine the type of health system a community receives. Heath care providers will never be given enough resources to satisfy all the demands placed upon them by a community that is becoming increasingly informed and demanding. This paper discusses the matter of justice as it relates to the distribution of health resources. It translates the theoretical constructs of distribution into a practical situation that arose at The Geelong Hospital. It is important to emphasise that the aim of giving the example is not necessarily to provide the right answer but rather to assist in determining what ought to be the questions.

Geelong community's priorities and expectations of public health care

Abstract This thesis set out to achieve the following objectives: (1) To identify the priorities and expectations that the Geelong community has of its public health care system. (2) To determine if there is a common view on the attributes of a just health system. (3) To consider a method of utilising the data in the determination of health care priority setting in Barwon Health. (4) To determine a model of community participation which enables ongoing input into the decision making processes of Barwon Health. The methodology involved a combination of qualitative and quantitative research. The qualitative work involved the use of focus groups that were conducted with 64 members of the Geelong community. The issues raised informed the development of the interview schedule that was the basis of the quantitative study, which surveyed a representative sample of 400 members of the Geelong community. Prior to reporting on this work, the areas of distributive justice, scarcity and community participation in health care were considered. The research found that timely access to public hospitals, emergency care and aged care services were the major priorities; for many people, the cost was less relevant than a quality service. Shorter waiting times and increased staffing levels were strongly supported. Increased taxes were nominated as the best means of financing the health system they sought. Community based services were less relevant than hospital services but health education was supported. An egalitarian approach to resource distribution was favoured although the community was prepared to discriminate in favour of younger people and against older people. There was strong support for the community to be involved in decision making in the public health care system through surveys or focus groups but very little support was given to priorities being determined by politicians, administrators and to a lesser extent, medical professionals.

Dark light

Daniel Armstrong takes astronomical images of the southern sky. From these images each star is individually selected and mapped into grid like alignments and symmetrical shapes. The images present an optical play between structure and mapping.

Circle: orbital commutation

In exercising vision we employ strategies to perceive space and to distinguish the objects of attention. Some processes however remain invisible to us; how we process binocular vision; and how we resolve vision in motion. This work images invisible motion perspective. Revelation of invisible mechanisms of vision exposes the haptic qualities of sight and their contribution to proprioception and ʻaffordanceʼ. Figuring the ʻvortex of visionʼ also releases symbolic and metaphoric potentials. This innovative outcome of practical research develops imagery which depicts relative movement in space using the principles of motion perspective (Herschel) and optic flow (J. J. Gibson); the locative awareness of volumes in space through the dimensions of time and space presented in 2D imagery. The mural scale (3.5 metres) work presented in 'Circle', a group show of work around the idea of 'the circle' curated by Melinda Capp is derived from a large production of digital photographs made in the London Underground. In this work, the circle is associated with the orbit of the commuter which bends around the twin poles of home and employment, work and rest, circulating in an ellipse around the Ideal Life. Each traveller's path is a braid woven through gyrations of force and resistance. Optic flow, emulated with the rotating lens, tracing the moving subject, makes this visible.

Microscopic / telescopic (universes unfold)

This exhibition was inspired by lens based observation; what is observed through the microscope – plankton and single cell organisms – finds its origin in what is observed through the telescope – stars and galaxies. The project explores two spatially divergent contexts. Artist, Melinda Capp explores the micro-scopic with porcelain objects, artist books and images derived microscopes and Daniel Armstrong references the macro-scopic with video, photography, lens based objects and installation of interactive sculpture / optical instruments to create an experiential connection between celestial phenomena/images and the viewer.

Three flying saucers

Three Flying Saucers is wall mounted set of three works which parody the iconic kitsch set of three flying ducks which inhabit the walls of many houses from the 1950’s to today. The project proposes a time in the future where contact with alien intelligent life has been established and we have finally obtained proof that Flying Saucers were real and had been visiting our world for many decades. Now these mysterious celestial forms have been adopted as the new kitsch and adorn the homes of the future.

Fragmentos

Curatorial Aims and Objectives: Fragmentos was a curated exhibition (or expose) of 13 contemporary Australian artists. It was presented at the upstairs gallery at the Escuela Activa de fotografia in Cuernavaca, Morelos in Mexico. The curatorial objective was to present small samples or fragments from the creative practice of a number Australian artists. It would therefore act as introduction to their broader practice and as a way of representing the diverse range of creative explorations by a number contemporary, mostly Melbourne based Australian artists. These artists were selected on the basis of their diverse and often conceptual approaches to art making. All the artists have an established practice in the arts and their work reflects an experimental and investigative approach to materials and processes as well as exploring a wide range of conceptual and thematic concerns. Visitors to the Fragmentos exhibition were primarily local Mexican artists, art students and academics and members of the general public. The gallery is located in the heart of a photography school in central Cuernavaca but the students are engaged in a wide range of practices and the local arts community is vibrant and divers. Many of the works presented in this exhibition invited audience interaction and even the opportunity to contribute to the works providing a connection to the Australian artists involved and as a way of demystifying the ideas behind the works. One of the main curatorial objectives was to create a sense of connection and dialogue between local Mexican artists and the works. By offering samples and fragments, some of which were from unfinished work (in development) the audience could have an experience which was akin to visiting an artists studio or at least seeing something from behind the scenes This gives a sense of the artists as people, which is often not the case with highly resolved and finished works of art, displayed in a white cube. To facilitate this sense of discovery I made a number of small tables using builders timber work horses with a simple ply wood top to act as benches on which the artists work could be placed and to suggest the idea of things being in a transitional stage and undergoing and development. Also, the inclusion of pin boards, magnifying glasses, G Clamps were used during the installation to invoke this sense of workshop or studio. The works were very well received and I gave a number of public talks and presentation to student groups as well as after hour’s appointments to discuss the exhibition with various academics. The project has also generated some new engagements between Mexican and Australian artists with at least 3 outcomes emerging.

Sisters

Melinda Capp and her sister Meredith are identical twin. The Sisters installation presented at the Castlemaine state festival is an exploration of the experience and memories of having grown up as a twin and the complexity for both the self as single and self as other/double which underpins and confronts both the physical and psychological sense being a twin. Nature / Nurture: The work is explored as a dichotomy of Nature / Nurture by referencing the domestic context of childhood (which can be interpreted as an exposition of the influence of nurture) and reference to the physical, genetic aspect of being a twin (a reference to Nature). The Installation was located in a bedroom of a 1960’s brick house, now empty, and invites the viewer to enter into a world which pulls between these two forces of nature/nurture, which shape the sense of identity and realization of self for each twin. The bond between twins emerges at the cellular level and continues for the rest of their lives. Despite all emergence of individuality and bloodline thread binds them together forever no matter the distance between them and changes through time In dark wooden wardrobe two dresses, made from fine white tissues paper, hang quietly on each side of the robe with backlighting which floods the room with an ethereal luminance. Placed in the center of a large bare wall, a small image of Melinda and Meredith as young children (a photo transfer also on the ephemeral tissue paper) hangs in isolation. This placement and the surrounding space unites these two young twins together, bound in symmetry like a mirror image in the vast open space of the empty wall, a symbol of the potential for growth and individual identity in a world which surrounds them. On the opposite wall a series of object and artifacts are pressed between sheets of acrylic and backlit as if they were some sorts of scientific samples for detailed inspection. Feathers/hair, handmade paper with embroided (reference to the traditionally feminine arts) text and the words Blood Ties traced out. Each object is placed for analysis and hovers in space at the viewers approximate eye level like a series of clues for the revelation of some deeper insight. Hidden speakers were embedded within the walls of the room and played looped recordings at low level inviting the viewer to listen as a voyeur. A series of whispered schoolyard chants by Melinda and Meredith (identical wording were individually recorded by each sister and then superimposed) and a collage of spoken word, memories and anecdotes from the period of their childhood. Most notably recollections of the Apollo Moon landing. A symbol of the ability of science to transcend and reveal that which lies beyond and within, while at the same time counterpointed by the poetics of childhood songs emerging in unison as two twins reveal their innate unification.