The legal role of medical professionals in decisions to withhold or withdraw life-sustaining treatment : part 3 (Victoria)

This is the final article in a series of three that examines the legal role of medical professionals in decisions to withhold or withdraw life-sustaining treatment from adults who lack capacity. This article considers the position in Victoria. A review of the law in this State reveals that medical professionals play significant legal roles in these decisions. However, the law is problematic in a number of respects and this is likely to impede medical professionals’ legal knowledge in this area. The article examines the level of training that medical professionals receive on issues such as refusal of treatment certificates and substitute decision-making, and the available empirical evidence as to the state of medical professionals’ knowledge of the law at the end of life. It concludes that there are gaps in legal knowledge and that law reform is needed in Victoria. The article also draws together themes from the series as a whole, including conclusions about the need for more and better medical education and about law reform generally.

Producing better outcomes : music and public services

Music has played an important role in social life for thousands of years, and its varied forms of communication have significantly influenced the types of public services reported in this book. It is now time for practitioners and academics to sing songs of resilience that reinvigorate the public’s understanding of the positive role music can play in all of our lives, and for public services to better resource music projects. The last twenty years have seen major advances in studies of music and its affects on the brain’s neuroplasticity, but as yet no one has managed to provide a comprehensive response to Oliver Sachs’ (2006) question: why does music, for better or worse, have so much power? This chapter seeks to demonstrate the power of those music making experiences that bridge the gap between the physicaland social sciences across commercial, social and cultural contexts.

Resourcing resilience through recreational music programs

Many music programs in Australia deliver a United States (US) package created by the Recreational Music-Making Movement, founded by Karl Bruhn and Barry Bittman. This quasi-formal group of music makers, academics and practitioners uses the logic of decentralised global networks to connect with local musicians, offering them benefits associated with their ‘Recreational Music Program’ (RMP). These RMPs encapsulate the broad goals of the movement, developed in the US during the 1980s, and now available as a package, endorsed by the National Association of Music Merchants (NAMM), for music retailers and community organisations to deliver locally (Bittman et al., 2003). High participation rates in RMPs have been historically documented amongst baby boomers with disposable income. Yet the Australian programs increasingly target marginalised groups and associated funding sources, which in turn has lowered the costs of participation. This chapter documents how Australian manifestations of RMPs presently report on the benefits of participation to attract cross-sector funding. It seeks to show the diversity of participants who claim to have developed and accessed resources that improve their capacity for resilience through recreational music performance events. We identify funding issues pertaining to partnerships between local agencies and state governments that have begun to commission such music programs. Our assessment of eight Australian RMPs includes all additional music groups implemented since the first program, their purposes and costs, the skills and coping strategies that participants developed, how organisers have reported on resources, outcomes and attracted funding. We represent these features through a summary table, standard descriptive statistics and commentaries from participants and organisers.

Design for eco-services. Part A - Environmental Services

Without the virtually free services of nature like clean air and water, humans would not last long. Natural systems can be incorporated in existing urban structures or spaces to add public amenity, mitigate the heat island effect, reduce pollution, add oxygen, and ensure water, electricity and food security in urban areas. Th ere are many eco-solutions that could radically reduce resource consumption and pollution and even provide surplus ecosystem services in the built environment at little or no operational cost, if adequately supported by design. Th is paper is the fi rst of a two part paper that explains what eco-services are, then provides examples of how design can generate natural as well as social capital. Using examples of actual and notional solutions, both papers set out to challenge designers to ‘think again’, and invent ways of creating net positive environmental gains through built environment design.

Design for eco-services. Part B - Building Services

Without the virtually free services of nature like clean air and water, humans would not last long. Natural systems can be incorporated in existing urban structures or spaces to add public amenity, mitigate the heat island eff ect, reduce pollution, add oxygen, and ensure water, electricity and food security in urban areas. Th ere are many eco-solutions that could radically reduce resource consumption and pollution and even provide surplus ecosystem services in the built environment at little or no operational cost, if adequately supported by design. Th is is the second part of a two part paper that explains what eco-services are, then provides examples of how design can generate natural as well as social capital. Using examples of actual and notional solutions, both papers set out to challenge designers to ‘think again’, and invent ways of creating net positive environmental gains through built environment design.

Managing wetlands sustainably as ecosystems : The contribution of the law (part 1)

The ways in which a society set standards of behaviour and of conduct for its members vary hugely. For example, accepted practices, recognised customs, spiritually or morally inspired norms, judicially declared rules, executively formulated edicts, formal legislative enactments or constitutionally embedded rights and duties. Whatever form they assume, these standards are the artificial construction of the human mind. Accordingly the law - whatever its form - can do no more and no less than regulate or set standards for human behaviour, human conduct, and human decision-making. The law cannot regulate the environment. It can only regulate human activities that impact directly or indirectly upon the environment. This applies as much to wetlands as components of the environment as it does to any other components of the environment or the environment at large. The capacity of the law to protect the environment and therefore wetlands is thus totally dependent upon the capacity of the law to regulate human behaviour, human conduct and human decision-making. At the same time the law needs to reflect the specific nature, functions and locations of wetlands. A wetland is an ecosystem by itself; it comprises a range of ecosystems within it; and it is part of a wider set of ecosystems. Hence, the significant ecological functions performed by wetlands. Then there are the benefits flowing to humans from wetlands. These may be social, economic, cultural, aesthetic, or a combination of some or of all of these. It is a challenge for a society acting through its legal system to find the appropriate balance between these ecological and these human values. But that is what sustainability requires.The ways in which a society set standards of behaviour and of conduct for its members vary hugely. For example, accepted practices, recognised customs, spiritually or morally inspired norms, judicially declared rules, executively formulated edicts, formal legislative enactments or constitutionally embedded rights and duties. Whatever form they assume, these standards are the artificial construction of the human mind. Accordingly the law - whatever its form - can do no more and no less than regulate or set standards for human behaviour, human conduct, and human decision-making. The law cannot regulate the environment. It can only regulate human activities that impact directly or indirectly upon the environment. This applies as much to wetlands as components of the environment as it does to any other components of the environment or the environment at large. The capacity of the law to protect the environment and therefore wetlands is thus totally dependent upon the capacity of the law to regulate human behaviour, human conduct and human decision-making. At the same time the law needs to reflect the specific nature, functions and locations of wetlands. A wetland is an ecosystem by itself; it comprises a range of ecosystems within it; and it is part of a wider set of ecosystems. Hence, the significant ecological functions performed by wetlands. Then there are the benefits flowing to humans from wetlands. These may be social, economic, cultural, aesthetic, or a combination of some or of all of these. It is a challenge for a society acting through its legal system to find the appropriate balance between these ecological and these human values. But that is what sustainability requires.

Managing Wetlands Sustainably as Ecosystems: The Contribution of the Law (Part 2)

In this Part 2 attention is turned towards the legal arrangements in nation states for managing wetlands. These national arrangements have effect within the international arrangements already mentioned and any regional arrangements that are relevant. However, each national system is a reflection of its own historical, cultural, political and constitutional background. It is the purpose of this Part 2 to review and assess the national approaches to wetlands management. This involves an analysis of a range of instruments. These are: constitutional rules; strategic rules; regulatory rules; and management rules. Each of these sets of rules performs different functions, assumes different forms and is differentially capable of enforcement.