Factors associated with the wish to hasten death : a study of patients with terminal illness

Background. There is considerable debate regarding the clinical issues surrounding the wish to hasten death (WTHD) in the terminally ill. The clinical factors contributing to the WTHD need further investigation among the terminally ill in order to enhance understanding of the clinical assessment and treatment needs that underlie this problem. A more detailed understanding may assist with the development of appropriate therapeutic interventions. Method. A sample of terminally ill cancer patients (N=256) recruited from an in-patient hospice unit, home palliative care service and a general hospital palliative care consulting service from Brisbane Australia between 1998–2001 completed a questionnaire assessing psychological (depression and anxiety), social (family relationship, social support, level of burden on others) and the impact of physical symptoms. The association between these factors and the WTHD was investigated. Results. A high WTHD was reported by 14% of patients. A discriminant function analysis revealed that the following variables were associated with a high WTHD (P<0·001): higher levels of depressive symptoms, being admitted to an in-patient hospice setting, a greater perception of being a burden on others, lower family cohesion, lower levels of social support, higher levels of anxiety and greater impact of physical symptoms. Conclusions. Psychological and social factors are related to a WTHD among terminally ill cancer patients. Greater attention needs to be paid to the assessment of psychological and social issues in order to provide appropriate therapeutic interventions for terminally ill patients.

Look before you leap : the epistemic violence that sometimes hides behind the word "inclusion"

This paper demonstrates how Indigenous Studies is controlled in some Australian universities in ways that continue the marginalisation, denigration and exploitation of Indigenous peoples. Moreover, it shows how the engagement of white notions of “inclusion” can result in the maintenance of racism, systemic marginalisation, white race privilege and radicalised subjectivity. A case study will be utilised which draws from the experience of two Indigenous scholars who were invited to be part of a panel to review one Australian university’s plan and courses in Indigenous studies. The case study offers the opportunity to destabilise the relationships between oppression and privilege and the epistemology that maintains them. The paper argues for the need to examine exactly what is being offered when universities provide opportunities for “inclusion”.

Doctors and their patients : A context for understanding the wish to hasten death

There is a paucity of research that has directly examined the role of the health professional in dealing with a terminally ill patient's wish to hasten death (WTHD) and the implications of this for the support and services needed in the care for a dying patient. Themes to emerge from a qualitative analysis of interviews conducted on doctors (n=24) involved in the treatment and care of terminally ill patients were (i) the doctors' experiences in caring for their patients (including themes of emotional demands/expectations, the duration of illness, and the availability of palliative care services); (ii) the doctors' perception of the care provided to their respective patients (comprising themes concerning satisfaction with the care for physical symptoms, for emotional symptoms, or overall care); (iii) the doctors' attitudes to euthanasia and (iv) the doctors' perception of their patients' views/beliefs regarding euthanasia and hastened death. When responses were categorised according to the patients' level of a WTHD, the theme concerning the prolonged nature of the patients' illnesses was prominent in the doctor group who had patients with the highest WTHD, whereas there was only a minority of responses concerning support from palliative care services and satisfaction with the level of emotional care in this group. This exploratory study presents a set of descriptive findings identifying themes among a small group of doctors who have been involved in the care of terminally ill cancer patients, to investigate factors that may be associated with the WTHD among these patients. The pattern of findings suggest that research investigating the doctor-patient interaction in this setting may add to our understanding of the problems (for patients and their doctors) that underpins the wish to hasten death in the terminally ill.

Terminally ill cancer patients’ wish to hasten death

This exploratory study investigated factors associated with the wish to hasten death among a sample of terminally ill cancer patients. Semi-structured interviews conducted on a total of 72 hospice and home palliative care patients were subjected to qualitative analysis using QSRNUDIST. The main themes to emerge suggested that patients with a high wish to hasten death had greater concerns with physical symptoms and psychologica l suffering, perceived themselves to be more of a burden to others, and experienced higher levels of demoralization, while also reporting less confidence in symptom control, fewer social supports, less satisfaction with life experiences and fewer religious beliefs when compared with patients who had a moderate or no wish to hasten death. The implications of these findings will be discussed.

Adolescent protective behaviour to reduce drug and alcohol use, alcohol-related harm and interpersonal violence

Typically adolescents' friends are considered a risk factor for adolescent engagement in risk-taking. This study took a more novel approach, by examining adolescent friendship as a protective factor. In particular it investigated friends' potential to intervene to reduce risk-taking. 540 adolescents (mean age 13.47 years) were asked about their intention to intervene to reduce friends' alcohol, drug and alcohol-related harms and about psychosocial factors potentially associated with intervening. More than half indicated that they would intervene in friends' alcohol, drug use, alcohol-related harms and interpersonal violence. Intervening was associated with being female, having friends engage in overall less risk-taking and having greater school connectedness. The findings provide an important understanding of increasing adolescent protective behavior as a potential strategy to reduce alcohol and drug related harms.

Comparing international television news : the case of violence presentation in Germany, Great Britain and Russia -- [in German : Gewalt in internationalen Fernsehnachrichten - eine komparative Analyse medialer Gewaltpräsentation in Deutschland, Großbritannien und Russland]

This is an important book that ought to launch a debate about how we research our understanding of the world, it is an innovative intervention in a vital public issue, and it is an elegant and scholarly hard look at what is actually happening. Jean Seaton, Prof of Media History, U of Westminster, UK & Official Historian of the BBC -- Summary: This book investigates the question of how comparative studies of international TV news (here: on violence presentation) can best be conceptualized in a way that allows for crossnational, comparative conclusions on an empirically validated basis. This book shows that such a conceptualization is necessary in order to overcome existing restrictions in the comparability of international analysis on violence presentation. Investigated examples include the most watched news bulletins in Great Britain (10o'clock news on the BBC), Germany (Tagesschau on ARD) and Russia (Vremja on Channel 1). This book highlights a substantial cross-national violence news flow as well as a cross-national visual violence flow (key visuals) as distinct transnational components. In addition, event-related textual analysis reveals how the historical rootedness of nations and its symbols of power are still manifested in televisual mediations of violence. In conclusion, this study lobbies for a conscientious use of comparative data/analysis both in journalism research and practice in order to understand what it may convey in the different arenas of today’s newsmaking.

Health, Death, and Indigenous Australians in the Coronial system

This paper details research conducted in Queensland during the first year of operation of the new Coroners Act 2003. Information was gathered from all completed investigations between December 2003 and December 2004 across five categories of death: accidental, suicide, natural, medical and homicide. It was found that 25 percent of the total number of Indigenous deaths recorded in 2004 were reported to, and investigated by, the Coroner, in comparison to 9.4 percent of non-Indigenous deaths. Moreover, Indigenous people were found to be over-represented in each category of death, except in death in a medical setting, where they were absent.

Domestic violence in the urban fringe

Police call data for domestic violence incidents in the city of Brisbane were used to further explore the locational disadvantage thesis. it was hypothesised that the supposed additional burdens and stresses on disadvantaged families living in the outer suburbs may be reflected in significantly higher rates of reported domestic violence. Using an index of relative socioeconomic disadvantage and employing Analysis of variance (ANOVA) this research shows that significantly higher rates of reported domestic violence occur in the inner suburbs relative to the middle or outer suburbs of Brisbane. This finding adds further doubt to the magnitude of locational disadvantage impacts on outer suburban low income family households.

Safeguarding Rural Australia : Data Report No. 2 - Intentional Violence

This report focuses on our examination of extant data which have been sourced with respect to intentional violence perpetrated or experienced by males in regional and remote Australia. The nature of intentional violent acts can be physical, sexual or psychological or involve deprivation or neglect. We have presented under the headings of: self-harm including suicide; homicide; assault, sexual assault and the threat of assault; child abuse; other family and intimate partner violence; harassment, stalking and bullying; alcohol related social violence; and animal abuse. State variations in interpersonal violence are also presented. Additional commentary resulting from exploration, examination and analyses of secondary data is published online in complementary reports in this series.

Safeguarding Rural Australia: Data Report No. 3 - Unintentional Violence

This report focuses on our examination of extant data which have been sourced with respect to unintentional serious and violent injuries to males living in regional and remote Australia. Such injuries typically might be caused by, for example, transport accidents, occupational exposures and hazards, burns and so on. Thus unintentional violent incidents cause physical trauma the consequences of which can sometimes lead to chronic conditions including psychological harm or substance abuse. Additional commentary resulting from exploration, examination and analyses of secondary data is published online in complementary reports in this series.

Safeguarding rural Australia : addressing masculinity and violence in rural settings. Data report No. 4 - Risky behaviour - misuse of alcohol, illicit drugs, firearms use and abuse, other risky behaviour

This report focuses on our examination of extant data which have been sourced with respect to personally and socially risky behaviour associated with males living in regional and remote Australia . The AIHW (2008: PHE 97:89) defines personally risky behaviour, on the one hand, as working, swimming, boating, driving or operating hazardous machinery while intoxicated with alcohol or an illicit drug. Socially risky behaviour, on the other hand, is defined as creating a public disturbance, damaging property, stealing or verbally or physically abusing someone while intoxicated with alcohol or an illicit drug. Additional commentary resulting from exploration, examination and analyses of secondary data is published online in complementary reports in this series.

Safeguarding rural Australia : addressing masculinity and violence in rural settings. Data report no. 5. Consequences of violence - juvenile offenders, long-term health consequences, anxiety and repression, other chronic disabilities

This report considers extant data which have been sourced with respect to some of the consequences of violent acts and incidents and risky behaviour for males living in regional and remote Australia . This has been collated and presented under the headings: juvenile offenders; long-term health consequences; anxiety and repression; and other chronic disabilities. Additional commentary resulting from exploration, examination and analyses of secondary data is published online in complementary reports in this series.

Globalization, frontier masculinities and violence : booze, blokes and brawls

Over the last two decades, two new trajectories have taken hold in criminology - the study of masculinity and crime, after a century of neglect, and the geography of crime. This article brings both those fields together to analyse the impact of globalisation in the resources sector on frontier cultures of violence. This paper approaches this issue through a case study of frontier masculinities and violence in communities at the forefront of generating resource extraction for global economies. This paper argues that the high rates of violence among men living in work camps in these socio-spatial contexts cannot simply be understood as individualised expressions of psycho-pathological deficit or social disorganisation. Explanations for these patterns of violence must also consider a number of key subterranean convergences between globalising processes and the social dynamics of male-on-male violence in such settings.