Withholding and withdrawing life-sustaining medical treatment

• At common law, a competent adult can refuse life-sustaining medical treatment, either contemporaneously or through an advance directive which will operate at a later time when the adult’s capacity is lost. • Legislation in most Australian jurisdictions also provides for a competent adult to complete an advance directive that refuses life-sustaining medical treatment. • At common law, a court exercising its parens patriae jurisdiction can consent to, or authorise, the withdrawal or withholding of life-sustaining medical treatment from an adult or child who lacks capacity if that is in the best interests of the person. A court may also declare that the withholding or withdrawal of treatment is lawful. • Guardianship legislation in all jurisdictions allows a substitute decision-maker, in an appropriate case, to refuse life-sustaining medical treatment for an adult who lacks capacity. • In terms of children, a parent may refuse life-sustaining medical treatment for his or her child if it is in the child’s best interests. • While a refusal of life-sustaining medical treatment by a competent child may be valid, this decision can be overturned by a court. • At common law and generally under guardianship statutes, demand for futile treatment need not be complied with by doctors.

Drawing and writing on the screen

This chapter focuses on the physicality of the iPad as an object, and how that physicality affects the interactions children have with the device generally, and the apps specifically. Thinking about the physicality of the iPad is important because the materials, size, weight and appearance make the iPad quite unlike most other toys and equipment in the kindergarten space. Most strikingly, this physicality does not ‘represent’ the virtual vast dimensions of the iPad brought about through the diverse functions and contents of the apps contained in it. While the iPad is small enough and functional enough to be easily handled and operated even by young children, it is capable of performing highly complex, highly technological tasks that take it beyond its diminutive dimensions. This virtual-actual contrast is interesting to consider in relation to the other resources more commonly found in a kindergarten space. While objects such as toys, bricks, building materials often do prompt the child to imagine and invent beyond the physical boundaries of the toy, they not have the same types of virtual-actual contrasts of a digital device such as the iPad. How then, might children be drawn to the iPad because of its physical, technological and virtual difference? Particularly, how might this virtual-actual difference impact on the physical skills associated with writing and drawing: skills usually learnt through the use of a pencil and paper? While the research project did not set out to compare how digital and paper-based resources affect writing and drawing skills there was great interest to see how young children negotiated drawing and writing on the shiny glass surface of the iPad.

Life story work and social work practice : a case study with ex-prisoners labelled as having an intellectual disability

In common with other professions social workers have the power to articulate certain ‘‘truths’’ about the people who use their services (Hare Mustin, 1994). These knowledge statements about people, often situated in case files may become the only background information of the lived experience for people with disability (Gillman, Swain, & Heyman, 1997). Social workers need to develop interviewing, assessment and recording practices that give precedent to the worldview of service users, if they are to truly understand and respond effectively to people's lives (Bigby, 2007). One such way of doing this is by adopting a life story approach to working with vulnerable people, which can provide a holistic stance to a person's social reality (Ortiz, 1985). This article outlines the use of this approach in research with Queensland ex-prisoners who were labelled as having an intellectual disability. By explaining the process used by the first author (hereafter known as the researcher), the methodological findings of this study illustrate how life story work can contribute to social work practice.

The impact of employment-level characteristics on work-life interference in school aged children

Work–life interference is important for school-aged workers because it influences their educational outcomes/career aspirations. Although research highlights the role of work hours in determining work–life interference for these workers, work/job-level characteristics have received limited attention. Using survey data from Queensland school students who work part-time, we assess the influence of a range of employment-level variables on work–life interference. The results of multiple regression analysis indicate work–life interference is exacerbated by having low trust in managers and limited scope to refuse work hours and stability in work hours, emphasising the importance of organisational variables in integrating work and non-work spheres for school-aged workers.

Crafting and retelling everyday lives : disabled people's contribution to bioethical concerns

This commentary draws out themes from the narrative symposium on “living with the label “disability”” from the perspective of auto/biography and critical disability studies in the humanities. It notes the disconnect between the experiences discussed in the stories and the preoccupations of bioethicists. Referencing Rosemarie Garland-Thompson’s recent work, it suggests that life stories by people usually described as “disabled” offer narrative, epistemic and ethical resources for bioethics. The commentary suggests that the symposium offers valuable conceptual tools and critiques of taken-for-granted terms like “dependency”. It notes that these narrators do not un–problematically embrace the term “disability”, but emphasize the need to redefine, strategically deploy or reject this term. Some accounts are explicitly critical of medical practitioners while others redefine health and wellbeing, emphasizing the need for reciprocity and respect for the knowledge of people with disability, including knowledge from their experience of “the variant body” (Leach Scully, 2008).

Writing Indigenous vampires: Aboriginal gothic or Aboriginal fantastic?

The usual postmodern suspicions about diligently deciphering authorial intent or stridently seeking fixed meaning/s and/or binary distinctions in an artistic work aside, this self-indulgent essay pushes the boundaries regarding normative academic research, for it focusses on my own (minimally celebrated) published creative writing’s status as a literary innovation. Dedicated to illuminating some of the less common denominators at play in Australian horror, my paper recalls the creative writing process involved when I set upon the (arrogant?) goal of creating a new genre of creative writing: that of the ‘Aboriginal Fantastic’. I compare my work to the literary output of a small but significant group (2.5% of the population), of which I am a member: Aboriginal Australians. I narrow my focus even further by examining that creative writing known as Aboriginal horror. And I reduce the sample size of my study to an exceptionally small number by restricting my view to one type of Aboriginal horror literature only: the Aboriginal vampire novel, a genre to which I have contributed professionally with the 2011 paperback and 2012 e-book publication of That Blackfella Bloodsucka Dance! However, as this paper hopefully demonstrates, and despite what may be interpreted by some cynical commentators as the faux sincerity of my taxonomic fervour, Aboriginal horror is a genre noteworthy for its instability and worthy of further academic interrogation. (first paragraph)

Writing and the disappearance of architecture theory

One of the first architects to write a book was Vitruvius, the Roman architect who published De Architectura in the 1st century BC, a book that would become the foundation for Western Architectural Thought. When I was an undergraduate, the history of architecture was taught via a series of books by architects that were at least, if not more significant than the buildings. From De Architectura to Alberti’s rejoinder De re aedificatoria (On the Art of Building) in the fifteenth century, Palladio’s Quattro Libri (The Four Books of Architecture) 1570, and Laugier’s Essai sur l'Architecture 1753. In the 1990s, we treasured the heroic architecture books of the 20th century from Le Corbusier, Vers une Architecture, to Aldo Rossi’s the Architecture of the City, Rem Koolhaas’s Delirious New York, and of course Robert Venturi’s Learning from Las Vegas which for me was the very starting point for the postmodern movement.

Time, space, and text in the elementary school digital writing classroom

Theorists of multiliteracies, social semiotics, and the New Literacy Studies have drawn attention to the potential changing nature of writing and literacy in the context of networked communications. This article reports findings from a design-based research project in Year 4 classrooms (students aged 8.5-10 years) in a low socioeconomic status school. A new writing program taught students how to design multimodal and digital texts across a range of genres and text types, such as web pages, online comics, video documentaries, and blogs. The authors use Bernstein’s theory of the pedagogic device to theorize the pedagogic struggles and resolutions in remaking English through the specialization of time, space, and text. The changes created an ideological struggle as new writing practices were adapted from broader societal fields to meet the instructional and regulative discourses of a conventional writing curriculum.

Women IN Sport or Women OR Sport - The search for work/sport/life balance.

The current ‘holy grail’ for our health and well-being centres around the search for, and establishment of, a work/life balance. For many individuals, this appears to be an ever-elusive goal – forever slipping from our grasp as we juggle the day-to-day battle for our attention and time from an array of sources. When we add the word ‘Women’ to this mix, often the number of sources related to these demands multiplies in alignment with the number of roles we fill. To take this to even another level, consider the addition of the words ‘Sport’ or ‘Elite Athlete’ to ‘Women’ and ‘Work/Life Balance’, and the search for the ‘holy grail’ becomes more literal! Many sportswomen at the elite level face significant challenges in balancing working to support themselves and/or their families, studying to lay the foundations of a post-sport career, (often) spending the equivalent of full-time hours training towards their sporting goals, and additionally investing in the things that are important for them outside of these two areas – the ‘Life’ component. Getting the work/life balance ‘balanced’ has been suggested to be a key component of investing in our health and well-being. The same is applicable to sportswomen, with the added suggestion that if the balance between work/sport/life is achieved, this can positively impact upon sporting performance itself. These ideas and observations will be explored via experience within the Australian elite sporting environment from a psychologist’s perspective, with questions and invitations for further discussion.

Doctors' knowledge of the law on withholding and withdrawing life-sustaining medical treatment

Objectives To examine the level of knowledge of doctors about the law on withholding and withdrawing life-sustaining treatment from adults who lack decision-making capacity, and factors associated with a higher level of knowledge. Design, setting and participants Postal survey of all specialists in emergency medicine, geriatric medicine, intensive care, medical oncology, palliative medicine, renal medicine and respiratory medicine on the AMPCo Direct database in New South Wales, Victoria and Queensland. Survey initially posted to participants on 18 July 2012 and closed on 31 January 2013. Main outcome measures Medical specialists’ levels of knowledge about the law, based on their responses to two survey questions. Results Overall response rate was 32%. For the seven statements contained in the two questions about the law, the mean knowledge score was 3.26 out of 7. State and specialty were the strongest predictors of legal knowledge. Conclusions Among doctors who practise in the end-of-life field, there are some significant knowledge gaps about the law on withholding and withdrawing life-sustaining treatment from adults who lack decision-making capacity. Significant consequences for both patients and doctors can flow from a failure to comply with the law. Steps should be taken to improve doctors’ legal knowledge in this area and to harmonise the law across Australia.

Building communities through co-creative storytelling : sound walking in New England

The Story Project is a small, not-for-profit community media arts company based on the Sunshine Coast hinterland. It specialises in facilitating first-person storytelling. Since 2012 The Story Project has been collaborating with a small community arts organisation based in northern NSW, Uralla Arts, to record local heritage in first-person story form and to curate and present it ways that will appeal to new generations of listeners. The initial collaboration was funded by a Federal government Community Heritage program. The project successfully adapted a participatory method of life storytelling to this regional context and some 40 stories were contributed to a collection. A more ambitious suite of projects to develop soundwalks in a number of towns across the New England region has since grown from this initial collaboration. The soundwalks seek to combine local creative works in oral story, music and visual forms, and make them accessible through an application that can be downloaded to GPS-enabled mobile devices. While soundwalks are not new, the needs and challenges of creative community-building that New England soundwalks attempt to solve in this regional setting hold value for a broader range of interests than just those of the immediate project stakeholders. This paper reports on a research collaboration between The Story Project and QUT researchers that looked at The Story Project’s engagement with Uralla Arts and other New England community-based networks and organisations. It considers how this instance of story-centred, participatory media arts practice contributes to building population-wide capacity for creative expression.

The sideways hourglass : establishing the lemniscate as a narrative structure for writing and reading non-linear stories

This thesis is a study in narratology that examines the pre-theoretical ideas that underlie the study of narrative and time. The thesis explores how the lemniscate can be transported from geometry to narrative in order to structure a non-linear story that breaks the rules of causality and chronology by coupling physical movement through space with the backward pull of memory. The findings offer new possibilities for understanding the nexus between shape and story and for recording non-linear narratives that are marked by simultaneity, counterpoint, and reversal.

Save Your Life Tonight : Heads Up

Save Your Life Tonight is a factual entertainment series produced by WildBear Entertainment for the Australian Broadcasting Corporation (ABC) and was filmed in front of a live studio audience at Royal Brisbane and Women's Hospital (RBWH). Save Your Life Tonight is a unique studio based medical series that explores Australia’s top 10 health issues in an exciting and entertaining way. Driven by charismatic host Andrew Daddo, along with resident GP Dr Liz Marles and a panel of leading experts, each episode is a fast-paced, dynamic exploration of the causes, symptoms, treatments and, most importantly, prevention of these leading health issues. But Save Your Life Tonight doesn't just talk about the issues, it shows the issues! Save Your Life Tonight features real patients, real doctors, real tests, real diagnoses, and real surgical procedures – live on stage! For the "Heads Up" episode, the program explores the issues of mental health. Only half of the Australians suffering from severe mental heath issues are receiving treatment. Featuring Ian Hickie on the panel, we also see a young mum face her crippling bird phobia with the help of a Wedge Tailed Eagle.

Physical activity, walking and quality of life in women with depressive symptoms

Background Physical activity (PA) has a positive association with health-related quality of life (HRQL) in the general population. The association between PA and HRQL in those with poor mental health is less clear. Purpose To examine the concurrent and prospective dose-response relationships between total physical activity (TPA) and walking only with HRQL in women aged 50-55 with depressive symptoms in 2001. Methods Participants were 1904 women born in 1946-1951 who completed mailed surveys for the Australian Longitudinal Study on Women's Health in 2001, 2004, 2007 and 2010 and who, in 2001, reported depressive symptoms. At each time point, they reported their weekly minutes of walking, moderate PA, and vigorous PA. A summary TPA score was created that accounted for differences in energy expenditure among the three PA types. Mixed models were used to examine associations between TPA and HRQL (SF-36 component and subscale scores) and between walking and HRQL, for women who reported walking as their only PA. Analyses were conducted in 2013-2014. Results Concurrently, higher levels of TPA and walking were associated with better HRQL (p<0.05). The strongest associations were found for physical functioning, vitality, and social functioning subscales. In prospective models, associations were attenuated, yet compared with women doing no TPA or walking, women doing “sufficient” TPA or walking had significantly better HRQL over time for most SF-36 scales. Conclusions This study extends previous work by demonstrating trends between both TPA and walking and HRQL in women reporting depressive symptoms.