Advance directives, autonomy and the refusal of life-sustaining medical treatment

As Australian society 1s agemg, individuals are increasingly concerned about managing their future, including making decisions about the medical treatment they may wish to receive or refuse if they lose decision-making capacity. To date, there has been relatively little research into the extent to which legal regulation allows competent adults to make advance refusals of life-sustaining medical treatment that will bind health professionals and others when a decision needs to be made at a future time. This thesis aims to fill this gap in the research by presenting the results of research into the legal regulation of advance directives that refuse life-sustaining medical treatment. In the five papers that comprise this thesis, the law that governs this area is examined, and the ethical principle of autonomy is used to critically evaluate that law. The principal finding of this research is that the current scheme of regulation is ineffective to adequately promote the right of a competent adult to make binding advance directives about refusal of medical treatment. The research concludes that legislation should be enacted to enable individuals to complete an advance directive, only imposing restrictions to the extent that this is necessary to promote individual autonomy. The thesis first examines the principle of autonomy upon which the common law (and some statutory law) is expressed to be based, to determine whether that principle is an appropriate one to underpin regulation. 1 The finding of the research is that autonomy can be justified as an organising principle on a number of grounds: it is consistent with the values of a liberal democracy; over recent decades, it is a principle that has been even more prominent within the discipline of medical ethics; and it is the principle which underpins the legal regulation of a related topic, namely the contemporaneous refusal of medical treatment. Next, the thesis reviews the common law to determine whether it effectively achieves the goal of promoting autonomy by allowing a competent adult to make an advance directive refusing treatment that will operate if he or she later loses decision-making capacity. 2 This research finds that conunon law doctrine, as espoused by the judiciary, prioritises individual choice by recognising valid advance directives that refuse treatment as binding. However, the research also concludes that the common law, as applied by the judiciary in some cases, may not be effective to promote individual autonomy, as there have been a number of circumstances where advance directives that refuse treatment have not been followed. The thesis then examines the statutory regimes in Australia that regulate advance directives, with a focus on the regulation of advance refusals of life-sustaining medical treatment.3 This review commences with an examination ofparliamentary debates to establish why legislation was thought to be necessary. It then provides a detailed review of all of the statutory regimes, the extent to which the legislation regulates the form of advance directives, and the circumstances in which they can be completed, will operate and can be ignored by medical professionals. The research finds that legislation was enacted mainly to clarify the common law and bring a level of certainty to the field. Legislative regimes were thought to provide medical professionals with the assurance that compliance with an advance directive that refuses life-sustaining medical treatment will not expose them to legal sanction. However, the research also finds that the legislation places so many restrictions on when an advance directive refusing treatment can be made, or will operate, that they have not been successful in promoting individual autonomy.

Free software as a democratic principle

Software forms an important part of the interface between citizens and their government. An increasing amount of government functions are being performed, controlled, or delivered electronically. This software, like all language, is never value-neutral, but must, to some extent, reflect the values of the coder and proprietor. The move that many governments are making towards e-governance, and the increasing reliance that is being placed upon software in government, necessitates a rethinking of the relationships of power and control that are embodied in software.

Connecting Diversity : Paradoxes of Multicultural Australia

Commissioned by SBS, and published in March 2006, Connecting Diversity: Paradoxes of Multicultural Australia is a follow-up study to SBS’s 2002 report, Living Diversity: Australia’s Multicultural Future. The attitudes of many younger Australians from culturally diverse backgrounds reveal paradoxes about Australian multiculturalism today. This report sheds light on their views, experiences and expectations and the role of media in their lives. Younger, culturally and linguistically diverse Australians are often the subject of mediafanned controversy about disaffection, ‘ethnic gangs’ and cultural isolation. While these controversies tend to be localised – Cronulla, Inala or Bankstown – Connecting Diversity tells a national and quite different story. This research builds upon the findings of the 2002 report, Living Diversity: Australia’s Multicultural Future, which challenged common assumptions about contemporary multicultural Australia. In an era of fragmenting media and assumed political apathy, Connecting Diversity further examines many of the findings of the earlier study, with a new focus on younger people, cultural identity and media use. Connecting Diversity reveals individual experiences and often contradictory ideas about media and diversity in Australia. Disjunctions appear to exist between an individual’s experience and their thoughts about Australia’s national identity. Multiculturalism is valued for broadening the appreciation of difference, yet this support can coexist with concerns about perceived segregation, usually ‘elsewhere’ in Australia. Younger people tend to be more comfortable with cultural difference than previous generations and cite their own diverse network of friends as one of the reasons for this. Even so, some describe experiences of racism that engender a feeling of exclusion from ‘mainstream’ society. In their everyday lives, social relationships are navigated through regular and familiar connections on the one hand, and experiences and expressions of disconnection on the other. Racism and tolerance may be expressed almost simultaneously. These disconnections are often managed through ‘practical tolerance',allowing them to negotiate these apparent contradictions. The connections can be based simultaneously on such things as work, family,religion, friendships or location. The result is a multilayered sense of personal belonging and community connection. A large number of respondents in these focus groups expressed frustration at the failings of media, especially news and current affairs coverage, yet spoke enthusiastically about the accessibility and range of media compared to what was available to previous generations. In their many forms, media remain a key ingredient of self-identification among younger Australians of culturally diverse backgrounds who are especially cynical about media and disillusioned by their perceived inability to influence issues that are important to them. These findings reveal that although they may be cynical about media messages, these younger Australians are looking for connection through media and are seeking ways to participate in meaningful ways. This raises questions about the possibilities for media to empower younger people to play a part in genuine cultural democracy. By capturing the attitudes of Australians of culturally diverse backgrounds under the age of 40, Connecting Diversity: Paradoxes of Multicultural Australia provides an insight into social trends and the generational and cultural changes that are now shaping Australia.

Vulnerable and invisible : depictions of trafficking victims in public awareness campaigns

Public concern about the crime of human trafficking has dramatically risen over the last two decades. . This concern and panic has both spawned and been fuelled by an array of public awareness campaigns that aim to educate the public about this crime. Campaigns such as the Blue Blindfold Campaign in the UK, the UN-driven Blue Heart Campaign, and the worldwide Body Shop campaign have contributed to the public’s awareness and, to an extent, understanding of the phenomenon of human trafficking. This research explores these and other government and non-government campaigns aimed at raising public awareness of human trafficking. It questions the rationale, call to action and impact of these efforts, and analyses the depiction of trafficking victims in these campaigns. In particular, this research argues that some of these campaigns perpetuate an understanding of a hierarchy of victimisation of trafficking. A public focus on sex trafficking often results in the conflation of prostitution and trafficking, and renders invisible the male and female victims of trafficking for other forms of labour.

An Introduction to Political Communication, 5th Edition

An Introduction to Political Communication introduces students to the complex relationship between politics, the media and democracy in the United Kingdom, United States and other contemporary societies. Brian McNair examines how politicians, trade unions, pressure groups, NGOs and terrorist organisations make use of the media. Individual chapters look at political media and their effects, the work of political advertising, marketing and public relations, and the communicative practices of organizations at all levels, from grass-root campaigning through to governments and international bodies. This fifth edition has been revised and updated to include: • the 2008 US presidential election, and the early years of Barack Obama’s term • the MPs’ expenses scandal in Britain, and the 2010 UK election campaign • the growing role of bloggers and online pundits such as Guido Fawkes in the political agenda setting process • the emergence of social media platforms such as Twitter, YouTube and Facebook, and their destabiising impact on the management of political crises all over the world, including the Iranian pro-reform protests of July 2009 and the Israeli atack on the anti-blockade flotilla of May 2010 • the growing power of Wikileaks and other online information sources to challenge state control of classified information

Beyond difference : reconfiguring education for the user-led age

In recent years, various observers have pointed to the shifting paradigms of cultural and societal participation and economic production in developed nations. These changes are facilitated (although, importantly, not solely driven) by the emergence of new, participatory technologies of information access, knowledge exchange, and content production, many of whom are associated with Internet and new media technologies. In an online context, such technologies are now frequently described as social software, social media, or Web2.0, but their impact is no longer confined to cyberspace as an environment that is somehow different and separate from ‘real life’: user-led content and knowledge production is increasingly impacting on media, economy, law, social practices, and democracy itself.

Introduction to special issue on what criminology can say about the war on terror

On 20 September 2001, the former US President, George W. Bush, declared what is now widely, and arguably infamously, known as a ‘war on terror’. In response to the fatal 9/11 attacks in New York and Washington, DC, President Bush identified the US military response as having far-reaching and long-lasting consequences. It was, he argued, ‘our war on terror’ that began ‘with al Qaeda, but … it will not end until every terrorist group of global reach has been found, stopped and defeated’ (CNN 2001). This was to be a war that would, in the words of former British Prime Minister, Tony Blair, seek to eliminate a threat that was ‘aimed at the whole democratic world’ (Blair 2001). Blair claimed that this threat is of such magnitude that unprecedented measures would need to be taken to uphold freedom and security. Blair would later admit that it was a war that ‘divided the country’ and was based on evidence ‘about Saddam having actual biological and chemical weapons, as opposed to the capability to develop them, has turned out to be wrong’ (Blair 2004). The failures of intelligence ushered in new political rhetoric in the form of ‘trust me’ because ‘instinct is no science’ (Blair 2004). The war on terror has been one of the most significant international events in the past three decades, alongside the collapse of the former Soviet Union, the end of apartheid in South Africa, the unification of Europe and the marketization of the People's Republic of China. Yet, unlike the other events, it will not be remembered for advancing democracy or sovereignty, but for the conviction politics of particular politicians who chose to dispense with international law and custom in pursuit of personal instincts that proved fatal. Since the invasions of Afghanistan in October 2001 and …

Corporate, risk, mining camps and knowledge/power

Australia is currently in the midst of a major resources boom. However the benefits from the boom are unevenly distributed, with state governments collecting billions in royalties, and mining companies billions in profits. The costs are borne mostly at a local level by regional communities on the frontier of the mining boom, surrounded by thousands of men housed in work camps. The escalating reliance on non–resident workers housed in camps carries significant risks for individual workers, host communities and the provision of human services and infrastructure. These include rising rates of fatigue–related death and injuries, rising levels of alcohol–fuelled violence, illegally erected and unregulated work camps, soaring housing costs and other costs of living, and stretched basic infrastructure undermining the sustainability of these towns. But these costs have generally escaped industry, government and academic scrutiny. This chapter directs a critical gaze at the hopelessly compromised industry–funded research vital to legitimating the resource sector’s self–serving knowledge claims that it is committed to social sustainability and corporate responsibility. The chapter divides into two parts. The first argues that post–industrial mining regimes mask and privatise these harms and risks, shifting them on to workers, families and communities. The second part links the privatisation of these risks with the political economy of privatised knowledge embedded in the approvals process for major resource sector projects.

Democratization and Violence: European and International Perspectives

It is a startling fact that when in the mid-80s a ‘third wave’ of democracy took hold in Latin America and Eastern Europe, both democracy and violence were simultaneously on the rise worldwide. Almost by definition democracies represent an institutionalized framework and a way of life that ensures non-violent means to share power between communities of people with widely differing values and beliefs. As Keane (2004) points out, ‘violence is anathema to [democracy’s] spirit and substance’ (p. 1). Accordingly, the process of democratization was accompanied by expectations that violence would generally decrease, and that these countries would embark on a process of reducing levels of violence as Western European countries had done earlier in the 19th and 20th century.

g4c2c: A model for citizen engagement at arms' length from government

The recognition that Web 2.0 applications and social media sites will strengthen and improve interaction between governments and citizens has resulted in a global push into new e-democracy or Government 2.0 spaces. These typically follow government-to-citizen (g2c) or citizen-to-citizen (c2c) models, but both these approaches are problematic: g2c is often concerned more with service delivery to citizens as clients, or exists to make a show of ‘listening to the public’ rather than to genuinely source citizen ideas for government policy, while c2c often takes place without direct government participation and therefore cannot ensure that the outcomes of citizen deliberations are accepted into the government policy-making process. Building on recent examples of Australian Government 2.0 initiatives, we suggest a new approach based on government support for citizen-to-citizen engagement, or g4c2c, as a workable compromise, and suggest that public service broadcasters should play a key role in facilitating this model of citizen engagement.