Between a rock and a hard place: exploring the conflict between respecting the privacy of patients and informing their carers

Background: A patient's right to privacy is considered fundamental to medical care, with physicians assuming the role of guardian of the clinical information which is conveyed to the patient. However, as a patient's health declines, physicians are often challenged by the need to protect patient privacy while addressing the expectations of the patient's carers, who seek medical information to provide appropriate care at home.

Aims: This study sought to explore the expectations of patients, their carers and physicians regarding the communication of clinical information to carers.

Methods: Surveys were distributed in outpatient clinics at a metropolitan quaternary hospital, with responses from 102 patients and carers, as well as 219 medical staff.

Results: The expectations of patients and carers differed from those of medical staff. Physicians typically believed discussions with carers should begin following the patient's permission and at the patient's request. Patients and carers, however, believed information should be automatically offered or provided when questioned. Further, carers generally felt information updates should occur regularly and routinely, whereas physicians indicated updates should occur with prompting either by a major clinical change or in response to a carer's concern.

Conclusion: Physicians should be aware that the expectations of patients and carers regarding information communication to carers may not match their own. Meanwhile, patients and carers should be made aware of the constraints upon physicians and should be encouraged to convey their preferences for information sharing. These tasks could be facilitated by the development of a prompt sheet to assist the clinical encounter.

Current findings on Australian children in postseparation disputes : outer conflict, inner discord

This paper sets out descriptive baseline data on the first 111 Australian families participating in a current study of the efficacy of child-focused and child-inclusive Family Law Mediation. The families come from the first of two treatment groups in that comparative study. While outcome data are not yet available on this group, the baseline data, gathered prior to intervention, are of interest and value. The paper describes the nature of parents' conflict with each other, the strength of their parental alliance, and the psychological functioning of their children at the time of presentation to the mediation service. High mental health risk for the children in these families is evident, both from parents' and children's perspectives. Uniquely, the paper includes the perceptions of 73 children about their parents' conflict and its impact on them. Implications are discussed, underscoring the imperative of early intervention with separating families that includes screening of the children's experience of conflict and their own needs for recovery.

Aid to conflict-affected countries : lessons for donors

Investigates how aid might prevent conflicts from breaking out or becoming worse.

Aid to conflict-affected countries : lessons for donors

The first section looks at the implications of conflict for aid effectiveness and selectivity. We argue that, while aid is generally effective in promoting growth and by implication reducing poverty, it is more effective in promoting growth in post-conflict countries. We then consider the implications of these findings for donor selectivity models and for assessment of donor performance in allocating development aid among recipient countries. We argue that, while further research on aid effectiveness in post-conflict scenarios is needed, existing selectivity models should be augmented with, inter alia, post-conflict variables, and donors should be evaluated on the basis, inter alia, of the share of their aid budgets allocated to countries experiencing post-conflict episodes. We also argue for aid delivered in the form of projects to countries with weak institutions in early post-conflict years. The second section focuses on policies for donors operating in conflict-affected countries. We set out five of the most important principles: (1) focus on broad-based recovery from war; (2) to achieve a broad-based recovery, get involved before the conflict ends; (3) focus on poverty, but avoid ‘wish lists’; (4) help to reduce insecurity so aid can contribute more effectively to growth and poverty reduction; and (5) in economic reform, focus on improving public expenditure management and revenue mobilisation. The third section concludes by emphasising the fact that there is no hard or fast dividing line between ‘war’ and ‘peace’ and that it may take many years for a society to become truly ‘post’-conflict’. Donors, therefore, need to prepare for the long haul.

The perennial problem of police gratuities : public concerns, political optics, and an accountability ethos

Despite the perennial nature of the problem of gratuities in considerations of police ethics, many prior analyses of this issue have rested on anecdotal, piecemeal or hypothetical considerations.. This paper draws on a unique sample of actual complaint cases involving gratuities, providing evidence of a range of public concerns about the problem. Gratuities are analysed and contextualised by reference to the concept of conflict of interest, which draws attention to the potential for the performance of public duty to be tainted in fact or appearance. In either case, public trust in the integrity of the police is damaged, giving rise to "political optics" as a key problem with gratuities.  The paper argues that an accountability ethos must be developed to promote active responsibility and a preparedness to prioritise the public interest in policing.

Designing adaptive artificial agents for an economic production and conflict model

Production and conflict models have been used over the past 30 years to represent the effects of unproductive resource allocation in economics. Their major applications are in modelling the assignment of property rights, rentseeking and defense economics. This paper describes the process of designing an agent used in a production and conflict model. Using the capabilities of an agent-based approach to economic modelling, we have enriched a simple decision-maker of the kind used in classic general equilibrium economic models, to build an adaptive and interactive agent which uses its own attributes, its neighbors’ parameters and information from its environment to make resource allocation decisions. Our model presents emergent and adaptive behaviors than cannot be captured using classic production and conflict agents. Some possible extensions for future applications are also recommended.