Why wrongful birth actions are right

A wrongful birth action is a claim in negligence brought by parents of a child against a doctor who has "wrongfully" caused their child to be born. These claims can be divided into two categories: those where a doctor performs a failed sterilisation procedure that leads to a healthy child being born; and those where a doctor fails to provide sufficient information to allow parents to choose to abort a handicapped child. The recent decision of the High Court of Australia in Cattanach v Melchior (2003) 77 ALJR 1312 falls into the former category. The decision to allow the parents to receive damages for the costs of raising and maintaining their child has generated much public debate. Despite the endorsement of this "wrongful birth" action, there are indications that the legislature will overturn the decision. This article examines whether there is a sound doctrinal basis for recognising wrongful birth actions.

Medical treatment and the good death: an ethical analysis of euthanasia, physician assisted suicide, and the right to die

Frequent advances in medical technologies have brought fonh many innovative treatments that allow medical teams to treal many patients with grave illness and serious trauma who would have died only a few years earlier. These changes have given some patients a second chance at life, but for others. these new treatments have merely prolonged their dying. Instead of dying relatively painlessly, these unfortunate patients often suffer from painful tenninal illnesses or exist in a comatose state that robs them of their dignity, since they cannot survive without advanced and often dehumanizing forms of treatment. Due to many of these concerns, euthanasia has become a central issue in medical ethics. Additionally, the debate is impacted by those who believe that patients have the right make choices about the method and timing of their deaths. Euthanasia is defined as a deliberate act by a physician to hasten the death of a patient, whether through active methods such as an injection of morphine, or through the withdrawal of advanced forms of medical care, for reasons of mercy because of a medical condition that they have. This study explores the question of whether euthanasia is an ethical practice and, as determined by ethical theories and professional codes of ethics, whether the physician is allowed to provide the means to give the patient a path to a "good death," rather than one filled with physical and mental suffering. The paper also asks if there is a relevant moral difference between the active and passive forms of euthanasia and seeks to define requirements to ensure fully voluntary decision making through an evaluation of the factors necessary to produce fully informed consent. Additionally, the proper treatments for patients who suffer from painful terminal illnesses, those who exist in persistent vegetative states and infants born with many diverse medical problems are examined. The ultimate conclusions that are reached in the paper are that euthanasia is an ethical practice in certain specific circumstances for patients who have a very low quality of life due to pain, illness or serious mental deficits as a result of irreversible coma, persistent vegetative state or end-stage clinical dementia. This is defended by the fact that the rights of the patient to determine his or her own fate and to autonomously decide the way that he or she dies are paramount to all other factors in decisions of life and death. There are also circumstances where decisions can be made by health care teams in conjunction with the family to hasten the deaths of incompetent patients when continued existence is clearly not in their best interest, as is the case of infants who are born with serious physical anomalies, who are either 'born dying' or have no prospect for a life that is of a reasonable quality. I have rejected the distinction between active and passive methods of euthanasia and have instead chosen to focus on the intentions of the treating physician and the voluntary nature of the patient's request. When applied in equivalent circumstances, active and passive methods of euthanasia produce the same effects, and if the choice to hasten the death of the patient is ethical, then the use of either method can be accepted. The use of active methods of euthanasia and active forms of withdrawal of life support, such as the removal of a respirator are both conscious decisions to end the life of the patient and both bring death within a short period of time. It is false to maintain a distinction that believes that one is active killing. whereas the other form only allows nature to take it's course. Both are conscious choices to hasten the patient's death and should be evaluated as such. Additionally, through an examination of the Hippocratic Oath, and statements made by the American Medical Association and the American College of physicians, it can be shown that the ideals that the medical profession maintains and the respect for the interests of the patient that it holds allows the physician to give aid to patients who wish to choose death as an alternative to continued suffering. The physician is also allowed to and in some circumstances, is morally required, to help dying patients whether through active or passive forms of euthanasia or through assisted suicide. Euthanasia is a difficult topic to think about, but in the end, we should support the choice that respects the patient's autonomous choice or clear best interest and the respect that we have for their dignity and personal worth.

Low-flow oxygen therapy: selecting the right device

The authors provide and overview of oxygen therapy principles, describing the indications and care requirements of three low flow oxygen therapy devices and providing an algorithm for managing refractory hypoxaemia.

The generation of new high angle boundaries during the hot torsional deformation of aluminium

The crystallographic rotation field for deformation in torsion is such that it is possible for orientations close to stable orientations to rotate away from the stable orientation. A Taylor type model was used to demonstrate that this phenomenon has the potential to transform randomly generated low-angle boundaries into high-angle boundaries. After imposing an equivalent strain of 1.2, up to 40% of the simulated boundaries displayed a disorientation in excess of 15°. These high-angle boundaries were characterised by a disorientation axis close to parallel with the sample radial direction. A series of hot torsion tests was carried out on 1050 aluminium to seek evidence for boundaries formed by this mechanism. A number of deformation-induced high-angle boundaries were identified. Many of these boundaries showed disorientation axes and rotation senses similar to those seen in the simulations. Between 10% and 25% of all the high-angle boundary present in samples twisted to equivalent strains between 2 and 7 could be attributed to the present mechanism.

Review of applications of the Cutting Angle methods

The theory of abstract convexity provides us with the necessary tools for building accurate one-sided approximations of functions. Cutting angle methods have recently emerged as a tool for global optimization of families of abstract convex functions. Their applicability have been subsequently extended to other problems, such as scattered data interpolation. This paper reviews three different applications of cutting angle methods, namely global optimization, generation of nonuniform random variates and multivatiate interpolation.

Priming vs. rhyming : orthographic and phonological representations in the left and right hemispheres

The right cerebral hemisphere has long been argued to lack phonological processing capacity. Recently, however, a sex difference in the cortical representation of phonology has been proposed, suggesting discrete left hemisphere lateralization in males and more distributed, bilateral representation of function in females. To evaluate this hypothesis and shed light on sex differences in the phonological processing capabilities of the left and right hemispheres, we conducted two experiments. Experiment 1 assessed phonological activation implicitly (masked homophone priming), testing 52 (M = 25, F = 27; mean age 19.23 years, SD 1.64 years) strongly right-handed participants. Experiment 2 subsequently assessed the explicit recruitment of phonology (rhyme judgement), testing 50 (M = 25, F = 25; mean age 19.67 years, SD 2.05 years) strongly right-handed participants. In both experiments the orthographic overlap between stimulus pairs was strictly controlled using DICE [Brew, C., & McKelvie, D. (1996). Word-pair extraction for lexicography. In K. Oflazer & H. Somers (Eds.), Proceedings of the second international conference on new methods in language processing (pp. 45–55). Ankara: VCH], such that pairs shared (a) high orthographic and phonological similarity (e.g., not–KNOT); (b) high orthographic and low phonological similarity (e.g., pint–HINT); (c) low orthographic and high phonological similarity (e.g., use–EWES); or (d) low orthographic and low phonological similarity (e.g., kind–DONE). As anticipated, high orthographic similarity facilitated both left and right hemisphere performance, whereas the left hemisphere showed greater facility when phonological similarity was high. This difference in hemispheric processing of phonological representations was especially pronounced in males, whereas female performance was far less sensitive to visual field of presentation across both implicit and explicit phonological tasks. As such, the findings offer behavioural evidence indicating that though both hemispheres are capable of orthographic analysis, phonological processing is discretely lateralised to the left hemisphere in males, but available in both the left and right hemisphere in females.

Selecting the right integration of research into practice strategy

Healthcare professionals need to be cognizant of integration of research into practice literature to advance clinical practice. This article describes the strengths and limitations associated with 10 currently used integration of research into practice strategies and the issues that need to be considered when selecting an appropriate strategy. Selecting the right strategy that ensures the uptake of best available evidence is an essential component of developing evidence-based practice and ultimately improving patient care.

Extended cutting angle method of global optimization

Methods of Lipschitz optimization allow one to find and confirm the global minimum of multivariate Lipschitz functions using a finite number of function evaluations. This paper extends the Cutting Angle method, in which the optimization problem is solved by building a sequence of piecewise linear underestimates of the objective function. We use a more flexible set of support functions, which yields a better underestimate of a Lipschitz objective function. An efficient algorithm for enumeration of all local minima of the underestimate is presented, along with the results of numerical experiments. One dimensional Pijavski-Shubert method arises as a special case of the proposed approach.

Freedom of political communication, public officials and the emerging right to personal privacy in Australia

In recent times Australian courts have demonstrated a willingness to fashion a right to personal privacy at common law. The Australian Law Reform Commission has noted this impOt1ant development and said it was likely to continue in the absence of legislative action in the area. The aim of this article is to outline a theoretical framework to underpin and inform the development of this emerging right - howsoever framed - and the extent to which it is possible for the law to provide meaningful privacy protection to public officials under the Constitution.

Femoral sulcus angle and increased patella facet cartilage volume in an osteoarthritic population

Objective
The patellofemoral joint is an example of an incongruent articulation commonly affected by osteoarthritis (OA). The relationship between femoral sulcus angle and the development and progression of patellofemoral OA is unclear. The aim of this study was to examine the relationship between the femoral sulcus angle at baseline and patella cartilage volume at baseline and at 2-year follow-up among community based adults with established knee OA.

Methods
One hundred subjects had magnetic resonance imaging of their symptomatic knee at baseline and at 2-year follow-up. From these images, patella cartilage volume was determined. Radiographic skyline views of the patellofemoral joint were taken at baseline to measure the femoral sulcus angle.

Results
For every 1° increase in the femoral sulcus angle (i.e., as the sulcus angle became more shallow) there was an associated 9.1 mm3 (95% CI 3.1, 15.0) increase in medial patella cartilage volume at baseline (P = 0.003). There was a similar trend that approached statistical significance between the femoral sulcus angle and the lateral patella facet cartilage volume at baseline (P = 0.09). There was no association between the femoral sulcus angle at baseline and the change in patella cartilage volume over 2 years in either patellofemoral compartment.

Conclusion
These results infer that the femoral sulcus angle is a cross-sectional determinant of the amount of patella cartilage, but is not a major determinant of the annual change of patella cartilage volume among people with knee OA. These data suggest that a shallower sulcus in the context of established OA may be an advantageous anatomical variant. Further longitudinal studies are required to determine the role of the femoral sulcus angle in OA.

Identifying the "right patient" : nurse and patient perspectives on how to verify patient identity during medication administration

In this paper, we report on a research project funded by the Australian College of Mental Health Nurses’ and Bristol Myers Squibb Research Grant in 2007. We examined ways in which Mental Health Nurses could correctly identify patients during medication administration that promote medication safety and that are acceptable to both consumers and nurses. Central to the safe practice of medication administration are the “five rights” – giving the right drug, in the right dose, to the right patient, via the right route, at the right time. In non-psychiatric settings, such as medical and surgical inpatient units, the use of identification aids, such as wristbands, are common. In most Victorian psychiatric inpatient units, however, standardised identification aids are not used. Anecdotally, consumers dislike some methods of patient identification, such as wearing wrist bands, and some nurses perceive consumers’ rights are infringed through wearing personal identifiers. In focus groups, mental health consumers and Mental Health Nurses were invited to discuss their experiences of patient identification during routine psychiatric inpatient medication administration. They were also asked their opinions of, and preferences for, different ways of verifying “right patient” during routine medication administration. In our paper, we will present the findings of a qualitative research project in which we explored the experiences, opinions, and preferences of mental health consumers and Mental Health Nurses towards methods of correctly identifying patients during medication administration.