The legal role of medical professionals in decisions to withhold or withdraw life-sustaining treatment: part 2 (Queensland)

This is the second article in a series of three that examines the legal role of medical professionals in decisions to withhold or withdraw life-sustaining treatment from adults who lack capacity. This article considers the position in Queensland, including the parens patriae jurisdiction of the Supreme Court. A review of the law in this State reveals that medical professionals play significant legal roles in these decisions. However, the law is problematic in a number of respects and this is likely to impede medical professionals' legal knowledge in this area. The article examines the level of training medical professionals receive on issues such as advance health directives and substitute decision-making, and the available empirical evidence as to the state of medical professionals' knowledge of the law at the end of life. It concludes that there are gaps in legal knowledge and that law reform is needed in Queensland.     

Assessing and managing the threat posed by fixated persons in Australia

In July 2013, the Australian State of Queensland established the first fixated threat assessment service outside Europe to specifically assess and manage lone, fixated persons. The Queensland Fixated Threat Assessment Centre (QFTAC) is a collaboration between the Intelligence, Counter-Terrorism and Major Events Command of the Queensland Police Service and Queensland Health’s Forensic Mental Health Service. It has been modelled on the original Fixated Threat Assessment Centre (FTAC) which has been operating in the United Kingdom since 2006, with modifications to reflect local needs and differing mental health and legal practices. This paper describes the background to the development of these services, the rationale for their expansion to the Asia Pacific region, and outcome data for QFTAC’s first 12 months of operations. These findings support the efficacy of proactive FTAC-style approaches to managing the threat posed by fixated individuals to public figures and the wider community.     

The "last vestiges of life"

On 4 June 2010, Deputy State Coroner Schapel of the Coroner's Court of South Australia ruled that he had jurisdiction to conduct an inquest into the death of Tate Spencer-Koch, who was declared deceased following complications during her home-birth. Coroner Schapel considered he had jurisdiction on the basis that Tate was a "person in the eyes of the law" under the born alive rule, as she had completely left her mother's body and she could be shown to have been alive after birth, evident from the PEA detected in her heart 10 minutes following her delivery. Close consideration of this ruling, however, reveals issues with the application of the born alive rule in the case.     

Homicidal poisoning. A dying modality of lethal violence?

Review of the experience of the Cuyahoga County (Cleveland, Ohio and its suburbs) Coroner's Office with homicidal poisonings over the past 3 1/2 decades reveals that this modality of felony homicides constitutes but a tiny fraction of the total case load and small percentages of overall homicides and drug- and chemical-caused deaths of all types. These findings are representative of selected medicolegal establishments across the country, as well as in the United States as a whole. Precise definition of the several types of felonious homicidal poisonings is suggested in the interest of clarity and accuracy of statistical data.     

Monitoring doctors' clinical competence: a Queensland focus

The medical profession is held accountable in numerous ways, many of which are concerned with clinical competence. However, while Australia's State medical boards are statutorily charged with protecting the public from incompetent practice, they have never instituted programs aimed at maintaining the standards of all practitioners. The article describes recent legislative changes and developments in undergraduate medical education, which aim to increase physicians' accountability in relation to competence, and compares developments in Queensland and other States with those in the United Kingdom, Quebec and New Zealand. The investigation of clinical incompetence as currently undertaken by the Medical Board of Queensland should, and will, be adopted in other States. However, responding to incompetence is necessarily piecemeal, and the article further argues that the States should develop inclusive revalidation strategies. Both the community and leading voices within the profession are demanding greater commitment to a self-regulation culture that is more transparent and has sharper teeth.     

Legislative Practice as Discursive Action: A Performance in Three Parts

Paralleling Henry and Milovanovic’s theory of constitutive criminology this paper considers several dialogic relationships created in and through an engagement with the Governing Principles of the Penalties and Sentences Act, an example of penal legislation practiced in the Australian State of Queensland. Fairclough’s method of Critical Discourse Analysis is enlisted providing the discussion with three prominent discourses performed in the text: purposive, individualising and moral/behavioural. The discussion proposes that dealings with the text both inform and prepare responses across a variety of relational situations involving the State, society, those directly engaged with the criminal justice system and the Act itself. Of specific concern is how the legislation discursively limits or permits action within these relationships whilst ignoring its own constitutive force and relational responsibilities.     

The role of government regulations in the adoption of cloud computing: A case study of local government

Cloud computing is a technology that facilitates improved productivity, improved efficiency and lower costs. This technology has the potential to improve the reliability and scalability of organizational systems and leads to an enhanced focus on core business and strategy. Despite the Australian Federal Government's ‘cloud-first’ strategy and policies and the Queensland State Government's ‘digital-first’ strategy, the adoption of cloud services at the local government level has been limited, largely due to a lack of specificity among government regulations and a lack of regulations that provide support to local governments. This empirical study deploys a mixed research method designed to develop a cloud regulations model to assist governments in adopting cloud computing services. By integrating Australian Cloud Policy Frameworks with the extant research on cloud computing, this study conducted 21 field interviews with Information Technology (IT) managers and surveyed 480 IT staff from Australia's 47 local governments. This research paper presents and validates a revised set of factors used to develop government regulations specific to cloud computing adoption. The factors that we found to be statistically significant were cost, quality of services, security, privacy, management, government-based facilitating conditions, and firm-based facilitating conditions regulations. Based on these findings, this research concludes that government regulation is a significant aspect in decision making for the adoption of any new technology such as cloud computing.     

Australian Aboriginal Property Rights as Issues of Indigenous Sovereignty and Citizenship

Aboriginal Australians have traditionally enjoyed little protection from the law. The matter of land has been at the heart of white settler/Aboriginal relations since the nation was first founded. It is only recently that recognition has been given to the land rights of Australian indigenous people. This recognition was finally made at the property law level in 1992 through the High Court decision in Mabo v. Queensland (n. 2) ([1992] 175 CLR 1). The 1993 High Court decision in The Wik Peoples v. Queensland ([1996] 71 ALJR 173) reinforced that recognition. It did so through the principle that pastoral lessees' and native title holders' rights might co-exist except that, in the event of any inconsistency, the pastoralists' rights were to prevail, provided pastoral activity was being pursued. The most recent legal change is the parliamentary revision of the Native Title Act so that the Wik co-existence principle was put to rest, mainly through permitting the State governments to upgrade pastoral holdings to a form of freehold, thus immunising them from native title claims, and minimising the payment of compensation. In this paper we argue that the country must consider what has been lost in this about-turn from the recognition of native title to land in Mabo . We argue that the nation must consider the emphases in the Mabo judgments upon the significance of international law and the need for the common law not to be locked into a racist past. From that point, we contend for the need to recognise not only native title to land but what lies beyond that: indigenous political and human rights.     

节约型政府的基本内涵与创建思路

建设节约型政府是党和国家提出的一项旨在加强政府自身建设的重大举措,具有较大的现实意义。建设节约型政府必须以制度创新为重点,采取以下措施加以推进。第一,要强化成本意识,树立节约理念;第二,要转变政府职能,缩小政府规模;第三,要优化决策机制,提高决策水平;第四,要加强预算约束,建立绩效预算制度;第五,要推行电子政务,提高政府管理效率。     

When video cameras watch and screen: Privacy implications of pattern recognition technologies

Computer vision technologies based on pattern recognition software will soon allow identifying human behaviour that deviates from a pre-defined normality. Such applications are foreseen, amongst others, to be used in public places with purposes of crime prevention, especially in the context of the fight against terrorism. This technology increases the level of automation of video surveillance, changing the main nature of surveillance. The balance of power between the citizen and the State is altered, calling for a new balancing of interests. The automation of risk detection moreover raises the issue of the protection against partially automated decision-making. This paper will deal with the challenges raised by proactive video surveillance technologies to the way how privacy and security have been balanced so far. Attention will moreover be brought to the new safeguards that should be devised to protect the citizens from increased scrutiny and growing automation of the decision-making process.     

An Integration of Hindsight Bias and Counterfactual Thinking: Decision-Making and Drug Courier Profiles

Counterfactual thinking and hindsight bias have each generated separate, substantial bodies of research and provided insight into some areas of legal decision-making. An investigation of the relationship between Counterfactual thinking and hindsight bias in a situation in which both are implicated is presented in a legal decision-making context utilizing drug courier profiles and illegal search and seizure. The findings, which demonstrate each of these cognitive processes and show a pattern of results that supports an integrative relationship between them, are discussed in the contexts of social cognition and of legal decision-making. A suggested causal model of decision-making in this context is also presented. Specific implications of these findings for civil actions to remedy illegal searches are discussed.     

Explaining fear of crime in Queensland

A model to explain fear of crime in Queensland is developed and fitted to data from the 1991 Queensland Crime Victims Survey. Fear of crime is measured from the answers to the question about respondents' feelings of safety when walking alone in their area after dark. The results suggest that factors such as gender, age, poverty, educational level, labor force status, level of incivility in the area, perceived amount of crime in the area, and neighborhood cohesion all make an impact on fear of crime in a way that is consistent with the theory. The results also show that fear of crimein Queensland is explained by very concrete factors that can be subject to intervention and policy formulation by relevant bodies.The views expressed in this paper are those of the authors and do not necessarily reflect those of the Government Statistician's Office or the Queensland Government.     

Queensland general practitioners' applications of the "mature minor" principle: the role of patient age and gender

Most Australian jurisdictions do not have legislation that stipulates an age by which a minor can make their own medical treatment decisions. Instead, they rely on Gillick v West Norfolk and Wisbech Area Health Authority [1986] AC 112, an English common law decision that recommends individual assessments of "maturity". This study explores how medical practitioners in the State of Queensland understand and apply this legal authority when faced with a young person wishing to make a contentious medical treatment decision. Almost 200 doctors made decisions about a hypothetical patient's competence and confidentiality, and detailed their reasoning in an open-ended format. The data indicate that the vagaries of existing legal criteria allow for a range of philosophical perspectives and idiosyncratic heuristics to play a role in assessment practices, and that particular combinations of patient age and gender made these cognitive shortcuts more likely to occur. A notable proportion of such processes are not consistent with legal guidelines, and this has implications for general practitioners' vulnerability to litigation as well as young patients' treatment trajectories.     

《保守国家秘密法》修改述评

本文对保密法修改的几个重大问题进行了系统阐述。作者提出,公开与保密不可分割,本次保密法修改确立了公开优先的原则,等于隐含确认了公开是原则、保密是例外;保密行政管理部门应该准确定位,主要承担决策与监督职能,不应沦为一般的行政执法部门;本次保密法修改的缺憾在于未能在决策权的统一和充实保密行政管理部门的监督手段方面有更多的制度创新。     

法治财政建设中党规与国法的功能适配

在党领导一切和依宪治国相统一的背景下,规范化、法治化的党政关系是时代发展的必然.从财政法治建设的视角检视,尽管党的政治领导已经有较为成熟模式,但在具体事务上的党政分工并不清晰.基于我国政治现实,党务财政已经成为财政体系的组成部分.但执政党的自身政治定位决定了,其对财政事务的领导适宜规划、引导和督促,而非直接介入具体事务...     

Skeletal identification using the frontal sinus region: a retrospective study of 39 cases

The importance of identification using the frontal sinus has been previously demonstrated in case reports. In this study, 39 cases of identification using frontal sinus comparison from the Ontario Chief Coroner's Office were reviewed and differences between antemortem and postmortem radiographs examined. All cases involved decedents older than twenty years. Three cases were rejected due to poor antemortem and postmortem film quality. One subject had no frontal sinus. Thirty-five cases provided conclusive postmortem to antemortem pattern matches. Sixteen cases also yielded metric (quantitative) matches. Duration between antemortem and postmortem radiographic examinations, age, gender, and cause of death did not affect the ability to obtain a match. This is the largest study undertaken on actual cases and demonstrates the validity of frontal sinus pattern matching for forensic identification.     

Compstat in Australia: An analysis of the spatial and temporal impact

One of the major trends in policing sweeping across democratic societies since the mid-1990s is a management approach commonly known as COMPSTAT. Despite widespread global adoption, empirical evaluation of the impact of COMPSTAT lags behind popular accounts of its crime control benefits.

Purpose

This article evaluates the crime control impact of Queensland Police Service's version of COMPSTAT known as “Operational Performance Reviews” (OPRs).

Method

A mixed model analytic approach was used to assess the role of OPRs in explaining spatial and temporal variations in crime patterns across Queensland's 29 police districts.

Results

Analysis of the impact of OPRs on reported crime (specifically assaults, robberies and unlawful entries) suggests major differences between police districts, and that some districts are driving overall statewide crime reductions, whilst others confound positive effects of implementation of OPRs in Queensland.

Conclusions

The results demonstrate that the crime drop experienced throughout Queensland found in prior research (Mazerolle et al., 2007) is most likely attributable to a small number of police districts. The implication of these findings is that a number of districts could (and should) be called-upon during maturation of Queensland's OPRs to reduce specific crime problems in their districts and facilitate ongoing crime reductions across the state.     

Sterilisation of intellectually disabled minors

The complex issue of sterilisation of minors with intellectual disabilities has arisen again for Australia with proposals for a uniform approach by the Standing Committee of Attorneys-General under which the principal forum for decision-making about such matters will be State and Territory administrative tribunals. This provides an opportunity not just for scrutiny of the proposed legislation and model but evaluation of the role of decision-making bodies, their procedural supports and the criteria on the basis of which sterilisations of young people should be authorised by Australia's courts and tribunals. The opportunity exists for an approach to be forged on the basis of empirical assessment of the success of administrative tribunal involvement, understanding of the phenomenon of "therapeutic" and "non-therapeutic" sterilisation of minors in contemporary Australia and current medical and psychological awareness of ways to manage menstruation and the potential for pregnancy for vulnerable young people.     

A review of nail gun suicides and an atypical case report

The nail gun was designed as a powerful industrial tool to drive nails into various hard surfaces with ease. Serious injuries associated with the tool are uncommon and deaths are rare. Unintentional injuries normally occur from misuse of the tool or from ricocheting nails. The intentional use of a nail gun to commit suicide is unusual. This paper will review successful and unsuccessful suicide attempts by use of a nail gun. We will present an atypical case of suicide committed with a nail gun by a 46-year-old depressed male investigated by the Allegheny County Coroner's Office in Allegheny County, Pennsylvania in April 2002. This case reports for the first time a unique pathological finding of a ring of bone traveling with the nail, which has not been seen in wounds of the head caused by other types of projectiles.     

Patients' decisions to die: the emerging Australian jurisprudence

A series of decisions by McDougall J in Hunter and New England Area Health Service v. A (2009) 74 NSWLR 88; Martin CJ in Brightwater Care Group (Inc) v. Rossiter (2009) 40 WAR 84; Higgins CJ in Australian Capital Territory v. JT (2009) 232 FLR 322; and Kourakis J in H Ltd v. J (2010) 240 FLR 402 has built upon prior decisions in New South Wales, Queensland and Victoria. The combination of authority has provided a reasonably homogeneous set of principles on the basis of which future decision-making can take place by clinicians, institutions and courts. It is apparent that, wherever possible, effect will be given to competent patients' wishes in relation to cessation of treatment, nutrition and hydration. However, scrutiny will be applied to patients' capacity in order to examine not the rationality or correctness of their decisions per se but their capacity to make them. It is probable that a rigorous approach will be taken both to whether patients' mental ill health deprives them of capacity and to whether they are provided with sufficient information to understand the consequences and processes of deprivation of nutrition, hydration and medication.