"Chartering" the limits of involuntary psychiatric treatment in Victoria: interpreting the Mental Health Act 1986 (Vic) in the age of the Charter of Human Rights and Responsibilities Act 2006 (Vic)

The Mental Health Act 1986 (Vic) allows for individuals with a serious mental illness to be treated on an involuntary basis either in a psychiatric hospital (on an involuntary treatment order) or in the community (on a community treatment order). The Act also establishes the Mental Health Review Board with the authority to review these orders within eight weeks of those orders being made and at least once every 12 months thereafter. This article analyses a recent decision of the board, Re Appeal of 09-085 [2009] VMHRB 1, in which the appellant challenged a decision of a psychiatrist to extend his community treatment order for a further 12 months. The appellant argued that aspects of his involuntary treatment under the Act amounted to "cruel, inhuman or degrading" treatment and therefore breached his right to freedom from "cruel, inhuman or degrading" treatment under s 10(b) of Victoria's recently enacted Charter of Human Rights and Responsibilities Act 2006 (Vic). Thus, the board was asked to consider whether the definition of "treatment" under the Act was compatible with the rights and freedoms enacted by the Charter. This was the first time that a Victorian court or tribunal had considered the impact of the Charter on involuntary psychiatric treatment. The decision was also a prelude to the Victorian Government's announcement that it would comprehensively review its mental health legislation, now the oldest in Australia. As this case highlights, in determining the future direction of mental health legislation and policy in Victoria, the Charter has been crucial.     

Transfers from prison to hospital under Sections 47 and 48 of the Mental Health Act between 2011 and 2014

In England and Wales, prisoners with mental disorder of such severity as to warrant inpatient treatment may be transferred to hospital under the Mental Health Act. UK Government guidance recommends that this process should be completed within 14 days; however, evidence suggests that in many cases it can take much longer. This retrospective service evaluation of 64 male prisoners, who were transferred under Section 47 or Section 48, aimed to evaluate transfer durations. The mean time from referral to admission was 76 days. Prisoners with a psychotic disorder were admitted more quickly. Remand prisoners were admitted more quickly than sentenced prisoners. Findings suggest that, in the UK the transfer time of prisoners under Sections 47 and 48 of the Mental Health Act continues to far exceed the 14-day target which raises concern about equivalence of care for prisoners. Our findings support arguments for fundamental amendments to the admissions process.     

List of primary care, dental and psychiatric health manpower shortage areas designated under Section 332 of the Public Health Service Act

This notice provides a list, updated as of December 31, 1982, of primary care, dental, and psychiatric health manpower shortage areas designated by the Secretary of Health and Human Services under the authority of section 332 of the Public Health Service Act.     

Advance directives in action in a regional palliative care service: "road testing" the provisions of the Medical Treatment Act 1988 (VIC)

In order to explore the usefulness and acceptability of the provisions of the Medical Treatment Act 1988 (Vic) for palliative care patients in a rural region in Victoria, Australia, between July and December 2004 patients were given information explaining the Act and the opportunity to discuss it with the research officer. Grounded theory methodology was used to evaluate client responses. Findings suggested that palliative care patients are willing to engage in advance care planning but they have to be well enough and need skilled, practical, face-to-face assistance to complete the required legal forms. Written materials alone are not adequate, but provide the opportunity for medical staff to have conversations about death and dying. Doctors and nurses should understand the provisions of the Act to assist patients and families. It is recommended that advance care planning, appropriate to the jurisdiction, be an integral part of the palliative care assessment process.     

澳大利亚基本公共卫生服务的法律保障（二）——政府作用

为引导基本公共卫生服务方向，澳大利亚政府扮演了独特和关键的角色，联邦与州／特区政府签订公共卫生产出资助协议，州／特区、市镇政府制定公共卫生计划。同时，为了组织实施基本公共卫生服务，澳大利亚政府从传染病的总体预防与控制、计划免疫、母婴保健、慢性病预防控制、弱势群体综合公共服务等方面采取了有效措施。     

Decriminalisation of abortion performed by qualified health practitioners under the Abortion Law Reform Act 2008 (Vic)

In 2008, the Victorian Parliament enacted the Abortion Law Reform Act 2008 (Vic) and amended the Crimes Act 1958 (Vic) to decriminalise terminations of pregnancy while making it a criminal offence for unqualified persons to carry out such procedures. The reform legislation has imposed a civil regulatory regime on the management of abortions, and has stipulated particular statutory duties of care for registered qualified health care practitioners who have conscientious objections to terminations of pregnancy. The background to, and the structure of, this novel statutory regime is examined, with a focus on conscientious objection clauses and liability in the tort of negligence and the tort of breach of statutory duty.     

澳大利亚基本公共卫生服务的法律保障（三）——立法动向和借鉴意义

通过不断加强公共卫生立法,澳大利亚联邦政府在卫生与老年部下设了国家预防保健局,日益关注公民权利的法律保护,推动示范法律的研究和运用,将风险管理引入立法程序,促进联邦与州/特区的立法协作。中澳两国存在特有的公共卫生关系,澳大利亚在公共卫生法律方面的实践和经验,为我国提供了借鉴意义,特别是法律示范和统一机制、立法过程的风险评估以及基本公共卫生服务的公平性等方面。     

Authority to treat: a comparative look at the jurisdiction,practice and procedure of the Supreme Court of Victoria,Children's Court of Victoria and Family Court of Australia in medical matters

The medical treatment of children is a crucial interface of law and medicine. The problems in this emotive area of law are compounded by the current state of the law in Australia which is uncertain and fractured. It is the purpose of this article to examine the jurisdictions of the various courts that stand competent to order that a child undergo medical treatment in circumstances where the child's parents/guardian refuse to provide consent to such treatment. The problems associated with the present system are identified and proposals for the reform of the current system offered.     

Using PMCT of Individuals of Known Age to Test the Suchey–Brooks Method of Aging in Victoria,Australia

The estimation of an individual's age at death plays a critical role in the investigation of unidentified human remains. The Suchey–Brooks method, which involves the analysis of degenerative morphological changes in the pubic symphysis, is currently widely used to estimate age in adults. This study tested the applicability of the Suchey–Brooks method on a contemporary adult Australian (Victorian) subpopulation by observing three‐dimensional volume‐rendered postmortem computed tomographic (PMCT) reconstructions of the pubic symphysis of 204 individuals aged 15–100 years. Results showed the method was reliable for females (85% correct allocations) but not for males (67% correct allocations). It is therefore recommended that extreme caution be used when applying the Suchey–Brooks method for estimating age at death of an individual in this subpopulation from PMCT images. The results suggest further investigation into alternate age estimation methods is required.