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.     

Unscientific health practice and disciplinary and consumer protection litigation

Evidence-based health care is expected of their practitioners by contemporary health professions. This requires health care to have a foundation in scholarly literature and to have a scientifically valid methodology. However, there are many instances of registered and unregistered practitioners either providing assessment and treatment that does not conform to such requirements or making representations about likely efficacy that are unjustifiable by reference to peer-reviewed clinical knowledge. Sometimes such conduct is predatory and deliberately exploitative; other times it is simply misconceived on the part of practitioners who regard themselves as medical pioneers. This editorial situates such conduct within unscientific and unorthodox health practice. It surveys recent consumer protection and disciplinary decisions to evaluate the role of the law in regulating such conduct. It argues in favour of an assertive legal response to protect vulnerable patients or potential patients against forms of treatment and promises of outcomes that are unscientific and deceptive.     

Social process in grizzly bear management: lessons for collaborative governance and natural resource policy

In this study, we analyze a case of governance in natural resource management. Building on the limited body of literature on termination and using methods of problem orientation and social process mapping, we examine a stakeholder engagement process designed to address conflicts in grizzly bear management in Banff National Park, Alberta. Terminated in 2009 after several years of collaboration, this stakeholder engagement process explicitly used the policy sciences framework to cultivate dialogue, improve participants?? decision-making skills, and make consensus-based recommendations for grizzly bear management. Our analysis demonstrates the utility of undertaking social process mapping and problem orientation in order to understand a natural resource policy problem. We include recommendations to foster a social process that allows for clarification and advancement of the common interest in stakeholder groups, insights into how social process can contribute to policy termination, and reflections on the practical, collaborative use of the policy sciences to solve problems of governance. This analysis complements other articles on this case that examine stakeholder perspectives, initial outcomes, and decision process, collectively providing a thorough policy analysis.     

Sentencing Councils and Victims

This article explores the place victims have, and should have, in bodies that formulate sentencing guidelines, with particular reference to sentencing guidelines in England and Wales and the Sentencing Council's obligation under the Coroners and Justice Act 2009 to have regard to ‘the impact of sentencing decisions on victims of offences’ when devising guidelines. The issues are situated in political and penological contexts; the place of victims in sentencing commissions or advisory bodies in the USA, England and Australia is analysed and the meaning and significance of the Sentencing Council's obligation towards victims is considered, relating the specific obligation to broader issues concerning the place of victims within bodies that formulate sentencing guidelines. While incorporating victims within sentencing commissions might undermine commissions’ aims, it can play an important role in helping to boost public confidence in criminal justice, a touchstone for all western governments’ criminal justice policies.     

The Devil's Lettuce: Primary Caregivers have the Constitutional Right to Distribute Medicinal Marijuana to Their Terminally Ill Child

Pediatric cancer is a tragedy that affects many American families. Despite the effectiveness of pediatric cancer treatments, patients experience adverse side effects that can be relieved by medical marijuana. However, medicinal marijuana is only lawful in twenty‐eight states, including the District of Columbia. This Note proposes that all fifty states enact compassionate‐use statutes permitting parents to lawfully possess and distribute the herb to their terminally ill child (between the ages of five to fourteen) to alleviate the effects of cancer treatments. Medicinal marijuana use provides pediatric cancer patients with better‐quality lives and the determination to win the war against cancer.     

Coercion and Contract at the Margins: Deportable Labor and the Laws of Employment Termination Under US Capitalism (1942–2015)

In 1917, Congress created the status of temporary labor migrant. A new kind of restricted worker born from nineteenth‐century free labor politics, employer and citizen worker demands under modern liberal capitalism, and state labor market regulation, temporary migrants have always had an employer‐dependent legal status and been subject to deportation. Yet, since 1942, changing rights and legal processes have governed migrant employment termination across sectors. By drawing on employment cases from archival and unpublished files made available to me under FOIA, and court decisions, I compare the impact of laws of employment termination on deportable laborers beginning in 1942, when government agencies planned migration, and under privatized migration after 1964. From agriculture and war to today's service and knowledge economies, I demonstrate how employment rights have always shaped deportable workers' legal status. Yet, I also show how today's rights and legal processes, in contrast to the past, hardly mitigate employer control over migrants under contemporary capitalism.     

Reducing Intimate Partner Violence Among Latinas Through the Moms’ Empowerment Program: an Efficacy Trial

Although intimate partner violence (IPV) is a particularly prevalent public health concern among Latina populations, the evidence-based treatment options for Latinas who experience IPV are limited. The present study tested the efficacy of the Moms’ Empowerment Program (MEP), an intervention for Spanish-speaking Latina mothers who had recently experienced IPV. Participants (N?=?95) were assigned to a Treatment (n?=?55) or a waitlist Control (n?=?40) condition, and those in the Treatment group completed a 10-week intervention designed to address the problems associated with IPV. Intent-to-treat analyses using multiple regression revealed that Latinas’ participation in the MEP was associated with reductions in IPV exposure. These findings provide preliminary evidence that the MEP may reduce exposure to physical violence among Spanish-speaking Latinas.     

Cold Case Homicides: DNA Testing of Retained Autopsy Sexual Assault Smears

Archival medical examiner specimens may contain perpetrator DNA evidence useful in unsolved (“cold case”) homicides. The Office of the Chief Medical Examiner (OCME) histology slide archives were searched for sexual assault smears for all 376 female homicides from 1990 to 1999. Of these, the OCME had sexual assault smears on 84 of which 13 slides had sperm. Of these 13, six were still unsolved. DNA profiles were obtained on all six (5 from smears and one from swabs). Combined DNA Index System ( submission resulted in two matches (“hits”) for new suspects. In addition, three suspects were eliminated in two cases. Our review of archival sexual assault smears resulted in DNA profiles that were able to assist in the investigation of four cold case homicide investigations. It may be worthwhile for medical examiner offices to search their archival histology slides for sexual assault smears on previously unsolved cases particularly those prior to the mid‐1990s when DNA testing was less widely available.