Journal of Law and Medicine最新文献

Risk assessment is an important component of judicial decision-making in many areas of the law. In Australia, those convicted of terrorist offences may be the subject of continued detention in prison or extended supervision in the community if there is an "unacceptable risk" of them committing future terrorism offences. Forensic psychologists and psychiatrists may provide evidence of risk through identifying and measuring risk factors with the aid of tools that use scales based on statistical or actuarial risk prediction. This column focuses on criticisms of the use of the second revision of the Violent Extremism Risk Assessment tool (VERA-2R) in determining the risk of future terrorist acts.

This article examines whether the current termination laws of Australia and Aotearoa New Zealand align with the midwifery scope of practice. It begins with an introduction to termination of pregnancy from a health care perspective. An overview of previous and current legal frameworks in Australia and Aotearoa New Zealand that impact upon the provision of termination of pregnancy health services is provided. Midwives' scope of practice is explained and the legal and administrative factors obstructing midwives' ability to work to their full scope are discussed. Midwives' needs to enable the provision of termination care are considered. The article concludes that the current laws are not supportive of midwives as termination care providers and their needs to realise their full scope of practice are not being met.

Tasers, a form of police weaponry causing neuromuscular incapacitation and extreme pain, were confirmed in 2010 to be used in New Zealand inpatient mental health units. Their use on patients, or tāngata whai ora (persons seeking wellbeing), raises ethical concerns about harm prevention, moral duties, and human rights in healthcare. The New Zealand healthcare system, grounded in principles and rights, regulates procedures to uphold fundamental rights. This article explores the ethical justifications and criticisms of taser use in mental health wards from a principlist perspective. It questions the ethical limits of State power regarding non-maleficence, beneficence, and autonomy, arguing that tasers pose disproportionate harm to vulnerable patients and undermine ethical healthcare standards. Concerns are raised to promote policy development, monitoring, and reporting, aimed at addressing the ethical issues associated with taser use in mental health settings.

An increasing number of jurisdictions worldwide have enacted assisted dying laws allowing persons to end their lives with assistance. All existing frameworks have in common that they restrict access to persons who (1) act autonomously and (2) suffer from certain illnesses. The second restriction has been criticised on the basis that it makes judgments about which lives are worth living by only allowing persons with specific medical conditions, but not others, to die with assistance. To avoid such judgments, some scholars endorse an autonomy-only view which requires autonomy as the only necessary condition for assisted dying. After considering the criticism the second access restriction has attracted, this article analyses the complexities of enacting autonomy-only assisted dying laws using Germany as a case study. It concludes that the challenges this approach faces in practice will likely prevent autonomy-focused assisted dying frameworks from becoming law in the near future.

United States and European Union laws demand separate clinical studies in children as a condition for drugs' marketing approval. Justified by carefully framed pseudo-scientific wordings, more so the European Medicines Agency than the United States Food and Drug Administration, "Pediatric Drug Development" is probably the largest abuse in medical research in history. Preterm newborns are immature and vulnerable, but they grow. Adolescents are bodily no longer children. Younger children are not another species. Instead of reasonable dose-finding, most "pediatric" studies replicate at best what is known already; others withhold effective treatment and/or harm by substandard comparison, triggering "pediatric" drug labels and "pediatric" careers. Researching deception and fraud focuses currently on individuals. The mechanisms by which lawmakers and the public were and are deceived need elucidation in our increasingly complex society, including new types of conflicts of interest. Candidly addressing deception and fraud at the interface of medicine and law will help to unmask pseudoscience.

The purpose of this study was to identify whether NHS Trusts where discrimination in the delivery of care to patients from the South Asian community had been demonstrated had taken any actions to address the issue over the subsequent year. Freedom of information requests were sent to three trusts which had provided evidence of disparate provision of biologic therapy to patients with Crohn's disease, their associated Clinical Commissioning Groups and Healthwatch organisations to seek evidence whether they had remedied the situation. Requests were also sent to the Care Quality Commission, NHS Improvement and the Equality and Human Rights Commission seeking examples where they had responded to inequitable delivery of care related to ethnicity. No organisation had any evidence of responses to the situation, many unable to accept its existence. Legal duties are discussed, and the only remedy appears to be through the tort of negligence.

Should medical schools psychologically screen medical school applicants and students? Arguably, psychological screening could be used to identify at-risk candidates who have psychological conditions that make them more likely to act unprofessionally. In this column we analyse the arguments for and against such screening. We argue that psychological testing should be used by medical schools as part of a program to support students so that they are at less risk of engaging in poor professional behaviour.

Recently, the Therapeutic Goods Administration (TGA) updated its guidance on cosmetic injectables advertising. The updates confirm that all direct or indirect advertising of cosmetic injectable products, including botulinum toxins or dermal fillers, is prohibited in Australia. While some commentators have lamented these updates, they present no changes to the law. As cosmetic injectables are prescription-only medicines, they have long been subject to the statutory prohibition on direct-to-consumer advertising of medicines in Australia. The updates, however, signal a real change to the TGA's enforcement stance and attitude. In this way, the updated guidance illustrates the practical application of the TGA's responsive and risk-based approach to regulation - a focus of this column. The changes also bring into view some of the emerging dangers associated with cosmetic injectables and related cosmetic treatments. This column explores the regulation of cosmetic injectables, the TGA's changing approach, and its implications.

This editorial reviews the changes over two decades in the United States and Australia in relation to the law governing access to drugs enabling medical termination of pregnancy. It also scrutinises three contentious decisions by the United States Supreme Court between 2022 and 2024 in relation to abortion. It argues that the receptive environment in the United States Supreme Court, as it is currently constituted, to challenges to the lawfulness of terminations of pregnancy and abortion medications is likely to inspire comparable challenges as part of the "Abortion Wars" in other countries, including Australia. However, a combination of factors is likely to protect access to terminations, particularly first trimester medical terminations. These include the clinical trajectory of changes made gradually over two decades by the Food and Drug Administration in the United States, the Therapeutic Goods Administration in Australia and Medsafe in New Zealand; evolving attitudes in the community; and the subversive accessibility of "mere pills".

This article explores the origins and operation of s 19(2) of the Health Insurance Act 1973 (Cth) and argues that it may not now and may never have created a barrier to Medicare access for prisoners as is commonly thought. Advocates have long asked for a s 19(2) exemption to allow Medicare access in custody. However, even if such an exemption were granted, it may not provide the access to Medicare necessary to have meaningful benefit for prisoners and may have other unintended consequences. We offer an alternative solution to the unquestionable need for Medicare access in prisons that requires no political intervention. This is based on our finding that denial of Medicare access to prisoners has always been practically rather than legally imposed, and the established fact that prisoners do not lose their entitlements to Medicare benefits while incarcerated.