Journal of Law and Medicine最新文献

This research investigates the nursing management of intoxicated individuals treated under involuntary legislation in the emergency departments (EDs) of metropolitan hospitals in Queensland, Australia. A qualitative research approach was employed, using focused ethnography to conduct interviews with nurses working in these settings. The goal was to gain insight into their experiences with involuntary legislation when caring for patients intoxicated by alcohol. The study examined how ED nurses manage individuals during the intoxication phase, a time when impaired decision-making can lead to risks of self-harm or harm through misadventure. It also explored the legislative options available to nurses and how they implement them for involuntary assessment, treatment, and care. The aim of this research was to offer insight into nurses' perspectives on the current management of intoxication in EDs in Queensland, fostering discussion on what constitutes effective legal decision-making, and encouraging further research and development in this area.

Arguably, mandatory consent and informed consent should extend to mandatory informed financial consent (IFC), for all health practitioners where patients will incur costs to avoid the toxic effects of surprise invoices. Broad ethical and conduct guidance can be found in documents such as the 2020 Medical Board of Australia Good Medical Practice Code of Conduct and the 2024 Australian Medical Association (AMA) IFC position statement. The AMA expectation is clear enough that every medical practitioner should ensure that their patients are fully aware of their fees and that they encourage open discussion with their patients about health care costs. This is an example of a positive move towards specific IFC guidance. However, there remain inconsistencies between the codes and, unfortunately, an absence of guidance from some Colleges & Associations. Ahpra (Australian Health Practitioners Regulation Agency) should therefore consider the publication of consistent IFC guidance applicable to all Australian health practitioners.

Despite the importance of veterinary telemedicine, there are no Acts or regulations that regulate the practice in Australia. It has been left to veterinary boards to provide non-statutory guidance in the form of general codes of professional practice and professional standards. Identifying the rules governing veterinary telemedicine is difficult because different sets of laws and rules apply in each jurisdiction and those laws and rules are not always consistent. More specifically, in the absence of a physical examination of the animal by a veterinarian, telemedicine does not fit "neatly" into traditional principles of veterinary practice and the regulation of scheduled drugs. All this leads to uncertainty and a lack of clarity. This article explores these issues by examining the key rules in each jurisdiction. Some reference is also made to the equivalent rules governing telehealth (also an unregulated space) for the medical profession.

Human embryo research can provide important scientific insights to enhance medical knowledge, improve health care and advance human flourishing. This research also poses unresolved legal and ethical questions. Since 2002, Australia has had legislation in place that limits the use of human embryos for research through strict licensing conditions. However, there has been no formal review of these laws in almost 15 years and the scientific landscape has shifted dramatically. The development of stem cell-based embryo models that closely resemble human embryos, and culturing techniques that allow human embryos to be grown to potentially beyond 14-days post-fertilisation, is pushing the limits of the current legislative framework. We argue that a comprehensive review is needed to address recent scientific developments and to better account for contemporary public values.

This editorial reviews the important decision by the European Court of Human Rights in Pindo Mulla v Spain (17 September 2024) (Pindo Mulla). It identifies the reasoning process of the Grand Chamber in adopting an analysis consistent with the 1990 decision of the Ontario Court of Appeal in Malette v Shulman (1990) 67 DLR (4th) 321 that, when an adult is competent, they are entitled to make autonomous decisions, including by an advance care directive, about matters such as administration of blood products, even though their decision will foreseeably have highly adverse consequences for their health and even for their survival. The emphasis placed by the Grand Chamber on the entitlement to autonomous decision-making by adult patients as entitlement to the right to respect for private life, viewed in light of the right to freedom of religions is likely to have significant ramifications in reducing the potential for paternalist decision-making in a variety of cases where patients indicate that they reject certain forms of treatment. The editorial reviews practical clinical and administrative challenges raised by the Pindo Mulla case and recommendations made by a 2025 New South Wales coronial decision directed toward addressing some of the issues.

In Re Devin [2025] the Family Court of Australia considered a case of an 11-year old biologically male child whose mother argued was gender dysphoric and should be prescribed puberty blockers. Strum J found that despite the child attending for six years, the gender clinic failed to make a diagnosis of gender dysphoria until court proceedings had commenced. He also raised concerns about the Australian Standards of Care and Treatment Guidelines of the Royal Children's Hospital Melbourne which endorsed a gender-affirming model of care. In finding that gender dysphoria could be influenced by external factors, Strum J was critical of the expert witnesses called by the mother whose model of care to gender affirm "unreservedly" was an "oddly binary approach." Strum J held that in exercising its jurisdiction, the Family Court was not concerned with the cause of transgender people, but only with what was in the best interests of the child.

Consumer expertise is increasingly being leveraged in health service improvement to enhance patient satisfaction and experiences of care given the disparities in consumer and clinical prioritisation of health outcomes and treatment preferences. The value of experiential expertise is slowly being discovered in legal disputes with the involvement of consumers in health complaint investigations, but consumer perspectives remain underutilised in findings of law. This article explores whether expert opinion evidence could be tendered by consumer representatives in medical litigation and whether it should be recognised to minimise perceived (or actual) injustice against patients and their carers maligned as lay people in the judicial system. This theoretical exercise concludes that experiential expertise could qualify as expert opinion evidence, and this recognition would afford greater credibility to judicial decisions in line with recognised principles of procedural fairness.

In Australia, there are not enough doctors practising medicine in certain locations and specialties to meet demand. To address these shortages, Australia is attempting to encourage more international medical graduates (IMGs) to immigrate. Yet a cohort of IMGs already in Australia is not currently practising medicine: doctors from a refugee or asylum-seeker background (refugee doctors). Research has confirmed that refugee doctors can face substantial obstacles to attaining legal entitlement to practise medicine in Australia, yet they receive little coordinated support in overcoming them. Legal preconditions for registration of medical practitioners in the United Kingdom and Australia are similar, but in contrast to Australia, the United Kingdom has experimented with a broad range of significant initiatives to assist refugee doctors. This article analyses relevant laws and policies in both countries and the support provided to refugee doctors in meeting them, and makes recommendations for Australia to emulate the United Kingdom's model.

Students of medicine and law rarely interact during their tertiary education. They hold stereotypical views which may impede their collaboration in the workplace. The aim of our study was to explore the impact of law and medicine students learning together in a simulated interprofessional learning (IPL) activity. Students enrolled in the final year of a Medicine program, and in a Bachelor of Laws program participated in an interprofessional simulation case workshop and guided reflection. Data comprised the written reflections of consenting students and were analysed using an inductive thematic analysis approach. Three main themes were identified: New perspectives; Our goals are very similar; and IPL prepares us for the workplace. Contact with the other profession is effective in challenging perceptions and attitudes, developing a more positive view on how they may collaborate in a health care context. IPL between medicine and law can assist both groups in developing their readiness to commence work.

Surrogacy is increasingly becoming a preferred method for individuals and couples to expand their families. Despite this trend, the surrogacy birth care policies for health care professionals in countries such as Australia remain notably underdeveloped and inconsistent. This study aims to explore surrogacy birth care policies in hospitals in Australia. A random observational survey was conducted in metropolitan hospitals across New South Wales and Victoria. Hospital policies and protocols were reviewed via their websites, with follow-up inquiries made through telephone and email regarding surrogacy birth care policies. One hundred and twelve hospitals were randomly contacted through the maternity wards. Only 10 hospitals were found to have surrogacy birth care policies in place. This short report emphasises the urgent need for comprehensive surrogacy birth care policies in hospitals. Clear guidelines are crucial for respectful care, defining health care roles, and enhancing surrogate birth experiences.