Journal of law and medicine
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Direct-to-consumer genetic testing: for some people it is to be discouraged, controlled, and in some jurisdictions even prohibited. For others, direct-to-consumer testing is merely the natural evolution of the human genome project. ⋯ This article, in making some brief recommendations that can be quickly implemented, seeks to draw a middle ground. The balance proposed aims not to smother what this writer sees as one of the most significant developments in health care in recent times, but to encourage the introduction of consumer-friendly measures that will allow the research community the time to explore the fundamental question posed by direct-to-consumer testing: does it actually do harm?
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This study examines whether the lure of injury compensation prompts whiplash claimants to overstate their symptoms. Claim settlement is the intervention of interest, as it represents the point at which there is no further incentive to exaggerate symptoms, and neck pain at 24 months is the outcome of interest. ⋯ The results show clearly that removing the financial incentive to over-report symptoms has no effect on self-reported neck pain in a fault-based compensation scheme, and this finding concurs with other studies on this topic. Policy decisions to limit compensation in the belief that claimants systematically misrepresent their health status are not supported empirically Claimants do not appear to be "cured by a verdict".
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The legalisation of voluntary physician-based euthanasia is currently the subject of much political, social and ethical debate and there is evidence in Australia of growing support for its implementation. In addressing many of the issues that surround legalisation, the article looks at some overseas jurisdictions that have legalised euthanasia to determine whether the social, political and ethical concerns prominent in the Australian debate have proved problematic in other jurisdictions. In addition, the article examines the report on the Dying with Dignity Bill 2009 (Tas) which commented extensively on the issues relating to voluntary physician-based euthanasia.
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Supporting patients and families in circumstances where medical error has caused significant harm is said to be governed by the principles of ordinary treatment: honest, open communication, empathy and respect. By and large, harmed patients look for acknowledgment of the events that occurred including errors, acceptance of responsibility, a sincere apology, and assurance that lessons learned will be put to preventive use. Australia's National Open Disclosure Standard purports to respond to these reasonable expectations, yet it advises health care professionals that while they may express regret for what has occurred, they should take care not to state or agree that they, or other health care professionals, or health care organisations, are liable for the harm caused to the patient. ⋯ State health department Open Disclosure policies and State and Territory civil liability legislation should be reviewed to remove obfuscatory and dissembling language and increase consistency between jurisdictions and between policies and statutes. The National Open Disclosure Standard should be revised to encourage and support full disclosure and genuine apology. If these processes fail, statutory reform should be considered.
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Article 12 of the United Nations Convention on the Rights of Persons with Disabilities requires states parties to ensure that persons with disabilities "enjoy legal capacity on an equal basis with others in all aspects of life". This column explores what is meant by "legal capacity" and its constituent elements of legal standing and legal agency. It outlines recent research on what is meant by "support" to exercise legal capacity and explores the issue of whether mental health and guardianship laws that enable substituted decision-making for those with mental and intellectual impairments contravene Article 12.