Journal of law and medicine
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The Australian High Court recently found that the common law could allow parents to claim tortious damages when medical negligence was proven to have led to the birth of an unplanned, but healthy, baby (Cattanach v Melchior (2003) 215 CLR 1). In Harriton v Stephens (2006) 80 ALJR 791; [2006] HCA 15 and Waller v James; Waller v Hoolahan (2006) 80 ALJR 846; [2006] HCA 16 the High Court in a six-to-one decision (Kirby J dissenting) decided that no such claim could be made by a child when medical negligence in failing to order an in utero genetic test caused the child severe disability. In an era when almost all pregnancies will soon require patented fetal genetic tests as part of the professional standard of care, the High Court, by barring so-called "wrongful life" (better termed "wrongful suffering") claims, may have created a partial immunity from suit for their corporate manufacturers and the doctors who administer them. What lessons can be learnt from this case about how the Australian High Court is, or should be, approaching medical negligence cases and its role as guardian of the Australian common law?
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Medico-legal autopsies can be directed by coroners. However, in a number of jurisdictions family members can lodge objections with coroners against such procedures taking place. ⋯ Reviewing recent Victorian developments, they emphasise the public interest in autopsies which reveal medical causes of death. They identify the ongoing importance of coroners being able to exercise their statutory function to undertake death investigations effectively and to make informed recommendations to reduce the incidence of avoidable deaths.
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Withholding and withdrawing life-sustaining medical treatment are common in paediatric practice, especially in intensive care units. However, not all clinicians apparently adhere to principles in ethical guidelines or to the principles which are to be found in judgments from common law cases arising when doctors and parents dispute treatment. This article examines selected ethical guidelines and compares them to judgments in leading cases. ⋯ Although "best interests" must essentially pertain to the individual child, the interests of others are not irrelevant. In legal cases "best interests" of the child are defined in terms such as "burden versus benefit", "futility", "indignity", "intolerability", "prolonging death rather than saving life" and "quality of life". These or like terms should form the basis of ethical decisions in discussions with parents when contemplating withholding or withdrawing life-sustaining treatment.
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This article critically examines the successes and failures of the current internal and external regulatory regimes for ensuring the delivery of patient safety in public hospitals. It argues that governments should develop a holistic approach to regulation through the enhancement of existing compliance mechanisms in conjunction with some formal regulation to ensure that public hospital systems-deliver high standards of service with minimal patient harm. It recommends that a Patient Safety Authority be established in order to assist with the monitoring of incidents and the enforcement of compliance with patient safety standards.