Journal of law and medicine
-
Review Comparative Study
The law and practice associated with advance directives in Canada and Australia: similarities, differences and debates.
This article is a summary of research that investigated the Canadian and Australian legislative framework associated with advance directives in health care. The research focused on the context in which older people are encouraged to use advance directives. These are directions about refusal of medical treatment given in advance of incompetence. ⋯ Several confusing issues were also identified with the legislation related to advance directives. There appears to be a move towards appointing a substitute decision-maker, but with significant differences across the Australian States and in Canadian Provinces. The "conversation" about future decisions emerged as an important theme, together with an emphasis on the process of "advance care planning" replacing the focus on advance directive forms.
-
The escalation in popularity of complementary and alternative medicine (CAM) has begun to stimulate regulatory responses to ensure the safety and efficacy of different modalities. The Therapeutic Goods Authority in Australia oversees a scheme of listing and registration, said to lead the world. Established CAM courses now confer recognised bachelor degrees. ⋯ Integrating CAM, however, involves a critical incoherence, well illustrated by the Victorian legislation. Clinical competence can only be properly assessed against standards established through scientific validation. If CAM systems, which purport to offer alternatives to science-based medicine, are regulated through conventional instruments, they may well be relinquishing the very identities which set them apart.
-
A major reason that The Netherlands has taken a different approach to the rest of the world on such a fundamental moral issue is that the courts and legislature in that country have accorded the interests of doctors a cardinal role in the euthanasia debate. This article argues that the interests of doctors are of only incidental and peripheral relevance in relation to the moral status of euthanasia. The moral status of euthanasia has little to do with the preparedness of doctors to administer the lethal injection or their general attitude towards the practice. Euthanasia is principally about the interests of the patient and the impact that the practice may have on the community in general, not preserving the conscience or improving the working life of doctors.