Addressing a Human Rights Crisis: Health Care for Prisoners in Australia.

People are sent to prison as punishment and not to experience additional punishment. Nevertheless, this principle is habitually violated in Australia: prisoners frequently receive health care that is inferior to health care that is available in the general community. Numerous official inquiries have identified deficiencies in prisoner health services, notwithstanding the apparent intention of legislative provisions and non-statutory guidelines and policies in various jurisdictions to ensure prisoners receive appropriate health care. This article proposes law reforms to address this human rights crisis. It recommends the passage of uniform legislation in all Australian jurisdictions that stipulates minimum prison health care service standards, as well as mechanisms for ensuring they are implemented. The article also suggests that, in the short-term, until prison health care is significantly improved, substandard health care for prisoners should be treated as a potentially mitigating sentencing factor that can reduce the length of a defendant's prison term.

How to Manage a Pandemic?: Decision-Making under the Public Health and Wellbeing Amendment (Pandemic Management) Act 2021 (Vic).

Victoria is the first Australian jurisdiction to enact legislation establishing a regulatory framework specifically to guide government management of the COVID-19 pandemic and future pandemics. The Public Health and Wellbeing Amendment (Pandemic Management) Act 2021 (Vic) inserts Pt 8A into the Public Health and Wellbeing Act 2008 (Vic). The worthwhile stated objective of Pt 8A is to ensure that decision-making in response to an existing or emergent pandemic is "proactive and responsive", "informed by public health advice and other relevant information", and transparent and accountable. This column analyses sections of Pt 8A related to this aim, which grant decision-making powers, require various matters to inform this decision-making, and provide measures for oversight of decision-making. The column argues that Pt 8A constitutes a useful model on which Victoria and other jurisdictions could build and recommends further legislative amendments to help achieve its objective.

"A Nasty Bump": Lessons from Refugee Doctors' Defiance of Discrimination, 1937-1950.

Prominent members of the Australian medical profession sought to prevent European doctors who immigrated to Australia in the late 1930s and 1940s from practising medicine. This article explores how these so-called "refugee doctors" contested the major strategies used by Victorian, New South Wales and Queensland statutory medical boards, influenced by the British Medical Association - Australian doctors' peak body - to impede their medical practice. In Australia's eastern States, refugee doctors challenged refusals to grant them registration to practise medicine, appealed decisions to deregister them, and practised medicine while unregistered. The article also considers lessons we might learn from this history, including the importance of reducing the potential for international medical graduates to whom Australia grants refuge to experience unfair obstacles both to practising their profession and challenging discrimination against them. Equally important is to remove temptations for them to practise medicine without registration and lower the risk of them doing so.

Responses to Monkeypox: Learning from Previous Public Health Emergencies.

Since the 1970s, the zoonotic disease monkeypox was reported as appearing in humans, principally in central and west Africa. However, from May 2022, escalating numbers of persons worldwide contracted it. On 23 July 2022, the World Health Organization declared this outbreak to be a public health emergency of international concern (PHEIC) and initially observed that it was "concentrated among men who have sex with men, especially those with multiple sexual partners." The international public health response to monkeypox provides a litmus test to evaluate whether lessons have been learned from experiences of other infectious diseases in recent decades. This editorial identifies evidence of progress in the following areas: the declaration of a PHEIC in relation to monkeypox; some high-income countries' responses to monkeypox; naming of the virus, its variants and the disease it causes; protection of LGBTIQ+ communities and engagement of them to curb transmission of monkeypox; and efforts to ensure access to equitable vaccines.

A Panacea for Australia's COVID-19 Crisis? Weighing Some Legal Implications of Mandatory Vaccination.

Although Australia's rates of infection, illness and mortality from COVID-19 have been relatively low, they have escalated with the rapid transmission of the Delta variant. Restrictions imposed on people's liberties to curb the spread of the virus in several Australian States have engendered economic hardship, mental health challenges, and collective exhaustion and impatience. Several vaccines have been developed and approved for use in Australia that have proven effective in reducing the likelihood that the vaccinated will contract COVID-19 and, if infected, transmit and suffer serious illness and/or die from it. Public debate has thus centred on whether mandatory vaccination could be the panacea for Australia's COVID-19 crisis, and several Australian governments and employers have already imposed vaccination requirements. This article explores some potentially significant implications of mandatory vaccination for two areas of the law - human rights and employers' liability - to consider whether, from a legal perspective, mandatory vaccination could constitute a viable solution to Australia's present predicament.

Embracing the Future: Using Artificial Intelligence in Australian Health Practitioner Regulation.

Artificial intelligence (AI) - computerised technology that imitates aspects of human intelligence - is developing at a rapid pace. It is increasingly used to improve the efficiency and effectiveness of multifarious processes in private industry and public administration. Among the statutory authorities that have begun to explore the potential for AI to assist them are regulators of Australia's health professions. Protection of the public is a chief objective of this area of administrative law. This section considers some possible uses of AI - and particularly its capacities to analyse and draw inferences from data, make predictions and decisions, and automate tasks - that might help regulators achieve this goal. The section also contemplates the implications of AI involvement in the regulation of health practitioners for the rule of law and human rights it protects and recommends measures that might be taken to mitigate risks of their infringement.

Professional reports for sentencing courts: recommendations for reporting on child exploitation material offenders' risk of recidivism and prospects for rehabilitation.

Denunciation and general deterrence are major objectives of sentencing those who are convicted of possessing or distributing child exploitation material in Australia (CEM offenders), but courts also strive to achieve specific deterrence. To this end, courts tend to rely on professional reports as evidence of risk of reoffending and prospects for rehabilitation. After outlining matters that courts consider when sentencing CEM offenders, we discuss key empirical findings concerning CEM offenders' risk of recidivism, and then evaluate two approaches for assessing this risk: actuarial assessments; and structured professional judgment. We recommend that professional reports prepared for sentencing reflect current research findings regarding risk of recidivism amongst CEM offenders and that the structured professional judgment approach is used. We also recommend that matters which inform offenders' risk of recidivism and their prospects for rehabilitation be reported separately.

Moritz Meyer and the Medical Board: Preventing Refugee Doctors from Practising Medicine in Victoria, Australia, 1937-1958.

In 1937, the Medical Board of Victoria (the Board) declined to register Moritz Meyer to practise medicine in Victoria, Australia. Meyer was a Jewish doctor who had completed his medical degree in Germany and obtained postgraduate qualifications in Scotland. Meyer successfully challenged the Board's decision in the Supreme Court of Victoria and the Board's appeal against that decision to the High Court of Australia, which was dismissed. In response to Meyer's victory, the Board, under the influence and together with the British Medical Association, successfully lobbied the Victorian Parliament to prevent doctors from practising medicine in Victoria unless they had completed their studies in Victoria or in a country in which Victorian doctors, by virtue of their registration in Victoria, were entitled to practise medicine. Meyer's case received substantial press coverage, but historians have referred to it only in passing. This article fills a notable gap in the historiography about this period by illuminating the significance of Meyer's matter. It analyses the decisions in this case and considers their impact on European doctors who sought refuge in Victoria immediately before, during and after World War II, and on the medical profession and lay community. It then seeks to explain these reactions to Meyer's matter.

Hartnett, Epstein, Van der Hope: Regulating Unconventional Doctors.

Doctors Francis Timothy Hartnett, Zygmunt Epstein and Izso Hartmayer Van der Hope were the first medical practitioners to appeal against decisions of the Medical Board of Victoria (Board) to cancel doctors' registration to practise medicine after finding that they had engaged in infamous conduct in a professional respect. This article analyses the Board's decisions in the 1940s regarding these three doctors and their appeals. The article argues that the doctors were unconventional and the Board's members, whose own career successes were built on their adherence to custom, allowed their aversion to the doctors' nonconformity to compromise their impartial assessment of their behaviour. The Board had only the finding of infamous conduct and the sanction of deregistration with which to respond to doctors; conduct that fell below professional standards, but in these three cases, cancellation of the doctors' registration to practise medicine was unduly severe and disproportionate to the gravity of their behaviour. This investigation illustrates the importance of the passage of legislation - after these cases were heard - empowering the Board to impose more lenient sanctions than deregistration for doctors' unprofessional conduct. It also highlights that regulators of the medical profession must still ensure that any antipathy they may feel towards doctors for their unconventionality does not influence their assessment of a fitting response to their conduct.

Monitoring a "Menace": Peer Review and the Regulation of Substance-Addicted Doctors, 1933-1948.

This article examines the first power that Victorian parliamentarians granted to the Medical Board of Victoria (Board) to regulate impaired doctors. Convinced that substance-addicted doctors were a "menace", in 1933 the legislature gave the Board discretion to remove their names from its register of "legally qualified medical practitioners". In the next 15 years, however, the Board chose not to cancel the registration of several doctors who came to its attention for their addiction to alcohol or drugs and instead the Board monitored those doctors; it mostly sought assurances from the practitioners that they were obtaining treatment for their addiction, abstaining from consuming alcohol and drugs, and refraining from practising medicine, usually until their treating practitioners considered that they were fit to resume medical practice. This article evaluates the benefits and pitfalls of the Board's regulation of these doctors, including in light of Anglo-American legal scholars' discussion at that time about the merits of the growth of administrative agencies and their work. The article then considers the lessons that can be learnt from this history about how substance-dependent doctors should be regulated and who should be involved in decision-making regarding their regulation.

"My [Electronic] Health Record" ­ Cui Bono (For Whose Benefit)?

We examine the operation of Australia's national electronic health records system, known as the "My Health Record system". Pursuant to the My Health Records Act 2012 (Cth), every 38 seconds new information about Australians is uploaded onto the My Health Record system servers. This information includes diagnostic tests, general practitioners' clinical notes, referrals to specialists and letters from specialists. Our examination demonstrates that the intentions of successive Australian Governments in enabling the collection of clinical data through the national electronic health records system, go well beyond statutorily articulated reasons (overcoming "the fragmentation of health information"; improving "the availability and quality of health information"; reducing "the occurrence of adverse medical events and the duplication of treatment"; and improving "the coordination and quality of healthcare provided to healthcare recipients by different healthcare providers"). Not only has the system failed to fulfil its statutory objectives, but it permits the wide dissemination of information that historically has been confined to the therapeutic relationship between patient and health practitioner. After considering several other purposes for which the system is apparently designed, and who stands to benefit from it, we conclude that the government risks losing the trust of Australians in its electronic health care policies unless it reveals all of its objectives and obtains patients' consent to the use and disclosure of their information.

A delayed inheritance: the Medical Board of Victoria's 75-year wait to find doctors guilty of "infamous conduct in a professional respect".

The Medical Board of Victoria (Board) was created in 1844 to register "legally qualified medical practitioners". It was not until 1933, however, that the Board attained the power to remove from its register a doctor who had engaged in "infamous conduct in a professional respect" (the power), even though the General Council of Medical Education and Registration of the United Kingdom on which the Board was modelled had been granted the power 75 years earlier. This article argues that the delay in the Board's inheritance was attributable to successive Victorian Parliaments' distrust of the Board and that this attitude was unwarranted, at least from early in the 20th century. The article maintains that the granting of the power to the Board was a crucial event in the history of the regulation of the Victorian medical profession. This is illustrated both by the difficulty encountered by the medical profession in dealing with doctors' unethical conduct before 1933, and the Board's concern to use its new authority responsibly and appropriately to protect the public and the profession in the three years after it attained the power.

Cancer-associated mutations in the MDM2 zinc finger domain disrupt ribosomal protein interaction and attenuate MDM2-induced p53 degradation.

The p53-inhibitory function of the oncoprotein MDM2 is regulated by a number of MDM2-binding proteins, including ARF and ribosomal proteins L5, L11, and L23, which bind the central acidic domain of MDM2 and inhibit its E3 ubiquitin ligase activity. Various human cancer-associated MDM2 alterations targeting the central acidic domain have been reported, yet the functional significance of these mutations in tumor development has remained unclear. Here, we show that cancer-associated missense mutations targeting MDM2's central zinc finger disrupt the interaction of MDM2 with L5 and L11. We found that the zinc finger mutant MDM2 is impaired in undergoing nuclear export and proteasomal degradation as well as in promoting p53 degradation, yet retains the function of suppressing p53 transcriptional activity. Unlike the wild-type MDM2, whose p53-suppressive activity can be inhibited by L11, the MDM2 zinc finger mutant escapes L11 inhibition. Hence, the MDM2 central zinc finger plays a critical role in mediating MDM2's interaction with ribosomal proteins and its ability to degrade p53, and these roles are disrupted by human cancer-associated MDM2 mutations.

Cluster roots of Leucadendron laureolum (Proteaceae) and Lupinus albus (Fabaceae) take up glycine intact: an adaptive strategy to low mineral nitrogen in soils?

BACKGROUND AND AIMS: South African soils are not only low in phosphorus (P) but most nitrogen (N) is in organic form, and soil amino acid concentrations can reach 2.6 g kg(-1) soil. The Proteaceae (a main component of the South African Fynbos vegetation) and some Fabaceae produce cluster roots in response to low soil phosphorus. The ability of these roots to acquire the amino acid glycine (Gly) was assessed. METHODS: Uptake of organic N as 13C-15N-Gly was determined in cluster roots and non-cluster roots of Leucadendron laureolum (Proteaceae) and Lupinus albus (Fabaceae) in hydroponic culture, taking account of respiratory loss of 13CO2. KEY RESULTS: Both plant species acquired doubly labelled (intact) Gly, and respiratory losses of 13CO2 were small. Lupin (but not leucadendron) acquired more intact Gly when cluster roots were supplied with 13C-15N-Gly than when non-cluster roots were supplied. After treatment with labelled Gly (13C : 15N ratio = 1), lupin cluster roots had a 13C : 15N ratio of about 0.85 compared with 0.59 in labelled non-cluster roots. Rates of uptake of label from Gly did not differ between cluster and non-cluster roots of either species. The ratio of C : N and 13C : 15N in the plant increased in the order: labelled roots < rest of the root < shoot in both species, owing to an increasing proportion of 13C translocation. CONCLUSIONS: Cluster roots of lupin specifically acquired more intact Gly than non-cluster roots, whereas Gly uptake by the cluster and non-cluster roots of leucadendron was comparable. The uptake capacities of cluster roots are discussed in relation to spatial and morphological characteristics in the natural environment.

Ribosomal protein L11 negatively regulates oncoprotein MDM2 and mediates a p53-dependent ribosomal-stress checkpoint pathway.

The gene encoding p53 mediates a major tumor suppression pathway that is frequently altered in human cancers. p53 function is kept at a low level during normal cell growth and is activated in response to various cellular stresses. The MDM2 oncoprotein plays a key role in negatively regulating p53 activity by either direct repression of p53 transactivation activity in the nucleus or promotion of p53 degradation in the cytoplasm. DNA damage and oncogenic insults, the two best-characterized p53-dependent checkpoint pathways, both activate p53 through inhibition of MDM2. Here we report that the human homologue of MDM2, HDM2, binds to ribosomal protein L11. L11 binds a central region in HDM2 that is distinct from the ARF binding site. We show that the functional consequence of L11-HDM2 association, like that with ARF, results in the prevention of HDM2-mediated p53 ubiquitination and degradation, subsequently restoring p53-mediated transactivation, accumulating p21 protein levels, and inducing a p53-dependent cell cycle arrest by canceling the inhibitory function of HDM2. Interference with ribosomal biogenesis by a low concentration of actinomycin D is associated with an increased L11-HDM2 interaction and subsequent p53 stabilization. We suggest that L11 functions as a negative regulator of HDM2 and that there might exist in vivo an L11-HDM2-p53 pathway for monitoring ribosomal integrity.