Australia after Bawa-Garba: Does Reflective Learning Remain Tenable for Health Care Practitioners?

Should a written reflection about regrets be part of the private life of a doctor - or of any health care practitioner - or something that can be used in the public domain when things do go wrong? This article examines the tenability of reflective practice in Australia after the Bawa-Garba cases, outlining the options for the future of reflective practice, and assessing the options ranging from maintaining the current status quo to protecting the use of reflections via absolute legal privilege. In particular, this article explores the value of reflective practice in the broader context, weighing up which of the options for change to reflective practice bring with it the greatest enhancement to public safety. This work concludes by suggesting a potential method for allowing the continued safe implementation of reflective practice by stakeholder groups: briefly considering the novel proposition in the Williams Review that could be adopted in Australia.

Australia after Cresswell and Chapman: A Legal and Regulatory Paradox, or an Opportunity for Uniformity?

Australia, like many overseas jurisdictions, has recognised the need to cope with advancing medical technology and changing community attitudes towards assisted reproductive technology (ART). Despite this, several States in Australia still do not have legislative instruments regulating ART, and those that have legislated have done so in a non-uniform way. In 2018/2019, four cases came before State Supreme Courts, where the female applicants had to endure significant legal battle in order to utilise their late partner's gametes, highlighting the inability of the law to provide an appropriate clinical framework. This article outlines and discusses the current position of Australian States on the utilisation of posthumous gametes and how the recent decisions of the Supreme Courts of New South Wales, Queensland and Western Australia augment the current law and National Health and Medical Research Council Guidelines, and finally, considers how future legislation might account for the potential posthumous utilisation of oocytes.

Protecting the Continued Development of Collaborative Expert Witness Evidence in Australia: Surely We Should?

Australia has recognised the need to cope with changing attitudes towards advocate and expert witness immunity. While some international jurisdictions have chosen to abolish the immunity altogether, Australia has most recently, via the High Court decisions in Attwells v Jackson Lalic Lawyers Pty Ltd [2016] HCA 16 and Kendirjian v Lepore [2017] HCA 13, recognised the need for the immunity to exist, albeit with significantly narrowed scope. Generally, the principles and scope of expert witness immunity tend to follow that of advocate immunity. However, Australia is widely accepted as the most advanced judicial system supporting the use of concurrent expert evidence. This analysis discusses the unique position of Australia after these two High Court decisions that shape expert witness immunity, recognising the ongoing policy of protecting the finality of litigation. However, the legislature must be careful not to maintain this as the foremost reason for the immunity merely because the courts have chosen this pathway previously. Nor should the legislature merely maintain the status quo of expert witness immunity following advocate immunity.

Carbon Dioxide Insufflation Increases Colonoscopic Adenoma Detection Rate Compared With Air Insufflation.

GOALS: To determine the effect of carbon dioxide insufflation on the most important outcome measure of colonoscopic quality: adenoma detection rate (ADR). BACKGROUND: Bowel cancer is the second most common cause of cancer deaths in males and females in Australia. Carbon dioxide has in recent times become the insufflation methodology of choice for screening colonoscopy for bowel cancer, as this has been shown to have significant advantages when compared with traditional air insufflation. STUDY: Endoscopies performed over a period of 9 months immediately before and after the implementation of carbon dioxide insufflation at endoscopy centers were eligible for inclusion. RESULTS: The difference in ADR between the carbon dioxide and air insufflation methods was statistically significant, with an increased ADR in the carbon dioxide group. The superiority of carbon dioxide insufflation was sustained with a logistic regression model, which showed ADR was significantly impacted by insufflation method. CONCLUSIONS: Carbon dioxide insufflation is known to reduce abdominal pain, postprocedural duration of abdominal pain, abdominal distension, and analgesic requirements. This study represents for the first time the beneficial effect of carbon dioxide insufflation upon the key quality colonoscopy indicator of ADR.