Banning Engineered Stone: A Landmark Australian Public Health Law Reform.

Union activism, medical lobbying and occupational health and safety prosecutions led to a major public health initiative in Australia - the banning from 1 July 2024 of work with engineered/artificial stone, including manufacturing, supplying, processing and installing it. This editorial contextualises within the history of regulation of workers' exposure to risks of contracting silicosis the growing international awareness of the dangers posed by working with engineered stone, particularly in relation to making and installing kitchen and bathroom benchtops made from engineered stone. It argues that the Australian initiative is an important public health decision that has a sound justification, is likely to save many lives and should be emulated internationally.

The Anatomy Act 1977 (NSW) Dissected: Review and Reform.

This column discusses the Anatomy Act 1977 (NSW) and its regulatory environment. The column begins with examining the history of anatomy regulation in the United Kingdom and Australia. It then goes on to analyse the history of the current anatomy regulation in New South Wales, pointing out areas for reform.

Donor conception, direct-to-consumer genetic testing, choices, and procedural justice: an argument for reform of the Human Fertilisation and Embryology Act 1990.

In this article, using theories of procedural justice and 'slow violence', we consider potential reform of the Human Fertilisation and Embryology Act 1990. Our theoretical discussion is underpinned by findings from the ConnecteDNA project, exploring how people affected by donor conception experience direct-to-consumer genetic testing (DTCGT). The negative impacts of DTCGT, especially shock discoveries about the circumstances of someone's conception in adulthood, are linked to donor anonymity, and how its continued protection is experienced as a barrier to the rights and agency of donor-conceived people. We focus on two key issues relating to the donor information access process set out in section 31ZA of the 1990 Act. The first is that it excludes certain cohorts of donor-conceived people, creating inequalities of access to donor information. The second is the impact of the use of DTCGT to search for that information. We discuss what a procedurally just process of law reform would look like, concluding that, whatever (prospective) approach to donor anonymity is taken, the donor information access process should be the same for all donor-conceived people. We thus argue that, even were the status quo to be maintained, reform of the donor information access process with retrospective effect would be required.

Looking back to look forward-the history of VAD laws in Australia and future law reform in the Australian territories.

Taking one's own life or attempting to do so has long been decriminalised in Australia. Aiding, counselling, or inciting another person to kill him or herself, however, remains a criminal offence. Yet, all six Australian States have now introduced laws allowing assistance in dying under certain circumstances. This article traces the recent history of Voluntary Assisted Dying (VAD) laws in Australia. It examines the introduction of the world's first assisted dying legislation in the Northern Territory in 1995 followed by the Federal Government's 1997 deprivation of the Territories' power to legislate on assisted dying invalidating said law. It further considers the fifty-seven failed Bills attempting to achieve law reform in this context in Australian jurisdictions between 1993 and 2017 with a view to identifying what factors may have contributed to the continuing lack of success. This article then outlines the rapid introduction of VAD laws in all six Australian States decriminalising VAD over the span of only 5 years. It ponders what may have changed to bring about this law reform. This article closes by contemplating potential future law reform in the Australian Territories, which have been reinstated with jurisdiction to legislate on VAD in December 2022.

'Everything is Obstetric Violence Now': Identifying the Violence in 'Obstetric Violence' to Strengthen Socio-legal Reform Efforts.

Since its global uptake, 'obstetric violence' is increasingly used to capture any/all violations during reproductive healthcare, with few conceptual limits. Consequently, it runs the risk of becoming an overgeneralised concept, making it difficult to operationalise in socio-legal reform efforts. This article draws on the Latin American origins of the concept and aims to provide a theoretical framework to support a focused and coherent socio-legal reform agenda. It offers a universal definition of violence, being the violation of physical or psychological integrity, and localises this definition using the 'view from everywhere'. The article proposes that violence will qualify as 'obstetric violence' if the violation of integrity occurs in the context of antenatal, intrapartum and postnatal care. Further, the subject of the violence is the birthing woman, trans or non-binary person. Thinking in terms of a 'continuum of violence' in reproductive healthcare ensures that different forms of obstetric violence are recognised and helps envisage overlaps with other violences.

Use of advance directives to promote supported decision-making in mental health care: Implications of international trends for reform in New Zealand.

Advance directives are advocated, in many jurisdictions, as a way to promote supported decision-making for people who use mental health services and to promote countries' compliance with their obligations under the United Nations Convention on the Rights of Persons with Disabilities. The United Nations Convention on the Rights of Persons with Disabilities promotes the use of tools to further personal autonomy which would include integrating the use of advance directives into mental health law, to clarify the effect (or force) an advance directive carries when its maker comes under the relevant mental health legislation. In addition, securing the active use of advance directives requires adoption of certain supportive practices and policies within health services. Here, we discuss a number of approaches taken to advance directives in revised mental health legislation, and the associated practices we think are required.

Disability Law Reform in Australia: Principles, Pragmatism and Politics.

This editorial reviews two landmark contributions to disability reform in Australia, both published in 2023 - the 12 volume report of the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability and the important Commonwealth Government of Australia report on the operation of the 10-year-old National Disability Insurance Scheme. It contends that each leaves Australia with major steps that need to be taken to enable persons with disability to live in a fairer, safer and more inclusive environment in which their human rights are genuinely respected. The reports contain many challenges where a balance needs to be orchestrated between implementation of principled reform and what is financially feasible. If Australia's governments are to adopt the recommendations in the reports, politics will need to be set aside and collaboration between Federal and State governments will be essential. Attitudes and practices will have to change in government and the general community, laws, protocols and even institutions will need to be reformed, accountability mechanisms will need to be tightened, and considerable sums of money will have to be spent.

Spit Hoods: Reforms to Law and Practice.

Spit hoods have been used for decades to reduce the ability of people to spit and bite police officers, corrective services officers, paramedics, doctors and nurses. However, historically and in public consciousness they have sinister resonances and often induce fear, panic and distress in persons to whom they are applied or in whose presence they are worn. Problematically frequently spit hoods have been used on detainees from ethnic minorities, including in Australia, on Indigenous persons, individuals with mental illnesses and children taken into custody. On a number of occasions spit hoods have been used with other forms of restraint and been associated with deaths in custody. This editorial reviews high profile cases internationally where spit hoods have played a role in precipitating deaths, important reports and reviews, including from coroners, ombudsmen and commissions of inquiry, into their abuse, and law reform in relation to spit hoods. It supports their abandonment and their replacement with other personal protective equipment options for maintaining custodians' and carers' occupational health and safety.

Comparing Voluntary Assisted Dying Laws in Victoria and Western Australia: Western Australian Stakeholders' Perspectives.

In 2021, two years after voluntary assisted dying (VAD) laws commenced in Victoria, Western Australia (WA) was the second Australian jurisdiction to permit VAD. While the two regimes are broadly similar, key differences exist. This article reports on findings from a qualitative study of WA participants with VAD experience across four stakeholder groups (patients and families; health practitioners; regulators and VAD system personnel; and health and professional organisation representatives), focusing particularly on participants' reflections on aspects of the WA VAD regime which differs from that in Victoria and the practical implications of those differences. Globally, participants viewed VAD as operating smoothly in Western Australia and, despite identifying some areas for improvement, that WA's model was more functional and accessible than Victoria's. By comparing two different VAD models, this article's findings add to growing empirical evidence about VAD in Australia and can inform future VAD reforms and reviews.

Roundtable on Deregistration and Gender Law Reform Internationally.

In this roundtable discussion, early-career researchers working in the field of law, gender, and sexuality discuss international and trans-national developments to legal gender. 'The Future of Legal Gender' research project focused on the legislative framework of England and Wales to develop a prototype for decertification. The domestic legislation, however, was situated within a wider international context throughout the project. This roundtable discussion, therefore, provided an opportunity for reflection on the transnational issues raised by decertification, with a particular focus on developments arising in the jurisdiction(s) studied by the early career researchers. The roundtable began with a brief outline of these recent developments before moving to an open discussion on key themes including the value of reform on wider society, changes on-the-ground by non-state actors, and alternative processes for tackling gender inequalities without certifying legal gender. The online conversation took place on 28 June 2021 and has been transcribed and edited for continuity, clarity, and referencing.

Best interests and low thresholds: legal and ethical issues relating to needle and syringe services for under 18s in Sweden.

Access for legal minors to needle and syringe programmes raises a number of practical, legal and ethical challenges that traverse clinical practice, child protection and child rights. This article addresses the current legal age restriction on access to needle and syringe programmes (NSPs) in Sweden. Based on legislation and legislative preparatory works, it traces the rationale for retaining an age restriction in the context of a policy priority to improve access for people who inject drugs. Building on threshold theory and child rights literature, the article unpacks the apparent tension between protecting the low threshold nature of service provision, child protection duties of healthcare staff, and the best interests of the child. It explores whether this tension could be alleviated through replacing a legal age restriction for all with best interests assessments for each individual, and discusses the potential ethical and practical challenges involved in such a change.

Superannuation Access for IVF Purposes: Time for Reform?

Australia's superannuation system permits the early withdrawal of funds from superannuation accounts in limited circumstances. There has been a trend towards increasing use of the early withdrawal provisions to fund in vitro fertilisation (IVF) treatment through the broad "compassionate release" ground. A 2018 government report recommended tightening the relevant criteria for release, which would restrict release for IVF purposes to those suffering from a mental illness related to their childlessness. This article examines the impact of childlessness in those wishing to have children and concludes that the current release criteria should not be tightened in such a manner. However, the article suggests positive changes in the law to achieve greater compliance with the current law, which restricts early superannuation release to when a lack of alternative funding is unavailable.

Sentencing and mental disorder: the evolution of the Verdins Principles, strategic interdisciplinary advocacy and evidence-based reform.

In DPP v O'Neill, the Victorian Court of Appeal excluded personality disorders from the scope of the sentencing principles that apply to offenders with mental health problems around Australia (the 'Verdins principles'). This decision was based on a fundamental misunderstanding of the nature of personality disorders and had the potential to create serious injustice for many marginalised people. To redress this problem, the authors engaged in a unique process of strategic advocacy, which resulted in the Victorian Court of Appeal overturning O'Neill in the recent case of Brown v The Queen. This article examines the evolution of the Verdins principles, the problems that arose in O'Neill, the collaborative strategy used to address those problems and the successful outcome of that interdisciplinary strategy.

National trends and cost of litigation in UK National Health Service (NHS): a specialty-specific analysis from the past decade.

BACKGROUND AND AIMS: Medical litigation claim and costs in UK are rising. This study aims to analyse the 10-year trend in litigation costs for individual clinical specialties in the UK from 2009/10 to 2018/19. METHODS: Data were procured from National Health Service (NHS) Resolution. Number of claims, total litigation costs and cost per claim were ascertained for each financial year. The data collected also includes the number of claims and average amount per claim per speciality during the years 2009-2019 (2009/2010 to 2018/2019 financial years). RESULTS: The total annual cost of NHS litigation is currently £3.6 billion(2018/2019). Damages make up the greatest proportion of costs(£1.5 billion). Surgical specialties have the greatest number of claims annually(2847) but Obstetrics has the greatest total litigation(£1.9 billion) and cost per claim(£2.6 million). Number of claims, total costs and cost per claim are significantly greater in 2018/2019 than in 2009/2010. CONCLUSIONS: Addressing the issue of litigations is complex. Medically there are speciality specific issues that require attention, whilst some general measures are common to all: effective communication, setting realistic targets and maintaining a motivated, adequately staffed workforce. These, alongside legal reforms, may reduce the financial burden of increasing litigation on the NHS.

Comprehensive Decriminalisation of Abortion: An Analysis of Concept, Arguments and Regulatory Frameworks.

In 2018-2019, the Belgian Parliament launched two legal initiatives that fundamentally challenge the role of criminal law in relation to the regulation of abortion. Similarly, some Australian jurisdictions and New Zealand have recently decriminalised abortion in all stages of pregnancy and instead approach it as a form of health care. In light of these developments, this article conceptualises "comprehensive decriminalisation" of abortion as the withdrawal of the regulation of abortion from criminal codes and statutes and the removal of specific criminal sanctions. Next, it examines the strengths and limits of the arguments for and against comprehensive decriminalisation and considers the potential impact of decriminalisation on abortion access and stigma. Finally, it illustrates the distinction between decriminalisation and deregulation by addressing the regulatory approaches of Australian jurisdictions, Belgium, Canada and New Zealand to late-term abortion in particular.

Don Chalmers: His Contributions to Legal Research and Education, Health Law, and Research Ethics, Locally and Globally.

Distinguished Professor Don Chalmers retired from the Law Faculty at the University of Tasmania on Friday 10 July 2020. This article is dedicated to Don, providing a brief account and acknowledgment of his fine contributions to legal research and education and law reform, particularly in the field of health and medical law, research ethics and policy reform. He has been an excellent colleague, mentor, leader, teacher, and researcher. He deserves to enjoy a long and rewarding retirement, though we, and many others, will not allow him to slip entirely out of the limelight. Don is still much needed, and still has so much to give in our ongoing quest to ensure that legal, research ethics and policy responses are adequate in reaping the benefits and responding to the challenges of biomedical advances.

Dancing away from Reform: The Inquest into the Death of Six Patrons of NSW Music Festivals.

In late 2019, the Deputy State Coroner for New South Wales (NSW), Magistrate Harriet Grahame, handed down her findings in relation to the death of six patrons of NSW music festivals. 179 pages in length, the decision represents a comprehensive attempt to understand recent music festival tragedies. The Coroner found that there was compelling evidence to support initiatives such as pill testing, changing the way festivals are policed (including discontinuing the use of sniffer dogs) and enhancing the overall safety of music festivals. The Coroner also questioned whether, in light of the evidence presented to the Inquest, there is a fundamental need to rethink contemporary approaches to drugs and criminalisation. In its response to date, the NSW Government has rejected the idea of pill testing and indicated that it will continue to use sniffer dogs at music festivals as a drug detection strategy. In one of the few recommendations of the Coroner that it has accepted, the NSW Government has agreed to the use of drug amnesty bins and agreed to a trial of less punitive measures of dealing with more minor drug possession offences via the use of Criminal Infringement Notices.

Gross Negligence Manslaughter in Healthcare: Time for a Restorative Justice Approach?

This article explores the merits of employing a restorative justice approach in cases of gross negligence manslaughter involving healthcare professionals, in line with the recent policy turn towards developing a just culture in addressing episodes of healthcare malpractice within the National Health Service in England. It is argued that redress for victims and rehabilitation of offenders should operate as key values, underpinning the adoption of a restorative justice approach in such cases. It would also be vital that a structured pathway was designed that established suitable protocols and safeguards for both victims and offenders taking account of problematic issues such as the informality of the process, power asymmetries between parties, and the context in which the offence took place. Taking all such matters into account, we propose that consideration be given to establishing a pilot involving the use of restorative justice in cases of gross negligence manslaughter involving healthcare professionals, which would be subject to judicial and stakeholder oversight to ensure transparency and accountability, which in turn could inform future policy options.

'Rape myths' and a 'reasonable belief' of consent R v Lazarus [2017] NSWCCA 279.

Judicial directions in rape trials are designed to emphasise to jury members the importance of negating consent or that the accused believed on reasonable grounds that the complainant consented. After a jury convicted the accused in R v Lazarus [2015], the NSW Court of Appeal in R v Lazarus [2016] NSWCCA 52 found that the trial judge misdirected the jury on the question of the state of mind of the accused at the time of the alleged rape. After a judge sitting without a jury acquitted the accused, the NSW Court of Appeal in R v Lazarus [2017] NSWCCA 279 found that the judge in the re-trial failed to direct herself in relation to making a finding about the steps taken by the accused to establish whether the complainant was consenting. As well as reviewing the reasoning in the decisions, this article discusses rape myths and the justice gap and considers law reform on the issue of consent in rape cases.

Conscientious objection to abortion, the law and its implementation in Victoria, Australia: perspectives of abortion service providers.

BACKGROUND: In Victoria, Australia, the law regulating abortion was reformed in 2008, and a clause ('Section 8') was introduced requiring doctors with a conscientious objection to abortion to refer women to another provider. This study reports the views of abortion experts on the operation of Section 8 of the Abortion Law Reform Act in Victoria. METHODS: Nineteen semi-structured qualitative interviews were conducted with purposively selected Victorian abortion experts in 2015. Interviews explored the impact of abortion law reform on service provision, including the understanding and implementation of Section 8. Interviews were transcribed verbatim and analysed thematically. RESULTS: The majority of participants described Section 8 as a mechanism to protect women's right to abortion, rather than a mechanism to protect doctors' rights. All agreed that most doctors would not let moral or religious beliefs impact on their patients, and yet all could detail negative experiences related to Section 8. The negative experiences arose because doctors had: directly contravened the law by not referring; attempted to make women feel guilty; attempted to delay women's access; or claimed an objection for reasons other than conscience. Use or misuse of conscientious objection by Government telephone staff, pharmacists, institutions, and political groups was also reported. CONCLUSION: Some doctors are not complying with Section 8, with adverse effects on access to care for some women. Further research is needed to inform strategies for improving compliance with the law in order to facilitate timely access to abortion services.