Topics
Ethics
Research Priority Setting Is Not Research: A Call for Ethical Clarity in Australia
In Australia, research priority setting (RPS) may be misclassified as research requiring ethics approval, despite its purpose as a collaborative, pre-research involvement activity. Treating RPS as research creates delays, diverts resources and undermines partnership principles central to inclusive, community-centred priority setting. Recent revisions to the National Statement on Ethical Conduct in Human Research clarify that pre-research consultation does not require ethics review, creating an opportunity for consistent national practice. We call for institutions to recognise RPS as involvement and provide proportionate, non-ethics oversight to accelerate RPS and deliver more responsive research agendas that reduce waste.
Bec Jenkinson, Gordon McGurk, Jonathan Quicke, Janelle Bowden, Nadine E. Foster
Organ Donation After Oral Ingestion of a Voluntary Assisted Dying Substance
Organ donation after voluntary assisted dying (VAD) is increasingly undertaken in jurisdictions where it is legally permissible, including Australia, although previously all reported cases involved intravenous administration of the life-ending substance. A 55-year-old woman in Victoria has become the first known person to have successfully donated organs and tissues after self-administration of an oral substance, despite initial uncertainty about feasibility due to the unpredictable time to death (agonal phase). With Victorian legislation requiring self-administration as the default, this case provides a precedent, opening the possibility of donation for others in this majority VAD cohort where oral administration is obligatory.
Joanne Kantianis, Helen I. Opdam, Rohit L. D'Costa
Equity, Diversity and Inclusion From the Start: Reforming Australia's Research Infrastructure for Inclusive Participation
Danielle M. Muscat, Kirsten J. McCaffery, Heather L. Shepherd, Marguerite Tracy
A Match Made in Health Care: Can Ethics and Governance Better Support Impactful Implementation Research?
Natalie Taylor, Zhicheng Li, Cathelijne van Kemenade, Jackie Curtis, Patrick Bolton
Genomic Newborn Screening: Commodity or Public Good?
Genomic newborn screening (gNBS) can screen for a broad range of genetic conditions, potentially enabling early treatment and improving health outcomes. However, it remains outside publicly funded programmes due to limited evidence and substantial implementation challenges. Offering gNBS in the interim as a fee-for-service option in Australia risks creating inequitable healthcare access, fragmenting care and limiting control over genomic data. Conversely, prohibiting private access may unfairly deny potential benefits to individual infants and families. This article discusses the ethical and practical implications of offering gNBS on a fee-for-service basis prior to a decision being made regarding public funding. Although fee-for-service gNBS undermines equitable access, regulated private offerings by public genomics services could mitigate some of the risks. We emphasise the need for large-scale, well-designed research studies to inform the development and equitable implementation of robust gNBS programmes within public healthcare frameworks.
Christopher Gyngell, Sebastian Lunke, Danya Vears, Zornitza L. Stark
Implementing Voluntary-Assisted Dying in New South Wales Correctional Settings
Daniel Mogg, Michael H. Levy
Shifting focus to adolescent wellbeing and inclusive participation in the digital age
Jodie Bailie · Helen Dickinson · Briony Lipton · Marissa Shields
Specialists’ fees and out‐of‐pocket costs: a challenge of our time
The continued rise in specialists’ fees and out-of-pocket cost is causing significant financial and access challenges for patients
Brendan Murphy
Medicolegal consequences of doctors accepting bequests and gifts under a patient’s will
The development of specific professional standards and/or guidelines for doctors, coupled with education, could reduce the medicolegal risk of doctors becoming entangled in civil litigation about will validity and/or receipt of testamentary gifts
Nicole E Kroesche · Tina L Cockburn · Kelly Purser · Karen A Sullivan
Adult attention deficit hyperactivity disorder in Australia: how its current commercial model for diagnosis and treatment is encouraging misdiagnosis
High costs and inconsistent diagnostic standards for attention deficit hyperactivity disorder in adults contribute to overdiagnosis in high-functioning individuals and exclusion of more impaired patients
Richard CJ Bradlow · Ferghal Armstrong · Edward Ogden
Cass Review does not guide care for trans young people
Good medicine is guided by the values of the patient, not those of a clinician, politician or commentator. The Cass Review, lacking expertise and compromised by implicit stigma and misinformation, does not give credible evidence-based guidance
Julia K Moore · Cate Rayner · S Rachel Skinner · Katie Wynne · Blake S Cavve · Brodie Fraser · Uma Ganti · Claire McAllister · Gideon Meyerowitz‐Katz · Tram Nguyen · Anja Ravine · Brian Ross · Darren B Russell · Liz A Saunders · Aris Siafarikas · Ken C Pang
The contribution of evidence‐based practice and the practice‐based evidence approaches to contemporary Australian psychology: implications for culturally safe practice
Adopting a broader and more inclusive approach to evidence represents an important step toward addressing the persistent inequities experienced by many Aboriginal and Torres Strait Islander peoples and diverse communities
Paul Gray (Wiradjuri) · Dawn Darlaston‐Jones · Pat Dudgeon AM (Bardi) · Kate Derry · Joanna Alexi · William Smith (Wiradjuri and Wemba Wemba) · Tanja Hirvonen (Jaru and Bunuba) · David Badcock · Shraddha Kashyap · Belle Selkirk (Noongar)
Linguistic manoeuvres: obstetric violence camouflages harm and loss of consent from birth
A discussion on birth trauma, informed consent and obstetric violence in Australia
Harsha Ananthram · Liz Sutton · Rebecca Matthews · Nadine Montgomery · James Titcombe · Ajay Rane
Reducing unprofessional practices in referrals to abortion care: proposing a minimum professional standard
This perspective applies the principles of medical professionalism to abortion referrals, presents a spectrum of referral practices, proposes a minimum standard for professional abortion referral, and identifies strategies to promote person-centred referrals
Shelly Makleff · Bronwen Merner · Kirsten I Black · Louise Keogh
Voluntary assisted dying: challenges in Northern Territory remote Aboriginal communities
Discussion of findings from a public voluntary assisted dying consultation process in the Northern Territory and how to ensure equitable access and cultural safety. Telehealth could improve access but presents clinical and legal challenges
Geetanjali Lamba · Kane Vellar · C Paul Burgess · Camille La Brooy · Paul A Komesaroff
Ante‐mortem interventions for deceased donation: legal barriers and uncertainty in Australia's decision‐making frameworks
Legal uncertainty constitutes a substantial barrier to efforts aimed at ensuring consistent good medical practice in relation to the provision of ante-mortem interventions during end-of-life care and facilitating opportunities for donation and transplantation
Shih‐Ning Then · Dominique E Martin · Helen I Opdam
Dignity of risk in residential aged care: a call to reframe understandings of risk
Choice and dignity need to be deeply embedded in the daily care of residents, and risk-based decisions should be supported by effective organisational policies
Maria Foundas
When may an adult woman with cognitive impairment still have capacity to consent to an abortion?
Capacity to consent to abortion is decision-specific, so that even when a woman is found to lack capacity to make decisions in other areas of her life, she may still have capacity to consent to an abortion
Julia P Duffy · Sam Boyle · Casey M Haining
Implementing voluntary assisted dying in New South Wales correctional settings
Discussion of the ethical and legal difficulties in implementing voluntary assisted dying (VAD) in New South Wales correctional settings, and our approaches towards community-equivalence in VAD for terminally ill prisoners
Diya Ahluwalia · Leigh Haysom
Clinicians’ discretion to contact patients’ at‐risk relatives about their genetic risk: new guidance from Australia's privacy regulator provides timely clarification
The Office of the Australian Information Commissioner’s recently updated guidance clarifies clinicians’ discretion to assist patients with notifying their relatives about genetic risk without breaching federal privacy laws
Jane Tiller · Margaret FA Otlowski
Should self‐administered voluntary assisted dying be supervised? A Queensland case
ABC, a grieving older person, died after consuming a voluntary assisted dying (VAD) substance prescribed for their spouse. A Queensland coroner’s inquest recommended the law require self-administration to be medically supervised. This case highlights the tensions between facilitating access to VAD and community safety.
Eliana Close · Katrine Del Villar · Ben P White
Dismantling barriers to research and clinical care for individuals with a vision impairment
Accessibility in research is an ongoing commitment that will continue to change based on the needs and preferences of the community. We must weigh up the impact of incorporating accessibility practices in research with the social cost of forgoing them
Eden G Robertson · Kate Hetherington · Meredith Prain · Julia Hall · Leighton Boyd AM · Rosemary Boyd OAM · Emily Shepard · Hollie Feller · Sally Karandrews · Fleur O'Hare · Kanae Yamamoto · Matthew P Simunovic · Robyn V Jamieson · Alan Ma · Lauren Ayton AM · Anai Gonzalez‐Cordero
Physician advocacy, international humanitarian law, and the protection of health care workers in conflict zones
International humanitarian law in its current form cannot be relied upon as the sole mechanism of prevention and response to attacks on health care in conflict zones
Irma Bilgrami · Christopher Guy · Vanessa Carnegie · Sandra Lussier
Murru Minya: a national exploration of ethical research and research ethics in Aboriginal and Torres Strait Islander health and medical research
This work is an invitation to address the urgent systemic change required to safeguard Aboriginal and Torres Strait Islander peoples and communities on our terms
Felicity Collis (Gomeroi) · Michelle Kennedy (Wiradjuri)