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Objectives: Voluntary assisted dying (VAD) legislation has now been passed in all Australian states. Although VAD has been operating in many settings worldwide for a considerable time, the specific costs associated with VAD seem unclear. The aim of this study was therefore to outline the common resource implications associated with VAD. Methods: A rapid literature review and grey literature search were undertaken. Results: We found a paucity of empirically informed detail regarding the actual costs required to implement VAD. Hence, we tabulated a list of potential costs that could be used for subsequent evaluation and a future research agenda. Conclusions: There is a lack of publicly available information related to the costs associated with implementing VAD. Given that this is a significant change in policy and many multidisciplinary practitioners may be directly or indirectly involved in VAD it is important that associated costs are clearly outlined so that appropriate resources can be allocated. What is known about the topic? Voluntary assisted dying (VAD) legislation has now been passed in all Australian states. Although VAD has been operating internationally for a considerable time, there have been calls for more data to understand the resources required to implement VAD. What does this paper add? We found a paucity of empirically informed detail regarding the actual costs required to implement VAD. Hence, we tabulated a list of potential costs that could be used for subsequent evaluation and outline a research agenda. What are the implications for practitioners? Given that a significant number of practitioners may be directly or indirectly involved in VAD it is important that associated costs are clearly outlined so that appropriate resource allocation can be considered. [ABSTRACT FROM AUTHOR]

This Perspective begins with a case study that raises two important questions: who is responsible for the existence of non-compliant Medicare billing, and who is responsible for eliminating it? In the discussion that follows, I argue, first, that the problem has been created by individual clinicians and by Medicare itself (i.e. the organisational structure that administers Medicare). Second, and more importantly, I argue that the ethical obligation to eliminate the problem extends more broadly to include both the government and the medical profession. What is known about the topic? The scale of non-compliant Medicare billing is contested. What does this paper add? This Perspective frames non-compliant Medicare billing (and denial of its existence) as a ubiquitous cultural problem. What are the implications for practitioners? Strategies aimed at reducing non-compliant Medicare billing need to target the normative behaviour of societal actors as well as individual practitioners. [ABSTRACT FROM AUTHOR]

Noninvasive prenatal testing (NIPT) has become widely available in recent years. While initially used to screen for trisomies 21, 18, and 13, the test has expanded to include a range of other conditions and will likely expand further. This paper addresses the ethical issues that arise from one particularly controversial potential use of NIPT: screening for adult‐onset conditions (AOCs). We report data from our quantitative survey of Australian NIPT users' views on the ethical issues raised by NIPT for AOCs. The survey ascertained support for NIPT for several traits and conditions including AOCs. Participants were then asked about their level of concern around implications of screening for AOCs for the future child and parent(s). Descriptive and comparative data analyses were conducted. In total, 109 respondents were included in data analysis. The majority of respondents expressed support for NIPT screening for preventable (70.9%) and nonpreventable AOCs (80.8%). Most respondents indicated concern around potential harmful impacts associated with NIPT for AOCs, including the psychological impact on the future child and on the parent(s). Despite this, the majority of participants thought that continuation of a pregnancy known to be predisposed to an AOC is ethically acceptable. The implications of these data are critically discussed and used to inform the normative claim that prospective parents should be given access to NIPT for AOCs. The study contributes to a body of research debating the ethical acceptability and regulation of various applications of NIPT as screening panels expand. [ABSTRACT FROM AUTHOR]

Objective. Data linkage is a very powerful research tool in epidemiology, however, establishing this can be a lengthy and intensive process. This paper reports on the complex landscape of conducting data linkage projects in Australia. Methods. We reviewed the processes, required documentation, and applications required to conduct multi-jurisdictional data linkage across Australia, in 2023. Results. Obtaining the necessary approvals to conduct linkage will likely take nearly 2 years (estimated 730 days, including 605 days from initial submission to obtaining all ethical approvals and an estimated further 125 days for the issuance of unexpected additionally required approvals). Ethical review for linkage projects ranged from 51 to 128 days from submission to ethical approval, and applications consisted of 9-25 documents. Conclusions. Major obstacles to conducting multi-jurisdictional data linkage included the complexity of the process, and substantial time and financial costs. The process was characterised by inefficiencies at several levels, reduplication, and a lack of any key accountabilities for timely performance of processes. Data linkage is an invaluable resource for epidemiological research. Further streamlining, establishing accountability, and greater collaboration between jurisdictions is needed to ensure data linkage is both accessible and feasible to researchers. [ABSTRACT FROM AUTHOR]

Introduction: Facilitators to implement shared cancer follow‐up care into clinical practice include mechanisms to allow the oncologist to continue overseeing the care of their patient, two‐way information sharing and clear follow‐up protocols for general practitioners (GPs). This paper aimed to evaluate patients, GPs and radiation oncologists (ROs) acceptance of a shared care intervention. Methods: Semi‐structured interviews were conducted pre‐ and post intervention with patients that were 3 years post radiotherapy treatment for breast, colorectal or prostate cancer, their RO, and their GP. Inductive and deductive thematical analysis was employed. Results: Thirty‐two participants were interviewed (19 patients, 9 GPs, and 4 ROs). Pre intervention, there was support for GPs to play a greater role in cancer follow‐up care, however, patients were concerned about the GPs cancer‐specific skills. Patients, GPs and ROs were concerned about increasing the GPs workload. Post intervention, participants were satisfied that the GPs had specific skills and that the impact on GP workload was comparable to writing a referral. However, GPs expressed concern about remuneration. GPs and ROs felt the model provided patient choice and were suitable for low‐risk, stable patients around 2–3 years post treatment. Patients emphasised that they trusted their RO to advise them on the most appropriate follow‐up model suited to their individual situation. The overall acceptance of shared care depended on successful health technology to connect the GP and RO. There were no differences in patient acceptance between rural, regional, and cancer types. ROs presented differences in acceptance for the different cancer types, with breast cancer strongly supported. Conclusion: Patients, GPs and ROs felt this shared cancer follow‐up model of care was acceptable, but only if the RO remained directly involved and the health technology worked. There is a need to review funding and advocate for health technology advances to support integration. Patient or Public Contribution: Patients treated with curative radiotherapy for breast, colorectal and prostate cancer, their RO and their GPs were actively involved in this study by giving their consent to be interviewed. [ABSTRACT FROM AUTHOR]

When researching with or about families in home-based research, there are numerous unexpected ethical issues that can emerge, particularly in qualitative research. This paper is based on reflective accounts of four homed-based research projects, two in the UK and two Australia, which examined ethical dilemmas identified when engaged in home-based research with young children. Using a synergy of ecocultural theory and Foucauldian ideas of Heterotopia as theoretical conceptualisations, the authors employed reflective lenses to guide their approach, and examine dilemmas and complexities when conducting research in the home. We argue that, to address ethical dilemmas, researchers need to problematise and reflect upon the nature of respectful approaches and the ethical implications of their behaviours. We conclude that, although ethical codes are valuable when researching families at home, researchers should plan for and forefront their methodological approaches in ways that are family-centred, whilst also framed by practices that are ethical, respectful and reflective to the situated contexts of family's ecologies and heterotopias. [ABSTRACT FROM AUTHOR]

Summary: The quality of the helping relationship is experienced when theories and principles are enacted in practice. Here, the people social workers seek to serve are able to decide whether the practice they experience is useful. One way that social workers can enhance the quality of the relationships they develop is to 'start where the person is at'. In order to explore what this phrase means in and for effective social work practice, this paper revisits Martin Buber's articulation of the I/thou relationship seeking to shed light on the notion of personhood in this value-based profession. Two participants, within a larger research project exploring the experiences of social workers in the Australian child welfare field, independently used the language of personhood to refer to the way they conceptualised the process of engaging with people. Both were referring to enacting the transcendent value of each person in terms of a practice philosophy. These personal narratives inspired the authors to move away from the usual professional discourse about the skills involved in relationship building and instead reflect on their own practice in order to capture something philosophical about caring relational processes. Revisiting humanistic conceptualisations of the helping relationship such as the I/thou has the potential to discourage practitioners from seeing relationships as transactional. This has particular significance in practice contexts characterised as risk-averse, austere or involuntary, and/or where people may be feeling anxious, stressed and/or simply unheard. Contemporary implications for social work practice are discussed. [ABSTRACT FROM AUTHOR]

Objectives: To provide insights into the obstacles which pose challenges to the set-up of any National Registry in Australia. Methods: An analysis of our experience in executing a Multi-Institutional Agreement (MIA) and obtaining ethics and governance approvals, post-award of a large Medical Research Futures Fund grant in June 2020. Results: From July 2020, our timeline to an executed MIA was 283 days, despite full-time staff working towards this goal. Subsequently, after lead site ethics approval, time to site governance approvals ranged from 9 to 291 days. A total of 214 emails were sent during the MIA development and signing. There were 11–71 emails sent to individual governance offices and the number of requested points of additional information ranged from 0 to 31 queries. Conclusions: There were considerable time delays in executing the initial (pre-research) stages of a National Federal Government funded Registry project which required substantial time and resources. We report a wide variation in requirements between different states and institutions. We propose several strategies which could be implemented to facilitate a more streamlined approach to research ethics and governance. This centralised approach would allow for better use of funding and facilitate better progress in medical research. What is known about the topic? Research ethics and governance are essential elements in research, but these systems are imperfect, with many groups reporting the need for reform of the systems governing research. What does this paper add? We report on our own experiences in establishing a National Disease registry, and the numerous inconsistencies encountered, prior to being able to conduct any research. What are the implications for practitioners? We propose several strategies which could be implemented to facilitate a more streamlined, centralised approach to research ethics and governance. [ABSTRACT FROM AUTHOR]

Engagement in health research is increasingly practised worldwide. Yet many questions remain under debate in the ethics field about its contribution to health research and these debates have largely not been informed by those who have been engaged in health research. This paper addresses the following key questions: what should the ethical goals of engagement in health research be and how should it be performed? Qualitative data were generated by interviewing 22 people with lived experience, members of the public, and engagement managers about power sharing in health research. Thematic analysis of study data identified the following five themes: the value of engagement in research, ideal engagement, tokenistic engagement, terms to describe those engaged, and engagement roles in research. The paper presents that data and then considers what insights it offers for what engagement should look like—its ethical goals and approach—according to those being engaged. [ABSTRACT FROM AUTHOR]

Policy and research acknowledge that the quality of end-of-life care in hospitals can be poor, with families reporting significant concerns regarding physical and psychosocial care. In order to design appropriate evidenced-based care approaches, we conducted qualitative research examining the perspectives of bereaved families of patients who received end-of-life care in our health network. This paper reports on ethical dilemmas facing practitioner-researchers conducting interviews with bereaved families. We recruited 40 bereaved family members to participate in semi-structured interviews discussing the care a loved one received while a patient under the general medicine units. Bereaved participants expressed grief, humour and anger regarding their experience, and several reported perceptions of negligent and harmful care. Irrespective of the protocols in place to mitigate distress, this posed an ethical dilemma for the practitioner-researcher as a member of the health network, who needed to balance clinical and research roles when responding to distress. The practitioner-researcher's own bias and assumptions emerged when analysing families' distressing recollections. More broadly, the issues discussed have clinical implications for models of hospital bereavement support. Participants' use of photos and mementos jointly served to include the presence of the deceased in the research interview, but also highlighted the potential to utilise visual methods to examine sensitive research issues. It helps every practitioner-researcher to distinguish between research-oriented goals and clinical responsibilities to care provision as they consider their human research ethics application before beginning any research. [ABSTRACT FROM AUTHOR]

Concern with climate change, and coal's contribution to it, has centred coal in an intensely moralised politics of accusation in Australia. This paper discusses the ordinary ethics through which pro‐coal lobbyists in Australia relate to this moralised landscape and offers an analysis of the everyday and ordinary production of complicity with climate change. It argues that complicity is not just something that insufficiently ethical people engage in, but instead highlights the ways in which the coal industry derives a moral weight for its defenders. This complicity is made and reproduced precisely through the everyday practices of ethical deliberation figured in response to interpersonal moral accusations. These insights are made possible through the author's own positionality and surprising affinities with pro‐coal lobbyists, and thus this paper argues for an anthropology of extractive industry which embraces the interplay of anthropological rapport with complicity. [ABSTRACT FROM AUTHOR]

This paper presents additional qualitative results from Phase 1 of a larger study examining potentially morally injurious events/experiences (PMIE) and/or moral injury (MI) among Australian veterans (Hodgson et al. in J Relig Health 60(5):3061–3089, 2021). It makes specific reference to (1) betrayal and (2) retribution experienced or perpetrated by Australian military veterans during military conflicts and peacekeeping missions. During two veteran seminars conducted in Adelaide, South Australia, a total of 50 veterans were recruited, 10 of whom were willing to be interviewed and audio-recorded about their deployment experiences. Narrative data analysis of veteran transcripts indicated that all participants had engaged in or were exposed to a PMIE/MI of one kind or another, and all had experienced betrayal and/or witnessed or perpetrated retribution. Given the ethical, moral and spiritual issues involved, the role of chaplains in addressing moral injury for the benefit of veterans through the use of 'Pastoral Narrative Disclosure' (PND) is suggested—with a specific focus upon 'restoration' and 'ritual'. Additional research is recommended with regard to acts of betrayal and retribution among veterans, as well as the further development of PND to address PMIE/MI. [ABSTRACT FROM AUTHOR]

New technologies have afforded increased access to genetic testing providing valuable information for individuals and those biologically related. However, the management of such information is challenging for psychologists given the ethical issues that may arise. This paper aims to review the utility of existing ethical standards and current legislation for psychologists when encountering genetic information. Current legislation and guidelines involved in the management of genetic information applicable for psychologists is critically reviewed in light of relevant ethical principles. While knowledge of information that has arisen from genetic testing may guide psychological therapy, intervention, and education, psychologists have a responsibility to uphold their ethical obligations in order to meet the needs of their clients and their families and to prevent harm. Outside the domain of ethically approved human research, and specific guidance for trained genetic counsellors in Australia, ethical guidance on the management of human genetic information is not readily available for psychologists. Technological advances can be expected to continue to present epistemic dilemmas about the use of genetic material. The implications for future psychological practice is discussed. : What is already known about this topic: (1) Increased access to genetic testing can provide valuable information for individuals and those biologically related. (2) Genetic testing poses new and significant challenges for psychologists, especially in respect to the ethical issues that can occur. (3) Given that findings from genetic testing may guide therapy goals, interventions, and psychoeducation, psychologists have a responsibility to uphold ethical obligations in order to meet the needs of their clients and their families and to prevent harm. Yet, clear guidelines for ethical obligations regarding the handling of genetic testing are not readily available. What this topic adds: (1) Within the framework of current legislation, the four core ethical standards of beneficence, autonomy, justice, and non-maleficence work together with the APS Code of Ethics and ethical guidelines for psychologists. (2) While the use of genetic information has the potential to affect whole communities, it should be used in such a way that maintains ethical principles, meeting the needs of the individual and family. (3) It is important that ethical guidelines for genetic information in the field of psychology remain cohesive to meet the needs of rapid technological advances and changing legislation. [ABSTRACT FROM AUTHOR]

In this paper we explore methodological considerations for recruiting stigmatised populations online. Advertising for research participants via social networking sites (SNS) has increasingly become a tool of choice for both quantitative and qualitative researchers. However, such recruitment practices pose a range of challenges for researchers, especially in handling negative commentary such as trolling and its potential negative impact on prospective research participants. Using a case study involving a project on the health and well-being of older lesbian, gay, bisexual, transgender and intersex (LGBTI) people in Australia, we outline the types of commentary we received on our advertising campaign, as well as our strategies for managing such commentary. We seek to offer ways in which researchers working with stigmatised populations, as well as controversial issues that may attract hostile attention, can effectively manage participant recruitment as researchers increasingly utilise online technologies for recruitment advertising. [ABSTRACT FROM AUTHOR]

This paper provides a set of principles and ethics, developed in collaboration between Pacific‐ and Australian‐based researchers, to guide research practice in a project enabling the self‐reporting of children with disability in Vanuatu and Papua New Guinea (PNG). The paper presents both a summary of academic literature relating to these principles and ethics, as well as their succinct 'translation' into a set of action statements for researchers working with children with disability. The paper offers a base for further development by others to guide research practice and foster the autonomous participation of children with disability in developing countries. [ABSTRACT FROM AUTHOR]

Writing from experiences in the consulting room in private practice in Australia, the author refers to the layered complexity of a conflict of ethical duty which has legal and social implications. The paper explores how the ethics that are congruent with creating a safe vas bene claustrum can be diametrically opposed to the social and legal structures and processes on which we all rely. It is suggested that within the vas, analysts and analysands engage in a shared process of emotionally connected, layered, symbolic thinking. Subpoenas directed at analysts are seeking concrete evidence that will stand up in court. The paper argues that this is a category error based on ignorance and misconceptions of what analytic work entails. The intrusion of a subpoena into the vas has the potential to cause havoc in the mental health and the lives of already vulnerable, possibly traumatized and isolated individuals. It can undermine a fundamental human right and undermine the profession of psychotherapy as a whole. The paper proposes that analysts have an ethical obligation to protect the work contained within the vas from these category errors and to educate other professionals as to why we cannot provide the kind of evidence that the courts require. [ABSTRACT FROM AUTHOR]

For governments concerned with enhancing labour market efficiency, employer-sponsored temporary labour migration schemes have become increasingly popular. However, the equity implications of these arrangements, which constrain the mobility of migrant workers, have largely been ignored. This paper assesses the factors affecting the vulnerability of employer-sponsored migrant workers and addresses the question of whether these schemes comply with ethical principles relating to fair treatment. It draws upon migration ethics, political economy and socio-legal perspectives to evaluate visa schemes in Australia, Canada and Sweden. The paper argues that there is an ethically justifiable case for selectively restricting certain rights of migrant workers within clearly defined parameters. However, policies facilitating worker mobility, restricting sponsorship to higher-skilled occupations, promoting enforcement and worker representation, and providing accessible opportunities for permanent residency and citizenship help to ensure that employer-sponsored temporary labour migration schemes comply with ethical principles relating to the fair treatment of workers. [ABSTRACT FROM AUTHOR]

Research examining the relationship at the interface of personality, values, moral foundations and its impact on employees' subjective well‐being, resilience, job performance and satisfaction is almost non‐existent. This study addresses this Special Issue's call focusing on the key antecedents and consequences of resilience on individual and/or organisational level outcomes. It does so by analysing data from two different, though comparative cross‐national studies in Australia and India. Employing a quantitative survey method, we collected data from 195 respondents in Australia and 257 respondents from India. Employing the core theory of moral foundations in association with its relationships with individual personality, values, well‐being and resilience, our findings suggest a significant relationship between personality traits and individual moral foundations, and psychological well‐being via values. The study offers distinctive contributions to the literatures on well‐being, resilience and moral foundations theory. Specifically, the personality trait of extroversion influences power and achievement or self‐enhancement values through individualised moral foundations. Second, the study found that values of benevolence and universalism, or compassionate values, form the basis for biological mechanisms of resilience through individual moral foundations of fairness/harm care. The paper concludes with implications for theory and practice. [ABSTRACT FROM AUTHOR]

Advances in prosthetic design should benefit people with limb difference. But empirical evidence demonstrates a lack of uptake of prosthetics among those with limb difference, including of advanced designs. Non-use is often framed as a problem of prosthetic design or a user's response to prosthetics. Few studies investigate user experience and preferences, and those that do tend to address satisfaction or dissatisfaction with functional aspects of particular designs. This results in limited data to improve designs and, we argue, this is pragmatically and ethically problematic. This paper presents results of a survey we conducted in 2017 with people with upper limb difference in Australia. The survey sought to further knowledge about preferences surrounding prosthetics and understanding of how preferences relate to user experience, perspective, and context. Survey responses demonstrated variety in the uptake, use and type of prosthetic—and that use of, preferences about, and impacts of prosthetics rely not just on design factors but on various contextual factors bearing on identity and social understandings of disability and prosthetic use. From these results, we argue that non-use of prosthetics could be usefully reframed as an issue of understanding how prosthetics can best support users' autonomy. This supports the claim that there is a need to incorporate user engagement into design processes for prosthetic limbs, though further work is needed on methods for doing so. [ABSTRACT FROM AUTHOR]

Children can sometimes find it difficult to articulate their experiences if they have to rely solely on words. Giving children the opportunity to use arts-based research approaches can support their participation in research and create a bridge that enables them to express their perspectives and feelings. This paper focuses on the ethical and practical considerations when using photo elicitation interviews (PEI) in research with children. The discussion and examples provided are drawn from an international study that used auto-driven PEI, where photographs are taken by children themselves, to explore children’s experiences of living with a chronic condition and the impact condition management may have on their everyday lives. In this paper we critically explore the issues arising from our use of PEI including children’s participation and engagement, balancing power and control, and keeping children safe. The main areas of focus for the paper are how PEI provided a means of shifting control; how setting photographic boundaries influenced our PEI study with children; and how we addressed risks associated with the method. Our experience shows that PEI is an engaging and valuable research method, providing a powerful medium for obtaining rich data with children. However, PEI is challenging and it requires researchers to conscientiously address ethical and practical aspects that extend beyond those inherent to standard (words-alone) interviews. [ABSTRACT FROM PUBLISHER]

Learning analytics is an emerging field in which sophisticated analytic tools are used to inform and improve learning and teaching. Researchers within a regional university in Australia identified an association between interaction and student success in online courses and subsequently developed a learning analytics system aimed at informing learning and teaching practices. Contemporary literature draws attention to ethical considerations and moral tensions in the implementation of learning analytics. This paper presents a case study of the ethical implications of a learning analytics implementation at CQUniversity, a regional Australian university. There was an institutional assumption that student data, consensually gathered at enrollment could be analyzed beyond the scope of the original consent. Further, academics were using the data in a manner not intended by the designers of the learning analytic system, and academics interpreted the student's individualized data to label students based on their estimate of success. The learning analytics system is still being used and the ethical findings from this paper have implications for CQUniversity, academics and students. In order to resolve the ethical dilemmas the university could increase transparency of the process to students and obtain consent at multiple levels throughout the student journey. [ABSTRACT FROM AUTHOR]

This paper draws on theories of the gift to address the ethics of representing Aboriginality in Australian children's literature, which is a contentious debate that centres on who is eligible to tell Aboriginal stories and how the stories can be told. Considering the historical indebtedness in Australian racial relations, the paper suggests that children's books that incorporate reference to Aboriginal cultural elements constitute a metaphorical 'gift' exchange between Aboriginal custodians as the givers and writers as the recipients who are expected to 'return' such an intellectual gift through their books in an appropriate manner. In this view, the paper specifies the ethical issues confronted by non-Aboriginal writers for children, including Patricia Wrightson, Phillip Gwynne and Kate Constable, and examines the way in which the gift relationship sheds light on the question of how to avoid infringement of Aboriginal protocols without submitting to self-censorship. A caring gesture, underlining the relationship between self and others in gift exchanges, is identified to negotiate the writer's interests in Aboriginal stories with cultural sensitivity against unauthorised appropriation. The paper therefore argues that the morality of gift exchanges, which demands a balanced consideration of disparate interests in obligatory reciprocation, offers a possible solution to the dilemma of non-Aboriginal writers in the treatment of Aboriginal subject matter. [ABSTRACT FROM AUTHOR]

Religion-based LGBTQA + conversion practices frame all people as potential heterosexuals whose gender aligns with their birth sex (in a cisgender binary model of male and female sexes). Deviation from this heterosexual cisgender social identity model is cast as curable 'sexual brokenness'. However, research shows conversion practices are harmful, and particularly associated with increased experiences of abuse, mental health diagnoses, and suicidality. This paper explores their contribution to the particular harms of moral injury and religious trauma, drawing firstly on the foundational moral injury literature to offer a unique conceptual framework of spiritual harm and moral injury, and secondly on a rare qualitative 2016–2021 study of the spiritual harms reported in semi-structured interviews of 42 survivors of LGBTQA + change and suppression practices in Australia. The paper examines the survivors' support needs around the nature and extent of religious trauma and moral injury, to inform services working towards supporting their recovery from such experiences and their resolution of conflicts deeply bound in their sense of self and belonging. It argues that impairment of conversion survivors' relationships with religious communities, and religious self-concepts, point to the need for additional improvements in pastoral practice. • Research shows a globally common range of religion-based LGBTQA + conversion practices. • Spiritual harms associated with conversion practices have not yet been investigated. • Coercion in conversion practices was linked to stronger religious trauma responses. • Complicity in experiences of conversion practices was closely linked to moral injury. • Attending to spiritual and cultural factors will aid in survivors' recovery. [ABSTRACT FROM AUTHOR]

The disciplines of ethics, science, and the law often conflict when it comes to determining the limits and boundaries of embryo research. Under current Australian law and regulations, and in various other jurisdictions, research conducted on the embryo in vitro is permitted up until day fourteen, after which, the embryo must be destroyed. Reproductive technology and associated research is rapidly advancing at a rate that contests current societal and ethical limits surrounding the treatment of the embryo. This has brought about the question of the adequacy of the fourteen-day rule and whether it is necessary for it be reconsidered and reformed. This paper will highlight some of the tensions that exist in ethics, science, and the law in relation to the extension of the rule. It will be concluded that any move to extend the rule must be accompanied by close consultation with the public as the ultimate stakeholders in how the future of reproductive technology is created, constructed, and contested. [ABSTRACT FROM AUTHOR]

In this paper, we present two grounds for arguing that abortion should be decriminalised. First, we consider the implications of the fact that the long‐standing ethical debate concerning the morality of abortion has to date proven intractable. We maintain that because the philosophical literature has failed to demonstrate conclusively that views either for or against abortion's moral acceptability are false, the matter remains at a stalemate in terms of rational debate, contributing to the ongoing absence of political and popular consensus about the issue in our society. In these circumstances, we argue, the law should adopt a minimalist position by not imposing criminal sanctions for abortion. Second, we present evidence, often neglected in the moral debates about abortion, that the risks of carrying a fetus to term and of delivery are substantial for a woman. Most laws recognise that, should her life be endangered by her pregnancy, a woman's right to life shall prevail. However, the impacts of carrying a fetus to term and delivery on a woman are not restricted to the risks to her life, but extend to significant permanent changes to her body, and include risks of injury that are not negligible. We argue that a woman should not be compelled to take these risks by laws prohibiting abortion, when no conclusive argument exists against the morality of abortion. We also address, albeit briefly, the issue of late‐term abortion. [ABSTRACT FROM AUTHOR]

Issue Addressed: Most academic journals that publish studies involving human participants require evidence that the research has been approved by a human research ethics committee (HREC). Yet journals continue to receive submissions from authors who have failed to obtain such approval. In this paper, we provide an ethical justification of why journals should not, in general, publish articles describing research that has no ethics approval, with particular attention to the health promotion context.Methods: Using theoretical bioethical reasoning and drawing on a case study, we first rebut some potential criticisms of the need for research ethics approval. We then outline four positive claims to justify a presumption that research should, in most instances, be published only if it has been undertaken with HREC approval.Results: We present four justifications for requiring ethics approval before publication: (1) HREC approval adds legitimacy to the research; (2) the process of obtaining HREC approval can improve the quality of an intervention being investigated; (3) obtaining HREC approval can help mitigate harm; and (4) obtaining HREC approval demonstrates respect for persons.Conclusion: This paper provides a systematic and comprehensive assessment of why research ethics approval should generally be obtained before publishing in the health promotion context. So what? Journals such as the Health Promotion Journal of Australia have recently begun to require research ethics approval for publishing research. Health promotion researchers will be interested in learning the ethical justification for this change. [ABSTRACT FROM AUTHOR]

Mature minor consent only became available in Australia in 2007. There is neither an explicitly defined protocol, nor a clear definition evident in the literature relating to use of the mature minor concept in health research. Due to difficulties in defining fixed age ranges to varying levels of maturity and vulnerability, there is a lack of clarity surrounding when it might be reasonable and ethical to apply for or grant a waiver for parental consent. This paper describes the challenges faced and solutions created when gaining approval for use of mature minor consent in a respondent-driven sampling (RDS) study to explore the social norms and alcohol consumption among 14-17-year-old adolescents (n = 1012) in the community. The University's Human Research Ethics Committee granted mature minor consent for this study, and the techniques applied enabled recruitment of adolescents from community-based settings through use of RDS to achieve the required sample. This paper has relevance for research that requires a waiver for parental consent; it presents a case study for assessing mature minors and makes recommendations on how ethical guidelines can be improved to assist human research ethics application processes. [ABSTRACT FROM AUTHOR]

This paper examines the few, but important legal and coronial cases concerning withdrawing or withholding life-sustaining treatment from severely disabled or critically impaired infants in Australia. Although sparse in number, the judgements should influence common clinical practices based on assessment of 'best interests' but these have not yet been adopted. In particular, although courts have discounted assessment of 'quality of life' as a legitimate component of determination of 'best interests,' this remains a prominent component of clinical guidelines. In addition, this paper highlights the lack of uniform clinical guidelines available to medical professionals and parents in Australia when making end-of-life decisions for severely ill infants. Thus, it is argued here that there is a need for an overarching prescriptive uniform framework or set of guidelines in end-of-life decision-making for impaired infants. This would encourage greater transparency, consistency, and some degree of objectivity in an area that often appears subjective. [ABSTRACT FROM AUTHOR]

This paper reports a 40-year follow-up of 57 graduates from the initial intake to an Australian medical school who were selected on the basis of either academic criteria alone or desirable personal qualities as assessed by non-cognitive tests and an interview (with a third small group satisfying both criteria). Both students and teaching staff have remained blind to the basis for selection until the present day. Analysis of their under- and post-graduate careers indicates that 'academic' entrants were more likely to complete an intercalated BMedSci degree and to become specialists, while 'personal qualities' entrants were more likely to graduate with honours, become GPs, and win higher degrees after graduation. However, gender more significantly predicted these outcomes, with female results similar to 'personal qualities' entrants and males' similar to 'academic.' The results are interpreted with reference to the aims and structure of the Newcastle medicine curriculum. [ABSTRACT FROM AUTHOR]

The aim of this paper is to reflect critically on the current health promotion initiatives targeting overweight individuals in Western countries. The paper’s methodological approach is to draw on analytical findings from my and other sociologists’ empirical work on how the problems of overweight people are being defined in various settings in Denmark, England, Australia and the US. I try to illustrate how health promotion targeting overweight individuals can not only be seen as a project aimed at securing longer lives and fewer illnesses for people carrying excess fat but also a moral project that, in a more general sense, aims to tell people how they ought to live their lives. I link this moral aspect of health promotion to a) the medicalization tendency in current Western society (e.g. a growing pharmaceutical industry and its economic interest in transforming the human condition of being overweight into a treatable disorder) and b) the strong focus on individual risk today. One of the main arguments in the paper is that health in relation to overweight is primarily defined from a biomedical perspective that praises certain physical measurements of the body, as well as dominant societal values such as  self-responsibility and self-control, and that a combination of biomedicine and these dominating values can lead to health promotion becoming a problematic moral endeavour. [ABSTRACT FROM PUBLISHER]

There are circumstances where ethics overload may be counterproductive to the successful achievement of research outcomes, especially for disempowered client groups. This paper describes and questions the complex time-consuming nature of seeking ethical approval from multiple Human Research Ethics Committees (HRECs) for a comorbidity research project in South Australia. Applications for ethical approval of a major research project involving surveys and interviews of managers and clinicians from mental health and alcohol and other drug services, community advocates and other relevant services were submitted to three major HRECs. Collectively, it took a duration of 10 months to receive full approvals from these HRECs. In addition, a number of Site-Specific Assessments were needed and further approvals were required from multiple Non-Government Organisations (NGOs). Each review process required a detailed application, sometimes followed by lengthy negotiation periods and amendments. These cumbersome, often duplicated processes took a considerable amount of researcher and committee time from a three-year project funding period, thereby delaying the project by almost a year. We discuss the impact of these delays on the timing, progress and potential quality of the research, and on the research team, employed staff, doctoral students involved, and the research budget. We also discuss the additional complexities and inconsistencies of involving two vulnerable populations, Aboriginal Australians and people from refugee backgrounds. This paper informs researchers and funding bodies about this major issue, and offers some suggestions for more effective ethical review processes. [ABSTRACT FROM PUBLISHER]

The settlement in Australia of people fleeing from war and persecution is claimed as proof of its humanitarian credentials. Australia’s identity as a settler colony draws attention to a darker history, featuring colonial practices that remain in the background of educational debates. The paper begins with two examples of harsh and punitive punishment, endorsed electorally and mobilised to manage the racial other. This background sets the context for understanding the cultural politics of besiegement and its implications for schooling. We explore how teachers might be freed up from existing discourses of power and knowledge, by examining their ethical conduct (‘care of the self’). Using findings from two Australian studies conducted in the cities of Brisbane and Greater Western Sydney, we explore possibilities for developing alternative political subjectivities for teachers and pre-service teachers. It is through careful attention to their ethical sensibilities that teachers will be empowered to steer education towards a different ontological politics. [ABSTRACT FROM AUTHOR]

Dominant constructions of professionalism in early childhood education can diminish early childhood teachers’ and educators’ undertaking of advocacy at the systems or political level. In this paper, we propose an ethically grounded construction of professionalism that provides space for professional practice to move beyond the classroom and into the political sphere. Findings from interviews with four early childhood teachers from Australia who undertake systems advocacy as part of their professional practice show that this work is driven by ethical influences that extend beyond the rule-based imperative, in ethical codes, that teachers should undertake systems advocacy. Findings highlight the value of considering systems advocacy as practice that emerges from an interplay of three theoretical foundations of ethics: deontology, utilitarianism and virtue ethics. Implications for teacher professionalism and the building of a teacher disposition that incorporates systems advocacy are considered. [ABSTRACT FROM PUBLISHER]

The national ethical guidelines relevant to assisted reproductive technology (ART) have recently been reviewed by the National Health and Medical Research Council (NHMRC). The review process paid particular attention to the issue of non-medical sex selection, although ultimately, the updated ethical guidelines maintain the pre-consultation position of a prohibition on non-medical sex selection. Whilst this recent review process provided a public forum for debate and discussion of this ethically contentious issue, the Victorian case of JS and LS v Patient Review Panel (Health and Privacy) [2011] VCAT 856 provides a rare instance where the prohibition on non-medical sex selection has been explored by a court or tribunal in Australia. This paper analyses the reasoning in that decision, focusing specifically on how the Victorian Civil and Administrative Tribunal applied the statutory framework relevant to ART and its comparison to other uses of embryo selection technologies. The Tribunal relied heavily upon the welfare-of-the-child principle under the Assisted Reproductive Treatment Act 2008 (Vic). The Tribunal also compared non-medical sex selection with saviour sibling selection (that is, where a child is purposely conceived as a matched tissue donor for an existing child of the family). Our analysis leads us to conclude that the Tribunal’s reasoning fails to adequately justify the denial of the applicants’ request to utilize ART services to select the sex of their prospective child. [ABSTRACT FROM AUTHOR]

In February 2016 a twelve-month-old asylum seeker, who came to be know as Baby Asha, was transferred from Nauru and hospitalized in Brisbane. This case came to public attention after Doctors refused to discharge Asha as she would have been returned to detention on Nauru. What in other circumstances would have been considered routine clinical care, quickly turned into an act of civil disobedience. This paper will discuss the ethical aspects of this case, along with its implications for clinicians and the broader healthcare community. [ABSTRACT FROM AUTHOR]

This paper documents the self-positioning of a segment of middle class parents, whom we call ‘community-minded’, as they distinguish themselves from pedagogies and parenting practices for education often associated with ‘tiger parenting’ and ‘Asian’ practices in Australia. Increased public interest has scrutinised the growth of high achieving Asian-Australian students and commonly depicts ‘Asian success’ as being about ethnicity and/or race. As academics argue, such essentialism validates existing capitals among middle-class parents and feeds into a politics of racial hostility. Building on this literature, we focus on this site of tension as one of a struggle between ‘old’ and ‘new’ middle classes. Drawing on a small study in Sydney NSW, we deal with a fraction of the middle classes for whom particular educational strategies are disavowed as part of their self-positioning as moral, ‘community-minded’ citizens. This is analysed as a response to broader changes across education, the economy and migration trajectories which have emerged alongside what Watkins and Noble call the ‘ethnicisation’ of academic achievement. These tensions provide insight into how ‘old’ and ‘new’ middle classes are attempting to co-exist in Australian schools, as global political and economic transformations are negotiated within the micropolitics of parenting and cultural constructions of childhood. [ABSTRACT FROM AUTHOR]

Research is crucial to advancing knowledge about dementia, yet the burden of the disease currently outpaces research activity. Research often excludes people with dementia and other cognitive impairments because researchers and ethics committees are concerned about issues related to capacity, consent, and substitute decision-making. In Australia, participation in research by people with cognitive impairment is governed by a national ethics statement and a patchwork of state and territorial laws that have widely varying rules. We contend that this legislative variation precludes a consistent approach to research governance and participation and hinders research that seeks to include people with impaired capacity. In this paper, we present key ethical principles, provide a comprehensive review of applicable legal rules in Australian states and territories, and highlight significant differences and ambiguities. Our analysis includes recommendations for reform to improve clarity and consistency in the law and reduce barriers that may exclude persons with dementia from participating in ethically approved research. Our recommendations seek to advance the national decision-making principles recommended by the Australian Law Reform Commission, which emphasize the rights of all adults to make their own decisions and for those with impaired capacity to have access to appropriate supports to help them make decisions that affect their lives. [ABSTRACT FROM AUTHOR]

This paper examines three recent high-profile cases involving gifts and benefits to police. The cases, two from Australia and one from England, involved both frontline officers and senior managers. The analyses track the unfolding scandals, and how they were investigated and evaluated by official inquiries. In two of the cases, gifts and hospitality were enmeshed with wider forms of corruption. The official inquiries identified how gratuities undermined public confidence in the impartiality of police, and how inappropriate gifts and benefits were facilitated by liberal policies and deficient leadership. The paper concludes by arguing that police need to adopt a highly restrictive policy on gratuities, and follow through with effective forms of compliance management. [ABSTRACT FROM AUTHOR]

This paper presents a review of recent child therapy and family therapy texts and training courses in Australia. The aim was to determine the extent to which knowledge and information about child development and emotional and psychological problems in children and adolescents is included in the education and training of family therapists. The paper argues this is crucial to prevent the difficulties of young person's being ignored or exacerbated and discusses relevant ethical issues. [ABSTRACT FROM AUTHOR]

Objective. Chronic pain is experienced by one in five Australians and is estimated to be the nation's third most costly health problem. In 2013, a chronic pain treatment outcomes registry was established, with the goals of evaluating treatment of chronic pain in multidisciplinary centers, establishing a benchmarking system to drive quality improvement and providing answers to important questions regarding types of treatment ("dose," intensity, and response) and which treatment is appropriate for different patients. This paper describes the development and the first-phase implementation of the registry. Methods.A minimum data set of primarily patient-rated measures was developed for use within pain management services. Governance structures and protocols for data collection were established, and software and resources created, to support pain management services. Results. Data collection commenced in 21 centers in Australia and is being implemented in over 20 others across Australia and New Zealand within the first two years. Feedback in the initial phase has already resulted in improvements to the software and reports, as well as minor changes to the data set. Centers have submitted high-quality data describing the demographic and clinical characteristics of patients referred to specialist pain services. Conclusions. The electronic Persistent Pain Outcomes Collaboration has been established for Australasia and is strongly supported by specialist societies and consumer groups. The next phase will increase the proportion of follow-up data in order to realize the registry's goals of evaluation, benchmarking, and research to improve outcomes and services for patients experiencing persistent pain. [ABSTRACT FROM AUTHOR]

Assisted dying is a topic fraught with theological and ethical contention. It has been regularly debated in Australian parliaments and is currently under active consideration in New South Wales and Victoria. The Victorian process involved a public inquiry by a committee of Victoria's upper house which attracted more than a thousand submissions. This paper analyses the submissions made to that committee by Christian churches and organizations with a Christian affiliation. All bar one of the submissions were opposed to legalising assisted dying. The two most common themes in the Christian submissions were the need to expand palliative care services and that adequate palliative care could be an alternative to assisted dying; and that even narrowly constrained legalising of assisted dying could lead to a slippery slope with further expansions and potential harm to vulnerable populations. These arguments were not successful and the committee supported legalising assisted dying. Possible reasons for the failure of the Christian arguments are explored. [ABSTRACT FROM AUTHOR]

ADR processes are now used extensively in Australia to resolve disputes in courts and tribunals. In addition, government departments see ADR as an important tool in improving access to justice for ordinary citizens. However, what justice means in different ADR contexts may differ. One possible explanation for the divergence of views on justice and ethics in ADR practice is the fact that practitioners come from different professional backgrounds and disciplines and also use a range of processes. Also, while some processes have clearly stated normative purposes under enabling legislation and Charters, others do not. There are also industry-scheme ADR processes with normative purposes beyond individual disputes. Drawing from empirical research, this paper begins to explore the relationship between process purpose, underlying values and ethical responsibilities that arise for a range of ADR practitioners working in different fields and the potential of those processes to promote substantive and procedural justice. [ABSTRACT FROM AUTHOR]

This paper investigates what 'free-range' eggs are available for sale in supermarkets in Australia, what 'free-range' means on product labelling, and what alternative 'free-range' offers to cage production. The paper concludes that most of the 'free-range' eggs currently available in supermarkets do not address animal welfare, environmental sustainability, and public health concerns but, rather, seek to drive down consumer expectations of what these issues mean by balancing them against commercial interests. This suits both supermarkets and egg producers because it does not challenge dominant industrial-scale egg production and the profits associated with it. A serious approach to free-range would confront these arrangements, and this means it may be impossible to truthfully label many of the 'free-range' eggs currently available in the dominant supermarkets as free-range. [ABSTRACT FROM AUTHOR]

Qualitative researchers are compelled to use their personal judgements before, during and after interviews, particularly when their interview subjects are drawn from vulnerable groups. This paper discusses the dilemmas qualitative researchers encounter when collecting data that is ethically ‘sensitive’; and situates the discussion in the realm of the Australian Occupational Health & Safety (OH&S) legislative requirement of ‘duty of care’ using the Rapidly Degenerative Neurological Diseases Pilot Program in Western Australia as the case example. The paper is focussed upon the practicalities and ethical concerns of the researchers conducting qualitative data collections. The discussion seeks to provide practical reflections on lessons learned and suggestions for self-care practice for researchers in the field and calls for policies that instruct and protect them. [ABSTRACT FROM PUBLISHER]

Health in All Policies (HiAP) is a policy development approach that facilitates intersectoral responses to addressing the social determinants of health and health equity whilst, at the same time, contributing to policy priorities across the various sectors of government. Given that different models of HiAP have been implemented in at least 16 countries, there is increasing interest in how its effectiveness can be optimized. Much of the existing literature on HiAP remains descriptive, however, and lacks critical, empirically informed analyses of the elements that support implementation. Furthermore, literature on HiAP, and intersectoral action more generally, provides little detail on the practical workings of policy collaborations. This paper contributes empirical findings from a multi-method study of HiAP implementation in South Australia (SA) between 2007 and 2013. It considers the views of public servants and presents analysis of elements that have supported, and impeded, implementation of HiAP in SA. We found that HiAP has been implemented in SA using a combination of interrelated elements. The operation of these elements has provided a strong foundation, which suggests the potential for HiAPto extend beyond being an isolated strategy, to form a more integrated and systemic mechanism of policy-making. We conclude with learnings from the SA experience of HiAP implementation to inform the ongoing development and implementation of HiAP in SA and internationally. [ABSTRACT FROM AUTHOR]

In recent times, local governments in Australia's major cities have embraced the idea that the trees in their streets, parks, and private gardens are parts of a collective urban forest that can be managed to address complex policy problems and create more liveable and sustainable cities. In light of this proposition, applied and critical urban forest researchers have typically focused on questions of quantity with regard to some of the factors that influence the density and distribution of urban tree cover. In a few cases, however, researchers have documented qualitative changes to the urban trees and woodlands that ostensibly constitute the urban forest, suggesting that it might be apprehended in a more mutable and dynamic way. Building on these accounts, we turn to Deleuze and Guattari's theory of becoming to read the urban forest in an active and malleable light, developing a historical geography of urban forestry in Australia that discerns three urban forest projects we call the 'forest in a city', the 'city forest', and a new but not yet realised, 'city in a forest'. This finding renders the urban forest in more contingent, multiple, and mutable terms, leading us to finish the paper with a consideration of what seeing the urban forest as becoming means for future research. There, we suggest that Deleuze and Guattari's becoming directs us to different kinds of empirical, political, and ethical concerns that haven't received significant interest in the current literature. These include asking how, why, and with what consequences do particular styles of urban forestry emerge at particular space-times. How is qualitative difference and urban forest multiplicity dealt with in practice, as well as focusing on affect and everyday embodied encounters between people and trees in different urban places. [ABSTRACT FROM AUTHOR]

In this paper we report on the findings from six focus groups conducted with Australian medical students. The focus groups discussed students' perceptions of conflicts of interest and the influence of commercial values in health care and medical education. Our research revealed that students were aware of a number of structural influences that affected the medical education they received and that had the potential to shape their attitudes and practices as they progressed in becoming a doctor. We found that the pressures of educational workload and anticipated career trajectories tended to have an individualising effect that limited the perceived possibility of collective action and response to structural influences. We interpreted these findings through the lens of neoliberal governmentality to articulate the way commercial interests are negotiated and normalised by medical students. Based on these findings, we suggest that medical education should not only explicitly alert students to effects of political and commercial influences on the healthcare system, but also encourage the collective agency of students and strategies that do not place unrealistic expectations on individuals to effect structural change. [ABSTRACT FROM AUTHOR]

Abstract: Participatory action research is lauded for its emancipatory potential and practice relevance. Little research has focused on the ethical and political dimensions of power relations between management gatekeepers and staff in large organizations in the negotiation of action research. To illuminate the dynamics of this engagement, this paper is informed by Aristotle''s practical ethics of phronesis, arguing that ethics emerge through human interaction. The paper reports on a multi-method study and intervention in inter-professional learning and collaboration, conducted between 2008 and 2010, across an Australian health system. It draws on results from researchers'' progress notes, 139 semi-structured interviews and focus groups (492 participants), more than 200 h of organizational document analysis, and more than 200 h of ethnographic observation. From conventional thematic analysis, we note that the project had considerable support from senior managers who were gatekeepers for the research. Such support stemmed from managerialist tendencies, with senior managers explicitly aligning inter-professionalism with prospective health reforms and improvements to quality of care and patient safety. Senior managers were also enthusiastic about standardized processes. Many frontline staff were less supportive, and some were suspicious of or hostile towards management-led processes to improve and evaluate care. Some senior managers'' self perceived alignment with and support for the research process changed to resistance once this finding was presented. This paradox in the interplay of research findings and research process evinces the inherent tension between organizational politics and conducting action research that reflexive researchers need to negotiate in knowledge translation, exchange or mobilization exercises. [Copyright &y& Elsevier]

The focus of this special edition of Youth Studies Australia is on questions, issues, challenges and (tentative) solutions in relation to ensuring that research with young people is conducted ethically. This introductory paper by the guest editors of this edition draws on ethical principles as outlined in the National Statement on Ethical Conduct in Research Involving Humans and in the Fairbridge Code of Ethics for youth work. The authors explain how these principles can inform ethical youth research. In the process, they weave through comments to and from the remaining five papers, providing an authentic touchstone for the principles, as well as recommending the papers to you. [ABSTRACT FROM AUTHOR]

The paper explores ways that vocational education and training (VET) might become involved in the development of moral 'know-how, ready for workplace practice. The primary concern here is the transformation of earlier-learnt ethical principles to their applied moral behaviour, essential for appropriate practice within workplace environments. The argument is grounded in literature and a research study of 14 construction workers from various sectors of the industry in Queensland, Australia. The study identified four influential factors that frame the reports of the study participants' learning to judge, decide and act morally within the construction industry workplace: (1) upbringing, (2) schooling, (3) social contexts, and (4) workplace experience. The paper discusses the less-than-adequate way participants learnt their morals for workplace application and goes on to outline a potentially better way to train them through such paths. The conclusion from the study is that it is necessary to present moral contextualisation through sustained learning over time to gradually develop moral 'know-how', and that VET has a role to play in this process. [ABSTRACT FROM AUTHOR]