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The race against COVID-19 has been intense and painful and many of us are now looking for a way to move on. We may try to seize a degree of comfort and security by convincing ourselves that we are among the "fittest"—that is, among those who have managed to survive—who can now hope for a "new-normal" time, relatively unscathed. But this isn't what we should be hoping for. Our world, and ourselves, will never be free of COVID-19 or its insidious effects. COVID-19, like climate change, is a threat multiplier and the challenges it has raised are now indelibly engraved in our vulnerable, interconnected lives. Rather than vainly hoping for a return to an imaginary, erstwhile "normal" what we need is something more fundamental: a new version of hope that embraces a courage to learn what we need to do, to enable us to live a future to which we aspire. Perhaps counter-intuitively, we need to accept that the COVID-19 experience has already changed us deeply and hope that we can learn from this and from the future changes that the pandemic will give rise to. We need to radicalize our responses to the challenges, enabling ourselves to learn new lessons about old but increasingly pertinent topics, such as the realities of human fragility, and inter-connection. [ABSTRACT FROM AUTHOR]

Intense public interest in scientific claims about COVID-19, concerning its origins, modes of spread, evolution, and preventive and therapeutic strategies, has focused attention on the values to which scientists are assumed to be committed and the relationship between science and other public discourses. A much discussed claim, which has stimulated several inquiries and generated far-reaching political and economic consequences, has been that SARS-CoV-2 was deliberately engineered at the Wuhan Institute of Virology and then, either inadvertently or otherwise, released to the public by a laboratory worker. This has been pursued despite a clear refutation, through comprehensive genomic analysis, of the hypothesis that the virus was deliberately engineered and the failure of detailed investigations to identify any evidence in support of a laboratory leak. At the same time a substantial, established body of knowledge about the many factors underlying the emergence of novel zoonotic diseases has been largely ignored—including climate change and other mechanisms of environmental destruction, tourism, patterns of trade, and cultural influences. The existence and conduct of these debates have raised questions about the vulnerability of science to manipulation for political purposes. Scientific discourses are vulnerable because: (i) claims can be made with no more than probabilistic force; (ii) alleged "facts" are always subject to interpretation, which depends on social, ethical, and epistemological assumptions; and (iii) science and scientists are not inherently committed to any single set of values and historically have served diverse, and sometimes perverse, social and political interests. In the face of this complexity, the COVID-19 experience highlights the need for processes of ethical scrutiny of the scientific enterprise and its strategic deployment. To ensure reliability of truth claims and protection from corrupting influences robust ethical discourses are required that are independent of, and at times even contrary to, those of science itself. [ABSTRACT FROM AUTHOR]

Background: Eligibility to access the Victorian voluntary assisted dying (VAD) legislation requires that people have a prognosis of 6 months or less (or 12 months or less in the setting of a neurodegenerative diagnosis). Yet prognostic determination is frequently inaccurate and prompts clinician discomfort. Based on functional capacity and clinical and biochemical markers, prognostic tools have been developed to increase the accuracy of life expectancy predictions. Aims: This review of prognostic tools explores their accuracy to determine 6‐month mortality in adults when treated under palliative care with a primary diagnosis of cancer (the diagnosis of a large proportion of people who are requesting VAD). Methods: A systematic search of the literature was performed on electronic databases Medline, Embase and Cinahl. Results: Limitations of prognostication identified include the following: (i) prognostic tools still provide uncertain prognoses; (ii) prognostic tools have greater accuracy predicting shorter prognoses, such as weeks to months, rather than 6 months; and (iii) functionality was often weighted significantly when calculating prognoses. Challenges of prognostication identified include the following: (i) the area under the curve (a value that represents how well a model can distinguish between two outcomes) cannot be directly interpreted clinically and (ii) difficulties exist related to determining appropriate thresholds of accuracy in this context. Conclusions: Prognostication is a significant aspect of VAD, and the utility of the currently available prognostic tools appears limited but may prompt discussions about prognosis and alternative means (other than prognostic estimates) to identify those eligible for VAD. [ABSTRACT FROM AUTHOR]

The play of patience and impatience is often powerfully active in the experiences of the clinic. The onset of an illness, the exposure to suffering, and the awareness of our mortality that it awakens compel us to negotiate and renegotiate our relationships with time and with others. Seen in this way, drawing on the work of Emmanuel Levinas, what emerges is not a fixed value but rather a continuous axis in relation to which we valorize the complex and multifaceted ways in which we relate to the unfolding of time. [ABSTRACT FROM AUTHOR]

An editorial is presented reflecting on the mixed outcomes of voluntary assisted dying (VAD) in Victoria over the past four years, highlighting both progress and shortcomings, including challenges in practitioner availability and concerns about bureaucratic formalities. Topics include the increasing acceptance of VAD, challenges in implementation, and the urgent need for systematic, long-term data collection to assess the impact on various aspects of healthcare, and end-of-life experiences.

Gerrit Lindeboom's biography, Herman Boerhaave: The Man and His Work, presents a heroic account of Herman Boerhaave's life and his many contributions to medicine and medical education. He is portrayed as an outstanding eighteenth century educator who introduced into Leiden's Medical School a novel method of clinical teaching that was to be widely adopted and today remains at the centre of medical student instruction. Lindeboom's historiography induced a resurgence of interest in Boerhaave, a renewal of the myth concerning Boerhaave's innovative teaching and the publication of many acclamatory articles and false epithets, and several critical analyses. Such varying responses prompted this critical examination of the extant Boerhaavian literature, an appraisal of Lindeboom's objectivity and an assessment of his representations of Boerhaave's clinical teaching. In doing so, the moral nature of his historiography and that of those who were to sustain his assertions will be established, and the myth that surrounds the novelty and excellence of Boerhaave's clinical teaching will be evident. [ABSTRACT FROM AUTHOR]

The article focuses on the challenges clinicians face with the introduction of Voluntary Assisted Dying (VAD) legislation across Australia. Topics include the need for continuous monitoring of community and practitioner concerns, the widespread but varied support for VAD among clinicians, and the ongoing ethical and cultural complexities that require sustained dialogue and evaluation.

Testing in public health programs has long been recognised as beneficial but has often been experienced by community members as intrusive and paternalistic. Cervical screening has been seen as even more threatening by women who have experienced sexual violence or come from culturally and linguistically diverse communities. A simple and natural solution to these formidable barriers, increasingly recognised in recent years, has been presented by the advent of self‐testing. This article recounts the struggle to encourage medical practitioners to accept patient self‐testing. It emphasises the importance of scrutinising our own personal prejudices, listening to the community, and being open to novel strategies that ensure inclusiveness and respect for those whose interests we are seeking to serve. [ABSTRACT FROM AUTHOR]

An editorial is presented on the current state and future prospects of advance care planning (ACP). It highlights the historical significance and widespread promotion of ACP in medical education, ethical codes, clinical guidelines, and public forums. It further discusses the accumulated doubts about the impact of ACP on care and the need for evidence to support its central role in clinical care and social policy.

This article reflects on the assumption underlying the argument of Little et al. that "contested understandings" in the clinic are susceptible to reconciliation within a liberal framework described as "pragmatic pluralism". It is argued that no such reconciliation is possible or desirable because it is of the nature of the clinic that it provides a forum for multiple voices, ethical and cultural perspectives, and conceptual frameworks, and this is the source of its fecundity and creativity. Medicine itself cannot be represented by a single discourse, precisely because it is itself an unruly collection of practices that, despite their heterogeneity, are able to engage in productive dialogues with each other. The heteroglossia of the clinic, therefore, is not a problem to be overcome. Rather, it is a rich resource to be mobilized in accordance with its multiple inherent purposes. [ABSTRACT FROM AUTHOR]

The NSW Government has proposed a blanket lifting of COVID-19 restrictions when the proportion of fully vaccinated people rate reaches 70% of the adult population. If implemented, this would have devastating effects on Aboriginal populations. At the present time, vaccination rates in Aboriginal communities remain low. Once restrictions are lifted, unvaccinated people will be at high risk of infection. The risks of serious illness and death among Aboriginal people from a variety of medical conditions are significantly greater than for the wider population. This is also the case with COVID-19 in First Nations populations around the world. The vulnerability of Aboriginal people is an enduring consequence of colonialism and is exacerbated by the fact that many live in overcrowded and poorly maintained houses in communities with under-resourced health services. A current workforce crisis and the demographic structure of the population have further hindered the effectiveness of vaccination programmes. Aboriginal organisations have called on state and federal governments to delay any substantial easing of restrictions until full vaccination rates among Aboriginal and Torres Strait Islander populations aged 16 years and older reach 90-95%. They have also called for additional support in the form of supply of vaccines, enhancement of workforce capacity and appropriate incentives to address hesitancy. Australia remains burdened by the legacy of centuries of harm and damage to its First Nations people. Urgent steps must be taken to avoid a renewed assault on Aboriginal and Torres Strait Islander health. [ABSTRACT FROM AUTHOR]

An editorial is presented the ethical challenges posed by the integration of artificial intelligence (AI), particularly in the field of medicine. It authors discuss the complexities of how AI, such as large language models, might impact clinical care, decision-making, communication, and ethical considerations in medicine, while emphasizing the need for a deeper reflection on the values and fundamental aspects of medicine that AI seeks to supplement or replace.

Like other Arab countries, Jordan must find ways of responding to the rapid processes of change affecting many aspects of social life. This is particularly urgent in healthcare, where social and technical change is often manifested in tensions about ethical decision-making in the clinic. To explore the attitudes, beliefs and concerns relating to ethical decision-making among health professionals in Jordanian hospitals, a qualitative study was conducted involving face-to-face interviews with medical personnel in four hospitals in Amman, the capital of Jordan. Data were analysed thematically in relation to a pre-existing set of ethical categories. Interviews were conducted with thirty-eight doctors covering most medical specialities. Five major themes emerged from the interviews: ethical awareness, ethical issues, the impact of religion on ethical decision-making, practical and theoretical resources for ethical decision-making, and challenges. While uncertainty was expressed about some aspects of Western approaches to ethics, participants strongly supported adoption of a range of Western bioethical principles, including cultural and ethical diversity, along with adherence to Islamic religious norms. A range of serious ethical challenges facing the Jordanian health system were identified, covering social, legal, managerial, and technical issues. Ethical decision-making in Jordan is complex, having to accommodate the needs of patients, the opinions of doctors and their families, the views of religious authorities, managerial considerations, and both local norms and international standards. Health professionals struggle with three sets of tensions that emerge out of the struggle between traditional, community-embedded forms of social organization and the demands generated by globalization and the influence of Western culture: the tensions between tradition and modernity, conservatism and pragmatism, and religion and secularism. Doctors in Jordan prefer approaches to ethical decision-making that realize a balance between the extremes, although the exact nature of where that balance should lie remains uncertain. [ABSTRACT FROM AUTHOR]

This historiographic survey of extant English translations and interpretations of the renowned Hippocratic first aphorism has demonstrated a concerning acceptance and application of ancient deontological principles that have been used to justify a practice of medicine that has been both paternalistic and heteronomous. Such principles reflect an enduring Hippocratism that has perpetuated an insufficient appreciation of the moral nature of the aphorism's second sentence in the practice of the art of medicine. That oversight has been constrained by a philological discourse that has centred on the meanings of the aphorism's first sentence, while little consideration has been given to the more important ethical consideration within the second sentence's imperatives. [ABSTRACT FROM AUTHOR]

The focus of discussion about the ethical issues associated with the COVID-19 pandemic has been on the great suffering to which it has given rise. However, there may be some unexpected positive outcomes that also emerge from the global disaster. The rupturing of entrenched systems and processes, the challenging of certainties that seemed beyond question, and the disruption of the assumed consensus of modernity may contribute to a rediscovery of the challenges that compose an ethical life. Elements of such a process are evident in the surge of community support and mutual caring, of spontaneous acts of joyous solidarity, of suspension of past conflicts, and exploration of new forms of reconciliation. The experiences are tentative and the outcomes uncertain, but at least for a moment the hope of a new way forward has been raised. [ABSTRACT FROM AUTHOR]

The authors examine whether COVID-19 vaccinations should be mandatory. Topics discussed include assumptions on which the discussion is based, possible complaint of those opposed to COVID-19 vaccination and social distancing, and indication of recognition of the context and cultural sensitivity of the issues relating to vaccination.

Rituals may be understood broadly as stereotyped behaviours carrying symbolic meanings, which play a crucial role in defining relationships, legitimating authority, giving meaning to certain life events and stabilising social structures. Despite intense interest in the subject, and an extensive literature, relatively little attention has been given to the nature, role and function of ritual in contemporary medicine. Medicine is replete with ritualistic behaviours and imperatives, which play a crucial role in all aspects of clinical practice. Rituals play multiple, complex functions in clinical interactions and have an important role in shaping interactions, experiences and outcomes. Longstanding medical rituals have been disrupted in the wake of coronavirus disease 2019 (COVID‐19). Medical rituals may be evident or invisible, often overlap with or operate alongside instrumentalised practices, and play crucial roles in establishing, maintaining and guaranteeing the efficacy of clinical practices. Rituals can also inhibit progress and change, by enforcing arbitrary authority. Physicians should consider when they are undertaking a ritual practice and recognise when the exigencies of contemporary practice are affecting that ritual with or without meaning or intention. Physicians should reflect on whether aspects of their ritual interactions are undertaken on the basis of sentiment, custom or evidence‐based outcomes, and whether rituals should be defended, continued in a modified fashion or even abandoned in favour of new behaviours suitable for and salient with contemporary practice in the interests of patient care. [ABSTRACT FROM AUTHOR]

This review essay examines the emergence of the patient narrative or "pathography" in the late eighteenth and early nineteenth century in relation to the great cultural, epistemological, and ethical transformations that enabled the formation of modern medicine. John Wiltshire's book provides an historical overview of this complex process, as well as laying the basis for a contemporary critique of some of its key assumptions. [ABSTRACT FROM AUTHOR]

The Arab and Islamic world is in cultural, political and ethical flux. Pressures of globalisation contend with ancient ideas and concepts that permeate cultural frameworks. Health professionals are among the many groups battling to accommodate the rapidly changing conditions. In many predominantly Muslim countries intense debates are underway among clinicians about the impact of the forces of change on their practices. To help understand these forces we conducted a study of the experiences of clinicians in the Hashemite Kingdom of Jordan, a Middle Eastern nation state where the overwhelming majority of the population is Muslim. The sample contained 508 doctors and doctors-in-training, of whom 63% were male and 80% were younger than 40 years of age. It included both a quantitative survey, covering a wide range of issues, and qualitative, free-text written responses. Our results demonstrated high levels of disquiet related to the overall organisation and administration of the health care system, the specific content of ethical decisionmaking, and the impact of changing social, cultural and religious factors. Concerns included overcrowding, widespread corruption and hierarchical, non- democratic, management practices, and tensions relating to traditional and modern approaches to ethics, especially in relation to consent, organ donation, confidentiality, privacy, abortion, and the role of women. The roles of religion and religious authorities, the relative importance of the family, and community and tribal obligations were also areas of contention. The study exposes profound divisions and widely differing perspectives among Jordanian doctors and an abiding sense of uncertainty and instability within the profession. Many doctors express ambivalence in relation to both modern trends and traditional precepts. Three main axes of ethical contention were demonstrated, relating to the tensions between: "conservative" and "pragmatic" styles of decision-making; "traditional" approaches and internationalised standards of ethics; and the role of Islam and pressures to disengage ethical decision- making from religious authority. We speculate that these issues and divisions, and the deep sense of disquiet revealed by our data reflect large-scale forces to which Jordanian society is exposed and to a substantial degree may provide a way to understand the ethical predicament of many other countries in the contemporary Arab world. [ABSTRACT FROM AUTHOR]

Although the concept of 'conflict of interest' (COI) arises in many contexts in healthcare, it is often poorly understood, and commonly accepted, definitions are often circular, self‐contradictory and unable to provide procedural guidance. To overcome such confusion and imprecision, we offer a reformulation of COI that carefully defines interests, clarifies their scope and articulates a simple, non‐punitive approach to managing them. We define an 'interest' as 'a commitment, goal, obligation or duty related to a particular social role or practice'. We show how in a particular setting multiple interests can be at play, which can be either financial or non‐financial, with the latter often being the most potent drivers of behaviour. We define a 'conflict of interest' as the condition that arises when two coexisting interests directly conflict with each other: that is, when they are likely to compel contrary and incompatible outcomes. COI therefore reflect objective states of affairs rather than internal mental states; they do not imply moral error; and they are identified through public rather than private processes involving ethical dialogues among relevant stakeholders. Once a COI has been identified, responses must be determined based on the seriousness of the conflict and the conditions that generated it. Such responses may be minimal or they may require a formal disengagement from one of the conflicting interests. The framework described, reflects the rich diversity of interests in modern societies, is universally applicable and provides simple, readily applicable guidelines for the identification and management of conflicts arising between them. [ABSTRACT FROM AUTHOR]

Introduction: Contradictory social policies and attitudes about gender diversity raise questions about how we should understand the current status of the historical 'heterosexual' gender regime.Conclusion: Drawing on the work of the feminist philosopher and psychoanalyst Luce Irigaray, this essay argues that sexual difference is the irreducible starting point for all meaning, sense, morality and affect. [ABSTRACT FROM AUTHOR]

The article offers information on the concerns regarding the transvaginal implantation of synthetic mesh for the treatment of urinary stress. It discusses the wide-ranging issues relating to the accreditation and regulation of innovative medical treatments, the management of conflicts of interests, strategies for communication at multiple levels, and the protection of vulnerable patients and research participants.

Vaccination is a highly effective public health strategy that provides protection to both individuals and communities from a range of infectious diseases. Governments monitor vaccination rates carefully, as widespread use of a vaccine within a population is required to extend protection to the general population through “herd immunity,” which is important for protecting infants who are not yet fully vaccinated and others who are unable to undergo vaccination for medical or other reasons. Australia is unique in employing financial incentives to increase vaccination uptake, mainly in the form of various childcare payments and tax benefits linked to timely, age-appropriate vaccination. Despite relatively high compliance with the childhood vaccination schedule, however, the Australian government has determined that rates should be higher and has recently introduced policy that includes removing certain tax and childcare benefits for non-vaccinators and formally disallowing conscientious objection to vaccination (“No Jab No Pay”). In addition, it has raised the possibility of banning unvaccinated children from childcare centres (“No Jab No Play”). This article examines the impact of coercive approaches to childhood vaccination and raises the question of the ethical justification of health policy initiatives based on coercion. We consider the current evidence regarding childhood vaccination in Australia, the small but real risks associated with vaccination, the ethical requirement for consent for medical procedures, and the potential social harms of targeting non-vaccinators. We conclude that the evidence does not support a move to an increasingly mandatory approach that could only be delivered through paternalistic, coercive clinical practices. [ABSTRACT FROM AUTHOR]

An editorial is presented in which the author discusses the harmful effects of the use of drugs on the society despite strict drug policy and penalties in Australia. It talks about the consumption of cannabis, cocaine and ecstasy being common among young people in the modern society. It tells about the programs conducted to make the young people aware of the harmful effects of the use of illicit drugs.

The article focuses on a debate on universal electronic health record system called the ‘My Health Record', discussing its creation of records automatically for the individual citizens of Australia. It reports that the main motive behind the creation of My Health Record for the improvement of coordination of care, preventing duplication of services and investigations and helping avoid drug errors. The health record system benefits various sectors.

Objectives: Chinese medicine is a complex domain of theoretical and practical approaches that is being increasingly put under the research spotlight. The "Chinese Medicine in Australia"research project attempted to capture the clinical features of practitioners of Chinese medicine. Participants and Interventions: The project involved a national survey of Chinese medicine professional association members and registered practitioners in the state of Victoria, Australia (n = 655; response rate, 42%-55%) completed in 2012-2013. Design: The content and face validated survey was developed using new and previous workforce survey questions. Results: This paper reports on the workforce and practice characteristics of the survey respondents. Chinese medicine practitioners are highly educated, come from diverse backgrounds, and have chosen to practice predominantly in sole or multipractitioner private practice settings. An interest in the philosophy of Chinese medicine and previous experiences contributed to practitioners' decisions to study and practice Chinese medicine. Incorporating a variety of techniques, practitioners describe themselves as practicing predominantly Chinese acupuncture and herbal medicine. Conclusions: The results from this survey contribute to the understanding of the nature and description of Chinese medicine practice in Australia. [ABSTRACT FROM AUTHOR]

Research into the effects of medical interventions is one of the oldest traditions of any medicine, as is the study of its ethical dimension. In this paper, we briefly describe and recount the history of both quantitative and qualitative methods in clinical research. We discuss key theoretical, methodological and practical features of both methodological perspectives and consider some of the central ideas of medical ethics. We sketch a theory of the relationship between the quantitative and qualitative as essentially complementary and interdependent. The theory is illustrated by reference to the placebo effect and a research 'case study' from within the Chinese medicine community. We conclude that despite the challenges, combined research methodologies in Chinese medicine offer both scientific and ethical benefits. [ABSTRACT FROM AUTHOR]

Dance classes in urban settings may have a role in health-promotion programmes seeking to increase physical activity amongst young people. However, little is so far known about the motivations, experiences or health outcomes of those participating in dance classes. This qualitative study of young people attending recreational dance classes addressed motivations, the nature of the class experience, and implications for health and well-being. Data show that young dance participants' experiences of 'the physical' are embedded in social, community/cultural or other values, and involve respect for older teachers and physical knowledge/expertise gained over the long term. Encouragement of dance-class participation may offer an important strategy for health promotion as long as the physical activity value of dance classes is not promoted in narrow, bio-mechanical terms. [ABSTRACT FROM AUTHOR]

This qualitative study explores the concept of ideal palliative care as it broadens its field of application from terminal care to include people earlier in the course of an illness. Focus groups were held with palliative care professionals from community, inpatient, and hospital consultancy services to examine this issue. Palliative care professionals have clear views of what constitutes ideal care that include: establishing a relationship, setting goals, communication, acceptance, advocacy, flexibility, symptom relief, and recognising the identity of each person. There was agreement upon the nature of obstacles that prevented ideal care being achieved including obstacles created by families, other health professionals, administrative structures, and conflicts between the aims of care for a particular patient. Finally each clinician has a well-developed set of personal views of the acceptable limits to practice, although these views vary widely. The clusters of ideas emerging in this study describe three objects of different ontologic status. The elements of ideal care are conceptual in nature, highlighting the aspirations for workers. The obstacles reflect the real world that palliative care professionals must negotiate each day, giving rise to a form of care that was good enough. The acceptable standards and their limits is the degree to which staff will or will not accept the compromises in care raised by the real world of practice, reflecting the ethical stance of the workers. The pursuit of ideal care may be motivated by a complex mix of aspirations, real-world practicalities and fulfilment for both patients and staff. [ABSTRACT FROM AUTHOR]

Presents a discussion on the ethical issues raised by genetic testing for the condition hereditary non-polyposis colorectal cancer. Confidentiality of test results; Remarks regarding the privacy of patient records in public hospitals; Performance of genetic testing on children.

This article presents a fictional round table conversation on genetic testing. The topic of breach of confidentiality between a patient and his doctor was discussed, with the view that doctors should not talk about their patients to anyone else, except to professional colleagues, when necessary for medical care. It has to be understood that with a condition like hereditary non-polyposis cancer of the colon-for which only a few of what is likely to be hundreds of mutations are known-all we can do is to look for those we already know about. The best way to do this is to examine DNA from a person with the disease. If one finds a mutation it is usually straightforward to test other family members. One problem is that even if one has a gene for a disease, it does not follow that the person will get the disease. With other conditions the risk can vary between about 20% and 100%. It is technically possible to take samples from the fetus during pregnancy but there are risks both to the mother and the baby. From a legal point of view, pathology specimens are the property of the laboratory, not the patient. Doctors always emphasize to medical students how important it is to ask about family history for genetic and for other reasons.

Summary background We have shown previously that oestrogens attenuate cardiovascular and hormonal responses to stress in perimenopausal women. The cardiovascular role of oestrogens in men is uncertain, despite preliminary evidence that endogenous oestrogens produced by aromatization of androgenic precursors are of physiological importance; hypogonadal men have very low levels of circulating oestrogen. methods We therefore studied the haemodynamic and hormonal responses to a standardized laboratory mental stress test in 12 men (mean age 68·9 ± 2·6 SEM years) rendered hypogonadal as a result of treatment for prostatic cancer, before and after 8 weeks of oestrogen supplementation (oestradiol valerate 1 mg daily, n = 7) or placebo ( n = 5). The stress was administered as a standard mental arithmetic test of 10 minutes’ duration. Blood pressure, cortisol and ACTH were measured at baseline, and following 5 minutes and 10 minutes of stress, and ACTH again at 25 minutes on both days. Noradrenaline and adrenaline responses to mental stress, as well as changes in total body and forearm spillover of noradrenaline and noradrenaline clearance, were also measured. results Oestrogen supplementation was well tolerated, with minimal adverse effects. Mean oestradiol levels increased from < 30 pmol/l to 308 ± 65 pmol/l after oestrogen treatment. Oestradiol significantly attenuated the mental stress-induced increase in both systolic and diastolic blood pressures. Oestradiol also attenuated mental stress-induced increases in ACTH, cortisol and adrenaline, but did not influence either total body or forearm spillover of noradrenaline. Responses to stress were unchanged after administration of placebo. conclusions We conclude that oestrogen supplementation in men rendered hypogonadal as a result of treatment for prostate cancer is well tolerated and significantly attenuates blood pressure and hormonal responses to psychological stress. These findings suggest... [ABSTRACT FROM AUTHOR]

Examines the effects which estradiol administration and placebo has on the responses given to two stressors in ovariectomized sheep, with the use of a well-established model. Appearance of the cardiovascular responses of young women to psychological stress; Synchronizing of estrous cycles; Reference to the choice of estrogen doses in the conducted experiment.

Presents information on a study on how estrogen and estrous cycle affects glucocorticoid and catecholamine responses to stress in sheep. Discussion on the nature of the effects of sex hormones on the stress response in animal models; Methodology used in conducting the study; Result of the study on plasma estrogen, progesterone, follicle-stimulating hormone and luteinizing hormone levels.

The author reflects on the challenges faced by the Royal Australasian College of Physicians (RACP) in seeing the role and function of the Royal Australasian College of Physicians (RACP). He examines the two opposing roles of the RACP which has served to be the source of confusion and frustration which could appear as bureaucratic indifference. The author also mentions how the complexities in the said role requires measures to address the problem.

An introduction is presented in which the authors discuss various reports within the issue on topics including the role, nature, and status of truth in reconciliation discourses, creation of fecund practices based on vulnerability and loss, and reconciliatory discourse.

The article discusses the article "Clarifying Conflict of Interest," by Howard Brody. In the article the authors offer their opinions on several statements and assertions that are contained in Brody's article and on a need which exists for to have a systematic analysis and ethical dialogue in an effort to prevent ethical issues related to conflicts of interest that are raised as a result of relationships that are formed between physicians and for-profit organizations.

The proliferation of assisted dying legislative reforms globally is a significant change in the social and medico‐legal landscape of end‐of‐life care. Understanding the impacts of these legislative reforms on family members who care for a dying person is vital, yet under‐theorised in research. In this article, drawing on semi‐structured interviews with 42 carers for a person who has sought assisted dying in Australia, and extending ideas of ontological choreography we explore the new and complex choreographies enacted by carers in their endeavour to arrange a ‘good death’ for the dying person. We find that desires to fulfil the dying person’s wishes are often accompanied by normative pressures, affective tensions and complexities in bereavement. Enacting assisted dying requires carers to perform a repertoire of highly‐staged practices. Yet, institutional obstacles and normative cultural scripts of dying can constrain carer assisted dying practices. Understanding the nuances of carers’ experiences and how they navigate this new end‐of‐life landscape, we argue, provides critical insights about how assisted dying legislation is producing new cultural touchpoints for caring at the end of life. Moreover, we show how emerging cultural scripts of assisted dying are impacting in the lives of these carers. [ABSTRACT FROM AUTHOR]

Surveillance is a core function of all public health systems. Responses to the COVID-19 pandemic have deployed traditional public health surveillance responses, such as contact tracing and quarantine, and extended these responses with the use of varied technologies, such as the use of smartphone location data, data networks, ankle bracelets, drones, and big data analysis. Applying Foucault's (1979) notion of the panopticon, with its twin focus on surveillance and self-regulation, as the preeminent form of social control in modern societies, we examine the increasing levels of surveillance enacted during this pandemic and how people have participated in, and extended, this surveillance, self-regulation, and social control through the use of digital media. Consideration is given to how such surveillance may serve public health needs and/or political interests and whether the rapid deployment of these extensive surveillance mechanisms risks normalizing these measures so that they become more acceptable and then entrenched post-COVID-19. [ABSTRACT FROM AUTHOR]

The article discusses concerns over the ethics of infectious diseases including the limits of the responsibility of heath care workers who are subjected to personal danger, the scope of restrictive measures for controlling outbreaks and the allocation of scarce resources. It cites the articles by Peter Omonzejele and Ross Upshur in the issue of "Journal of Bioethical Inquiry" which address the ebola virus disease (EVD) epidemic and exemplify the cultural dependence of ethical reflection.

An introduction is presented which includes information on the articles within the issue on topics including advance care directives and advance care planning related to end of life care, dementia in older people, and community based care.