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In a medical emergency, the usual requirement to obtain consent before giving treatment does not apply. This exception to the general rule on consent to medical treatment is known as the ‘emergency principle’. By considering a case scenario, and by adjusting the facts to this scenario, we explain the circumstances in which the emergency principle will protect practitioners from an action in trespass. Although the fundamentals of this principle are uncontroversial, there are a number of uncertainties and inconsistencies in this law in relation to certain parameters. For example, whether a practitioner would ever be obliged to seek consent from a substitute decision-maker before providing emergency treatment is not clearly or consistently explained. We suggest the law should be clarified.

This paper outlines some of the issues faced by School-Based Youth Health Nurses working in Queensland, in relation to the legal principles surrounding the provision of reproductive and sexual health advice. The paper outlines a number of specific issues faced by nurses working within this setting and considers the legal principles underpinning the issues concerning consent and confidentiality. The discussion in this paper demonstrates how the legal principles – which are often viewed as complex and uncertain by nurses working within this field – may be used as a guide to underpin good practice and compliance with the law. Although this paper is considered in the context of nurses working within Queensland, the principles and factors outlined are relevant to healthcare practitioners working within all Australian jurisdictions.

The primary objectives of early phase clinical studies is to test novel and experimental treatments for their safety and toxicity in human beings, and to contribute to new knowledge in the hope it will be of benefit in the future. These studies are not designed to measure efficacy, and they are not designed with the intention of benefitting the research participants. By their very nature, these studies are potentially harm-inducing and any direct clinical benefits for research participants are merely an unintended side-effect. In this thesis I question the ethical and legal legitimacy of allowing parent/s to consent to their child’s involvement in early phase and first-in-human research on behalf of their child. The question arose from my concern that consenting for a child to participate in non-therapeutic early phase and first-in-human studies may be outside of the ethical, human rights and legal boundaries of what parents, as protectors of children, ought to be able to agree to. I was also concerned that parents’ were consenting mistakenly believing there may be some direct clinical benefit to their child; a phenomenon known as a ‘therapeutic misconception’, and that current practices enabled these misconceptions to exist. In seeking to answer these concerns I considered and applied human rights, rights of the child, ethical and legal standards. I found that current practices in paediatric non-therapeutic early phase and first-in-human place the sole responsibility and authority with parents to decide if their child should participate. However, the prevailing human rights, ethical and legal standard is that of best interests of child which imposes an obligation on parents to make decisions that are consistent with the value. But, I argue that due to the significant potential for harm and the limited potential for any real direct benefit to the child, participating in early phase and first-in-human studies is unlikely to be in the best interests of a particular ch

Medical research represents a substantial departure from conventional medical care. Medical care is patient-orientated, with decisions based on the best interests and/or wishes of the person receiving the care. In contrast, medical research is future-directed. Primarily it aims to contribute new knowledge about illness or disease, or new knowledge about interventions, such as drugs, that impact upon some human condition. Current State and Territory laws and research ethics guidelines in Australia relating to the review of medical research appropriately acknowledge that the functions of medical care and medical research differ. Prior to a medical research project commencing, the study must be reviewed and approved by a Human Research Ethics Committee (HREC). For medical research involving incompetent adults, some jurisdictions require an additional, independent safeguard by way of tribunal or court approval of medical research protocols. This extra review process reflects the uncertainty of medical research involvement, and the difficulties surrogate decision-makers of incompetent adults face in making decisions about others, and deliberating about the risks and benefits of research involvement. Parents of children also face the same difficulties when making decisions about their child’s research involvement. However, unlike the position concerning incompetent adults, there are no similar safeguards under Australian law in relation to the approval of medical research involving children. This column questions why this discrepancy exists with a view to generating further dialogue on the topic.