Voluntary assisted dying is different to suicide. But federal laws conflate them and restrict access to telehealth
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Voluntary assisted dying is now lawful in every Australian state and will soon begin in the Australian Capital Territory.
However, it’s illegal to discuss it via telehealth. That means people who live in rural and remote areas, or those who can’t physically go to see a doctor, may not be able to access the scheme.
A federal private members bill, introduced to parliament last week, aims to change this. So what’s proposed and why is it needed?
What’s wrong with the current laws?
Voluntary assisted dying doesn’t meet the definition of suicide under state laws.
But the Commonwealth Criminal Code prohibits the discussion or dissemination of suicide-related material electronically.
This opens doctors to the risk of criminal prosecution if they discuss voluntary assisted dying via telehealth.
Successive Commonwealth attorneys-general have failed to address the conflict between federal and state laws, despite persistent calls from state attorneys-general for necessary clarity.
This eventually led to voluntary assistant dying doctor Nicholas Carr calling on the Federal Court of Australia to resolve this conflict. Carr sought a declaration to exclude voluntary assisted dying from the definition of suicide under the Criminal Code.
In November, the court declared voluntary assisted dying was considered suicide for the purpose of the Criminal Code. This meant doctors across Australia were prohibited from using telehealth services for voluntary assisted dying consultations.
Last week, independent federal MP Kate Chaney introduced a private members bill to create an exemption for voluntary assisted dying by excluding it as suicide for the purpose of the Criminal Code. Here’s why it’s needed.
Not all patients can physically see a doctor
Defining voluntary assisted dying as suicide in the Criminal Code disproportionately impacts people living in regional and remote areas. People in the country rely on the use of “carriage services”, such as phone and video consultations, to avoid travelling long distances to consult their doctor.
Other people with terminal illnesses, whether in regional or urban areas, may be suffering intolerably and unable to physically attend appointments with doctors.
The prohibition against telehealth goes against the principles of voluntary assisted dying, which are to minimise suffering, maximise quality of life and promote autonomy.
Doctors don’t want to be involved in ‘suicide’
Equating voluntary assisted dying with suicide has a direct impact on doctors, who fear criminal prosecution due to the prohibition against using telehealth.
Some doctors may decide not to help patients who choose voluntary assisted dying, leaving patients in a state of limbo.
The number of doctors actively participating in voluntary assisted dying is already low. The majority of doctors are located in metropolitan areas or major regional centres, leaving some locations with very few doctors participating in voluntary assisted dying.
It misclassifies deaths
In state law, people dying under voluntary assisted dying have the cause of their death registered as “the disease, illness or medical condition that was the grounds for a person to access voluntary assisted dying”, while the manner of dying is recorded as voluntary assisted dying.
In contrast, only coroners in each state and territory can make a finding of suicide as a cause of death.
In 2017, voluntary assisted dying was defined in the Coroners Act 2008 (Vic) as not a reportable death, and thus not suicide.
The language of suicide is inappropriate for explaining how people make a decision to die with dignity under the lawful practice of voluntary assisted dying.
There is ongoing taboo and stigma attached to suicide. People who opt for and are lawfully eligible to access voluntary assisted dying should not be tainted with the taboo that currently surrounds suicide.
So what is the solution?
The only way to remedy this problem is for the federal government to create an exemption in the Criminal Code to allow telehealth appointments to discuss voluntary assisted dying.
Chaney’s private member’s bill is yet to be debated in federal parliament.
If it’s unsuccessful, the Commonwealth attorney-general should pass regulations to exempt voluntary assisted dying as suicide.
A cooperative approach to resolve this conflict of laws is necessary to ensure doctors don’t risk prosecution for assisting eligible people to access voluntary assisted dying, regional and remote patients have access to voluntary assisted dying, families don’t suffer consequences for the erroneous classification of voluntary assisted dying as suicide, and people accessing voluntary assisted dying are not shrouded with the taboo of suicide when accessing a lawful practice to die with dignity.
Failure to change this will cause unnecessary suffering for patients and doctors alike.
Michaela Estelle Okninski, Lecturer of Law, University of Adelaide; Marc Trabsky, Associate professor, La Trobe University, and Neera Bhatia, Associate Professor in Law, Deakin University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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How To Keep Your Mind From Wandering
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Whether your mind keeps wandering more as you get older, or you’re a young student whose super-active brain is more suited to TikTok than your assigned reading, sustained singular focus can be a challenge for everyone—and yet (alas!) it remains a required skill for so much in life.
Today’s edition of 10Almonds presents a nifty trick to get yourself through those tasks! We’ll also be taking some time to reply to your questions and comments, in our weekly interactive Q&A.
First of all though, we’ve a promise to make good on, so…
How To Stay On The Ball (Or The Tomato?) The Easy Way
For most of us, we face three main problems when it comes to tackling our to-dos:
- Where to start?
- The task seems intimidating in its size
- We get distracted and/or run out of energy
If you’re really not sure where to start, we recommended a powerful tool in last Friday’s newsletter!
For the rest, we love the Pomodoro Technique:
- Set a timer for 25 minutes, and begin your task.
- Keep going until the timer is done! No other tasks, just focus.
- Take a 5-minute break.
- Repeat
This approach has three clear benefits:
- No matter the size of the task, you are only committing to 25 minutes—everything is much less overwhelming when there’s an end in sight!
- Being only 25 minutes means we are much more likely to stay on track; it’s easier to defer other activities if we know that there will be a 5-minute break for that soon.
- Even without other tasks to distract us, it can be difficult to sustain attention for long periods; making it only 25 minutes at a time allows us to approach it with a (relatively!) fresh mind.
Have you heard that a human brain can sustain attention for only about 40 minutes before focus starts to decline rapidly?
While that’s been a popular rationale for school classroom lesson durations (and perhaps coincidentally ties in with Zoom’s 40-minute limit for free meetings), the truth is that focus starts dropping immediately, to the point that one-minute attention tests are considered sufficient to measure the ability to focus.
So a 25-minute Pomodoro is a more than fair compromise!
Why’s it called the “Pomodoro” technique?
And why is the 25-minute timed work period called a Pomodoro?
It’s because back in the 80s, university student Francesco Cirillo was struggling to focus and made a deal with himself to focus just for a short burst at a time—and he used a (now “retro” style) kitchen timer in the shape of a tomato, or “pomodoro”, in Italian.
If you don’t have a penchant for kitsch kitchenware, you can use this free, simple Online Pomodoro Timer!
(no registration/login/download necessary; it’s all right there on the web page)
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How Are You, Really?
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How Are You, Really? The Free NHS Health Test
We took this surprisingly incisive 10-minute test from the UK’s famous National Health Service—the test is part of the “Better Health” programme, a free-to-all (yes, even those from/in other countries) initiative aimed at keeping people healthy enough to have less need of medical attention.
As one person who took the test wrote:
❝I didn’t expect that a government initiative would have me talking about how I need to keep myself going to be there for the people I love, let alone that a rapid-pace multiple-choice test would elicit these responses and give personalized replies in turn, but here we are❞
It goes beyond covering the usual bases, in that it also looks at what’s most important to you, and why, and what might keep you from doing the things you want/need to do for your health, AND how those obstacles can be overcome.
Pretty impressive for a 10-minute test!
Is Your Health Above Average Already? Take the Free 10-minute NHS test now!
How old are you, in your heart?
Poetic answers notwithstanding (this writer sometimes feels so old, and yet also much younger than she is), there’s a biological answer here, too.
Again free for the use of all*, here’s a heart age calculator.
*It is suitable for you if you are aged 30–95, and do not have a known complicating cardiovascular disease.
It will ask you your (UK) postcode; just leave that field blank if you’re not in the UK; it’ll be fine.
How Old Are You, In Your Heart? Take the Free 10-minute NHS test now!
(Neither test requires logging into anything, and they do not ask for your email address. The tests are right there on the page, and they give the answers right there on the page, immediately)
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7 Principles of Becoming a Leader – by Riku Vuorenmaa
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We urge you to overlook the cliché cover art (we don’t know what they were thinking, going for the headless suited torso) because…
This one could be the best investment you make in your career this year! You may be wondering what the titular 7 principles are. We won’t keep you guessing; they are:
- Professional development: personal excellence, productivity, and time management
- Leadership development: mindset and essential leadership skills
- Personal development: your motivation, character, and confidence as a leader
- Career management: plan your career, get promoted and paid well
- Social skills & networking: work and connect with the right people
- Business- & company-understanding: the big picture
- Commitment: make the decision and commit to becoming a great leader
A lot of leadership books repeat the same old fluff that we’ve all read many times before… padded with a lot of lengthy personal anecdotes and generally editorializing fluff. Not so here!
While yes, this book does also cover some foundational things first, it’d be remiss not to. It also covers a whole (much deeper) range of related skills, with down-to-earth, brass tacks advice on putting them into practice.
This is the kind of book you will want to set as a recurring reminder in your phone, to re-read once a year, or whatever schedule seems sensible to you.
There aren’t many books we’d put in that category!
Pick Up Your Copy of the “7 Principles of Becoming a Leader” on Amazon Today!
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Smart Sex – by Dr. Emily Morse
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First, what this isn’t: this isn’t a mere book of sex positions and party tricks, nor is it a book of Cosmo-style “drive your man wild by using hot sauce as lube” advice.
What it offers instead, is a refreshingly mature take on sex, free from the “teehee” titillations and blushes that many books of the genre go for.
Dr. Emily Morse outlines five pillars of sex:
- Embodiment
- Health
- Collaboration
- Self-knowledge
- Self-acceptance
…and talks about each of them in detail, and how we can bring them together. And, of course, how we or our partner(s) could accidentally sabotage ourselves or each other, and the conversations we can (and should!) have, to work past that.
She also, critically, and this is a big source of value in the book, looks at “pleasure thieves”: stress, trauma, and shame. The advice for overcoming these is not “don’t worry; be happy” but rather is actual practical steps one can take.
The style throughout is direct and unpatronizing. Since the advice within pertains to everyone who has and/or wants an active sex life, very little is divided by gender etc.
There is some attention given to anatomy and physiology, complete with clear diagrams. Honestly, most people could benefit from these, because most people’s knowledge of the relevant anatomy stopped with a very basic high school text book diagram that missed a lot out.
Bottom line: this book spends more time on what’s between your ears than what’s between your legs, and yet is very comprehensive in all areas. Everyone has something to gain from this one.
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6-Minute Core Strength – by Dr. Jonathan Su
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We don’t normally do author biographies here, but in this case it’s worth noting that Dr. Su is a physiotherapist, military rehab expert, and an IAYT yoga therapist. So, these things together certainly do lend weight to his advice.
About the “6-minute” thing: this is in the style of the famous “7-minute workout” and “5 Minutes’ Physical Fitness” etc, and refers to how long each exercise session should take. The baseline is one such session per day, though of course doing more than one set of 6 minutes each time is a bonus if you wish to do so.
The exercises are focused on core strength, but they also include hip and shoulder exercises, since these are after all attached to the core, and hip and shoulder mobility counts for a lot.
A particular strength of the book is in troubleshooting mistakes of the kind that aren’t necessarily visible from photos; in this case, Dr. Su explains what you need to go for in a certain exercise, and how to know if you are doing it correctly. This alone is worth the cost of the book, in this reviewer’s opinion.
Bottom line: if you want core strength and want it simple yet comprehensive, this book can guide you.
Click here to check out 6-Minute Core Strength, and strengthen yours!
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‘Noisy’ autistic brains seem better at certain tasks. Here’s why neuroaffirmative research matters
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Pratik Raul, University of Canberra; Jeroen van Boxtel, University of Canberra, and Jovana Acevska, University of Canberra
Autism is a neurodevelopmental difference associated with specific experiences and characteristics.
For decades, autism research has focused on behavioural, cognitive, social and communication difficulties. These studies highlighted how autistic people face issues with everyday tasks that allistic (meaning non-autistic) people do not. Some difficulties may include recognising emotions or social cues.
But some research, including our own study, has explored specific advantages in autism. Studies have shown that in some cognitive tasks, autistic people perform better than allistic people. Autistic people may have greater success in identifying a simple shape embedded within a more complex design, arranging blocks of different shapes and colours, or spotting an object within a cluttered visual environment (similar to Where’s Wally?). Such enhanced performance has been recorded in babies as young as nine months who show emerging signs of autism.
How and why do autistic individuals do so well on these tasks? The answer may be surprising: more “neural noise”.
What is neural noise?
Generally, when you think of noise, you probably think of auditory noise, the ups and downs in the amplitude of sound frequencies we hear.
A similar thing happens in the brain with random fluctuations in neural activity. This is called neural noise.
This noise is always present, and comes on top of any brain activity caused by things we see, hear, smell and touch. This means that in the brain, an identical stimulus that is presented multiple times won’t cause exactly the same activity. Sometimes the brain is more active, sometimes less. In fact, even the response to a single stimulus or event will fluctuate continuously.
Neural noise in autism
There are many sources of neural noise in the brain. These include how the neurons become excited and calm again, changes in attention and arousal levels, and biochemical processes at the cellular level, among others. An allistic brain has mechanisms to manage and use this noise. For instance, cells in the hippocampus (the brain’s memory system) can make use of neural noise to enhance memory encoding and recall.
Evidence for high neural noise in autism can be seen in electroencephalography (EEG) recordings, where increased levels of neural fluctuations were observed in autistic children. This means their neural activity is less predictable, showing a wider range of activity (higher ups and downs) in response to the same stimulus.
In simple terms, if we imagine the EEG responses like a sound wave, we would expect to see small ups and downs (amplitude) in allistic brains each time they encounter a stimulus. But autistic brains seem to show bigger ups and downs, demonstrating greater amplitude of neural noise.
Many studies have linked this noisy autistic brain with cognitive, social and behavioural difficulties.
But could noise be a bonus?
The diagnosis of autism has a long clinical history. A shift from the medical to a more social model has also seen advocacy for it to be reframed as a difference, rather than a disorder or deficit. This change has also entered autism research. Neuroaffirming research can examine the uniqueness and strengths of neurodivergence.
Psychology and perception researcher David Simmons and colleagues at the University of Glasgow were the first to suggest that while high neural noise is generally a disadvantage in autism, it can sometimes provide benefits due to a phenomenon called stochastic resonance. This is where optimal amounts of noise can enhance performance. In line with this theory, high neural noise in the autistic brain might enhance performance for some cognitive tasks.
Our 2023 research explores this idea. We recruited participants from the general population and investigated their performance on letter-detection tasks. At the same time, we measured their level of autistic traits.
We performed two letter-detection experiments (one in a lab and one online) where participants had to identify a letter when displayed among background visual static of various intensities.
By using the static, we added additional visual noise to the neural noise already present in our participants’ brains. We hypothesised the visual noise would push participants with low internal brain noise (or low autistic traits) to perform better (as suggested by previous research on stochastic resonance). The more interesting prediction was that noise would not help individuals who already had a lot of brain noise (that is, those with high autistic traits), because their own neural noise already ensured optimal performance.
Indeed, one of our experiments showed people with high neural noise (high autistic traits) did not benefit from additional noise. Moreover, they showed superior performance (greater accuracy) relative to people with low neural noise when the added visual static was low. This suggests their own neural noise already caused a natural stochastic resonance effect, resulting in better performance.
It is important to note we did not include clinically diagnosed autistic participants, but overall, we showed the theory of enhanced performance due to stochastic resonance in autism has merits.
Why this is important?
Autistic people face ignorance, prejudice and discrimination that can harm wellbeing. Poor mental and physical health, reduced social connections and increased “camouflaging” of autistic traits are some of the negative impacts that autistic people face.
So, research underlining and investigating the strengths inherent in autism can help reduce stigma, allow autistic people to be themselves and acknowledge autistic people do not require “fixing”.
The autistic brain is different. It comes with limitations, but it also has its strengths.
Pratik Raul, PhD candidiate, University of Canberra; Jeroen van Boxtel, Associate professor, University of Canberra, and Jovana Acevska, Honours Graduate Student, University of Canberra
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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