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.
Jeffrey M Levine/Shutterstock
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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Burn – by Dr. Herman Pontzer
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We all have reasons to want to focus on our metabolism. Speed it up to burn more fat; slow it down to live longer. Tweak it for more energy in the day. But what actually is it, and how does it work?
Dr. Herman Pontzer presents a very useful overview of not just what our metabolism is and how it works, but also why.
The style of the book is casual, but doesn’t skimp on the science. Whether we are getting campfire stories of Hadza hunter-gatherers, or an explanation of the use of hydrogen isotopes in metabolic research, Dr. Pontzer keeps things easy-reading.
One of the main premises of the book is that our caloric expenditure is not easy to change—if we exercise more, our bodies will cut back somewhere else. After all, the body uses energy for a lot more than just moving. With this in mind, Dr. Pontzer makes the science-based case for focusing more on diet than exercise if weight management is our goal.
In short, if you’d like your metabolism to be a lot less mysterious, this book can help render a lot of science a lot more comprehensible!
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Regular Nail Polish vs Gel Nail Polish – Which is Healthier?
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Our Verdict
When comparing regular nail polish to gel nail polish, we picked the regular.
Why?
This one’s less about what’s in the bottle, and more about what gets done to your hands:
- Regular nail polish application involves carefully brushing it on.
- Regular nail polish removal involves wiping with acetone.
…whereas:
- Gel nail polish application involves deliberately damaging (roughing up) the nail to allow the color coat to adhere, then when the top coat is applied, holding the nails (and thus, the attached fingers) under a UV light to set it. That UV lamp exposure is very bad for the skin.
- Gel nail polish removal involves soaking in acetone, which is definitely worse than wiping with acetone. Failure to adequately soak it will result in further damage to the nail while trying to get the base coat off the nail that you already deliberately damaged when first applying it.
All in all, regular nail polish isn’t amazing for nail health (healthiest is for nails to be free and naked), but for those of us who like a little bit of color there, regular is a lot better than gel.
Gel nail polish damages the nail itself by necessity, and presents a cumulative skin cancer risk and accelerated aging of the skin, by way of the UV lamp use.
For your interest, here are the specific products that we compared, but the above goes for any of this kind:
Regular nail polish | Gel nail polish
If you’d like to read more about nail health, you might enjoy reading:
The Counterintuitive Dos and Don’ts of Nail Health
Take care!
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Sizing Aside: Are You Wearing The Right Bra For Your Breast Shape?
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It’s well-known that most women wear incorrectly-fitting bras. Even with careful measurements, buying “off-the-rack” can be a challenge, because the sizing system only takes two measurements, when there are actually many more things to consider. Today’s video demystifies a lot of what else is going on!
For example…
Some of the different breast shapes/arrangements to consider:
- Wide-set breasts: likely to find there’s a bit of a gap between your breasts and the inside (nearest to your sternum) parts of the cups—while spilling out a little at the outside edges. The solution? Bras that offer side-support, to keep things pointing more forwards. Central-closing bras can also help gather things together, and a balconette bra can redistribute things more evenly. Any of these options will be a lot more comfortable.
- Small breasts: bralettes are your friend, keeping things comfortable while not wearing more bra than necessary to do the job (of course going braless is also an option, but we’re talking bra-fitting here, not bra-flinging-off never to be seen again)
- Deflated breasts: often the case for someone who used to have larger breasts, but they lost size for hormonal reasons rather than for weight loss reasons. This often occurs a little while after childbirth, and also happens a lot in menopause. The bra recommendation for this? A push-up plunge bra with ¾ coverage not only provides cleavage if that’s wanted, but also, will keep things much more snug and thus more evenly-distributed. If ever you’ve found yourself needing to adjust yourself every now and gain while out, this will fix that and keep you comfortable for much longer.
There’s more, along with a visual guide, so do check it out:
Click Here If The Embedded Video Doesn’t Load Automatically!
Further reading
While we haven’t written about this specifically (maybe we’ll do a “Life Hacks” edition one of these days), we have written about…
Keeping Abreast Of Your Cancer Risk
Take care!
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Pistachios vs Cashews – Which is Healthier?
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Our Verdict
When comparing pistachios to cashews, we picked the pistachios.
Why?
In terms of macros, both are great sources of protein and healthy fats, and considered head-to-head:
- pistachios have slightly more protein, but it’s close
- pistachios have slightly more (health) fat, but it’s close
- cashews have slightly more carbs, but it’s close
- pistachios have a lot more fiber (more than 3x more!)
All in all, both have a good macro balance, but pistachios win easily on account of the fiber, as well as the slight edge for protein and fats.
When it comes to vitamins, pistachios have more of vitamins A, B1, B2, B3, B6, B9, C, & E.
Cashews do have more vitamin B5, also called pantothenic acid, pantothenic literally meaning “from everywhere”. Guess what’s not a common deficiency to have!
So pistachios win easily on vitamins, too.
In the category of minerals, things are more balanced, though cashews have a slight edge. Pistachios have more notably more calcium and potassium, while cashews have notably more selenium, zinc, and magnesium.
Both of these nuts have anti-inflammatory, anti-diabetic, and anti-cancer benefits, often from different phytochemicals, but with similar levels of usefulness.
Taking everything into account, however, one nut comes out in the clear lead, mostly due to its much higher fiber content and better vitamin profile, and that’s the pistachios.
Want to learn more?
Check out:
Why You Should Diversify Your Nuts
Enjoy!
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You, Happier – by Dr. Daniel Amen
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
The implicit question “what’s your brain type?” makes this book sound a little like a horoscope for science-enjoyers, but really, the “brain type” in question is simply a way of expressing which neurochemicals one’s brain makes most and/or least easily.
That’s something that a) really does differ from one person to another b) isn’t necessarily fixed forever, but will tend to remain mostly the same most of the time for most people.
And yes, the book does cover figuring out which neurotransmitter(s) it might be for you. On a secondary level, it also talks about more/less active parts of the brain for each of us, but the primary focus is on neurotransmitters.
It’s easy to assume “everyone wants more [your favorite neurotransmitter here]” but in fact, most people most of the time have most of what they need.
For those of us who don’t, those of us who perhaps have to work more to keep our level(s) of one or more neurotransmitters where they should be, this book is a great guide to optimizing aspects of our diet and lifestyle to compensate for what our brains might lack—potentially reducing the need to go for pharmaceutical approaches.
The style of the book is very much pop-science, but it is all well-informed and well-referenced.
Bottom line: if you sometimes (or often!) think “if only my brain would just make/acknowledge more [neurotransmitter], this book is for you.
Click here to check out You, Happier, and discover a happier you!
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What should I do if I can’t see a psychiatrist?
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People presenting at emergency with mental health concerns are experiencing the longest wait times in Australia for admission to a ward, according to a new report from the Australasian College of Emergency Medicine.
But with half of New South Wales’ public psychiatrists set to resign next week after ongoing pay disputes – and amid national shortages in the mental health workforce – Australians who rely on psychiatry support may be wondering where else to go.
If you can’t get in to see a psychiatrist and you need help, there are some other options. However in an emergency, you should call 000.
Why do people see a psychiatrist?
Psychiatrists are doctors who specialise in mental health and can prescribe medication.
People seek or require psychiatry support for many reasons. These may include:
- severe depression, including suicidal thoughts or behaviours
- severe anxiety, panic attacks or phobias
- post-traumatic stress disorder (PTSD)
- eating disorders, such as anorexia or bulimia
- attention deficit hyperactivity disorder (ADHD).
Psychiatrists complement other mental health clinicians by prescribing certain medications and making decisions about hospital admission. But when psychiatry support is not available a range of team members can contribute to a person’s mental health care.
Can my GP help?
Depending on your mental health concerns, your GP may be able to offer alternatives while you await formal psychiatry care.
GPs provide support for a range of mental health concerns, regardless of formal diagnosis. They can help address the causes and impact of issues including mental distress, changes in sleep, thinking, mood or behaviour.
The GP Psychiatry Support Line also provides doctors advice on care, prescription medication and how support can work.
It’s a good idea to book a long consult and consider taking a trusted person. Be explicit about how you’ve been feeling and what previous supports or medication you’ve accessed.
What about psychologists, counsellors or community services?
Your GP should also be aware of supports available locally and online.
For example, Head to Health is a government initiative, including information, a nationwide phone line, and in-person clinics in Victoria. It aims to improve mental health advice, assessment and access to treatment.
Medicare Mental Health Centres provide in-person care and are expanding across Australia.
There are also virtual care services in some areas. This includes advice on individualised assessment including whether to go to hospital.
Some community groups are led by peers rather than clinicians, such as Alternatives to Suicide.
How about if I’m rural or regional?
Accessing support in rural or regional areas is particularly tough.
Beyond helplines and formal supports, other options include local Suicide Prevention Networks and community initiatives such as ifarmwell and Men’s sheds.
Should I go to emergency?
As the new report shows, people who present at hospital emergency departments for mental health should expect long wait times before being admitted to a ward.
But going to a hospital emergency department will be essential for some who are experiencing a physical or mental health crisis.
Managing suicide-related distress
With the mass resignation of NSW psychiatrists looming, and amid shortages and blown-out emergency waiting times, people in suicide-related distress must receive the best available care and support.
Roughly nine Australians die by suicide each day. One in six have had thoughts of suicide at some point in their lives.
Suicidal thoughts can pass. There are evidence-based strategies people can immediately turn to when distressed and in need of ongoing care.
Safety planning is a popular suicide prevention strategy to help you stay safe.
What is a safety plan?
This is a personalised, step-by-step plan to remain safe during the onset or worsening of suicidal urges.
You can develop a safety plan collaboratively with a clinician and/or peer worker, or with loved ones. You can also make one on your own – many people like to use the Beyond Now app.
Safety plans usually include:
- recognising personal warning signs of a crisis (for example, feeling like a burden)
- identifying and using internal coping strategies (such as distracting yourself by listening to favourite music)
- seeking social supports for distraction (for example, visiting your local library)
- letting trusted family or friends know how you’re feeling – ideally, they should know they’re in your safety plan
- knowing contact details of specific mental health services (your GP, mental health supports, local hospital)
- making the environment safer by removing or limiting access to lethal means
- identifying specific and personalised reasons for living.
Our research shows safety planning is linked to reduced suicidal thoughts and behaviour, as well as feelings of depression and hopelessness, among adults.
Evidence from people with lived experience shows safety planning helps people to understand their warning signs and practice coping strategies.
Sharing your safety plan with loved ones may help understand warning signs of a crisis. Dragana Gordic/Shutterstock Are there helplines I can call?
There are people ready to listen, by phone or online chat, Australia-wide. You can try any of the following (most are available 24 hours a day, seven days a week):
Suicide helplines:
- Lifeline 13 11 14
- Suicide Call Back Service 1300 659 467
There is also specialised support:
- for men: MensLine Australia 1300 78 99 78
- children and young people: Kids’ Helpline 1800 55 1800
- Aboriginal and Torres Strait Islander people: 13YARN 13 92 76
- veterans and their families: Open Arms 1800 011 046
- LGBTQIA+ community: QLife 1300 184 527
- new and expecting parents: PANDA 1300 726 306
- people experiencing eating disorders: Butterfly Foundation 1800 33 4673.
Additionally, each state and territory will have its own list of mental health resources.
With uncertain access to services, it’s helpful to remember that there are people who care. You don’t have to go it alone.
Monika Ferguson, Senior Lecturer in Mental Health, University of South Australia and Nicholas Procter, Professor and Chair: Mental Health Nursing, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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