In this edition:

Support to legalise e-cigarettes as Victorian smoke bans take effect

The Victorian Government has implemented a ban on smoking in all outdoor dining areas in Victoria. The ban, which took effect on 1 August, covers restaurants, cafes, take-away shops, pubs and other licensed premises during times when food is served.

The Victorian Government has also implemented regulations to ensure e-cigarettes and shisha tobacco is regulated in the same way as other tobacco products. However, e-cigarettes containing nicotine continue to be illegal in Australia, as they are classed as poisons by the Therapeutic Goods Administration. A federal Parliamentary inquiry is currently examining whether the devices should be legalised in Australia, with more than 100 submissions being received as to the health benefits and impacts on the legalisation of new tobacco products.

Fact sheets about the Victorian Government’s changes can be accessed here, and information about the federal Parliamentary Inquiry into the Use and Marketing of Electronic Cigarettes and Personal Vaporisers in Australia can be accessed here.

Changes to advance care directives — Medical Treatment Planning and Decisions Act 2016 (Vic)

Russell Kennedy lawyer Felicity Iredale has had an article published in the Australian Health Law Bulletin titled 'Changes to advance care directives — Medical Treatment Planning and Decisions Act 2016 (Vic)'.

The law surrounding advance care directives and the associated obligations on health practitioners are set to change in Victoria in March 2018 with the introduction of the Medical Treatment Planning and Decisions Act 2016 (Vic) (the Act).

The new Act moves towards a scheme of patient-centred care, enabling a person to create legally binding advance care directives and appoint medical treatment decision-makers and support persons.

In preparation for the introduction of the Act, the Department of Health is working in conjunction with the Office of the Public Advocate as part of an implementation advisory group to develop a plan to prepare stakeholders for the introduction of the Act in March 2018.

Read the full article here.

If you have any questions, please contact Michael Gorton AM on 03 9609 1505 or Felicity Iredale on 03 8602 7254.

Superbug report reveals rise in antibiotic-resistant gonorrhoea

The Australian Commission on Safety and Quality in Health Care (Commission) has recently released its first report from Australia’s National Alert System for Critical Antimicrobial Resistances (CARAlert). The CARAlert system was established in March 2016 and collects data on priority organisms considered to have critical resistance to antibiotics, also known as “superbugs”.

The report found that from December 2016 to March 2017, a particular strain of gonorrhoea (Neisseria gonorrhoeae) was the most commonly report CAR, contributing 62% of all CARs reported. This particular strain was detected in every Australian state and territory. For patients with this strain usually treated with the antibiotic azithromycin, there are little to no effective treatment options.

The Commission has announced it will work with all states and territories to provide regular updates on the reporting of the gonorrhoea strain through CARAlert and promote consideration of the data for use in treatment guidelines. The Commission will continue to monitor CARAlerts and prepare summary reports as required.

For more information and to read the report, click here.

Study reveals burden of chronic respiratory conditions in Australia

The Australian Institute of Health and Welfare has released a detailed analysis of the burden of chronic respiratory conditions in Australia. The analysis relies on data from the Australian Burden of Disease Study 2011.

It found that respiratory conditions as a group contributed 8% of the total burden of disease and injury in Australia in 2011, a total of 374,985 disability-adjusted life years (DALY), and were ranked as the sixth leading contributor to total burden after cancer, cardiovascular diseases, mental and substance use disorders, musculoskeletal conditions and injuries.

The burden was similar for males and females, and has decreased from 17 DALY per 1,000 people in 2003 to 16 DALY per 1,000 people in 2011.

The burden was similar across states, however the Northern Territory was 1.6 times the national average. It generally increased with remoteness from major cities, and increased with socioeconomic disadvantage. The burden was also 2.5 times as high among Aboriginal and Torres Strait Islander people compared with non-Indigenous Australians. 36% of the burden was attributed to tobacco use, with occupational exposure and air pollution accounting for 4.4% and 0.1% respectively.

The full report can be accessed here.

UK court hands down decision in Charlie Gard end of life case

The high-profile Charlie Gard case could change the way end-of-life decisions play out around the world.

The parents of critically ill baby Charlie Gard dropped their legal bid to send him to the United States for an experimental treatment after new medical tests showed that the window of opportunity to help him had closed.

In January, after Charlie had seizures that caused brain damage, Great Ormond Street Hospital (GOSH) formed the view that further treatment was not appropriate and might prolong suffering. GOSH began discussions with the parents about ending life support and providing palliative care.

Charlie's parents wanted to try the experimental treatment and raised funds for a transfer to a hospital in New York. In February 2017, GOSH asked the High Court to override the parents' decision.

This case is noteworthy for multiple reasons, both in the huge amount of publicity it attracted, its progression through several courts, and the number of influential commentators who became involved.

This case highlights factors that may influence end-of-life cases around the world. For instance, the use of social media, crowdfunding to pay for unauthorised treatment and the fuelling of anti-establishment sentiment.

To read the judgment click here.