The Checkup

Episode 26: Healing or harm? The perils of overstepping boundaries in healthcare

Content warning: this episode of The Checkup discusses highly sensitive topics, including sexual assault. If you find this episode triggering, please contact Lifeline on 13 11 14.

Healthcare professionals are entrusted with the wellbeing of their patients, a relationship that carries an inherent power imbalance. Maintaining professional boundaries is critical, yet challenging, as overstepping these boundaries can have serious repercussions for both practitioners and patients.

In this episode of The Checkup, BN’s Emma Baker and Tyler Lim delve into the complex issue of boundary violations in healthcare. They explore the expectations placed on healthcare professionals to uphold these boundaries and examine recent cases where practitioners have been sanctioned for transgressions, such as inappropriate relationships with patients and inadequate consent during intimate examinations.

In this discussion, they consider the professional obligations around maintaining appropriate boundaries, the legal frameworks that guide these expectations, and the implications of boundary violations. Key questions considered in this episode include:

• What constitutes a professional boundary violation in healthcare?
• How can healthcare professionals navigate the fine line between building rapport and overstepping boundaries?
• What are the potential consequences of failing to maintain these boundaries?

This episode serves as a vital reminder for healthcare professionals to remain vigilant about their interactions with patients, ensuring they maintain the trust placed in them by adhering to ethical and professional standards.

This episode of The Checkup was recorded and edited by Audio Advantage.

Episode 25: Combatting vicarious trauma in the workplace

Content warning: this episode of The Checkup discusses highly sensitive topics, including vicarious trauma and psychological harm. If you find this episode triggering, please contact Lifeline on 13 11 14.

As legal professionals, we might find ourselves navigating emotionally challenging subject matters, graphic material or cases that involve emotionally charged parties. This can, in some instances, lead professionals to encounter 'vicarious trauma,' a phenomenon often experienced in high-stress industries such as law or healthcare at various stages of one's career.

In this episode of The Checkup, BN’s Natalie Laidlaw and Ashlee Sherman talk to Sally Ryan and Carly Schrever; psychologists and the directors of Human Ethos, about the complexities of vicarious trauma, empathy-based stress, burnout and compassion fatigue in the workplace. Together, they explore how we can recognise the symptoms of stress, both in ourselves and our colleagues, as well as some strategies to effectively manage and prevent vicarious trauma.

In their discussion, they consider the following questions:

• What is vicarious trauma?
• What are some of the risk factors that make people more likely than others to experience vicarious trauma?
• What are some signs to look out for in colleagues who are experiencing vicarious trauma?
• What is empathy-based stress?
• How can compassion fatigue arise?
• What is the best approach to dealing with the symptoms of burnout?
• How can we assist our colleagues who may be struggling?

This episode of The Checkup was recorded by Pughouse Studios and edited by Audio Advantage.

Episode 24: Voluntary assisted dying: Implementation, consequences, and obligations of the new laws on healthcare practitioners

Content warning: this episode of The Checkup discusses highly sensitive topics, including death and suicide. If you find this episode triggering, please contact Lifeline on 13 11 14.
 
The Voluntary Assisted Dying (VAD) laws have been passed in all Australian states and are currently being rolled out across the country. While the laws are already in operation in some states, other states will commence the laws in 2023.
 
These new laws will have a significant impact on the healthcare industry in Australia and they raise complex questions around practical implementation and their interplay with overlapping laws.  
 
In this timely episode of The Checkup, Demi Peters, an Associate in BN's national health law team, discusses this topical and divisive issue with BN Principal and health law expert, Samantha Pillay, and guest Ruthie Jeanneret, a PhD student at Queensland University of Technology who is researching patients and families' perspectives and experiences of decision-making about VAD in Australia and Canada. Ruthie is also a member of the team at the Australian Centre for Health Law Research tasked with writing the mandatory training in several Australian States that health professionals participating in VAD must complete.
 
Our speakers explore the technical aspects of the laws in each state and the obligations placed on medical practitioners implementing VAD in practice.
 
In their discussion, they will also consider the following questions:

• What is conscientious objection and how does it apply to practitioners who object to VAD practices? 
• What are the main considerations when a practitioner doesn't object but the institution does?
• Can VAD be raised with patients and when could these discussions amount to professional misconduct claims?
• What happens when VAD conflicts with existing laws such as negligence and criminal law?
• How do the VAD laws sit alongside a practitioner's duty of care, which is to exercise reasonable care and skill in the provision of professional advice and treatment?
• How does VAD impact telehealth?
• What overlaps exist between suicide and VAD that health care practitioners should be aware of?

Relevant links:

• LexisNexis quick reference card
• Episode 22 of The Checkup: The line between voluntary assisted dying and criminal conviction
• Enhancing End-of-Life Decision Making: Optimal Regulation of Voluntary Assisted Dying Project
• Del Villar, K et al, ‘Voluntary Assisted Dying and the Legality of Using a Telephone or Internet Service: The Impact of Commonwealth 'carriage Service' Offences’
• White, Ben, Del Villar, Katrine, Willmott, Lindy, Close, Eliana, & Jeanneret, Ruthie, (2022) 'Mapping the legal regulation of voluntary assisted dying in Victoria: The coherence of a new practice within the wider legal system'.

 
This episode of The Checkup was edited by Audio Advantage.

Music by ComaStudio from Pixabay.

Episode 23: When courts are asked to turn off life support: a conversation about futile treatment and best interests in the wake of the Archie Battersbee case

Content warning: this episode of The Checkup discusses highly sensitive topics involving children so listener discretion is advised. 

Who makes the decision when it comes to withdrawing a patient's life support? The recent UK case of Archie Battersbee has brought to light the challenging issues courts consider when intervening in cases relating to withdrawal of life support.

When these tragic and highly emotional matters arise, they involve the patients, families, hospitals, and clinicians. So with many parties involved and many factors to consider, how do the courts make their determination? 

In this episode of The Checkup, BN health law experts, Samantha Pillay and Lisa Fairley, examine the tragic story of Archie Battersbee and the laws around withdrawing life support. They discuss similar cases in the UK and Australia, what the courts take into account when making these types of decisions, and the exceptional case in Queensland for adult patients without capacity.

In their discussion, Sam and Lisa consider the following questions: 

• When will the courts intervene?
• What is futile and non-beneficial treatment and how much weight do courts give to this medical determination?
• How is a patient's best interests determined?
• What rights do patients and family members have when they disagree with doctors?

Relevant links:

• ABC Law Report - Life, death and the law
• BN Case Alert - Archie Battersbee
• The Guardian article - Archie Battersbee: how third parties can further complicate tragic life support cases
• Further details about Archie Battersbee's decisions
• The Hospital v S (a minor) [2019] NSWSC 642
• The case of Charlie Gard
• The case of Tafida Raqeeb
• "Mohammed's case"

This episode of The Checkup was edited by Audio Advantage.

Episode 22: The line between voluntary assisted dying and criminal conviction

Content warning: this episode of The Checkup discusses highly sensitive topics, including death and suicide. If you find this episode triggering, please contact Lifeline on 13 11 14.

In Australia, criminal law prohibits active voluntary euthanasia, however Voluntary Assisted Dying legislation has been introduced and/or passed in various states, making it accessible for persons who meet a certain criteria. The intersection of criminal law and new end-of-life legislation raises a few questions:

• What will we see change across the healthcare industry?
• Will patients and their treatment options be impacted?
• How will it impact the lives of our loved ones?

In this episode of The Checkup, BN’s Milyka McCutcheon unpacks these questions alongside Dr Katrine Del Villar, a health law researcher at Queensland University of Technology. Together, they also discuss a 2018 criminal prosecution involving the assisted death of a terminally ill woman, and how the application of today’s end-of-life legislation might have resulted in a different outcome.

 

This episode of The Checkup was editing by Audio Advantage.

Episode 21: Health Complaints Commissioner: uncovering the complaints resolution process with HCC Resolutions Manager Felicity Lathrop

Understandably, the thought of being contacted by the Health Complaints Commissioner (HCC) following a complaint can be stressful for practitioners and health service providers. However, in many cases, this is usually a result of a lack of understanding of the HCC's processes. In this episode of The Checkup, BN's Scott Shelly is joined by Felicity Lathrop, Resolutions Manager for the Health Complaints Commissioner in Victoria, to uncover the role of the HCC in the complaints resolution process, and hopefully relieve some of the anxiety practitioners and health service providers often feel when dealing with the HCC. Felicity walks us through a day in her life as Resolutions Manager, some of the recurring issues she sees amongst complaints, as well as some tips for health service providers to avoid receiving complaints and for advisers to better manage complaints.

This episode of The Checkup was recorded by Rolln Media and edited by Audio Advantage.

Episode 19: #FreeBritney – how would Britney’s conservatorship play out in Australia?

Most people will be familiar with the very public rise and fall of Britney Spears - from pop princess to a young mother tormented by the paparazzi, and the toll this inevitably took on her mental health which played out publicly for the world to see. However, in recent years, Britney has hit headlines for unexpected reasons. It's come to light that she has been the subject of a conservatorship since 2008, with her father appointed as her conservator and therefore responsible for making all personal and financial decisions on Britney's behalf. 13 years later, and after numerous court hearings, on 13 August 2021, Britney's father agreed to step down as conservator.

So, why was it so hard for Britney to have a say in who controlled her own personal and financial decisions? Why was the independence to make decisions taken away in the first place? And why has this lasted 13 years? Her situation raises the question - could this (or does this) happen in Australia?

In this episode of The Checkup, BN's Sam Pillay, Milyka McCutcheon and Lisa Fairley explore Britney's 13 year (and counting) legal battle, and unpack how Britney's situation would apply if she lived in Australia.

Episode 18: The COVID-19 Vaccination with Dr Lai Heng Foong

As we continue to witness the impact of the COVID-19 pandemic around the world, especially across countries like the UK, the US and of course, the devastating effect its having on India, the development and implementation of the COVID-19 vaccination has become an important and topical conversation for everyone.

 

In this episode of The Checkup, BN’s Kate Hickey and Hannah Shiel are joined, once again, by Dr Lai Heng Foong, an emergency physician and frontline worker, and Chair of the Australasian College for Emergency Medicine’s Public Health and Disaster Committee. We talked to Dr Foong last March (episode 14), just as the devastating impacts of COVID-19 were really starting to unfold around the world. Over 12 months and 3 million COVID-related deaths later, Dr Foong joins us to discuss the COVID-19 vaccination, including herd immunity, concerns surrounding the AstraZeneca vaccine and the risk ratios involved, who is required to have the vaccine, how it’s been developed, and why it should be considered a celebration of global cooperation. Kate and Hannah also provide some guidance to medical practitioners around receiving the COVID-19 vaccination from a medico-legal perspective.

Episode notes:

• Episode 14: On the frontline of COVID-19 with Dr Lai Heng Foong
• "Employers should not assume they can require employees to receive COVID-19 vaccination" 
• AHPRA Vaccination Statement

   

Episode 17: COVID, mental health and the rise of telehealth with Dr Erika Penney

If the COVID-19 pandemic taught us anything, it’s the importance of having the necessary infrastructure in place to allow us the ability to pick up the phone and get the health and medical assistance we require. This includes mental health support. Telehealth hasn’t just helped prevent the spread of the virus, it’s made quality healthcare more accessible to people who, due to various circumstances, were unable to access these services previously.

In this episode of The Checkup, BN's Kate Hickey and Hannah Shiel talk to Dr Erika Penney, a clinical psychologist and lecturer at the University of Technology Sydney. Erika shares some of her professional experiences from the pandemic, the pros and cons of telehealth, issues and information relating to consent, as well as some tips to help maintain and improve your mental health.

Episode notes:

https://mindspot.org.au/

https://thiswayup.org.au/

https://moodgym.com.au/

https://about.healthdirect.gov.au/video-call

This episode of The Checkup was recorded by Sydney Podcast Studios and edited by Audio Advantage.

Episode 16: Cultural and Legal Issues in Indigenous Health with Avelina Tarrago

Since the Closing the Gap initiative began 10 years ago, some progress has been made to improve the lives of Aboriginal and Torres Strait Islander people. But there is still work to be done in achieving equity in Indigenous health. In this episode, BN's Melissa Carius is joined by Avelina Tarrago to discuss the cultural and legal issues for health practitioners who have patients of Aboriginal and Torres Strait Island background. Avelina is a barrister with North Quarter Lane Chambers in Brisbane, and President of the Indigenous Lawyers Association of Queensland.  

This episode of The Checkup was recorded and edited by Audio Advantage - www.audioadvantage.com.au