There can be no disputing the proposition that doctors and nurses should be held accountable for their professional activities. In most circumstances this accountability should be achieved through appropriate and effective complaints and disciplinary procedures, but there will be cases where the criminal law should become involved. The criminal law, however, is a serious weapon, and should only be used to punish those whose conduct is truly criminal; it should not be used against those who have merely made a human (...) error. The task of the law should therefore be to identify those situations where a doctor or nurse has behaved in a way which demonstrates a criminally culpable state of mind. In NZ recently the law has failed to do this and has been used as a weapon against those who may be in no sense morally blameworthy. -/- In New Zealand recently the law has failed to do this and has been used as a weapon against those who may be in no sense morally blameworthy. In this respect, NZ has been out of step with other comparable jurisdictions and has demonstrably failed to distinguish between cases where death is caused accidentally (through the making of an ordinary human error) and cases where it is caused criminally (through recklessness or culpable negligence). This is a surprising situation in a jurisdiction which has prided itself on its willingness to adopt a reformist legal agenda. (shrink)

Background: New Zealand health and disability providers are expected to have local open disclosure policies in place, however, empirical analysis of these policies has not been undertaken. Aim: This study aims to examine the scope and content of open disclosure policies in New Zealand compare open disclosure policies in New Zealand, and provide baseline results for future research. Methods: Open disclosure policies were requested from all twenty New Zealand District Health Boards in June 2016. A total (...) of twenty-one policies were received, with nineteen policies included in the review. The data were analysed using conventional content analysis. Areas of identified guidance were categorised categorized under the headings: 1) identification of an adverse event, 2) actions before disclosure, 3) disclosure of harm, and 4) actions after disclosure. Results: A total of forty-six distinct areas of guidance could be categorized under the different phases of the open disclosure life-cycle. Conclusion: This review has identified significant unwarranted heterogeneity and important gaps in open disclosure documents in New Zealand which urgently needs to be addressed. Open disclosure policies which are both flexible and specific should enhance the likelihood that injured patients’ needs will be met. (shrink)

In 2003 and 2004, Aotearoa New Zealand enacted two key laws that regulate two very different ways in which the female body may be commodified. The Prostitution Reform Act 2003 (PRA) decriminalized prostitution, removing legal barriers to the buying and selling of commercial sexual services. The Human Assisted Reproductive Technology Act 2004 (HART Act), on the other hand, put a prohibition on commercial surrogacy agreements. This paper undertakes a comparative analysis of the ethical arguments underlying New Zealand’s legislative (...) solutions to prostitution and commercial surrogacy. While the regulation of prostitution is approached with a Marxist feminist lens with the aim to ensure the health and safety of sex workers, commercial surrogacy is prohibited outright for concerns of negative impacts on present and future persons. I ground the principles of each Act in their ethical foundations and compare these two against one another. I conclude that New Zealand’s legislative approach to regulating the commodification of the female body is ethically inconsistent. (shrink)

One of the key learning objectives in any health professional course is to develop ethical and judicious practice. Therefore, it is important to address how medical and pharmacy students respond to, and deal with, ethical dilemmas in their clinical environments. In this paper, we examined how students communicated their resolution of ethical dilemmas and the alignment between these communications and the four principles developed by Beauchamp and Childress. Three hundred and fifty-seven pharmacy and medical students (overall response rate=63%) (...) completed a questionnaire containing four clinical case scenarios with an ethical dilemma. Data were analysed using multiple methods. The findings revealed that 73% of the qualitative responses could be exclusively coded to one of the ‘four principles’ determined by the Beauchamp and Childress' framework. Additionally, 14% of responses overlapped between the four principles (multiple codes) and 13% of responses could not be coded using the framework. The subsequent subgroup analysis revealed different response patterns depending on the case being reviewed. The findings showed that when students are faced with challenging ethical dilemmas their responses can be aligned with the Beauchamp and Childress framework, although more contentious dilemmas involving issues of law are less easily categorised. The differences between year and discipline groups show students are developing ethical frames of reference that may be linked with their teaching environments and their levels of understanding. Analysis of these response patterns provides insight into the way students will likely respond in ‘real’ settings and this information may help educators prepare students for these clinical ethical dilemmas. (shrink)

This article evaluates New Zealand’s Medicines Amendment Bill 2011. This Bill is currently before Parliament and will amend the Medicines Act 1981. On June 20, 2011, the Australian and New Zealand governments announced their decision to proceed with a joint scheme for the regulation of therapeutic products such as medicines, medical devices, and new medical interventions. Eventually, the joint arrangements will be administered by a single regulatory agency: the Australia New Zealand Therapeutic Products Agency. The (...) medicines regulations in Australia and New Zealand will be updated as part of this process. The Medicines Amendment Bill addresses some of the well-recognised deficiencies in the Medicines Act 1981. However, a comprehensive overhaul of the Act is not being undertaken. I argue that repealing and replacing the Medicines Act 1981 would be preferable and advisable, given the number of legal difficulties with the Act and, in particular, where it does not align with equivalent current international law. (shrink)

In colonial states and settings, constitutional arrangements are often forged within contexts that serve to maintain structural racism against Indigenous people. In 2013 the New Zealand government initiated national conversations about the constitutional arrangements in Aotearoa. Māori leadership preceded this, initiating a comprehensive engagement process among Māori in 2010, which resulted in a report by Matike Mai Aotearoa which articulated a collective Māori vision of a written constitution congruent with te Tiriti o Waitangi by 2040.This conceptual article explores the (...) Matike Mai Aotearoa report on constitutional transformation as a novel means to address structural racism within the health system as a key domain within the constitutional sphere. Matike Mai suggests alternative conceptual structural formations through its focus on the kāwanatanga, the relational and the tino rangatiratanga sphere. This framework is informed by a range of Indigenous ethical values such as tikanga, belonging, and balance that can usefully inform the redesign of the health sector.We assert that constitutional transformation and decolonization are potentially powerful ethical sources of disruption to whiteness and structural racism. We argue that, to eliminate entrenched health disparities, change processes need to be informed by the Indigenous inspirations expressed in the Matike Mai report. (shrink)

In New Zealand an advance directive can be either an oral statement or a written document. Such directives give individuals the opportunity to make choices about future medical treatment in the event they are cognitively impaired or otherwise unable to make their preferences known. All consumers of health care have the right to make an advance directive in accordance with the common law. When we consider New Zealand's rapidly ageing population, the fact that more people now live (...) with and die of chronic rather than acute conditions, the importance given to respecting autonomous decision-making, increasing numbers of individuals who require long-term residential care, and financial pressures in the allocation of medical resources, there would seem to be a number of compelling reasons to encourage individuals to write or verbalise an advance directive. Indeed the promotion of advance directives is encouraged. However, caution should be exercised in promoting advance directives to older people, especially in light of several factors: ageist attitudes and stereotypes towards them, challenges in the primary healthcare setting, and the way in which advance directives are currently focused and formulated. This paper considers some of the specific challenges that need to be addressed if the promotion of advance directives are to improve outcomes of patient treatment and care near the end of life. (shrink)

The revision of the Council of International Organizations of Medical Sciences (CIOMS) International ethical guidelines for health‐related research (2016) heralds a paradigm shift from the ‘protectionist’ policies that emerged following historical research atrocities of the 20th century, towards a more nuanced and inclusive approach to research participation. Adopting this modified approach will enable countries to secure the benefits of research for individuals and for society as a whole, while at the same time minimizing the potential for exploitation and research‐related (...) harms. This article considers the potential impact of Guideline 16 of the CIOMS 2016 from a New Zealand perspective, with respect to research involving adults with impaired capacity and who are incapable of giving informed consent. While the CIOMS 2016 apply a ‘minimal risk’ threshold to guide research involving adults who lack capacity to consent, New Zealand law currently adopts a ‘best interests’ standard which significantly restricts the scope of permissible research that may be performed in this context. This article argues that the CIOMS 2016 should influence change to New Zealand’s legal framework for ethical review of research. CIOMS 2016 provides useful guidance for the necessary standards and processes to enable the responsible and ethical inclusion of adults with impaired capacity in research. (shrink)

Upon first consideration, the desire of an individual to amputate a seemingly healthy limb is a foreign, perhaps unsettling, concept. It is, however, a reality faced by those who suffer from body integrity identity disorder (BIID). In seeking treatment, these individuals request surgery that challenges both the statutory provisions that sanction surgical operations and the limits of consent as a defence in New Zealand. In doing so, questions as to the influence of public policy and the extent of personal (...) autonomy become important. Beyond legal issues, BIID confronts dominant conceptions of bodily integrity, medical treatment, and ethical obligations. This paper seeks to identify the relevant public policy concerns raised by BIID in New Zealand and the limits of autonomy, before moving on to consider how BIID sufferers may legally seek the treatment they require and how a doctor might be protected from criminal proceedings for assault for performing this treatment. It will be argued that it is possible to legally consent to the amputation of a healthy limb as medical treatment and that public perception should not be allowed to take precedence over this right. (shrink)

The term “off-label drug use” refers to drugs that have not yet acquired “approved” status or drugs that have acquired “approved” status but are used with a different dosage, route, or administration method other than that for which the drug has been approved. In New Zealand, the Medicines Act 1981 specifically allows for off-label drug use. However, this authority is limited by the Health and Disability Commissioner Regulations 1996 and the common law, which require that off-label drug use is (...) of an acceptable standard, that the patient should be fully informed, and that the patient should give informed consent. Off-label drug use is an important issue because the current law provides medical practitioners very wide discretionary power, without providing clarification for what is required of the practitioner in exercising his or her discretion in prescribing off-label. This paper discusses possible solutions to this issue, for example, establishing protocol for off-label use, an electronic database of off-label use, and the amendment of legal provisions. (shrink)

Although much recent social science and humanities work has been a revolt against simplification, this volume explores the contrast between simplicity and complexity to reveal that this dichotomy, itself, is too simplistic. John Law and Annemarie Mol have gathered a distinguished panel of contributors to offer—particularly within the field of science studies—approaches to a theory of complexity, and at the same time a theoretical introduction to the topic. Indeed, they examine not only ways of relating to complexity but complexity _in (...) practice._ Individual essays study complexity from a variety of perspectives, addressing market behavior, medical interventions, aeronautical design, the governing of supranational states, ecology, roadbuilding, meteorology, the science of complexity itself, and the psychology of childhood trauma. Other topics include complex wholes in the sciences, moral complexity in seemingly amoral endeavors, and issues relating to the protection of African elephants. With a focus on such concepts as multiplicity, partial connections, and ebbs and flows, the collection includes narratives from Kenya, Great Britain, Papua New Guinea, the Netherlands, France, and the meetings of the European Commission, written by anthropologists, economists, philosophers, psychologists, sociologists, and scholars of science, technology, and society. _Contributors._ Andrew Barry, Steven D. Brown, Michel Callon, Chunglin Kwa, John Law, Nick Lee, Annemarie Mol, Marilyn Strathern, Laurent Thévenot, Charis Thompson. (shrink)

:This article describes the well-developed and long-standing medical ethics teaching programs in both of New Zealand’s medical schools at the University of Otago and the University of Auckland. The programs reflect the awareness that has been increasing as to the important role that ethics education plays in contributing to the “professionalism” and “professional development” in medical curricula.

I said at the beginning that some quantum leaps in our thinking would be required as we face up to the challenges and changes that health care delivery will and must undergo.It is not a matter of politics, it is a matter of pragmatism.It is a matter of reality and it's a matter of simply having to face up to what, may I say, has been glaringly obious for some time.I know that doctors come with a strong ethos in terms (...) of their commitment to their patient and that is as it should be, but governments are always going to be constrained by the amount of money that is available to spend in any one particular field of health service.Within the priorities that governments have, health versus education, versus welfare, versus debt, debates will continue to be had.One of the strengths of New Zealand's health services, with its contracting arrangements, is that it is able to respond flexibly to the priorities that the government sets for the health services it seeks to deliver to every person in New Zealand.I am very optimistic that over time this new model of funding of our New Zealand health services will see a fairer distribution of the health dollars available to meet the wide range of medical needs of New Zealanders.Health care delivery is changing rapidly around the world.If we are to keep up in the future we must be realistic now. The challenge is mine as Minister of Health. The challenge is yours as health professionals. The challenge is ours as a community. (shrink)

Determining appropriate legal responses to the conduct of health care workers who endanger patients continues to provoke fierce debate. This is particularly true in the context of criminal law, which offers punishment as an obvious strategy. In the first of three papers which make up this issue's extended Health Care Law feature, Professor Alexander McCall Smith and Dr Alan Merry argue against the prosecution of health care workers except in circumstances where there is very dear evidence of a culpable frame (...) of mind. They do so against the backdrop of their description of proposed changes in New Zealand legislation on medical manslaughter. The catalyst for this change was a judge's refusal to countenance the prosecution of an anaesthetist for manslaughter for inadvertent error. In the authors' opinion the intervention by the New Zealand judge has given rise to a long overdue review of a harsh penal measure. However, in a commentary on McCall Smith and Merry's paper, Ron Paterson argues that all is not what it seems and that--in the light of New Zealand's 'no fault' system of compensation for medical accident--the present system should be maintained. (shrink)

Although nearly 99% of abortions in New Zealand are permitted in order to prevent danger or injury to a woman’s mental health (the ‘mental health exception’), the reasons why mental health considerations should effectively control access to abortion are not altogether clear. This article analyses abortion case law, statutes and debates from New Zealand, the United Kingdom and the United States to attempt to explain the legal connection between mental health considerations and access to abortion. The article argues (...) that the mental health exception evolved in response to a change in the predominant construction of women seeking abortion from ‘selfish’ to ‘desperate’, coinciding with increasing societal subscription to an expanded view of psychological harm. By conceptually accommodating both constructions of women seeking abortion, the article argues that the mental health exception usefully enabled society generally to proscribe the practice of abortion on the basis that it was unnatural and irrational, while nevertheless permitting it in cases considered to be deserving. (shrink)

Healthcare Ethics, Law and Professionalism: Essays on the Works of Alastair V Campbell features 15 original essays on bioethics, and healthcare ethics specifically. The volume is in honour of Professor Alastair V Campbell, who was the founding editor of the internationally-renowned Journal of Medical Ethics, and the founding director of three internationally leading centres in bioethics, in Otago, New Zealand, Bristol, UK, and Singapore. Campbell was trained in theology and philosophy and throughout his career worked with colleagues from (...) various disciplines, including law and various branches of healthcare. The diversity of topics and depth of contributors' insights reflect the breadth and impact of Campbell's philosophical work and policy contributions to healthcare ethics. Throughout his long academic career, Campbell's emphasis on healthcare ethics being practice-oriented, yet driven by critical reflection, has shaped the field in vital ways. The chapters are authored by leading scholars in healthcare ethics and law. Directly engaging with Campbell's work and influence, the essays discuss essential questions in healthcare ethics relating to its methodology and teaching, its intersection with law and policy, medical professionalism, religion, and its translation in different cultural settings. Chapters also grapple with specific enduring topics, such as the doctor-patient relationship, justice in health and biomedical research, and treatment of the human body and the dead. (shrink)

Over the past twenty years there has been a shift in medical law and practise to increasingly distrust the judgement of health professionals. An increasing number of codes of conduct, disciplinary bodies, ethics committees and bureaucratic policies now prescribe how health professional and health researchers should act and relate to their patients. The result of this, Mark Henaghan argues, has been to undermine trust and professional judgement in health professionals, while simultaneously failing to trust the patient to make decisions (...) about their care. This book will look at the issue of health professionals and trust comparatively in a number of countries including the USA, Canada, Australia, New Zealand and the UK. The book will show by historical analysis of legislation, case law, disciplinary proceedings reports, articles in medical and law journals and protocols produced by management teams in hospitals, how the shift from trust to lack of trust has happened. Drawing comparisons between situations where trust is respected such as in emergency situations, and where it is not for example routine decisions such as obtaining consent for an anaesthetic procedure, the book shows how this erosion of trust has the potential to dehumanise the special nature of the relationship between healthcare professionals and patients. The effect of this is that the practice of health care is turned into a mechanistic enterprise controlled by "management processes" rather than governed by trust and individual care and judgement. This book will be an invaluable resource for students and scholars of medical law and medical sociology, public policy-makers and a range of associated professionals, from health service managers to medical science and clinical researchers. (shrink)

The objective of this study was to review the design and delivery of medical ethics education within medical programs across Australia and New Zealand, how current teaching has been informed by the proposed core curriculum published in 2001 by the ATEAM and how it could look moving forward. We conducted a mixed methods study using an online questionnaire consisting of 51 items. This included both binary and open-ended questions to categorise and explore similarities and differences in (...) class='Hi'>medical ethics curricula in medical programs accredited by the Australian Medical Council across ANZ. Participants were asked about curriculum design format, duration, goals, assessments, content areas of their own ME curriculum. Convenors from 18 universities responded. The main commonality was that ME curricula were integrated both longitudinally and laterally with other content. There was also commonality in content areas addressed. The goals, format, educators, and assessments of the ME curricula were highly variable. Most respondents described a curriculum which prioritised knowledge and skill development related to ME. Although the core goals of including knowledge, skills, and attitudinal development in ME curricula are still present, there is no uniformity in terms of format, delivery, or assessment across medical programs in ANZ. This is an area for collaborative development. (shrink)

Development of the New Zealand nursing workforce has been shaped by social, political, scientific and interprofessional forces. The unregulated, independent and often untrained nurses of the early colonial period were succeeded in the early 1900s by registered nurses, with hospital‐based training, working in a subordinate role to medical practitioners. In the mid/late 1900s, greater specialisation within an expanding workforce, restructuring of nursing education, health sector reform, and changing social and political expectations again reshaped nursing practice. Nursing now has (...) areas of increasing autonomy, expanding opportunities for postgraduate education and leadership roles, and a relationship with medicine, which is more collaborative than in the past. Three current challenges are identified for nursing in New Zealand's rapidly evolving health sector; development of a nursing‐focused knowledge culture, strengthening of research capacity, and dissemination of new nursing knowledge. (shrink)

The National Women's Hospital research scandal saw women being involved in medical research without their knowledge and without the opportunity to make a choice about their participation. The 1988 Cartwright Inquiry into this decades-long study established a template for ethics review in New Zealand. Ethics committees were subsequently established to independently assess the potential benefits as well as risks of research. This book describes the gradual undermining of the independence of New Zealand ethics review and the politicisation (...) of ethics committees between 1988 and 2014. The authors, involved continuously in ethics review matters over the period, have seen substantial change brought about by government in response to another medical research crisis - in Gisborne in the late 1990s - and then between 2008 and 2010 an economic crisis involving foreign pharmaceutical companies. Some New Zealand medical researchers claimed that the ethics review process for clinical trials was too slow and was losing the country its economic advantage. This book traces the changes and the implications for a robust ethics review process in all research environments in New Zealand, especially those affecting Maori. The book includes a set of suggestions and recommendations aimed at enhancing independent ethics review, best practice, and the provision of adequate protection for all citizens. (shrink)

North America and New Zealand were colonized by England under an international legal principle that is known today as the Doctrine of Discovery. When Europeans set out to explore and exploit new lands in the fifteenth through the twentieth centuries, they justified their sovereign and property claims over these territories and the Indigenous people with the Discovery Doctrine. This legal principle was justified by religious and ethnocentric ideas of European and Christian superiority over the other cultures, religions, and races (...) of the world. The Doctrine provided that newly-arrived Europeans automatically acquired property rights in the lands of Native people and gained political and commercial rights over the inhabitants. England was an avid supporter of the Doctrine and used it around the world. The English colonial governments and colonists in New Zealand and America, and later the American state and federal governments and New Zealand governments, all utilized Discovery and still use it today to exercise legal rights to Native lands and to control their Indigenous people. In this article, the authors, an American Indian and a New Zealand Maori, use a comparative law methodology to trace and compare the legal and historical application of Discovery in both countries. The evidence uncovered helps to explain the current state of United States Indian law and the New Zealand law relating to Maoris. While the countries did not apply the elements of Discovery in the exact same manner, and at the same time periods, the similarities of their use of Discovery are striking and not the least bit surprising since the Doctrine was English law. Viewing American and New Zealand history in light of the international law Doctrine of Discovery helps to expand one's knowledge of both countries and their Indigenous peoples. (shrink)

What is sovereignty? Was it ceded to the Crown in the Treaty of Waitangi? If land was unjustly confiscated over a century ago, should it be returned? Is an ecosystem valuable in itself, or only because of its value to people? Does a property right entail a right to destroy? Can collectives (such as tribes) bear moral responsibility? Do they have moral rights? If so, what are the implications for the justice system? These questions are essentially philosophical, yet all thoughtful (...) New Zealanders will be keen to see them discussed clearly, rigorously, and dispassionately. This book gathers together essays by eminent philosophers on some of these problems. All of them are New Zealanders or have connections with this region. The problems which this book addresses on aspects of justice and ethics are of concern to all New Zealanders. Students of law, Maori studies, philosophy, politics, and history will find it particularly helpful. (shrink)

This paper presents students’ views about honest and dishonest actions within the pharmacy and medical learning environments. Students also offered their views on solutions to ameliorating dishonest action. Three research questions were posed in this paper: (1) what reasons would students articulate in reference to engaging in dishonest behaviours? (2) What reasons would students articulate in reference to maintaining high levels of integrity? (3) What strategies would students suggest to decrease engagement in dishonest behaviours and/or promote honest behaviours? The (...) design of the study incorporated an initial descriptive analysis to interpret students’ responses to an 18-item questionnaire about justifications for dishonest action. This was followed by a qualitative analysis of students’ commentaries in reference to why students would engage in either honest or dishonest action. Finally a qualitative analysis was conducted on students’ views regarding solutions to dishonest action. The quantitative results showed that students were more likely to use time management and seriousness justifications for dishonest actions. The qualitative findings found that students’ actions (honest or dishonest) were guided by family and friends, the need to do well, issues of morality and institutional guidelines. Students suggested that dishonest action could be ameliorated by external agencies and polarised views between punitive and rewards-based mechanisms were offered. These results suggest that these students engaged in dishonest action for various reasons and solutions addressing dishonest action need to consider diverse mechanisms that likely extend beyond the educational institution. (shrink)

Healthcare reforms in India have been a much-debated issue in the recent past. While the debate has focused mainly on the right to healthcare, another by-product that has evolved out of the debate was the current problem of medical malpractice and the healthcare law. The last decade has seen an increase in the healthcare facilities in the country. This, however, has come with a bulk of medical error cases which the courts have entertained. According to reports, there has (...) been an increase in medical litigation cases by 400% in the last decade. There are about 5.2 million cases of medical error in the country every year. While there exists a standard legal system in the country which entertains such complaints of medical malpractice, the attempt by regulators and medical practitioners should be to reduce these cases. This paper seeks to analyze the extent to which medical malpractice cases affect consumers. It analyzes the existing medical liability system which has mainly evolved through the jurisprudence laid down by the English courts and critiques it. It also looks into the major reasons for such medical mishaps. Authors argue that a “No-Fault” system may give better outcomes. They analyze this by looking at the no-fault liability model implemented in New Zealand. Narratives of no-fault liability being implemented in India have also been used. These are showcased from instances of Motor Vehicles Act, 1988, and Clinical Trial regulations. It is also argued that a by-product of a no-fault liability system is stringent regulations which are used to reduce the possibility of medical mishaps altogether. Lastly, the possible problems of the no-fault liability system are discussed in the paper. (shrink)

The recent wave of medical assistance in dying legalisation raises questions about proper oversight of the practice as new systems for data collection, case assessment and public reporting emerge. Newer systems, such as in Spain, New Zealand and Colombia, are eschewing the retrospective approach used for case assessment in older systems, particularly those in the Netherlands, Belgium and the USA, in favour of an approach requiring more extensive review prior to the procedure. This shift aims to increase compliance (...) with each jurisdiction’s specific safeguards and legal criteria as well as to protect vulnerable patients, but also risks stifling access to the practice and increasing administrative burden on clinicians and patients. Newer systems also tend to favour more extensive data collection than older systems, while failing to be as transparent with public reporting. Inconsistency in data collection and public reporting make it difficult for researchers, policymakers and the public to assess the practice and help achieve a balance between access and compliance. Research on oversight activities is sparse, and there is a need for clarity to determine how best to handle violations of the law and how to create best practices. (shrink)

Purpose This study aims to test the attitudes towards and social consequences of Edward Snowden’s revelations in New Zealand, taking into account New Zealand’s socio-cultural and political environment especially as regards privacy and state surveillance. Design/methodology/approach A questionnaire survey of 66 university students and semi-structured follow-up interviews with 18 respondents were conducted, in addition to reviews of the literature on privacy and state surveillance in New Zealand. The outcomes of the survey were statistically analysed and qualitative analyses (...) of the interview results were also performed. Findings Despite a lack of detailed knowledge concerning Snowden’s revelations and a relative lack of knowledge of domestic law enforcement agencies, as well as those devoted to protecting human rights and privacy, the revelations have had a noticeable effect on New Zealand youngsters’ attitudes towards privacy and state surveillance, mainly evidenced in their willingness to emulate Snowden’s actions and in their changed online behaviour, thereby demonstrating a chilling effect. Practical implications The study results suggest younger New Zealanders are aware of and concerned with their privacy and that the government should better publicise the existing mechanisms for protecting human rights and privacy as well as for whistle-blowing by individuals to give effect to the aspirations of younger citizens in particular. Social implications The results of this study, based on a questionnaire survey, indicates that state surveillance and other threats to privacy are issues of concern to younger New Zealanders and that better public education is needed as to the mechanisms that are available for citizens to protect their privacy and human rights. Originality/value This study is the first attempt to investigate the social impact of Snowden’s revelations on New Zealand youngsters’ attitudes toward privacy and state surveillance as part of cross-cultural analyses between eight countries. (shrink)

Advance directives convey consumers’ wishes about accepting or refusing future treatment if they become incompetent. They are designed to communicate a competent consumer’s perspective regarding the preferred treatment, should the consumer later become incompetent. There are associated ethical issues for health practitioners and this article considers the features that are relevant to nurses. In New Zealand, consumers have a legal right to use an advance directive that is not limited to life-prolonging care and includes general health procedures. Concerns may (...) arise regarding a consumer’s competence and the document’s validity. Nurses need to understand their legal and professional obligations to comply with an advance directive. What role does a nurse play and what questions arise for a nurse when advance directives are discussed with consumers? This article considers the cultural dimensions, legal boundaries, consumers’ and providers’ perspectives, and the medical and nursing positions in New Zealand. (shrink)

The Medical Faculty of the University of Otago, New Zealand is experimenting with a new approach to the teaching of medical ethics, making it an integral part of several courses in all years of the medical curriculum. During the author's twelve-month period as a visiting professor in the faculty, trial runs in ethics have been introduced in the preclinical sciences, in behavioural science and medical-decision analysis and in every clinical attachment. Proposals for permanent course requirements (...) will be considered by the faculty after a full evaluation of these experiments by both students and teaching staff. If such courses are to be implemented and maintained, medical facilities will need to appoint specialists in ethics, at least on a part-time basis. (shrink)

Success in sport can provide a source of national pride for a society, and vast financial and personal rewards for an individual athlete. It is therefore not surprising that many athletes will go to great lengths in pursuit of success. The provision of healthcare for elite sports people has the potential to create many ethical issues for sports doctors; however there has been little discussion of them to date. This study highlights these issues. Respondents to a questionnaire identified many ethical (...) matters, common to other areas of medicine. However they also raised problems unique to sports medicine. Some of these ethical difficulties arise out of the place of the sports doctor within the hierarchy of sport. Yet others arise out of the special relationship between sports doctors and individual players/athletes. This study raises some important questions regarding the governance of healthcare in sport, and what support and guidance is available to sports doctors. As medical and scientific intervention in sport escalates, there is a risk that demands for enhanced performance may compromise the health of the athlete, and the role the sports doctor plays remains a critical question. (shrink)

On the statute books, New Zealand has a strong regulatory system that protects nonhuman animals on farms. Animals are guaranteed the “Five Freedoms,” including freedom to express normal patterns of behavior. This theoretically strong protection is weakened considerably, however, through institutional structures and practices. A loophole in the law allowing practices that violate the Five Freedoms in “exceptional circumstances” is used frequently. The Ministry of Agriculture and Forestry is the government agency that administers animal welfare regulation. This agency is (...) also responsible for increasing primary production, and the farming industry has undue influence with MAF. The National Animal Welfare Advisory Committee is appointed by MAF, and this group is also dominated by industry interests, with a view of animal welfare that excludes behavioral concerns. These factors result in a weakening of welfare requirements. Various solutions to increase protection are proposed, including a requirement that all science and public concerns be taken into account when making decisions on animal welfare and that animal welfare be regulated by an independent government body. (shrink)

Final Report on Phase 1 of the New Zealand Law Foundation’s Artificial Intelligence and Law in New Zealand Project.

Few cross-national studies have been conducted on academic dishonesty. The aim of this study was to explore students’ disclosed levels of academic dishonesty between New Zealand and Nigeria. The measures obtained included incidence, acceptability, and justification of dishonest action. It was hypothesized that there would be differences between the two groups and that differences could be explained in terms of deontology, cultural relativism, utilitarianism, rational fair exchange, and/or response bias. There were 844 medical and health science students who (...) participated in the study and completed a questionnaire that explored incidence, acceptability, and justification of dishonest action. A binary logistic regression revealed that age and incidence were significant predictors of country allocation. Nigerian students reported more engagement in dishonest behaviors, and it is argued that these students have diverse cultural expectations, language variances, response strategies, norms, beliefs, and values. Educational interventions are essential to address concerns related to academic dishonesty such as promoting cross-cultural discourse, providing study skills programs, utilizing peer mentoring, creating formal exchange strategies, and endorsing honor codes. (shrink)

This paper explores the conduct of performance appraisals of nurses in a New Zealand hospital, and how fairness is perceived in such appraisals. In the health sector, performance appraisals of medical staff play a key role in implementing clinical governance, which, in turn, is critical to containing health care costs and ensuring quality patient care. Effective appraisals depend on employees perceiving their own appraisals to be fair both in terms of procedure and interaction with their respective appraiser. We (...) examine qualitative data from interviews and focus groups, involving 22 nurses in a single department, to determine whether perceived injustices impact on the effective implementation of the appraisal system. Our results suggest that particular issues had been causing some sense of injustice, and most of these were procedural. Potential solutions focus on greater formalisation of the performance appraisal process, and more training for appraisers and appraisees. (shrink)

The ethical behaviour and social responsibility of private companies, and in particular large corporations, is an important area of enquiry in contemporary social, economic and political thinking. In the past, a company's behaviour would be considered responsible as long as it stayed within the law of the society in which it operated or existed. Although this may be necessary, it is no longer sufficient. In this paper, we examine an energy company's response to an ethical incident in New Zealand (...) which prompted different responses across the country about the role of business in society. Thus, we argue that when a corporation is accused of unethical behaviour, executives of the company are usually compelled to offer responses to defend their actions and corporate image. Further, we use communicative response model, social issue life cycle theory, and organisational learning, to analyse the incident and how the company responded. Using social issues life cycle theory and organisational learning theory, we demonstrate that sustained pressure can potentially trigger a change of strategy that may serve to improve the ethical posture of a corporation and thereby improve the corporate image long term. We conclude that, although corporations may understand the significance of social issues to the performance and success of their business, this same understanding does not always translate into meaningful social action. (shrink)

This study assesses the extent to which job application forms violate the New Zealand Human Rights Act. The sample for the study includes 229 job application forms, collected from a variety of large and small, public- and private-sector organizations that together employ approximately 200,000 workers. Two hundred and four or 88% of the job application forms contain at least one violation of the Act. One hundred and sixty five or 72% contain two or more and 140 or 61% contain (...) three or more violations. The most common violations concern age, gender, nationality, and disability. The least common concern political opinion, ethical belief, religious belief, and sexual orientation. Despite widespread violations, many forms do have non-discriminatory questions that yield the same kind of useful information as discriminatory questions. Employers could incorporate these into their job application forms to bring themselves into compliance with the law. The same lessons also generally apply to North American employers, given the high degree of comparability between American, Canadian, and New Zealand anti-discrimination laws. (shrink)