Hunter and New England Local Health District - Free Essay Example

Sample details Pages: 7 Words: 2117 Downloads: 2 Date added: 2017/06/26 Category Law Essay Type Narrative essay Did you like this example? Hunter and New England Local Health District v McKenna [2014] HCA 44 Introduction The case of Hunter and New England Local Health District v McKenna[1] concerned the primary issue of whether a common law duty of care owed to third parties by health authorities and their employees were consistent with the appellantsà ¢Ã¢â€š ¬Ã¢â€ž ¢ statutory obligations in relation to detaining and discharging mentally ill persons[2], under the Mental Health Act 1990 (NSW) (MHA).[3] The High Court of Australia unanimously held in favour of the appellants. An objective of the MHA, however, was the à ¢Ã¢â€š ¬Ã‹Å"controlà ¢Ã¢â€š ¬Ã¢â€ž ¢ of mentally ill patients.[4] On this basis, the decision of the High Court is questionable, as the Court failed to assess a least restrictive environment enabling care and treatment against the necessity for à ¢Ã¢â€š ¬Ã‹Å"controlà ¢Ã¢â€š ¬Ã¢â€ž ¢. Such a need for control was required in these circumstances, and accordingly gave rise to a duty of care which was breached through the discharge of the patient. Don’t waste time! Our writers will create an original "Hunter and New England Local Health District" essay for you Create order Facts Mr Pettigrove, who suffered from a history of mental illness, was involuntarily admitted to, and detained in hospital, upon his friend, Mr Rose, being concerned about the mental state of Mr Pettigrove. Following an assessment by a psychiatrist, he was discharged into the custody of Mr Rose to enable them to travel to Victoria where Mr Pettigroveà ¢Ã¢â€š ¬Ã¢â€ž ¢s mother lived. During the car drive, Mr Pettigrove killed Mr Rose. Before later committing suicide, Mr Pettigrove told police that he had acted on impulse, believing that Mr Rose had killed him in a past life. Mr Roseà ¢Ã¢â€š ¬Ã¢â€ž ¢s family brought an action against the health authority claiming negligence on its part. The respondents alleged that the appellants owed Mr Rose and his relatives a duty to prevent Mr Pettigrove causing harm to Mr Rose, which it failed to do and as a consequence, they suffered nervous shock brought about by Mr- Roseà ¢Ã¢â€š ¬Ã¢â€ž ¢s death.[5] Procedural History At first instance, Elkaim DCJ, the trial judge of the New South Wales District Court found that there was no breach of duty of care as the respondents had failed to establish, that the risk was reasonably foreseeable and à ¢Ã¢â€š ¬Ã‹Å"not insignificantà ¢Ã¢â€š ¬Ã¢â€ž ¢ that a reasonable person would have taken precautions against it.[6] On appeal, the New South Wales Court of Appeal (consisting of Beazley P, Macfarlan JA, and Garling J dissenting) held that à ¢Ã¢â€š ¬Ã‹Å"[t]he Hospital owed Mr Rose a common law duty to take reasonable care to prevent Mr Pettigrove causing physical harm to Mr Roseà ¢Ã¢â€š ¬Ã¢â€ž ¢,[7] and that that duty had been breached by the manner of discharge. By special leave, the appellants appealed to the High Court of Australia. Decision and Judicial Reasoning On the 12th of November 2014, the High Court (consisting of French CJ, Hayne, Bell, Gageler and Keane JJ) unanimously allowed the appeal. The Court held that the appellants did not owe the alleged co mmon law duty of care to Mr Rose and the respondents as this duty was inconsistent with the statutory obligations prescribed by the MHA. Referring to the judgement in Sullivan v Moody,[8] the High Court highlighted the difficulty in determining the existence and nature and scope of a duty of care. The difficulties included where (a) the nature of the harm suffered is caused by criminal conduct; (b) the defendant has a specific discretion or obligation under the existence of a statutory power; (c) the class of persons to which a duty is owed to is difficult to confine and (d) there is a need to preserve legal principles, or a statutory scheme.[9] Although each of these areas were observed to be relevant to the case, the Court concentrated on the second point in particular when reaching its decision. The Court concluded that the provisions of the MHA, which prohibited the detention or the continued detention of an individual unless no other less restrictive care was available, w as inconsistent with a common law duty of care requiring regard for the safety and welfare of those whom a mentally ill person may come into contactwithwhennotà ¢Ã¢â€š ¬Ã¢â‚¬ detained. Emphasis on à ¢Ã¢â€š ¬Ã‹Å"Controlà ¢Ã¢â€š ¬Ã¢â€ž ¢ The MHA manifested the need for mentally ill patients to à ¢Ã¢â€š ¬Ã‹Å"receive the best possible care and treatment in the least restrictive environmentà ¢Ã¢â€š ¬Ã¢â€ž ¢[10] which, inherently favoured Mr Pettigroveà ¢Ã¢â€š ¬Ã¢â€ž ¢s discharge. Nonetheless, the objectives of the MHA, were equally concerned with the à ¢Ã¢â€š ¬Ã‹Å"controlà ¢Ã¢â€š ¬Ã¢â€ž ¢ of mentally ill persons including control intended to protect and prevent such persons, and others, from serious harm. Mr Pettigrove was admitted with principal diagnosis of exacerbation of chronic paranoid schizophrenia. He was certified by the medical superintendent to be mentally ill and involuntary admission and detention was found to be required.[11] During the early hours of the morning in the hospital, a nurse documented Mr Pettigrove to be à ¢Ã¢â€š ¬Ã‹Å"clearly experiencing psychotic phenomenonà ¢Ã¢â€š ¬Ã¢â€ž ¢, à ¢Ã¢â€š ¬Ã‹Å"pre-occupied and agitatedà ¢Ã¢â€š ¬Ã¢â€ž ¢ and having admitted to à ¢Ã¢â€š ¬Ã‹Å"voices that bother himà ¢Ã¢â€š ¬Ã¢â€ž ¢.[12] On the morning of the drive to Victoria, a psychiatrist assessed Mr Pettigrove and said that he did not have any distressing thoughts during the night. However, this was inconsistent with the nursesà ¢Ã¢â€š ¬Ã¢â€ž ¢ notes. Moreover, it is difficult to accept that the observations of that morning formed a sufficient basis to conclude the symptoms for which Mr Pettigrove had been admitted to hospital had disappeared. It may be argued that Mr Rose volunteered to drive Mr Pettigrove to Victoria and therefore he was adequately placed to exercise his own judgment about his ability to protect himself from harm.[13] However, Mr Roseà ¢Ã¢â€š ¬Ã¢â€ž ¢s offer was to drive Mr Pettigrove when he was à ¢Ã¢â€š ¬Ã‹Å"well enoughà ¢Ã¢â€š ¬Ã¢â€ž ¢[14] which clearly implied that Mr Rose relied on the hospital forming the view that, before he was discharged, Mr Pettigrove was fit to travel with him to Victoria. Therefore, Mr Roseà ¢Ã¢â€š ¬Ã¢â€ž ¢s safety was dependent upon an astute judgment by the appellants. In light of these observations, there was a need for control of Mr Pettigrove by continued detention. For the purposes of complying with statutory obligations, Mr Pettigroveà ¢Ã¢â€š ¬Ã¢â€ž ¢s involuntary treatment order could have been revoked and he could have simply been encouraged to remain in hospital as a voluntary patient to undergo further treatment. Further, these observations suggest that there was a à ¢Ã¢â€š ¬Ã‹Å"reasonably foreseeable riskà ¢Ã¢â€š ¬Ã¢â€ž ¢ that was à ¢Ã¢â€š ¬Ã‹Å"not insignificantà ¢Ã¢â€š ¬Ã¢â€ž ¢ that without appropriate treatment, Mr Pettigrove might cause harm to himself or a third party. Referring to the present case, the High Court stated that : à ¢Ã¢â€š ¬Ã‹Å"[For] a mentally ill person, the risk of that person acting irrationally will often not be insignificant, farà ¢Ã¢â€š ¬Ã¢â‚¬Ëœfetched or fanciful. And, in such cases, there will often be a risk that the irrational action will have adverse consequencesà ¢Ã¢â€š ¬Ã¢â€ž ¢.[15] These observations would have led a reasonable psychiatrist in the appellantsà ¢Ã¢â€š ¬Ã¢â€ž ¢ position, to continue to detain Mr Pettigrove and not consign him into the care of Mr Rose for a long road trip on their own. A reasonable psychiatrist would have asserted that Mr Pettigroveà ¢Ã¢â€š ¬Ã¢â€ž ¢s symptoms were liable to fluctuate and that there was no guarantee of recovery from a psychotic episode.[16] Therefore, a duty of care was owed to third parties and that duty was subsequently breached by the health authority in discharging Mr Pettigrove into the custody of Mr Rose. As a result, the appellants failed to uphold the aspect of à ¢Ã¢â€š ¬Ã‹Å"controlà ¢Ã¢â€š ¬Ã¢â€ž ¢ pursuant to the MHA. A Question of Public Policy Section 20 of the MHA ultimately promotes the civil rights of mentally ill persons by requiring minimum interference with their liberty. InCarrier v Bonham,[17]McPherson J referred to à ¢Ã¢â€š ¬Ã‹Å"more humane methods of treatmentà ¢Ã¢â€š ¬Ã¢â€ž ¢for mental health patients, enabling à ¢Ã¢â€š ¬Ã‹Å"greater liberty of movementà ¢Ã¢â€š ¬Ã¢â€ž ¢.[18] However, the right to dignity, autonomy and respect of mentally ill persons should not detract from the more imperative right to proper care and treatment, including protection. This priority assumes even greater significance when the personà ¢Ã¢â€š ¬Ã¢â€ž ¢s insight into his or her mental illness is impaired and their decision-making capacity is affected. [19] Such was the situation of Mr Pettigrove and therefore, the necessity for control through detention, should have outweighed the requirement for à ¢Ã¢â€š ¬Ã‹Å"least restrictiveà ¢Ã¢â€š ¬Ã¢â€ž ¢ care and treatment. Implications T he decision of this case creates a high level of immunity for psychiatrists and the institutions through which they provide services, from tortious liability for violent conduct of patients upon failure to impose involuntary detention or maintain involuntary detention.[20] This decision also reinforces the judgement of Sullivan v Moody, that when determining the nature and scope of a duty of care in particular circumstances, regard must be had to statutory obligations, which may serve to circumscribe or override the duty otherwise owed.[21] Conclusion The appellants owed, and breached a duty of care to Mr Rose and the respondents by discharging Mr Pettigrove. Such an act involved an imprudent exercise of the statutory duty under the MHA as the Act was equally concerned about the à ¢Ã¢â€š ¬Ã‹Å"controlà ¢Ã¢â€š ¬Ã¢â€ž ¢ of mentally ill patients as with their liberty. The High Court failed to evaluate this necessity of control against a least restrictive environment. Nevertheles s, the decision of the case heightens the tension surrounding both the balance between the liberty of mental health patients, and the protection of such patients and the wider community, as well as the coexistence of statutory powers and common law liability. Bibliography Articles/books/reports Freckelton, Ian, à ¢Ã¢â€š ¬Ã‹Å"Legal Liability for Psychiatristsà ¢Ã¢â€š ¬Ã¢â€ž ¢ Decisions about Involuntary Inpatient Status for Mental Health Patientsà ¢Ã¢â€š ¬Ã¢â€ž ¢ (2014) 22(2), Journal of Law and Medicine 280-289 Freckelton, Ian, à ¢Ã¢â€š ¬Ã‹Å"LiabilityofPsychiatristsforFailuretoCertifyà ¢Ã¢â€š ¬Ã¢â€ž ¢ (2003) 10(2) Psychiatry, Psychology and Law 397-404 Peterso, Kathryn, à ¢Ã¢â€š ¬Ã‹Å"Where is the line to be drawn? Medical Negligence and Insanity in Hunter Area Health Service v Preslandà ¢Ã¢â€š ¬Ã¢â€ž ¢ (2006) 28(1), Sydney Law Review 181-196 Rangarajan, Shrikkanth and Bernadette McSherry, à ¢Ã¢â€š ¬Ã‹Å"To Detain or Not to Detain: A Question of Public Duty?à ƒ ¢Ã¢â€š ¬Ã¢â€ž ¢ (2009) 16(2), Psychiatry, Psychology and Law 288-302 Scott, Russ, à ¢Ã¢â€š ¬Ã‹Å"Hunter Area Health Services v Presland: Liability of Mental Health Services for Failing to Admit or Detain a Patient With Mental Illnessà ¢Ã¢â€š ¬Ã¢â€ž ¢ (2006) 13(1), Psychiatry, Psychology and Law 49-59 Scott, Russ, à ¢Ã¢â€š ¬Ã‹Å"LiabilityforHealthServices for not Involuntarily Detaining and Treating a Mentally Ill Personà ¢Ã¢â€š ¬Ã¢â€ž ¢ (2015) 22(1), Psychiatry, Psychology and Law 1-31 Scott, Russ, à ¢Ã¢â€š ¬Ã‹Å"Liability of Psychiatrists and Mental Health Services for Failing to Admit or Detain Patients with Mental Illnessà ¢Ã¢â€š ¬Ã¢â€ž ¢ (2006) 14(3), Australasian Psychiatry 256-262 Cases Carrier v Bonham [2001] QCA 234 Hunter and New England Local Health District v McKenna [2014] HCA 44 McKenna v Hunter New England Local Health District; Simon v Hunter New England Local Health District [2013] NSWCA 476 Presland v Hunter Area Health Service [2003] NSWSC 754 Sullivan v Moody (2007) 207 CLR 562 Legislation Mental Health Act 1990 (NSW) Civil Liability Act 2002 (NSW) Other Blacker, Wendy, and Tejas Thete, à ¢Ã¢â€š ¬Ã‹Å"Detention or Release: The Common Law and Statutory Dichotomyà ¢Ã¢â€š ¬Ã¢â€ž ¢ (2014) Gadens https://www.gadens.com/publications/Pages/Detention-or-release-the-common-law-and-statutory-dichotomy.aspx at 4th April 2015 Leaver, Cameron, à ¢Ã¢â€š ¬Ã‹Å"Hunter and New England Local Health District V Merryn Elizabeth McKenna [2014] HCA 44; Hunter and New England Local Health District V Sheila Mary Simon Anor [2014] HCA44à ¢Ã¢â€š ¬Ã¢â€ž ¢ on Cameron Leaver, Hicksons Health Law Blog (13 November 2014) https://hicksonshealthlawblog.com/2014/11/13/hunter-and-new-england-local-health-district-v-merryn-elizabeth-mckenna-2014-hca-44-hunter-and-new-england-local-health-district-v-sheila-mary-simon-anor-2014-hca-44/ at 3rd April 2015 Merryn Elizabeth McKenna, à ¢Ã¢â€š ¬Ã‹Å"Appellantà ¢Ã¢â€š ¬Ã¢â€ž ¢s Chronologyà ¢Ã¢â€š ¬Ã¢â€ž ¢, Submission in Hunter and New England Local Health Services v McKenna, S142/2014, 25 July 2014 Hunter and New England Local Health District, à ¢Ã¢â€š ¬Ã‹Å"Appellantà ¢Ã¢â€š ¬Ã¢â€ž ¢s Submissionsà ¢Ã¢â€š ¬Ã¢â€ž ¢, Submission in Hunter and New England Local Health Services v McKenna, S143/2014, 25 July 2014 Van de Poll, John and Vahini Chetty, à ¢Ã¢â€š ¬Ã‹Å"Is a Hospital Liable for the Criminal Acts of Its Mental Health Patients?à ¢Ã¢â€š ¬Ã¢â€ž ¢ (May 2014) Holman Webb Lawyers https://www.holmanwebb.com.au/publications/is-a-hospital-liable-for-the-criminal-acts-of-its-mental-health-patients at 3rd April 2015 [1] [2014] HCA 44. [2] Mental Health Act 1990 (NSW) s 9 (definition of à ¢Ã¢â€š ¬Ã‹Å"mentally ill personà ¢Ã¢â€š ¬Ã¢â€ž ¢). [3] Ibid s 20. [4] Ibid s 4(1). [5] John Van de Poll and Vahini Chetty, à ¢Ã¢â€š ¬Ã‹Å"Is a Hospital Liable for the Criminal Acts of its Mental Health Patients?à ¢Ã¢â€š ¬Ã¢â€ž ¢ (May 2014) Holman Webb Lawyers https://www.holmanwebb.com.au/publications/is-a-hospital-liable-for-the-criminal-acts-of-its-mental-health-patients at 3 April 2015. [6] Civil Liability Act 2002 (NSW) s 5B (1). [7] McKenna v Hunter New England Local Health District; Simon v Hunter New England Local Health District [2013] NSWCA 476, [108] (Macfarlan J). [8] Sullivan v Moody (2007) 207 CLR 562. [9] Ibid [50]. [10] Mental Health Act 1990 (NSW) s 4(2). [11] Merryn Elizabeth McKenna, à ¢Ã¢â€š ¬Ã‹Å"Appellantà ¢Ã¢â€š ¬Ã¢â€ž ¢s Chronologyà ¢Ã¢â€š ¬Ã¢â€ž ¢, Submission in Hunter and New England Local Health Services v McKenna, S142/2014, 25 July 2014, 2. [12] Dr Russ Scott, à ¢Ã¢â€š ¬Ã‹Å"LiabilityforHealthServices for not Involuntarily Detaining and Treating a Mentally Ill Personà ¢Ã¢â€š ¬Ã¢â€ž ¢ (2015) 22(1) Psychiatry, Psychology and Law 1, 4. [13] Hunter and New England Local Health District, à ¢Ã¢â€š ¬Ã‹Å"Appellantà ¢Ã¢â€š ¬Ã¢â€ž ¢s Submissionsà ¢Ã¢â€š ¬Ã¢â€ž ¢, Submission in Hunter and New England Local Health Services v McKenna, S143/2014, 25 July 2014, 10 [54]. [14]14 Ibid 4 [21]. [15] Hunter and New England Local Health District v McKenna [2014] HCA 44, [31]. See also Presland v Hunter Area Health Service [2003] NSWSC 754. [16] McKenna v Hunter New England Local Health District; Simon v Hunter New England Local Health District [2013] NSWCA 476, [133] (Macfarlan J). [17] Carrier v Bonham [2002] QCA 234. [18] Ibid [36] (McPherson J). [19] Dr Scott Russ, à ¢Ã¢â€š ¬Ã‹Å"LiabilityforHealthServices for not Involuntarily Detaining and Treating a Mentally Ill Personà ¢Ã¢â€š ¬Ã¢â€ž ¢ (2015) 22(1) Psychiatry, Psychology and Law 1, 26. [20] Ian Freckelton, à ¢Ã¢â€š ¬Ã‹Å"Legal Liability for Psychiatristsà ¢Ã¢â€š ¬Ã¢â€ž ¢ Decisions about Involuntary Inpatient Status for Mental Health Patientsà ¢Ã¢â€š ¬Ã¢â€ž ¢ (2014) 22(2), Journal of Law and Medicine 280. [21] Wendy Blacker and Tejas Thete, à ¢Ã¢â€š ¬Ã‹Å"Detention or Release: The Common Law and Statutory Dichotomyà ¢Ã¢â€š ¬Ã¢â€ž ¢ (1 December 2014) Gadens https://www.gadens.com/publications/Pages/Detention-or-release-the-common-law-and-statutory-dichotomy.aspx at 4 April 2015.

Lambert Eaton Myasthenic Syndrome An Autoimmune Disease

Introduction Lambert-Eaton myasthenic syndrome, also known as Eaton Lambert syndrome, is an autoimmune disease that is characterized by the onset of severe muscle weakness. The muscle weakness involved with Lambert-Eaton myasthenic syndrome (LEMS) typically occurs in the pelvis and thigh muscles. Approximately 60 percent of LEMS cases are associated with a small cell lung cancer (SCLC), and the onset of LEMS symptoms often precedes the detection of the cancer (Gozzard). Patients who have LEMS that also have cancer tend to have a history of smoking and are usually older adults. LEMS occurs often in men with tumors in their chests, especially lung cancer. Individuals without cancer can develop LEMS at any age. However, LEMS is rarely seen in children and this disease is not hereditary. This disease is also more common in men than in women and the progression depends on whether it occurs with cancer. LEMS is named after Edward Lambert and Lee Eaton. These men were neurologists at the Ma yo Clinic in Rochester, Minnesota and they described Lambert-Eaton myasthenic syndrome in the 1950’s and 1960’s. Approximately 400 people in the United States have LEMS. This disease is an autoimmune disease in which the immune system attacks the body’s own healthy tissues. The immune system attacks neuromuscular junctions, which are the areas where a person’s nerves and muscles connects. This then affects the way muscles and nerves communicate and make it difficult to move muscles. LEMSShow MoreRelatedTeam : Based Learning : Case Study On John Stillmann1534 Words   |  7 PagesGravis Foundation of America, the most common form of MG is chronic autoimmune neuromuscular disorder, which can be seen by loss of strength in the voluntary muscle groups (2015). Much research has been done for Myasthenia Gravis, but there is still a lot of unknown information, such as a cure. In this study, one will learn what Myasthenia Gravis is, how it is tested, possible co mplications, and how it is treated. John’s Disease John shows symptoms as in Myasthenia Gravis (MG) such as diplopia, muscles

Effects of Washington D.C Snipers Free Essays

Effects of Washington D. C Snipers Two men that decide they want to take people’s lives into their own hands, can change the way American citizens live their everyday lives. This exact situation happened over a twenty-three day period, when John Muhammad and John Malvo went on a shooting spree in Washington D. We will write a custom essay sample on Effects of Washington D.C Snipers or any similar topic only for you Order Now C. John Allen Muhammad, a forty-one year old veteran expert marksman of the Persian Gulf War, was the main culprit of the crime. He was accompanied by John Lee Malvo, a seventeen year old Jamaican citizen. These two men killed ten people and wounded three others. The snipers had a strategic plan in shooting their victims. As appose to a random one day spree, they had a well thought out process of how to conduct this shooting. They cut a small hole out of the trunk of an old car. They used this hole to stick their gun out of and shoot people without getting caught, and without people knowing where the shooting was coming from. There were no particular people that they were trying to shoot. Everyone that was shot or wounded was random. They shot people picking their kids up from school, and people filling up with gas. This shooting scared people all over the community and throughout the nation. No one felt safe leaving their homes. Before the criminals were caught people were very cautious performing their everyday activities. Some people did not want to take their kids to school fearing that they, or their children might be in danger. The parents and children who did perform their everyday activities lived in fear every time Dial 2 they were in the open. This shooting also stopped people from wanting to get out of their car to fill up with gas. People also stopped going to the park, and even going out to run and exercise. People who had to walk to and from work were scared to go to their jobs in fear of being shot. Anytime people had to be out in the open, they felt as if they were a target. They were scared that somebody was always watching them through the scope of a rifle. Because the people did not know where the shooting was coming from, they did not know what warnings to look for. Once the shooters were caught, some of the tension was relieved. Even though some of the tension was relieved, some people still had the killings of innocent people in the back of their minds. Since someone had committed such an awful crime, they thought that someone else would commit this crime in a similar style. It took time before kids were out playing in the park again and people were back to their normal everyday activities. Because of this shooting, more cars are stopped and searched, because of small traffic violations to ensure the safety of others. More cameras have been put up throughout the city so cops can look at what happened after a crime has been committed, and hopefully bring the criminals to justice. During the time of big events, there are also more roads closed and blocked where all cars are stopped and questioned. Crimes like this also make it harder for the everyday citizen to buy a gun. It also makes people consider going and getting a concealed weapons license. Even today, five years later, people are still worried about crimes like this being committed. Some people feel as if they are a target every time they step out of their front door. Cops all over America have been trained to be able to spot suspicious behavior and know what to look for. The Government’s job is to make everyone feel safe, although this is not always possible because of similar situations from the past. How to cite Effects of Washington D.C Snipers, Papers