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At least 19 recordsLinked to original sources
PubMed2004

Gardner; Re BWV: resolved and unresolved issues at end of life.

The Medical Treatment Act 1988 (Vic) gives statutory recognition to a patient's (or their agent or guardian if incompetent) right to refuse medical treatment. The case of Gardner; Re BWV confirmed that medical treatment as defined under the Act included artificial nutrition and hydration and as such could be withdrawn, notwithstanding that this would result in the patient's death. This article analyses Gardner; Re BWV and argues that, by deliberately dealing narrowly with the issues at hand, both the Victorian Civil and Administrative Tribunal at first instance and the Victorian Supreme Court knowingly left BWV to die from dehydration over a period of weeks. By not addressing these issues, the tribunal, and more particularly the Supreme Court, lost an opportunity for a reform of the law, so urgently needed at end of life, which would have allowed for "mercy killing", thus sparing BWV and her family the lingering death she was given.

Aged↗
PubMed1988

In re Gardner.

Explore the source record for details and available documents.

Advance Directives↗
PubMed1987

In re Gardner.

Explore the source record for details and available documents.

Advance Directives↗
PubMed2004

Gardner; re BWV: Victorian Supreme Court makes landmark Australian ruling on tube feeding.

The Victorian Supreme Court has decided that artificial nutrition and hydration provided through a percutaneous gastrostomy tube to a woman in a persistent vegetative state may be withdrawn. The judge ruled, in line with a substantial body of international medical, ethical and legal opinion, that any form of artificial nutrition and hydration is a medical procedure, not part of palliative care, and that it is a procedure to sustain life, not to manage the dying process. Thus, the law does not impose a rigid obligation to administer artificial nutrition or hydration to people who are dying, without due regard to their clinical condition. The definition of key terms such as "medical treatment", "palliative care", and "reasonable provision of food and water" in this case will serve as guidance for end-of-life decisions in other states and territories. The case also reiterates the right of patients, and, when incompetent, their validly appointed agents or guardians, to refuse medical treatment. Where an incompetent patient has not executed a binding advance directive and no agent or guardian has been appointed, physicians, in consultation with the family, may decide to withdraw medical treatment, including artificial nutrition or hydration, on the basis that continuation of treatment is inappropriate and not in the patient's best interests. However, Victoria and other jurisdictions would benefit from clarification of this area of the law.

Administration, Cutaneous↗
PubMed2004

The medical provision of hydration and nutrition: two very different outcomes in Victoria and Florida.

Decisions to withhold or withdraw medical hydration and nutrition are amongst the most difficult that confront patients and their families, medical and other health professionals all over the world. This article discusses two cases relating to lawful withdrawal and withholding of a percutaneous endoscopic gastrostomy tube (PEG) from incompetent patients with no hope of recovery. Victoria and Florida have statutory frameworks that provide for advance directives, however in both Gardner; Re BWV and Schindler v Schiavo; Re Schiavo the respective patients did not leave documented instructions. The article analyses the two cases and their outcomes from legal, medical and ethical perspectives.

Adult↗
PubMed1988

The operativity effect in naming: a re-analysis.

According to Howard Gardner (1973), operativity, i.e. the extent to which it is possible to act with or upon an object, influences picture naming by aphasic subjects. In the present study, this influence is analysed with three purposes: (1) to replicate the Gardner's observation, (2) to avoid methodological biases and to extend the analyses, and (3) to look for alternative explanations. Sixty-four pictures corresponding to high- and low-frequency nouns rated as high or low in operativity were presented to 18 aphasic subjects. Frequency and operativity were found to significantly affect naming performance. More particularly, fewer semantic paraphasias were observed in confrontation with operative items and fewer phonemic paraphasias in the production of frequent nouns. However, the influence of operativity on the reduction of errors disappeared when age-of-acquisition and picture familiarity were introduced as co-variables. These dimensions were found to be better predictors of aphasic performance than operativity.

Adult↗
PubMed1977

Peripheral ameloblastoma: a study of 21 cases, including 5 reported as basal cell carcinoma of the gingiva.

The peripheral ameloblastoma and the basal cell carcinoma of the gingiva are probably the same lesion. This article describes the clinical features, natural history, and histopathology of nine acceptable cases published as peripheral ameloblastoma, five lesions published as basal cell carcinoma of the gingiva, and seven unpublished cases of peripheral ameloblastoma. Tissue sections were studied from seven of the cases published as peripheral ameloblastoma, three of the cases published as basal carcinoma, and all the unpublished cases. The peripheral ameloblastoma may exhibit several of the various histologic patterns found in the intraosseous ameloblastoma but has a marked tendency to be acanthomatous. These lesions appear to arise from either remnants of the dental lamina within the gingiva or from the surface epithelium. They are relatively innocuous lesions lacking the persistent invasiveness of intraosseous ameloblastoma. Peripheral ameloblastomas should be excised with a small margin of normal tissue and the surgical site re-examined periodically.

Adult↗
PubMed1981

Molecular cloning of infectious DNA from human papovavirus BK in Escherichia coli.

Recombinant DNA constructed from unit length BK virus DNA and from several defective viral forms was cloned in Escherichia coli HB101. The cloned unit length BK virus DNA retained its infectivity for human embryonic kidney cells, whereas the cloned defective DNA showed no infectivity. Restriction endonuclease digestion of cloned defective DNA and purified virus DNA indicated that many of the defective forms contain re-iterated sequences.

Cloning, Molecular↗
PubMed1992

Ferranti talks to potential buyers after Chapter 11 bankruptcy filing.

More than 500 nursing facilities and 26 hospitals that rely on the financial software of Ferranti Healthcare Systems Corp. are wondering what will happen now that the company filed for protection from creditors under the Federal Bankruptcy Act. Ferranti executives say they're talking to several potential buyers.

Bankruptcy↗
PubMed1993

Tetracycline-resistant propionibacteria from acne patients are cross-resistant to doxycycline, but sensitive to minocycline.

Antibiotic-resistant propionibacteria are being isolated with increasing frequency from antibiotic-treated acne patients. Minimum inhibitory concentrations (MICs) of three tetracyclines, extensively used in acne therapy, were determined for 46 resistant and 19 sensitive propionibacteria isolates. Sensitive strains were inhibited by < or = 1 microgram/ml of all three tetracyclines. For every resistant strain tested, the MIC of tetracycline exceeded that of doxycycline which, in turn, exceeded that of minocycline. The mean MIC for resistant strains was 20.61 +/- 4.56 micrograms/ml of tetracycline, 9.70 +/- 2.03 micrograms/ml of doxycycline and 1.95 +/- 0.35 micrograms/ml of minocycline. In order to determine whether these strains could be inhibited by concentrations of minocycline achievable in vivo, serum levels of minocycline were determined in acne patients receiving either the recommended dose of 50 mg b.d. (20 males, 14 females), or twice this dose (21 males, 12 females). Serum levels were significantly higher (P < 0.001, Student's t-test) in patients receiving 100 mg b.d. Males on 50 mg b.d. had significantly lower serum levels than females on the same dose (P < 0.05. Student's t-test). For all patients, the mean serum level on high-dose minocycline was 2.46 +/- 0.45 micrograms/ml, compared with 1.38 +/- 0.30 micrograms/ml on the smaller dose. These results indicate that tetracycline-resistant propionibacteria should be considered clinically minocycline sensitive, if patients who harbour such strains are prescribed 100 mg b.d. The recommended dose of minocycline for treating acne, especially in male patients, should be re-assessed.

Acne Vulgaris↗
PubMed1983

Is the statistical assessment of papers submitted to the "British Medical Journal" effective?

A study was performed to judge the effectiveness of the statistical assessment scheme for papers submitted to the "British Medical Journal." Statistical criticism of the content of 200 submitted papers which had already been seen by a subject referee led directly or indirectly to 73 (37%) being rejected for publication. In most cases (53 out of 73) serious problems requiring more than minor revision were identified. A comparison of reports on subsequently unpublished and published papers showed that adverse statistical assessments--suggesting major problems--were more common in the papers that were not accepted for publication. Moderate, or less, revision was recommended for 63% of published papers but 39% of the remainder. A checklist of relevant questions was used in making a detailed comparison of 12 published papers, six of which had been statistically assessed and six of which had not. This comparison yielded little evidence that the papers that had been assessed were statistically more acceptable than those that had not been assessed but re-emphasised the subjectivity of refereeing and assessment.

Periodicals as Topic↗