An ethical and legal minefield for an ambulance service

Adrenalin (epinephrine) does appear to revive people so one can only speculate that this is some sort of bureaucratic quantification exercise

Heart-attack patients will be used as guinea pigs in a controversial medical trial proposed by the Queensland Ambulance Service. Paramedics attending to cardiac arrest cases will inject either a life-saving drug - adrenalin - or a placebo into the patient. Neither paramedic nor patient will know -- only the trial operators.

Adrenalin is used to make the heart beat if it has stopped. A placebo such as a saline solution, will produce no response in a patient suffering a heart attack. Medical experts said the idea of the trial was to evaluate the value of adrenalin in a cardiac arrests and potential side-effects, and was vital to achieving advances in medicine.

But it has been slammed by frontline ambulance officers. "Let's keep these trials out of the ambulance service and get back to concentrating on the basics such as adequate staffing levels and better response times," one paramedic said.

The University of Western Australia recently started a trial to "determine the efficiency of adrenalin on the survival of patients suffering cardiac arrest". The three-year-study was being funded by the National Health and Medical Research Council.

A spokeswoman for Queensland Ambulance Commissioner Jim Higgins confirmed interest here in the trial of adrenalin. The QAS has sought medical ethics approaal from Queensland Health to participate in this trial" she said. "It is not happening here yet. We don't have a timeframe for Queensland." The spokeswoman declined to elaborate further on QAS plans for the trial.

But one senior paramedic expressed outrage yesterday. "I don't think these trials have any place in an emergency pre-hospital setting," he said. "The patient would have no say in participating in such a trial - they are, after all, in cardiac arrest - and you have to ask yourself, `Would this be acceptable for a member of my family in cardiac arrest?' "The answer of course would be No. "I wonder how the Premier, Emergency Services Minister or Commissioner would react if a loved member of their family had a cardiac arrest and a paramedic turned up and started injecting something other than adrenalin, "This is inappropriate use of the ambulance service." The paramedic said that if the trial went ahead, some patients would be injected with a placebo that would not save their lives. "And the QAS would have sanctioned this in the name of a clinical trial," he said.

Details of the trial came to light after a Sunday Mail report last week- and revealed concerns by ambulance officers about a mix-up of drugs. Adrenalin had been "potentially" incorrectly labelled as pethidine or mixed with pethidine. The drugs have the opposite effect. Pharmaceutical supply giant Astra-Zeneca issued a nationwide recall last month, admitting "there is a risk to patient safety through administering an incorrect product". A batch of 75,000 ampoules of adrenalin imported from Britain was under question. One "rogue" ampoule was found at a hospital in NSW, which prompted the recall.

Queensland paramedics said the deaths of two patients - who were supposedly given adrenalin but did not respond - should be investigated. Queensland's Health Quality and Complaints Commission said it would look into the allegations. AstraZenaca's market access director Liz Chatwin said no other wrongly labelled ampoules had been found last week. Testing on the rogue ampoule had yet to be done by the Therapeutic Goods Administration.

The above article by Darrell Giles appeared in the Brisbane "Sunday Mail" on July 22, 2007




Global cooling kills fish

Well, it's Southern hemispheric cooling anyway. Barramundi are Australia's most sought-after fish for eating



IT'S enough to make any barramundi fanatic reach for a hanky. Thousands of dead tropical fish - some more than a metre long - floating to the surface of Lake Moondarra, Mount Isa's main water supply. Authorities are blaming Queensland's big chill on the mass fish deaths, which have local anglers fearing the worst.

George Fortune, president of the Mount Isa Fish Stocking Group, said about 2000 fish had died in July. "It's been unusually cold for unusually long, and they just can't tolerate the low temperatures for any length of time," Mr Fortune said. "The barramundi come into the shallow parts of the dam to try to get warm, but they get caught up in the shallows, dying of the cold weather."

The cold snap affecting the whole state has seen the mercury drop to as low as 3.2C in Mount Isa this month. And the fish deaths have forced authorities to grapple with another unwanted problem: disposing of the carcasses.

Big pits have been dug to bury the barramundi, along with large numbers of sleepy cod and catfish. Mr Fortune said barramundi stocks in Lake Moondarra were down by as much as 40 per cent.

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Back to basics for misguided educators

Public debate is the first step towards improving the nation's failing school systems, writes Kevin Donnelly

HOW successful is Australia's education system? Based on apparent high rates of illiteracy, automatic promotion of students without the necessary knowledge and skills, our second-rate performance in the Trends in International Mathematics and Science Study tests and a dumbed-down, outcomes-based approach to curriculum, the answer is: not very.

Unsurprisingly, as noted in the federal government-funded survey Parents' Attitudes to Schooling, on being asked to give their views about the quality of school education, only 58.3per cent of parents of primary school-aged children expressed satisfaction, while at the secondary level that figure was 39.9 per cent.

Two of the top three parental concerns are the quality of the curriculum and the standard of teaching. As may be expected, those responsible for falling standards and under-achievement argue that all is well and that any talk of a crisis is a media beat-up or a conservative political ploy.

Take the Australian Education Union's submission to the Senate committee's inquiry into education standards, which held hearings across Australia early this month. The AEU argues that "standards in Australian schooling compare favourably with those in most other countries and historically", and that the Howard Government's concerns about standards are simply "a means of diverting attention from the inequity of its funding mechanisms and attacking its critics". By making public the parlous state of our education system, commentators such as myself, in articles in The Australian, are condemned by the AEU as being involved in "reactionary witch hunting" and guilty of employing "myths, misconceptions and deceit".

The AEU is not alone in wanting to shoot the messenger. Last year the educrats from the Australian Curriculum Studies Association and the Australian Secondary Principals Association put out a media release arguing the education debate had been "hijacked by partisan political views and media commentators pushing their own barrows". The Australian Association for the Teaching of English is another organisation that argues all is well; it describes Australian education as "spectacularly successful". Australia's high ranking in the Organisation for Economic Co-operation and Development's Program for International Student Assessment tests for 15-year-olds and the results of national literacy tests are used as evidence that our approach to education is world's best practice.

In opposition to public concerns about the way classic literature has been destroyed by politically correct theory and critical literacy, where students are taught to deconstruct texts in terms of power relationships and victim-hood, the AATE also argues that such theories represent the best way to teach English. Judging by other submissions to the Senate inquiry, it is obvious that fears about falling standards are not a media beat-up and that many respected and well-qualified teachers and educators argue that much needs to be done to strengthen and improve our education system.

As noted in the submission from the Australian Mathematical Sciences Institute, advocates of the PISA test ignore that the test evaluates so-called real-life skills, not the school curriculum. The AMSI submission also argues that PISA "is not a valid assessment of the mathematics knowledge, as only a fragment of the curriculum is tested" and "some of the questions are effectively general aptitude tests rather than mathematical ones".

Based on the results of the TIMSS tests, Australian students are in the second XI when it comes to international mathematics and science performance, and we have a longer tail of under-performing students. According to AMSI, the reasons for Australia's under-performance include the inferior quality of our curriculum documents, lack of expertise and confidence among primary-school teachers caused by flaws in teacher training and, as a result of universities dropping prerequisite subjects, a decline in the numbers of students taking more difficult senior-school courses.

Notwithstanding the AATE's claim that Australia has "internationally acclaimed, rigorous, research-based and balanced curricula and teaching methodologies", literacy is another area where there is increasing evidence that teachers and schools are being let down.

Kerry Hempenstall, an academic specialising in literacy at RMIT University in Melbourne, argues in his submission that many of the curriculum innovations that regularly wash over Australian classrooms lack a rigorous research base. The reality is that fads such as whole language, where the assertion is made that learning to read is as natural as learning to talk, have bred generations of illiterate students. As noted by Hempenstall, "These assertions have influenced educational practice for the last 20 years, yet they have each been shown by research to be incorrect. The consequence has been an unnecessary burden on struggling students to manage the task of learning to read. Not only have they been denied helpful strategies but they have been encouraged to employ moribund strategies."

One of the most telling critiques of outcomes-based education has been developed by a group of teachers associated with the Perth-based People Lobbying Against Teaching Outcomes (www.platowa.com). PLATO members have worked tirelessly in opposition to extending outcomes-based education into years 11 and 12 and have been instrumental in the West Australian Government's efforts to ameliorate the worst excesses of the new certificate. In their submissions, PLATO members Igor Bray, professor of physics at Murdoch University, Stephen Kessell, a retired associate professor at Curtin University, and Marko Vojkovic, a teacher, suggest that standards have fallen, that more needs to be done to strengthen teacher education and that teachers need to be properly supported in their work with academically based, clear and succinct syllabus road maps.

While many of those responsible for the present malaise vilify the media for placing education firmly on the public and political agenda, ignored is the fact education is far too important to leave to the so-called experts, and the first stage of strengthening and improving the system is public debate.

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Leftist cartoonist Leunig unhinged

The Melbourne cartoonist Michael Leunig became "unhinged" by widespread claims his cartoons were anti-Semitic, according to his former boss, editor-in-chief of The Age Michael Gawenda. Gawenda, who edited the paper for seven years, famously clashed with Leunig in 2002 over a cartoon that compared the plight of Jews in Nazi concentration camps during World War II to the Palestinians in modern Israel. Gawenda, who is Jewish, refused to publish the cartoon, a position he says "took me perhaps 10 seconds to decide".

"Such cartoons were de rigueur in Europe," Gawenda says in his memoir American Notebook: A personal and political journey, to be launched on August 1. But the cartoons were "intellectually lazy, consciously designed to wound and in some cases motivated by antipathy to Jews", he says.

"Leunig and I were friends. Not always close friends but friends nevertheless," he writes. "There were times when we drank together, and talked for hours."

But Gawenda says Leunig became "unhinged" by the attacks from people who found his cartoons on Israel "morally blind, suffused with hatred for the Israelis, with no sympathy or empathy for even the children and women who were victims of suicide bombers, about whom he showed not even the slightest sign of disgust".

Gawenda says the fact he was a Jew was used by Leunig to explain his decision to censor the cartoon, and was considered a matter of "great significance" by most of his critics. This was most evident when he decided the newspaper should support John Howard's decision in 2003 to commit Australian forces to the US-led war in Iraq. After an editorial to that effect, Gawenda says "a longtime colleague, a close friend of 20 years or more, stopped me and asked me how I could do it, how could I have supported Howard and this war. Why had I done this? Who had got to me? "Apart from a few words exchanged when we once ran into each other outside The Age, we have not spoken to each other again."

Gawenda, who moved after his stint as editor-in-chief to Washington to become US correspondent for The Age and The Sydney Morning Herald, says the default position of most journalists at The Age was on the political Left.

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Muslim thieves thwarted by hi-tech

A MILLION-DOLLAR haul of PlayStation consoles was tracked to a farm outside Sydney by satellite technology. The alleged heist was thwarted because the semitrailer containing 4704 Sony PS2 consoles was fitted with a GPS tracking device, enabling detectives to locate it within hours.

Police allege a city freight forwarding depot in Bourke Road, Alexandria, was broken into on March 24, 2005. In evidence tendered to Downing Centre Local Court in April, it was said consoles worth more than $1 million - in a trailer attached to a prime mover - were allegedly stolen. Police said the prime mover had been fitted with a GPS tracking device, which revealed its direction and speed after the truck was taken from the depot. GPS logs tendered to the court showed it travelled along the Princes Highway to Stoney Creek Road and onto the M5 motorway, which it followed until the Hume Highway exit at Casula. From there it travelled along Elizabeth Drive and Park Road in Wallacia before turning into a property on Silverdale Road at Werombi, near Warragamba Dam. The PolAir helicopter tracked the route, guiding officers from the State Crime Agency to the property.

When they arrived, the court was told, game consoles had allegedly been partially loaded into a shed next to the residence. Four men have been accused of involvement in the alleged heist. Youhanna Yacoub, 48, from Werombi, has pleaded not guilty to charges of receiving stolen property and larceny. George Ghassan, 60, of Fairfield, Kassar Jawish, 26, of Bankstown, and Sameer Ibrahim, 31, of Yagoona, have each pleaded not guilty to charges of larceny, receiving stolen goods and taking and driving a conveyance without consent. The four men were granted conditional bail to appear again in Downing Centre Local Court on August 13, when the part-heard matter resumes.

A spokesman for Sony Computer Entertainment Australia said the company had not been aware of the alleged theft. He declined to comment further. A representative of the Alexandria-based freight forwarding company could not be reached for comment.

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