Elderly Mans Hands

We keep people alive – but is that the same as living?

Modern medicine can keep people alive – but is that the same as really living?

I asked myself that question when my dear old Gran was dying a few years ago. She was aged in her 90s, and in her last few years earth-side she was virtually blind, 90% deaf, and suffering from dementia.

It was an awful, confusing, undignified way to go.

I ask myself that question again now, as I watch my dad go downhill. A four-year battle with cancer has him now bed-bound, unable to perform any functions for himself. He’s fed, he’s cleaned, he’s dressed, he’s shaved. He has an army of competent carers who tend to his needs around the clock.

And he has an army of health professionals topping up his painkillers, managing his discomfort as best as possible. He’s still with us right now, thanks to modern medicine.

But I wonder… Is that a good thing? At what point does quality of life and dignity take a backseat to simply drawing breath?

In this heart-wrenching article in the New York Times, doctor Sara Manning Peskin describes the agony that families go through when their loves ones are technically gone, though physically alive.

She describes a family’s agonising decision over whether to proceed or not with treatment, for their chronically ill mother.

“The immediate fear of watching her die outweighed the unfamiliar pain of sustaining her on machines and watching her disappear in a long-term care facility,” she says of their decision to keep their mum alive.

In these instances, “sparse cases of recoveries” occur, but the overwhelming majority of patients experience “painful, expensive, drawn-out deaths – ones we would never wish for ourselves or our own families”, she shares.

“When it comes to end-of-life decisions, doctors are terrified of violating patient autonomy. We are scared of our own medical opinions,” Dr Manning Peskin says.

“So instead of saying, ‘I recommend…’, we often offer a platter of life-prolonging measures, most of which are unlikely to improve a patient’s quality of life, but which offer the possibility of hope. The patient’s heart will still beat. Her personality will be gone, but her chest will still rise and collapse. Families see an opportunity for loss to be delayed, perhaps even dodged. Then we are surprised when they take us up on the offer to prolong dying.”

As medicine continues to get smarter – the US has just approved a digital pill that tracks when you take it – the number of people who are alive, without living, is only going to grow.

But I’m not sure whether we should be celebrating?

Honking the horn

What is wrong with Gold Coast drivers?

In the last 24 hours, I have witnessed some of the most ridiculous behavior on the roads I’ve seen in my 20-odd years of driving.

And – I’ve had enough.

It’s time to call on Gold Coast drivers to get your act together, or we’re going to see an increased number of reports of road rage in the nightly news.

For me this week, first, there was the roundabout honker. We both approached the roundabout at roughly the same time. Both of us were going straight, but we were at right angles to each other – she going west to east, me going south to north.

We both entered the roundabout at virtually the same time.

We both had plenty of room, and there was never any danger of us colliding.

But apparently Miss Silver Wagon, loitering on my right, felt that I should have waited until she’d completed her journey before I entered the circle of trust, so she honked at me as she sailed through the roundabout (well behind me, I might add).

Clearly, she was under the mistaken assumption that we should always give way to our right on roundabouts. This is not the rule – we should give way only to vehicles already on the roundabout, and as this handy dandy video shows, she might have been required to give way to me.

She wasn’t the only driver to honk me this week – I was also on the receiving end of a royal tooting when I carefully drove around another vehicle, which was blocking an intersection.

The final straw in terms of rudeness on the roads happened this morning. Driving the kids to school, I saw the driver of the vehicle in front of me wind down his window and piff an empty cup of Starbucks out onto someone’s lawn.

Really? In 2017, really? Do people still do this? Has clean up Australia Day taught us nothing?!

Throwing your garbage out the window isn’t just gross and environmentally hazardous, it’s also lazy and hugely inconsiderate.

I’ve lived in many different cities in my time, but I have to say the Gold Coast takes the cake for crazy, chaotic and downright inconsiderate drivers.

A little less distracted driving and a little more courtesy on the road could go a long way towards creating a more harmonious community!

Eating Drive Through

Of Principles, Burgers and Bin Crushers

“Here’s your drink sir, if you wouldn’t mind moving down to park in the waiting bay, your meal will be along shortly.”

Few sentences make my blood boil like the above line from a new generation of fast food drive-through personnel.

Yesterday I took my stand.

“No thanks, I don’t want to park and wait, I’ll just have my money back thanks.”

I was polite, but the reaction from the young girl was still complete shock.

“Um, move down and park. Please”, she repeated.

I politely repeated myself but the stand-off became moot as my food arrived (as I knew it would given the standard nature of my order) and the young girl handed it to me with eyes that said one word very clearly.

Really?

Munching on my chippies as I pulled out onto the road, I wondered what my 14 year old self would have thought about the last few minutes of my life.

Like most people working in fast food back in the late 90’s, I was completely caught up in the speed-of-service dogma and the holy Drive-Through Clock which was lord and master to all.

It told us all how long cars had been waiting and if that daily average wasn’t under 2 minutes, lord help your entire crew!

It’s all well and good when you’re getting ‘just a small fries thanks’ or ‘two ice cream cones please’, but when a Tarago full of half-pissed hungry people rocks up and that clock says 4mins 30 seconds before you even get to ‘please drive through to the first window’, naturally the average is going to skyrocket.

I remember one of my particularly savvy managers figured out that if you hit the incoming sensor plate with something metallic (say a bin-crusher for example) ten times, then run to the other end of the drive through and repeat the procedure on the outgoing sensor plate, well, let’s just say it ensured the daily average was no longer ever in danger of clearing 2 minutes.

Looking back now, it didn’t exactly boost enthusiasm for speed of service though (the opposite in fact), but we all thought it was a great idea!

So how did that enthusiastic 14 year old become the 34 year old who won’t be parked?

Principle, plain and simple (I also blame Larry David a fair bit).

Parking or Waiting Bays are a great addition to the drive through dynamic IF (repeat, IF) they are used sensibly to ensure that customers who order 19 lattes and forty gourmet (note term is used loosely here) burgers don’t cause cars behind to wait unnecessarily long.

The problem is that in reality they are invariably used as the modern form of that trusty metal bin crusher, to keep drive-through times down while at the same time resulting in (indeed, facilitating) a natural drop in speed of service focus.

Fast service is, I would argue, the main attraction and/or point of difference for customers to choose these chains.

Why would managers need to roster appropriately to ensure speed of service when one staff member can ensure that all cars cross that outgoing sensor as they ‘park over there and wait’?

It is not just fast food (don’t even start me on self-service checkouts), it is the general principle of doing what your advertising is saying that you are.

Or not doing in this case.

You can’t take the ‘fast’ out of fast food in practice but keep it up on the signs out the front.

Well I mean you can, clearly you can, but you shouldn’t, and my response to ‘being parked’ from now on will be ‘no problems, can I please have my money back thank you’.

Why are domestic violence rates still so high in Australia?: The Conversation

BY: Heather Douglas, The University of Queensland

Australian Bureau of Statistics (ABS) data released this week as part of the Personal Safety Study (PSS) reveals 16% of Australian women have experienced partner violence.

The 2016 PSS was conducted across Australia and surveyed around 21,000 people about their experience of violence. The PSS was last run in 2012, and before that in 2005, so it’s possible to make some comparisons across time.

The statistics show a mixed picture. Overall, the proportion of Australians who report that they experienced violence in the past year has declined from 8.3% in 2005 to 5.4% in 2016.

However partner violence remains high, especially towards women.

Around one in six women (16% or 1.5 million) have experienced physical violence by a partner, compared with one in seventeen men (5.9% or 528,800).

Read more: Study confirms intimate partner violence leading health risk factor for women

Women were much more likely to experience physical violence from a previous partner than a current one.

Around 2.9% of women reported violence by a current partner, while around 14.6% of women experienced violence by a previous partner. There has been little change in the partner violence figures since 2005.

In the last few years, significant resources have been devoted to changing attitudes towards domestic violence – so why aren’t the numbers going down?

One answer may be that broader attitudes towards women and relationships need to change and this takes a long time.

Campaigns like Let’s Change the Story and The Line focus on creating the deep and long-lasting cultural change that’s needed but it’s probably still too early to see results.

Another answer might be that some people are changing, and using violence less.

But as we talk more about domestic violence, it loses the stigma historically attached to it.

As a consequence, more people are prepared to name it and report it. This keeps the figures stable.

The ABS statistics show that higher numbers of women report violence by their intimate partners after separation than during the relationship. This is no surprise.

Leaving the relationship may threaten an abuser’s sense of control and violence may be one tactic used in an effort to reassert control or punish the victim for leaving.

Read more: Why doesn’t she just leave? The realities of escaping domestic violence

In 1990, Martha Mahoney coined the term “separation assault” in recognition of the phenomenon. Separation is now a well-known risk factor for heightened violence.

In government death reviews, actual or intended separation is a characteristic of a high proportion of intimate partner homicides.

Risk assessment tools that police and support services use in safety planning now routinely identify separation as a key risk factor for further violence and death.

As we reduce the stigma of naming domestic violence we may see more women seek help | Source: Annie Spratt/Unsplash

Notably, while the ABS statistics have remained relatively stable, calls on services have increased significantly over recent years.

Applications for domestic violence protection orders in Queensland have jumped from 23,794 in 2012-13 to 32,221 in 2015-16 – a 26% rise.

Similarly in Victoria, 74,551 family violence and personal safety matters were heard by the Victorian Magistrates Court in 2015–16. This was a 27% increase since 2011–12.

In Queensland, reports to police of breach of domestic violence protection orders have more than doubled between 2012 and 2017 and these have also increased significantly in Victoria.

According to annual reports, calls for support to Queensland’s domestic violence support line, DVConnect, have tripled between 2012 and 2016. Safesteps, Victoria’s domestic violence support line, has seen a similar increase.

Read more: Deaths after seeking help point to priorities in tackling domestic violence

Given the ABS reports that figures on domestic violence remain relatively stable, why is there such an increase in requests for support and services?

The ABS statistics are collected through a survey and questions about help-seeking are not included.

The increased numbers of applications for protection orders, reports of breach of those orders and increased calls to support services might suggest that people are increasingly willing to seek help in response to the violence they are experiencing.

Perhaps some are choosing to leave their violent partners. Again, this increase in help-seeking may be explained in part by a reduced stigma associated with domestic violence and the increased willingness of people to name it.

Another explanation might be that services are improving their understanding of domestic violence and are getting better at screening for domestic violence and making appropriate referrals.

Whatever the reason for them, the relative stability of the overall statistics in the ABS study leave no room for complacency. The figures remain too high.

As we reduce the stigma of naming domestic violence we may see more women seek help, and when they do they will often be placing themselves at serious risk. We need to continue to develop and resource robust responses to individual perpetrators and appropriate support for victims.


AUTHOR: Heather Douglas, Professor of Law, The University of Queensland

This article was originally published on The Conversation. Read the original article.

The Conversation

If you are in immediate danger call 000 now.  If you require advice or assistance, the following services offer counselling and support.
Lifeline 24/7 telephone crisis support 13 11 14
DV Connect Queensland Statewide Domestic Violence Hotline 24/7 phone 1800 811 811
1800RESPECT 24/7 phone 1800 737 732
Domestic Violence Prevention Centre Gold Coast

Why children need to be taught to think critically about Remembrance Day

AUTHOR: Kim Wilson, Macquarie University

A FEW years ago, my then four-year-old daughter came home from preschool wanting to know who the soldiers were and why they died.

As a history teacher for nearly two decades, I thought I had it covered. This was my moment to shine as a parent and educator. Unfortunately, I had grossly overestimated my capabilities.

I found myself stumbling over explanations and unable to find the words. Anyone who has tried knows it’s nearly impossible to describe to a four-year-old the machinations of war in a non-terrifying way.

How would I unpack the complex cultural participation in commemorations? I resorted to telling her:

“I’ll explain it when you’re older”.

I know, I know, shame on me.

But it got me thinking about how we position our students to engage meaningfully with wartime narratives and commemorations.

I think we’re missing valuable opportunities to teach students how to critically evaluate memorialisation as a historical artifact.

This deserves our attention because artifacts embody the ideological value systems of the community that create it and the society that, 100 years later, continues to use and observe it. In critiquing Remembrance Day, students will likely learn a great deal about the social and political customs of their own community.

How do schools now participate in commemoration?

What happens now is fairly straightforward. Schools will consult a website such as the Australian Government Department of Veterans’ Affairs to find a runsheet.

Students will be organised to speak, taking heed of the advice for the commemorative address to “highlight the service and sacrifice of men and women in all conflicts”.

A wreath may be purchased, a minute’s silence will be observed, and a recording of The Last Post and The Rouse and the Reveille will be played.

The concern is that uncritical engagement in the social act of commemoration is creating generations of historical tourists.

These “tourists” are not enabled to understand that memorials and commemorative services are interpretations of the past, or that such services are a representation of how present-day society believes it should interact with that past.

They simply pass through without understanding the full context.

Asking pupils to organise and participate in a commemorative event, or providing red paper to make poppies, will not help students develop capacity to recognise that memorial sites and the framing of historical narratives are responses to the context of the time they were created.

Why is this important?

Memorials and commemorative services use rhetoric that speaks to national identities.

Political leaders are adept at using these monuments, ceremonies and rhetoric to respond to current social anxieties in a way that often creates further divisions.

As historical tourists attending commemorative services, students (and the adults they grow into) are at risk of accepting without question nationalistic and political agendas that may not be in their best interests.

I want my students and pre-service teachers to recognise the political, social, and economic factors that influence how a society conducts and participates in memorialisation of the past.

Recognising and understanding this influence leads to active and proactive citizenship.

Preparing our students

How can teachers best prepare primary and secondary school students to think critically about memorialisation? Here is some sound advice from around the globe.

Monique Eckmann from the University of Applied Sciences Western Switzerland says:

“…the history of memory has to be studied; it is important to understand the context and the history of the decision to create a memorial or a commemoration day. Which advocacy groups took the initiative to propose a memorial place or a commemorative date, when, and for whom? What groups were involved in memorialisation politics? What victims are named, who is mentioned in the official memory, and who is not included in it?”

Alan S. Marcus, assistant professor of curriculum and instruction at the Neag School of Education at the University of Connecticut suggests:

  • providing students with or asking them to research the public and private purposes and missions of the memorial, and asking students to discuss how they may influence what is displayed,
  • asking students to interview other visitors at the memorial to learn about their experiences and how those visitors understand the monument and the commemorative services conducted there.

Barnaby Nemko, Head of History at St Helen’s School in Northwood, London, set his students the task of producing their own photographic memorial of the first world war, which would serve as a record for future generations.

The aim was for pupils to construct their own First World War photo memorial based on what they experienced on their day trip to the site of Ypres. Subsequently, the pupils would have to justify their choice of “exhibits”.

As a history teacher, I see great value in all these strategies. So I was surprised by the results of Nemko’s study.

The work his students produced displayed a complete lack of understanding that the photographic memorial they created was indeed an interpretation of the past.

He found that the historical monuments elicited such a strong emotional reaction from the students that it impaired their analytical skills, which were otherwise well developed in relation to other kinds of historical accounts.

What about the place of commemoration in pre-school?

The ConversationMy second child attends a different preschool. Fortunately, there are no commemorative activities offered at this centre.

I am more than a little relieved. I avoid stumbling again through the murky waters of attempting to explain war and remembrance to a child under the age of five.

More importantly, I just don’t think she’s ready to engage in the horrors of war and the complexities of how societies construct narratives to memorialise such events.


AUTHOR: Kim Wilson, Lecturer in History Education, Macquarie University

This article was originally published on The Conversation. Read the original article.

The Conversation