Mark Henaghan

Ethical, Legal, and Social Issues in the Translation of Genomics Into Health Care

PURPOSEnThe rapid continuous feed of new information from scientific discoveries related to the human genome makes translation and incorporation of information into the clinical setting difficult and creates ethical, legal, and social challenges for providers. This article overviews some of the legal and ethical foundations that guide our response to current complex issues in health care associated with the impact of scientific discoveries related to the human genome.nnnORGANIZING CONSTRUCTnOverlapping ethical, legal, and social implications impact nurses and other healthcare professionals as they seek to identify and translate into practice important information related to new genomic scientific knowledge.nnnMETHODSnEthical and legal foundations such as professional codes, human dignity, and human rights provide the framework for understanding highly complex genomic issues. Ethical, legal, and social concerns of the health provider in the translation of genomic knowledge into practice including minimizing harms, maximizing benefits, transparency, confidentiality, and informed consent are described. Additionally, nursing professional competencies related to ethical, legal, and social issues in the translation of genomics into health care are discussed.nnnCONCLUSIONSnEthical, legal, and social considerations in new genomic discovery necessitate that healthcare professionals have knowledge and competence to respond to complex genomic issues and provide appropriate information and care to patients, families, and communities.nnnCLINICAL RELEVANCEnUnderstanding the ethical, legal, and social issues in the translation of genomic information into practice is essential to provide patients, families, and communities with competent, safe, effective health care.

Show Some Emotion?: Emotional Dilemmas in Undertaking Research with Vulnerable Youth

There is debate about the proper role of emotions in research; however, in the pursuit of certain research questions, an emotional impact on researchers is unavoidable and has the potential to engulf researchers and research processes. This article explores the emotional challenges involved in completing a large, mixed-methods research project focused on high-risk youth. We outline four dilemmas researchers confronted as they managed the emotional impact of the fieldwork: tentative disclosures, catharsis, hopelessness, and motivation. Understanding these dilemmas enhanced the analysis and the conceptual work of the research.

Conditional openness: young people define practices for successful child protection interventions

Abstract Taking the reforms of child protection legislation that have occurred since the 1980s as a backdrop, this paper considers young people’s perspectives on the factors that facilitated their engagement with child protection services and the barriers they perceived to effective service delivery. Drawing on findings from a New Zealand study of young people’s experience of multiple service use (child protection, mental health, youth justice and remedial education), the paper identifies that that rather than being ‘resistant’ or ‘hostile’ to statutory child protection intervention, young people reported a ‘conditional openness’. This conditional openness was characterised by three themes: communication; continuity and consistency; and contextual and cultural responsiveness. Interventions with these characteristics activated this conditional openness allowing effective interventions to occur. Using a series of case studies, comprising interviews and agency case file records; the paper considers the experiences of 109 young people (12–17 years) as well as those of the ‘person most knowledgeable;’ an adult nominated by young people because they knew the young person’s situation well.

Article 12 of the UN Convention on the Rights of Children: Where Have We Come from, Where Are We Now and Where to from Here?

This article examines the context surrounding the creation of the UN Convention on the Rights of Children, focusing primarily on Article 12, and explains the importance of children having a voice in all matters affecting them. An analysis of the application of Article 12 in the New Zealand courts demonstrates that more work is required to ensure children are full participants in the judicial process, especially considering the ways children’s rights and voices have been unduly constrained by the new Family Dispute Resolution process introduced in 2014. The article also explores the fundamental importance of the involvement of children in political matters affecting them, focusing on a recent Australian model involving Aboriginal children and young people and recommends a reduction in the New Zealand voting age to ensure children and young people have a real voice in political matters and that Article 12 truly fulfils its potential.

Suicide prevention in mental health services: A qualitative analysis of coroners’ reports

Suicide is a major concern for mental health nurses because of its clear correlation with mental illness. In New Zealand, coroners investigate all deaths that appear to be a result of suicide, and provide reports to mental health services (MHS). The aim of the present study was to investigate coronial recommendations to MHS in relation to suicide prevention and to examine clinical and family responses to these. The present study was a three-phase design: (i) analysis of coroners recommendations related to suicide in MHS; (ii) interviews with clinicians for their response to the recommendations; and (iii) interviews with individuals working with families of consumers of MHS for their responses in relation to family-related recommendations. A qualitative content analysis was conducted on the recommendations from coroners, the interviews with clinical leaders, and the focus group for family workers. Coroners recommended that MHS should implement suicide-prevention strategies that would facilitate improved communication, risk containment, service delivery, and family involvement. Clinicians agreed with most recommendations, apart from those related to risk containment. Family workers endorsed the coronial perspective that family inclusion in MHS was suboptimal. Coroners, MHS, and mental health nurses need to consider the latest clinical evidence for suicide prevention. However, given the complexity of factors that influence suicide, it is important to be realistic about MHS role in preventing suicide, but ensure that MHS provide interventions for which there is evidence, including facilitating family participation and providing access to psychotherapies.

Engaging Youth in Youth Justice Interventions: Well-being and Accountability

This article argues that youth justice interventions which combine both accountability and well-being components (comprehensive) are most likely to be effective in terms of improving quality of life of youth and reducing the likelihood of reoffending. It also argues that effective interventions are those that actively engage youth and their families in the development of plans and in intervention processes (engagement). It draws on two case studies from a large national mixed-methods study: The Pathways to Resilience research programme.

Neuroscience and the Law in New Zealand

The New Zealand Court of Appeal has rejected evidence of neuroimaging to help juries assess the capacity of the accused in an insanity plea. This chapter says the Court of Appeal was right to do so because neuroimaging should not replace the role of the jury. The chapter explains; that neuroscience will help us better understand how the brain functions and what relationship there is between that functioning and how we make decisions. The chapter concludes that neuroscience will be helpful for insight into the human condition but cannot replace the moral choices of what we think is right or wrong or whether we should be culpable or should not be.