• PO Box 250, Corinda QLD 4075

2017 ASM: Guest Speakers

Andrew Robertson-web

Dr Andy Robertson

Deputy Chief Health Officer and Director of Disaster Management
Office of the Chief Health Officer | Public Health Division
Department of Health WA

Abstract

State Regulation of Medicinal Cannabis

In November 2016, the Therapeutic Goods Administration reclassified cannabis-based products (CBP) with tetrahydrocannabinol as Schedule 8 drugs. The Commonwealth Office of Drug Control also opened a license and permit scheme for cultivation and manufacture of medicinal cannabis. As current medical evidence for the safety and efficacy of CBP is still limited for most indications, the Western Australian Department of Health was required to develop the legislation, policy and processes to manage the expected demand for these drugs. This presentation will outline the benefits and challenges of this approach in managing an unregistered drug with limited benefits but significant consumer demand.

Drug Supplies in a Disaster Response

Disaster planning requires an understanding of the requirements in any major incident, whether that be an earthquake or a bioterrorism attack. Disaster responses may require the stockpiling and use of large quantities of pharmaceuticals, the rapid supply of these drugs, administration of drugs by other health professionals, and the rapid distribution and the use of unregistered novel pharmaceuticals to manage emerging chemical or infectious threats. In this presentation, the legislative options for rapidly supplying the required therapeutic agents, the issues with these approaches, and the strategies designed to address these, including the National Medical Stockpile, will be discussed.

Biography

Dr Andrew (Andy) Robertson is the Deputy Chief Health Officer and Director, Disaster Management within the Public Health Division in the Western Australia Department of Health (WA Health). With specialist qualifications in Public Health Medicine and Medical Administration, he served with the Royal Australian Navy from 1984 until 2003. Since 2003, in his role as Director, Disaster Management in WA Health, he has been involved in preparing for and managing health responses to a range of state and international disasters, including the Asian tsunami, Java earthquake, Nepal earthquake, Fukushima radiation incident and local cyclones, bushfires and heatwaves.

CSC, PSM, MBBC, MHSM, MPH, FAFPHM, FRACMA

Wojciech Chrzanowski

Dr Wojciech Chrzanowski

Senior Lecturer, Australian Institute for Nanoscale Science
and Technology, Charles Perkins Centre, Faculty of Pharmacy

Abstract

Nanosafety – from safety of nanoparticles to their therapeutic applications

Nanoparticles are ubiquitous in foods, baby formulas, medicines and the environment. Therefore, human and environmental exposure to nanomaterials is inevitable, and as the use of these nano-enabled products become more widespread, so too will concerns around their safety and impact on human and environmental health. However, progress in the development of nanoparticles and the steep increase in their applications do not match the progress in the evaluation of the possible environmental health and safety impacts across their life cycle. Thus, detailed data on nanoparticle safety is critically needed for both to protect health and to protect the sustainability and benefits of nanomaterials.

The author will present progress in nanoparticle toxicity screening using the state-of-art and ultrasensitive techniques that allow evaluation of toxicity of individual nanoparticles with resolution ~10 nm and 3D liver models. Generate methodological are aimed to form a framework for nanotoxicity testing that can be used in the future to guide safer-by-design drug formulations, food products and cosmeceuticals.

Biography

Dr Wojciech Chrzanowski received his PhD in 2003. In 2006 he was awarded with a prestigious Marie Curie Intra European Fellowship and moved to University College London, and then to the University of Glasgow. In 2010 he was appointed as a Lecturer at the University of Sydney. In 2014 he received DSc from the Polish Academy of Science. In he recived prestigious 2016 Sydney Accelerator Fellowship (SOAR). Currently he is a Senior Lecturer and Health and Medicine Theme Leader at the Australian Institute for Nanoscale Science and Technology.

His research centers around nanomedicine, nanosafety, nanomaterials and nano-bio-characterisation. His work has made a significant contribution to the understanding interaction of nanomaterials with living cells and tissue-like models assembled using magnetic 3D bioprinting. He develops stimuli responsive drug delivery systems that employ different types of nanoparticles to enhance the efficacy of drug therapy (i.e. chemotherapy) and regulated drug release. He also made a substantial contribution to the development of multifunctional surfaces that are capable of regulating cell responses.

PhD, DSc

paul_yovich-web2

Mr Paul Yovich SC

Barrister, Francis Burt Chambers

Abstract

Doctors Behaving Badly
  • An outline of the legal principles relating to professional disciplinary sanctions, including reference to the statutory definitions of the various levels of misconduct set out in the Health Practitioner National Law, and to the leading statements in the case law about how disciplinary sanctions are assessed.
  • Discussion of the apparatus of complaints and their resolution, and particularly about how to approach a professional disciplinary allegation if one is made against a medical professional.
  • Abuse of prescription or other medication by health practitioners, focusing inappropriate prescribing to patients
  • How those sorts of cases are typically dealt with in professional disciplinary cases, and why, and consider the law’s part to play in minimising inappropriate prescribing of drugs of dependence. How the criminal law deals with illicit drug use and distribution.

Biography

I graduated from the University of Western Australia at the end of 1988, then undertook Articles at the Crown Law Department as it was then called. I was admitted on 2 February 1990 and moved to the DPP’s office in 1993, a little over a year after it was set up independently. I worked there until 2011, prosecuting cases of all levels of seriousness up to and including willful murder and murder. In 2010 I prosecuted the first murder trial in Australia in which cameras were allowed in the court room; that case became the subject of two episodes of the documentary series “On Trial”. I also argued many appeals.

In July 2011 I moved to the private Bar at Francis Burt Chambers. Since then I have continued to prosecute from time to time, but I now primarily do defence work at trial and especially appeal level, professional disciplinary work, and coronial inquiries.

On 1 December 2015 I was appointed Senior Counsel.

B.Juris (Hons), LLB

brent hyslop-web

Dr Brent Hyslop

Clinical Senior Lecturer, Dunedin School of Medicine, University of Otago, New Zealand

Abstract

Dementia, best interests, and non-consensual drug trials

People with advanced dementia (and some other conditions) may be unable to consent to enrolment in clinical drug trials (CDTs). It is important, though, that dementia research continues and non-consensual CDTs may be proposed. Under New Zealand law, non-consensual CDTs (and other research) may only proceed if it is deemed to be in participants’ “best interests”.1 It has been argued, however, that non-consensual CDTs cannot be known to be in participants’ best interests and so are not currently permissible, leading to a 2017 Health and Disability Commissioner review.

In this paper, I argue that non-consensual CDTs are in some cases permissible under a best interests standard. Firstly, assuming clinical equipoise, enrolment in a trial offers participants a chance of receiving a superior treatment. The concept of best interests is inherently probabilistic and may be satisfied on this basis. Secondly, there may be an objective medical benefit from simply being enrolled in a clinical trial, regardless of which treatment is received (‘the inclusion benefit’). Thirdly, based on Right 7(4) and common law, a determination of best interests should include a subjective element. A best interests standard may be satisfied based on a person’s known wishes about participation in research. I conclude that, in some cases, non-consensual CDTs may be in a person with dementia’s “best interests”, although more clarity is still required on this issue.

[1] Health and Disability Commissioner (Code of Health and Disability Services Consumers’ Rights) Regulations 1996, Right 7(4)(a).

Biography

Dr Brent Hyslop is a geriatrician at Southern District Health Board and a Clinical Senior Lecturer at Dunedin School of Medicine, University of Otago, New Zealand. His interests include clinical ethics and law in the care of older adults and people with dementia. Recent publications include papers on mental capacity law and decision-making on fitness to drive.

FRACP, MBChB, ClinDipPallMed, PGDipBHL, and have completed requirements for MBHL

vera raposo-web

Professor Vera Lucia Raposo

Professor of the Faculty of Law of Macau University, China |
Professor of the Faculty of Law of Coimbra University, Portugal

Abstract

Off-label prescription and the best standard of care: do they go together?

Off label prescription refers to the use of an approved drug, but in different circumstances than the ones stated in its marketing authorization (MA) and in its label. Therefore, the drug may be use for clinical situations not envisaged in the MA, in groups of patients not included in the MA or by using a different delivery method.

This is a common practice all around the world, since frequently there is no specifically approved drug for certain medical condition, while there are good scientific evidences that a drug originally approved for another medical condition can also have good results for that first one.

Freedom of prescription is a defining note of the medical profession; therefore, the doctor has the power to choose which drug to use, even disregarding the content of the MA, provided it complies with the medical leges artis.

However, when a drug is prescribed off-label this means that it is being used in a medical scenario for which it has not been specifically authorized (i.e., the drug was not submitted to clinical trials concerning that particular medical situation). Because of the lack of scientific evidences regarding the efficiency and safety of the drug the patient can suffer serious injuries and, consequently, the doctor faces an increased risk of medical liability.

In most countries the law is not clear regarding the legitimacy of this practice, so, in the absence of express prohibition, doctors continue to prescribe off label, even though its legitimacy is still discussed.

This presentation will demonstrate that off-label prescription is not necessarily illegal. However, it depends on the fulfilment of certain requirements related with the medical decision to prescribe off-label: preference of the duly approved drug for the medical condition, patient’s informed consent, sound scientific grounds, monitoring and follow up of the patient. The decision must be taken by the doctor, having exclusively in consideration the patient’s well being and disregarding economic or pharmaceutical motivations.

Under these circumstance off-label prescription is not against leges artis; quite the opposite, frequently corresponds to the best standard of care.

Biography

Vera Lúcia Raposo holds a law degree, a post-graduated degree in medical law, a master and a PhD in juridical-political sciences, all obtained in the Faculty of Law of Coimbra University, Portugal.

Presently she is Auxiliary Professor of the Faculty of Law of Macau University and Assistant Professor at the Faculty of Law of Macau University, where she coordinates the Bachelor in Law in Portuguese Language. In the past she was of counsel in some law offices in Lisbon (Portugal), especially in the field of health law.

She authored several book and articles published in Portuguese, English, Spanish and Chinese, in particular about health/medical law and human rights.

Bachelor in Law, Post-Graduation in Medical Law, Master in Public Law, Doctorate in Public Law.

Michael Christmass-web

Dr Michael Christmass

Fellow in Addiction Medicine at Next Step Drug and Alcohol Service

Abstract

The problem is crystal… but is the solution clear?

Methamphetamine is a synthetic chemical with structural similarity to endogenous amines. Crystal methamphetamine is a highly potent form of methamphetamine that can be smoked or injected intravenously. Methamphetamine is not a new chemical and problematic use of this substance is not a new issue. Methamphetamine differs from common illicit substances (e.g. heroin) in that organic cultivation is unnecessary. Methamphetamine administration causes excess accumulation of the monoamines (nor-epinephrine, dopamine, serotonin) in the brain. Sympathetic outflow is increased markedly and psychological outcomes include euphoria, disinhibition, psychosis and hypersexuality. The evidence base for treatment is poor. Options include cognitive behavioural therapy with a limited, but potential, role for pharmacotherapy.

Biography

Fellow of the Australasian Chapter of Addiction Medicine (RACP) with a primary fellowship in general practice (RACGP). Working across in an outpatient setting in the community alcohol and drug service serving dedicated to the Perth CBD and surrounds and providing consultation liaison to Royal Perth Hospital. Also working as senior doctor in the only publically funded, medically supervised, inpatient withdrawal unit in Western Australia. Contributed to establishing the first pilot stimulant use disorder outpatient treatment clinic in Western Australia.

MBBS, MSc, PhD, FRACGP, FAChAM

Mr Colin Priddis

Director of Forensic Science, ChemCentre WA

Abstract

New Psychoactive Substances(NPS): the dynamic legal status of substances derived from licit and illicit sources

Typically NPS find their way into our community through an individual’s importations of substances via internet sources or organized crime syndicate importations. They challenge law enforcement at both the national and state levels. NPS are usually chemical derivatives of known licit or illicit drugs however can also, whilst bearing seemingly little chemical structure similarity, exert a strong interaction on specific receptor sites.

Impact on public health can be dramatic from elevated incidents of unusual and unexplained behavior through to road trauma, criminal activity and fatalities. The emergency departments, police and forensic scientists are left scrambling to understand the health, legal and analytical issues that arise from the diversity of NPS. This paper will discuss these issues and some of the solutions used in WA to counter the impact of NPS.

Biography

A Forensic Chemist for than 30 years and Director of the Forensic Science Laboratory since 2008. Operations cover drug analysis, clandestine laboratories, drug profiling, post mortem toxicology, road traffic toxicology, anti-doping toxicology, community health toxicology and chemical criminalistics including explosives, arson, fibres, glass, paint, mineralogy, soil and gunshot residue.

Qualifications in Organic Chemistry, Pharmacology and IT with additional training in QA, Clandestine Laboratory Investigation, CBRN, Management and Leadership. A member of RACI, ANZFSS and TIAFT and a NATA technical assessor.

Chair of the Former Senior Managers of ANZ Forensic Laboratories and a foundation member of the National Institute of Forensic Science (NIFS) Forensic Executive Committee. Mentor to the NIFS Chemical Criminalistics Specialist Advisory Group(SAG), past mentor to the Toxicology and Illicit Drugs SAGs and a member of the Standards Australia Forensic Standards Committee.

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