See my earlier post for references.... the reference to condo's to withstand the "inconvenience" of a superstorm is a reference to a real thing. (Some of the craziness of capitalism, the head-in-the-sand response to climate change... you just couldn't make it up.)
Sunday, October 30, 2016
Climate fate
See my earlier post for references.... the reference to condo's to withstand the "inconvenience" of a superstorm is a reference to a real thing. (Some of the craziness of capitalism, the head-in-the-sand response to climate change... you just couldn't make it up.)
Climate Fate 气候·命运
By Kamala E
Translation by Christie Dai
I was sitting in the waiting room when you flashed across the screen
我坐在候诊室里，你闪现在银屏 A heatwave smothered India and you were on the screen 热浪吞噬着印度，你出现在屏幕 As you tried to cross the street, your shoe stuck to the road 你想要穿过那条街，路面却粘住了你的鞋 So you ran on scorched bare feet, as the black tar slowly flowed 你只好光着烧伤的脚，跑过已熔化的黑柏油 Where there once were straight white lines, a crazy pattern morphed and swirled 原来笔直的白线，呈现出疯狂的弧度 As if a giant with a paintbrush splashed out and dwarfed the world 有如怪兽用大刷子胡乱泼墨，将世界一番蹂躏 You long for cooling rain, but the monsoon will be late 你渴求雨水的洗去热浪，但雨季却姗姗来迟 And this is how some people face their climate fate 这就是有些人面对的气候带来的命运 You're a woman of Maharashtra: farm life is what you know 你是马哈拉族女子，一辈子都在田地里打滚 With the earth so cracked and bare, nothing green can grow 大地变得如此干涸贫瘠，无一物能生长 As the debt piles up for the chemicals and seed 种子和农药令你举债重重 As you wonder how to fill the many mouths you have to feed 你也为那一张张嗷嗷待哺的嘴而忧愁 As you turn to your husband to say somehow you will cope 你望向他，跟他说我能行的 You see in his eyes there's no room for hope 你注视着他的双眼，希望却已然泯灭 Your nightmare just gets worse, the day you lose your mate 噩梦延续，那天你终于失去了他 And this is how some people face their climate fate 这就是有些人面对的气候带来的命运 You've lived in Karachi all of your life 你一辈子都在卡拉奇 There with your kids, your parents, your wife 与孩子、父母和妻 Last year the heatwave rolled in and swept a thousand lives away 去年热浪来袭，上千条生命被掳去 Overwhelmed the morgue, corpses left out to decay 连陈尸的当所也满患，只能任其腐烂 This time you swear you will be ready and not have to face that smell 你说这次准备好了，一定不会再有那味道 Of those left to rot in the very place they fell 那些倒下便就地腐烂的身体 So you dig out mass graves and pray for rain while you wait 于是你挖了大坑，等待祈求降雨 And this is how some people face their climate fate 这就是有些人面对的气候带来的命运 When Sandy struck New York, you'd left for somewhere calm 龙卷风珊迪席卷纽约时，你选择风平浪静之地 Flew back when it was over, once you knew you'd meet no harm 她走了你再回来，一旦知道风险已过 Another super-storm to hit won't be so inconvenient 再一波来袭也不无妨 Even if next time, Mother Nature is less lenient 就算下次，甚至比这次更猛 For you've bought yourself a condo with rooms sealed water-tight 因为你买了防风抗雨的高档寓所 Floodgates, pumps, power and emergency light 一应俱全的防洪设施 So you gamble on oil stocks, knowing you'll be all right mate 所以你继续哄炒着燃油股票，明白自己的生活不坏 And this is how some people face their climate fate 这也是有些人面对的气候带来的命运
Translation by Christie Dai
I was sitting in the waiting room when you flashed across the screen
我坐在候诊室里，你闪现在银屏 A heatwave smothered India and you were on the screen 热浪吞噬着印度，你出现在屏幕 As you tried to cross the street, your shoe stuck to the road 你想要穿过那条街，路面却粘住了你的鞋 So you ran on scorched bare feet, as the black tar slowly flowed 你只好光着烧伤的脚，跑过已熔化的黑柏油 Where there once were straight white lines, a crazy pattern morphed and swirled 原来笔直的白线，呈现出疯狂的弧度 As if a giant with a paintbrush splashed out and dwarfed the world 有如怪兽用大刷子胡乱泼墨，将世界一番蹂躏 You long for cooling rain, but the monsoon will be late 你渴求雨水的洗去热浪，但雨季却姗姗来迟 And this is how some people face their climate fate 这就是有些人面对的气候带来的命运 You're a woman of Maharashtra: farm life is what you know 你是马哈拉族女子，一辈子都在田地里打滚 With the earth so cracked and bare, nothing green can grow 大地变得如此干涸贫瘠，无一物能生长 As the debt piles up for the chemicals and seed 种子和农药令你举债重重 As you wonder how to fill the many mouths you have to feed 你也为那一张张嗷嗷待哺的嘴而忧愁 As you turn to your husband to say somehow you will cope 你望向他，跟他说我能行的 You see in his eyes there's no room for hope 你注视着他的双眼，希望却已然泯灭 Your nightmare just gets worse, the day you lose your mate 噩梦延续，那天你终于失去了他 And this is how some people face their climate fate 这就是有些人面对的气候带来的命运 You've lived in Karachi all of your life 你一辈子都在卡拉奇 There with your kids, your parents, your wife 与孩子、父母和妻 Last year the heatwave rolled in and swept a thousand lives away 去年热浪来袭，上千条生命被掳去 Overwhelmed the morgue, corpses left out to decay 连陈尸的当所也满患，只能任其腐烂 This time you swear you will be ready and not have to face that smell 你说这次准备好了，一定不会再有那味道 Of those left to rot in the very place they fell 那些倒下便就地腐烂的身体 So you dig out mass graves and pray for rain while you wait 于是你挖了大坑，等待祈求降雨 And this is how some people face their climate fate 这就是有些人面对的气候带来的命运 When Sandy struck New York, you'd left for somewhere calm 龙卷风珊迪席卷纽约时，你选择风平浪静之地 Flew back when it was over, once you knew you'd meet no harm 她走了你再回来，一旦知道风险已过 Another super-storm to hit won't be so inconvenient 再一波来袭也不无妨 Even if next time, Mother Nature is less lenient 就算下次，甚至比这次更猛 For you've bought yourself a condo with rooms sealed water-tight 因为你买了防风抗雨的高档寓所 Floodgates, pumps, power and emergency light 一应俱全的防洪设施 So you gamble on oil stocks, knowing you'll be all right mate 所以你继续哄炒着燃油股票，明白自己的生活不坏 And this is how some people face their climate fate 这也是有些人面对的气候带来的命运
Thursday, October 6, 2016
Health (Abortion Law Reform) Amendment Bill
The Queensland Health,
Communities, Disability Services and Domestic and Family Violence
Prevention Committee has been tasked with looking into the Health (Abortion Law Reform) Amendment Bill, put to Qld parliament in August 2016 by MP Rob Pyne. It's a private member's bill, and can be found at. It followed his introduction of a simple bill to decriminalise abortion, which the committee recommended against passing alone.
A summary of the second bill from the committee's website shows it includes provisions to legislate that:
Below is the submission I made (half at the deadline, and half, just afterwards in the hope that it would be considered).
Submission to the Queensland Health, Communities, Disability Services and Domestic and Family Violence Prevention Committee regarding the Health (Abortion Law Reform) Amendment Bill
A summary of the second bill from the committee's website shows it includes provisions to legislate that:
-
only a doctor may perform an abortion: a person who is not a doctor (or a registered nurse administering a drug to perform an abortion under the direction of a doctor) would commit an offence.
-
a woman does not commit an offence by performing, consenting to or assisting in an abortion on herself
-
an abortion on a woman who is more than 24 weeks pregnant may be performed only if two doctors reasonably believe the continuation of the woman’s pregnancy would involve greater risk of injury to the physical or mental health of the woman than if the pregnancy were terminated
-
conscientious objection: no-one is under a duty to perform or assist in performing an abortion; however a doctor has a duty to perform an abortion if it is necessary to save a woman’s life or prevent serious physical injury. Also, a registered nurse has a duty to assist in such circumstances.
-
patient protection or ‘safe zones’: a protected zone of at least 50 metres must be declared around an abortion facility; certain behaviour, e.g. harassment and intimidation, is prohibited within a protected zone. Publishing images of a person entering, leaving or trying to enter or leave an abortion facility is prohibited.
Below is the submission I made (half at the deadline, and half, just afterwards in the hope that it would be considered).
Submission to the Queensland Health, Communities, Disability Services and Domestic and Family Violence Prevention Committee regarding the Health (Abortion Law Reform) Amendment Bill
Dear committee members,
I am writing as a woman who grew up on
the Sunshine, Gold and Tweed Coasts, and as a doctor who has worked
as a junior doctor in obstetrics, gynaecology and paediatric
emergency, and as a general practitioner with over 20 years'
experience working in women's health, sexual health, family planning
and abortion services, in NSW, Tasmania and Western Australia.
I did not make a submission to the
committee regarding the associated Abortion
Law Reform (Woman's Right to Choose) Amendment Bill. However,
I read the committee's report with interest and was disappointed with
the decision not to recommend immediate passage of the bill to
decriminalise abortion.
My
daughter and I will be moving to Queensland next year, and these two
bills, important for all Queensland women of reproductive age, will
have a bearing on us, on my patients and on my medical practice.
Like
so many who gave written and oral presentations to the committee, I
am in favour of immediate complete decriminalisation of abortion.
I am
writing this submission to give qualified support to the passage
of the Health (Abortion Law
Reform) Amendment Bill 2016, only in conjunction with
passage of the Abortion Law
Reform (Woman's Right to Choose) Amendment Bill.
I
believe this bill is too
restrictive, however, I believe that on balance it would be better to
be passed (in conjunction with passage of the Abortion Law Reform
(Woman's Right to Choose) Amendment Bill), rather than having the
Abortion Law Reform (Woman's Right to Choose) Amendment Bill not pass
at all. I believe this bill makes substantial concessions to
alleviate concerns raised in the committee's report,
and should be seen as an attempt to introduce legal reform that will
be generally workable, introducing legal protection for Queensland
women seeking abortion and for health care professionals providing
abortion-related services to women in good faith.
I
would like to address each of the key elements of the bill in turn.
Only
qualified health practitioner may perform abortion
This
section of the legislation must be understood to be intended to
protect women from unsafe procedures, and
as such, is laudable.
Read
in conjunction with the conscientious refusal provision, however,
this section restricts abortion provision (apart from medication
administration) to doctors only,
while allowing doctors to refuse to perform a
service that a substantial number of women in Queensland require
(whatever figures we rely on for that estimate).
Experience
from abroad indicates that first trimester aspiration abortion can
safely be performed by appropriately
trained nurse practitioners, physician assistants and nurse
midwives1.
Although I am not aware of any jurisdiction in Australia where first
trimester aspiration abortion is carried out by nurse practitioners
or nurse midwives, there is no reason why, if proper training were
introduced for willing clinicians, such an initiative should be ruled
out in Queensland
by a ban with a ten-year imprisonment penalty. Many
women in remote and regional centres are unable to access first
trimester abortion close to home. A
new law shouldn't make it
impossible to implement an
initiative to reduce the
number of late abortions by improving access to early abortions.
It
has taken over a hundred years of the operation of criminal law
restricting abortion for abortion law to be seriously revisited in
Queensland. Medical, nursing and midwifery practice is continually
evolving. It makes most sense for regulation of who can perform
abortion, to ensure public safety, to be overseen by the medical and
nursing/midwifery boards and by existing general laws restricting
health care
practice to only those who are properly qualified.
It
would be preferable for this section to be
amended to include reference to other appropriately trained
clinicians, or to be omitted
altogether, on the understanding that Queensland
already has effective laws
prohibiting untrained people from providing
health care for which they
have not undergone proper training.
Those
objections notwithstanding, if this section is passed as it is, it
would not restrict existing practice and would provide legal
protection to doctors and nurses currently providing abortion-related
services. If it's the best that can be achieved, I support it.
Abortion
on woman more than 24 weeks pregnant
The
notion that decriminalising
abortion without restriction as to reason and gestation
will result in a rash of third trimester abortions overtaking
Queensland is an invention of those who are opposed to abortion on
non-scientific grounds.
The
experience of the ACT, where there is no gestation limit in law bears
this out. The only free-standing clinic where abortion is available
in the ACT provides procedures under 16 weeks' gestation only.2
In
Canada, where there is also no legal gestation on abortion, it is
estimated that abortion after 20 weeks makes up 0.86%
of all abortion.3
The
vast majority of pregnant
women seeking abortion do so as early as they can. Reasons
for presenting late for termination have been explored in the medical
literature and may be complicated. They represent a tiny
minority of abortions, but
the women undergoing abortion late are no less competent to make
decisions about their pregnancies than women requiring abortion who
are able to present for medical care early. Late abortion is
generally harder for women to undergo and clinicians to perform;
no-one directly involved in the decision-making process does so
lightly. There is no need for the additional restriction of law, in
the way of restrictions as to reason beyond 24 weeks' gestation. If a
woman 24 weeks pregnant or later determines that she requires an
abortion – whether because in the opinion of her doctors it is
necessary for her physical or mental health – or whether she
determines it is in the best interest of the foetus, or for some
other reason or set of reasons – there shouldn't be a legal
restriction preventing her doctors from performing it for her.
As
with the previous section, if the law will only be passed with this
proviso, it is better than not decriminalising abortion. However, it
represents an unnecessary interference in a woman's right to decide
how and whether to proceed with her own pregnancy.
Patient protection
I support this section of the bill. I
believe the protection zone should be greater, probably 150m, in
keeping with the ACT legislation.
Protesting and expressing minority
views about the morality of abortion can have a place in a democracy,
but there is no absolute right to such political communication that
outweighs women's right to privacy in seeking medical care. I have
witnessed the impact of distressing, hostile protest actions outside
abortion facilities on women seeking care and am in favour of
measures to prevent harassment of patients and staff.
Duty of care
Most health professional codes of
conduct recognise a right to conscientious refusal of care. The
impact of this on restricting reproductive health care is not well
documented, though an attempt to begin this work has been
undertaken.4
What is important to note is that in
general, where a right to refusal of care is acknowledged, it is not
considered to outweigh the right of women to access needed
healthcare. This generally includes an obligation of practitioners
refusing to perform abortion to refer women to others who will
provide services.
Again, it seems to me unnecessary to
include this assertion of the right to refuse care in the law when it
is already accepted in practice, but particularly without the
inclusion of the complementary obligation to refer to a practitioner
who will provide care. As I outlined in the section on who can
perform abortion, when only doctors may lawfully perform or prescribe
abortion medication, but they may refuse, if this is not combined
with a safeguard obliging referral to a practitioner who will provide
services, it could operate as a practical barrier to access.
In Western Australia where I currently
practice, and where there is a restriction requiring a woman seeking
abortion to be given information by a doctor not participating in the
abortion, it is not unusual for women to see more than one
practitioner; I have had patients who've needed to see 3, 4, even 5
doctors before being appropriately assisted to obtain an abortion.
This clearly results in delay and later procedures. It is not known
whether it ever results in women being unable to obtain abortion at
all, but this possibility can't be discounted. I am concerned that
the uneven emphasis on the right to conscientious refusal of care in
the bill, if not balanced with the internationally recognised
obligation to refer to a practitioner who will provide care, will
result in unnecessary and unfair difficulties for women seeking
abortion services, depending on the availability of clinicians who
support women's access to the full range of reproductive healthcare
services.
These are the concerns I have about the
Health (Abortion Law Reform) Amendment Bill. I believe the bill
should only be passed in conjunction with the passage of the bill to
decriminalise abortion, that its provisions don't represent the best
for the women of Queensland, but that they should be supported as
concessions to enable recommendation of decriminalisation of
abortion, which would certainly be a step towards the 21st
century.
1
Safety
of Aspiration Abortion Performed by Nurse Practitioners, Certified
Nurse Midwives, and Physician Assistants Under a California Legal
Waiver
Tracy A. Weitz, Diana Taylor, Sheila
Desai, Ushma D. Upadhyay, Jeff Waldman, Molly F. Battistelli, and
Eleanor A. Drey. American Journal of Public Health 2013 103, 3,
454-461
2http://www.shfpact.org.au/sexual-health/pregnancy-options
accessed 6/10/2016
3http://www.arcc-cdac.ca/backrounders/statistics-abortion-in-canada.pdf
accessed 6/10/2016
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