Cartwright

An 'unfortunate experiment' at National Women's

In 1987, Women's Health Action founders Sandra Coney and Phillida Bunkle, published an article called An 'unfortunate experiment' at National Women's in the monthly Metro magazine (Part 1 and Part 2). The article outlined an unethical study at the country's premier women's hospital. The study, started in 1966, involved following women with major cervical abnormalities without definitively treating them. By 1987 many had developed cervical cancer and some had died.

The revelations led to a Committee of Inquiry, named the Cartwright Inquiry after the presiding judge, Judge Dame Silvia Cartwright (New Zealand's Governor General 2001-2006). Her report (1988) was a blueprint for patients' rights in New Zealand and also recommended a National Cervical Screening Programme.

 

Cartwright Inquiry




'Cartwright comes of age?' Seminar

Full seminar report coming soon


'The foundations of Cartwright': then and now

The morning session of the seminar reassessed how the underlying principles of Cartwright are working now in the context of significant health-related issues: the exercise and enjoyment of health and disability services consumer rights, privacy of health information, and the fate of informed choice and consent in population health programmes.  The morning consisted of four keynote addresses from Health and Disability Commissioner Ron Paterson, Professor Kevin Dew, Assistant Privacy Commissioner Katrine Evans, and Women's Health Action founder and former health activist Sandra Coney.

'Consumer rights - have we come of age?'

Health and Disability Commissioner Ron Paterson explored the tensions between rhetoric and reality in the exercise, enjoyment and defense of health and disability services consumer rights.  Paterson contends that much has been achieved with the HDC and Advocacy processes working well; greater awareness of patients medical, cultural and family needs; improved communication between doctors and patients; and broader recognition of the need for informed consent.  However Paterson also identified unrealized hopes under the current New Zealand system including on-going issues with access to services; and a lack of evidence that overall patient and provider satisfaction with the health system has improved.  Ultimately Paterson believes that there is still a long way to go to achieve patient-centered, safe care as the universal norm.

'From informed consent to informed compliance?'

Population health and the culture of informed consent

Professor Kevin Dew from the School of Social and Cultural Studies at Victoria University explored the fate of informed choice and consent in the context of public health interventions such as childhood immunization programmes.   Dew explored the tension between the ideology of public health which is focused on the universal uptake of interventions with the goal of disease prevention; and the notion that individuals have a right to make informed choices about these interventions.  Dew demonstrated the ways in which public health knowledges become authoritative through appeals to "scientific rationality", "moral duty" and "public good".  Dew also demonstrated how those who do not comply with public health programmes are constructed as "irrational" and as "risky citizens".

Powerpoint presentation and written paper

'Privacy and public good?'

The future of health information

Assistant Privacy Commissioner Katrine Evans explored the tension between the right to privacy and public good in an age of shared electronic health records (EHR).  Evans outlined some of the benefits for health consumers of electronic health records including increased ability to audit; increased transparency; and increased accuracy.  She argued, though, that we cannot afford to ignore the potential risks of EHR which include privacy and security of personal health information; accidental loss of records; that it will become easier to silently collect information; and the ability to interface with other system eg. Insurers.  Evans argued for the need to recognize privacy as a major public good not just an individual right.  We need to ensure that privacy is factored in from the start of decision-making.  "Privacy by design," will help to achieve the benefits of EHR in a privacy-friendly way.

Powerpoint presentation