Academic literature on the topic 'Aboriginal Australians – Treaties'

While it is clear that international treaties become part of Australian domestic law only once implemented by domestic legislation, it is less certain whether implementing legislation is required to incorporate customary international law into Australian law. This question is assuming a new importance as international law moves beyond dealing simply with relationships between sovereign nations to protecting the human rights of groups and individuals within states. Since the arrival of Europeans, indigenous Australians have witnessed enormous violations of their human rights. InNulyarimmav.Thompson, members of the Aboriginal community alleged that certain Commonwealth Ministers and Members of Parliament had committed genocide, and sought various remedies. Since Australia has not implemented the Convention on the Prevention and Punishment of the Crime of Genocide by legislation, the case squarely raised the issue of whether customary international law, and in particular international criminal law, could become part of Australian law without the assistance of Parliament.

Murri Courts are a specialist criminal law practice that includes Elders and respected persons of the local Community Justice Group in the sentencing of Aboriginal and Torres Strait Islander defendants. Drawing on an ethnographic study of two southeast Queensland Murri Courts, this article explores the impact of State ordered out-of-home care on Aboriginal and Torres Strait Islander defendants and their children. We show how Community Justice Groups and specialist courts help to address the intergenerational impacts of child protection interventions. The rights of Australian Indigenous peoples to enjoy, maintain, control, protect and develop their kinship ties is recognised under the Human Rights Act 2019 (Qld) and international human rights treaties. We suggest that policymakers and legislators should better recognise and support Community Justice Groups and specialist courts as they provide an important avenue for implementing the rights of Australian Indigenous peoples to recover and maintain their kinship ties.

This prospective study was designed to describe problems that arise when Aboriginal people undergo anaesthesia, in order to develop guidelines for anaesthetists who are not accustomed to treating Aboriginal people. Data were collected on 1122 consecutive different individuals undergoing anaesthesia at Royal Darwin Hospital, 24.5% of whom described themselves as Aboriginal. Aboriginal patients were in a poorer physiological state than were non-Aboriginal patients. The prevalence of diabetes mellitus, renal disease and rheumatic heart disease reported in Aboriginal patients was very high. Communication difficulties were more commonly reported in Aboriginal patients; the most common difficulty was apparent shyness or fear, rather than actual language difficulty. The results suggest that the treatment of Aboriginal people involves diagnosis and management of diverse pre-operative medical problems, and that better management may be achieved by learning simple cultural strategies and by adding Aboriginal interpreters and health workers to the anaesthetic team.

From every State and Territory of Australia, including the islands of the Torres Strait over 200 delegates gathered at the 2017 First Nations National Constitutional Convention in Uluru, which has stood on Anangu Pitjantjatjara country in the Northern Territory since time immemorial, to discuss the issue of constitutional recognition. Delegates agreed that tokenistic recognition would not be enough, and that recognition bearing legal substance must stand, with the possibility to make multiple treaties between Aboriginal peoples and Torres Strait Islanders and the Commonwealth Government of Australia. In this paper, we look at the roadmap beyond such a potential change. We make the case for a redistributive approach to capital, and propose key outcomes for social reconstruction, should a voice to parliament, a Makarrata[1] Commission and multiple treaties be enabled through a successful referendum. We conclude that an alteration of the Commonwealth Constitution (Cth) is the preliminary overture of a suite of changes: the constitutional change itself is not the end of the road, but simply the beginning of years of legal change, which seeks provide a socio-economic future for Australia’s First Peoples, and the oldest continuing cultures in the world. Constitutional change seeks to transform the discourse about Aboriginal and Torres Strait Islander relations with the Australian state from one centred on distributive justice to one that is primarily informed by retributive justice. This paper concerns the future generations of Aboriginal and Torres Strait Islander children, and their right to labour in a market that honours their cultural contributions to humanity at large. [1] Yolŋu ceremony for coming together after a struggle.

Background Crusted scabies is a debilitating dermatological condition. Although still relatively rare in the urban areas of Australia, rates of crusted scabies in remote Aboriginal communities in the Northern Territory (NT) are reported to be among the highest in the world. Objective To estimate the health system costs associated with diagnosing, treating and managing crusted scabies. Methods A disease pathway model was developed to identify the major phases of managing crusted scabies. In recognition of the higher resource use required to treat more severe cases, the pathway differentiates between crusted scabies severity grades. The disease pathway model was populated with data from a clinical audit of 42 crusted scabies patients diagnosed in the Top-End of Australia’s Northern Territory between July 1, 2016 and May 1, 2018. These data were combined with standard Australian unit costs to calculate the expected costs per patient over a 12-month period, as well as the overall population cost for treating crusted scabies. Findings The expected health care cost per patient diagnosed with crusted scabies is $35,418 Australian dollars (AUD) (95% CI: $27,000 to $43,800), resulting in an overall cost of $1,558,392AUD (95% CI: $1,188,000 to $1,927,200) for managing all patients diagnosed in the Northern Territory in a given year (2018). By far, the biggest component of the health care costs falls on the hospital system. Discussion This is the first cost-of-illness analysis for treating crusted scabies. Such analysis will be of value to policy makers and researchers by informing future evaluations of crusted scabies prevention programs and resource allocation decisions. Further research is needed on the wider costs of crusted scabies including non-financial impacts such as the loss in quality of life as well as the burden of care and loss of well-being for patients, families and communities.

AbstractColonisation and subsequent policies targeting Aboriginal peoples in Australia have had devastating consequences, including trauma, disadvantage and marginalisation. These effects have passed from generation to generation and continue to manifest in poor health and well-being outcomes, particularly mental health disorders. Innovative and culturally relevant techniques are needed to remedy inequality and address intergenerational trauma. Equine-assisted psychotherapy (EAP)—an experiential therapy involving horses—is a new and increasingly evidence-based treatment approach, which offers potential for working with Aboriginal peoples. This article reviews the literature on outcomes of EAP to consider its potential as a culturally responsive therapy to treat trauma and increase well-being for Aboriginal people in Australia.

Communitarianism acknowledges and values, and not just instrumentally, the bonds that unite and identify communities. Communitarians also value community per se. This paper argues that trust is likely to be stronger in communities where these bonds are greater. Equity in health care is a social phenomenon. In health care, it is apparent that more communitarian societies, such as Scandinavia and within Aboriginal Australia, are likely to value more equity-orientated systems. Where, as in the latter case, this desire for equity takes place against a background of the powerful dominant (white) society treating the minority (black) society as dependent, Aboriginal trust in Australian society and in its public institutions is eroded. Lack of trust and inequity then come to the fore. This paper discusses institutional trust as a facilitator of equity in health care in the specific context of Indigenous health. The example used is Australian Aboriginal health but the principles would apply to other Indigenous populations as in for example South America.

Objective: To report on Aboriginal and Torres Strait Islander (Indigenous) users of MindSpot, a national service for the remote assessment and treatment of anxiety and depression. Methods: The characteristics and treatment outcomes of Indigenous patients who registered with MindSpot between January 2015 and December 2016, were compared with non-Indigenous users. Changes in psychological distress, depression and anxiety were measured using the Kessler 10-Item (K-10), Patient Health Questionnaire 9-Item (PHQ-9), and Generalised Anxiety Disorder Scale 7-Item (GAD-7), respectively. Results: Of 23,235 people who completed a MindSpot assessment between 1 January 2015 and 31 December 2016, 780 (3.4%) identified as Indigenous Australian. They had higher symptom scores, were more likely to live in a remote location, and a third reported no previous contact with mental health services. Fewer Indigenous patients enrolled in a treatment course, but those who did had similar rates of completion and similar reductions in symptoms to non-Indigenous patients. Conclusions: MindSpot treatments were effective in treating anxiety and depression in Indigenous Australians, and outcomes were similar to those of non-Indigenous patients. Services like MindSpot are a treatment option that can help overcome barriers to mental health care for Indigenous Australians.

A commitment in applied anthropological policy work to maximising cultural appropriateness or even to supporting what indigenous people say they want is not always possible. This proved to be the case in connection with formulating recommendations for land rights legislation in Australia's Northern Territory. Until 1992 the only rights in land that Aboriginal people had as the original occupiers of the continent were statutory (that is, through acts of state and federal parliaments). No treaties were signed with Aboriginal people and until that date the continent was treated as terra nullius, unowned, at the time of colonisation in 1788. From early on in the history of European colonisation, however, areas of land had been set aside for the use and benefit of Aboriginal people. These reserves were held by the government, or by one of a number of religious bodies that ministered to Aboriginal people, usually supported by government funding. Beginning with South Australia in 1966 all of the states, except Tasmania, have passed legislation that gives varying degrees of control of these reserves to land trusts governed by Aboriginal people. Each of these pieces of legislation had/have different shortcomings which included some or all of the following: the total area that had been reserved was small; the powers granted over the land were limited; the majority of the Aboriginal population did not benefit from the legislation; and none of them addressed the issue of self-determination. In 1973 a Royal Commission into Aboriginal Land Rights, with a single Commissioner, Mr. Justice Woodward, was established by the newly elected Federal Labor government, the first in 23 years. It was planned that it would deal with the continent but that it would begin by focusing on the Northern Territory which until 1978 was administered by the Federal government. At the time there were 25,300 Aboriginal people in the Territory making up 25% of the population.

This article provides a summary of the evolving definition of trauma, including different forms of trauma and its impact on the health, behaviours and well-being of individuals and communities. Specifically, it discusses collective, historical and intergenerational trauma and the value of these concepts in understanding the health and social challenges we see within colonized Indigenous communities, particularly within Australian Aboriginal communities. The article argues that the current approach to addressing challenges within Australian Indigenous communities will have limited impact unless accompanied by a significant focus on understanding and addressing the level of trauma that permeates these communities. Programmes and initiatives that focus on reducing the rates of certain variables, such as rates of infant mortality, rates of incarceration or rates of school completion, are very important but are only treating symptoms unless the underlying trauma is addressed. Due to the ongoing devastation caused by many years of forced child removal, this is especially important for health, legal and welfare practitioners within the child protection system and the social work field if we are to break the cycles of family and cultural disruption.

This thesis investigates the search for new relationships between indigenous and settler peoples in Australia and Canada. Both reconciliation and the treaty-making process in British Columbia are understood as attempts to build such relationships. Yetthese are policies that have arisen in response to the persistence of indigenous claims for recognition of rights and respect for identity. Consequently, I consider what the purpose of new relationships might be: is the creation of new relationships to be the means by which settlers recognise and respect indigenous rights and identities, or is there some other goal? To answer this, I analyse the two policies as the opening of negotiations over indigenous claims for recognition. That is, the opening of new political spaces in which indigenous people�s voices and claims may be heard. Reconciliation opened a space to rethink Australian attitudes to history and culture, to renegotiate Australian identity. Treaties in British Columbia primarily seek to renegotiate ownership and control of lands and resources. Both policies attempt to relegitimise the polities in which they operate, by making new relationships that provide for mutual recognition. However, the thesis establishes that these new spaces are not nearly as expansive or inclusive as they are made out to be. They are in fact defined by the internal struggles of settler society to make life more certain: to resume identities that are secure and satisfying, and to restore territorial control and economic security. This takes place with little regard for the legitimate claims of indigenous peoples to be recognised as people and to enjoy dynamic, flourishing identities of their own. Building new relationships becomes the path to entrenching old certainties.

The topic of this thesis is the prolonged denial and eventual recognition of the rights of the Indigenous peoples of Australia following the British assertion of sovereignty. The analysis considers the manner in which the denial and subsequent recognition of Indigenous rights has affected the system of government of the dominant society (the Commonwealth of Australia) in terms of the establishment and evolution of the constitutional framework and associated processes of institutional change in the principles, structures and procedures of the system of government. The primary jurisdiction in which this topic is explored is the Northern Territory of Australia; the primary contexts are the recognition of Indigenous land rights (defined broadly to include associated natural and cultural heritage and resource rights) and the Indigenous right to self government within ‘the state’ (the internationally constituted and recognised polity of the Commonwealth of Australia).
The thesis draws on analogous developments in Canada and New Zealand to demonstrate that, while significant progress has been made in the recognition of Indigenous rights since the 1960s, many forms of recognition remain conceptually and procedurally limited. In particular, associated regimes have almost invariably been devised and implemented within a fundamentally monocultural context in which Indigenous rights remain subject to unilateral abrogation or extinguishment by Commonwealth governments. In addition, the legal basis of and requirements for recognition of Indigenous rights according to Commonwealth law result in extremely variable levels of recognition in different areas and contexts, and principles and procedures for the mutual recognition and co-existence of Indigenous and Commonwealth law and systems of government are only partially apparent in the Federal and Northern Territory systems of government. In addition to extending and deepening the recognition of Indigenous rights throughout all relevant institutions of the system of government, to address these deficiencies the thesis argues that constitutional recognition and protection of Indigenous rights and the negotiation of treaties are essential if the Indigenous right of self-determination is to be respected and accommodated by the dominant society.

The continent nominated by Westerners “Terra Australis Incognita” was land occupied for tens of thousands of years; home to peoples whose surviving descendants, the Aboriginal and Torres Strait Islander people, could claim to have sustained the world's oldest culture. The colonists occupying the territory, however, declared it “terra nullius,” a land with no recognized claim. The colonial attitude to Indigenous culture was similar, treating it as “Intellectual nullius.” From the colonial occupation to the 1980s became the “Dark Ages for Indigenous Knowledge,” in which the trans-generational capability, engaged in Western knowledge, was rare. In this chapter, this history is revisited on a path to current contributions of the Black Academy to higher education. These are advanced here as: an Indigenous perspective; an oppositional approach; integrative Indigenous knowledge; contemporary Indigenous knowledge; and pure Indigenous knowledge. Reflecting on the research paradigm involved, emerging contributions of the Black Academy represent a supercomplex renaissance.

Geelong and the Surf Coast are treated here as one entity although there are marked differences between the two communities. Sitting on the home of the Wathaurong Aboriginal group, this G21 region is geographically diverse. Geelong serviced a wool industry on its western plains, while manufacturing and its seaport past has left it as a post-industrial city. The Surf Coast has benefitted from the sea change phenomenon. Both communities have fast growing populations and have benefitted from their proximity to Melbourne. They are deeply integrated with this major urban centre. The early establishment of digital infrastructure proved an advantage to certain sectors. All creative industries are represented well in Geelong while many creatives in Torquay are embedded in the high profile and economically dominant surfing industry. The Geelong community is serviced well by its own creative industries with well-established advertising firms, architects, bookshops, gaming arcades, movie houses, music venues, newspaper headquarters, brand new and iconic performing and visual arts centres, libraries and museums, television and radio all accessible in its refurbished downtown area. Co-working spaces, collective practices and entrepreneurial activity are evident throughout the region.

Background Lung cancer is the number one cause of cancer death worldwide.(1) It is the fifth most commonly diagnosed cancer in Australia (12,741 cases diagnosed in 2018) and the leading cause of cancer death.(2) The number of years of potential life lost to lung cancer in Australia is estimated to be 58,450, similar to that of colorectal and breast cancer combined.(3) While tobacco control strategies are most effective for disease prevention in the general population, early detection via low dose computed tomography (LDCT) screening in high-risk populations is a viable option for detecting asymptomatic disease in current (13%) and former (24%) Australian smokers.(4) The purpose of this Evidence Check review is to identify and analyse existing and emerging evidence for LDCT lung cancer screening in high-risk individuals to guide future program and policy planning. Evidence Check questions This review aimed to address the following questions: 1. What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? 2. What is the evidence of potential harms from lung cancer screening for higher-risk individuals? 3. What are the main components of recent major lung cancer screening programs or trials? 4. What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Summary of methods The authors searched the peer-reviewed literature across three databases (MEDLINE, PsycINFO and Embase) for existing systematic reviews and original studies published between 1 January 2009 and 8 August 2019. Fifteen systematic reviews (of which 8 were contemporary) and 64 original publications met the inclusion criteria set across the four questions. Key findings Question 1: What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? There is sufficient evidence from systematic reviews and meta-analyses of combined (pooled) data from screening trials (of high-risk individuals) to indicate that LDCT examination is clinically effective in reducing lung cancer mortality. In 2011, the landmark National Lung Cancer Screening Trial (NLST, a large-scale randomised controlled trial [RCT] conducted in the US) reported a 20% (95% CI 6.8% – 26.7%; P=0.004) relative reduction in mortality among long-term heavy smokers over three rounds of annual screening. High-risk eligibility criteria was defined as people aged 55–74 years with a smoking history of ≥30 pack-years (years in which a smoker has consumed 20-plus cigarettes each day) and, for former smokers, ≥30 pack-years and have quit within the past 15 years.(5) All-cause mortality was reduced by 6.7% (95% CI, 1.2% – 13.6%; P=0.02). Initial data from the second landmark RCT, the NEderlands-Leuvens Longkanker Screenings ONderzoek (known as the NELSON trial), have found an even greater reduction of 26% (95% CI, 9% – 41%) in lung cancer mortality, with full trial results yet to be published.(6, 7) Pooled analyses, including several smaller-scale European LDCT screening trials insufficiently powered in their own right, collectively demonstrate a statistically significant reduction in lung cancer mortality (RR 0.82, 95% CI 0.73–0.91).(8) Despite the reduction in all-cause mortality found in the NLST, pooled analyses of seven trials found no statistically significant difference in all-cause mortality (RR 0.95, 95% CI 0.90–1.00).(8) However, cancer-specific mortality is currently the most relevant outcome in cancer screening trials. These seven trials demonstrated a significantly greater proportion of early stage cancers in LDCT groups compared with controls (RR 2.08, 95% CI 1.43–3.03). Thus, when considering results across mortality outcomes and early stage cancers diagnosed, LDCT screening is considered to be clinically effective. Question 2: What is the evidence of potential harms from lung cancer screening for higher-risk individuals? The harms of LDCT lung cancer screening include false positive tests and the consequences of unnecessary invasive follow-up procedures for conditions that are eventually diagnosed as benign. While LDCT screening leads to an increased frequency of invasive procedures, it does not result in greater mortality soon after an invasive procedure (in trial settings when compared with the control arm).(8) Overdiagnosis, exposure to radiation, psychological distress and an impact on quality of life are other known harms. Systematic review evidence indicates the benefits of LDCT screening are likely to outweigh the harms. The potential harms are likely to be reduced as refinements are made to LDCT screening protocols through: i) the application of risk predication models (e.g. the PLCOm2012), which enable a more accurate selection of the high-risk population through the use of specific criteria (beyond age and smoking history); ii) the use of nodule management algorithms (e.g. Lung-RADS, PanCan), which assist in the diagnostic evaluation of screen-detected nodules and cancers (e.g. more precise volumetric assessment of nodules); and, iii) more judicious selection of patients for invasive procedures. Recent evidence suggests a positive LDCT result may transiently increase psychological distress but does not have long-term adverse effects on psychological distress or health-related quality of life (HRQoL). With regards to smoking cessation, there is no evidence to suggest screening participation invokes a false sense of assurance in smokers, nor a reduction in motivation to quit. The NELSON and Danish trials found no difference in smoking cessation rates between LDCT screening and control groups. Higher net cessation rates, compared with general population, suggest those who participate in screening trials may already be motivated to quit. Question 3: What are the main components of recent major lung cancer screening programs or trials? There are no systematic reviews that capture the main components of recent major lung cancer screening trials and programs. We extracted evidence from original studies and clinical guidance documents and organised this into key groups to form a concise set of components for potential implementation of a national lung cancer screening program in Australia: 1. Identifying the high-risk population: recruitment, eligibility, selection and referral 2. Educating the public, people at high risk and healthcare providers; this includes creating awareness of lung cancer, the benefits and harms of LDCT screening, and shared decision-making 3. Components necessary for health services to deliver a screening program: a. Planning phase: e.g. human resources to coordinate the program, electronic data systems that integrate medical records information and link to an established national registry b. Implementation phase: e.g. human and technological resources required to conduct LDCT examinations, interpretation of reports and communication of results to participants c. Monitoring and evaluation phase: e.g. monitoring outcomes across patients, radiological reporting, compliance with established standards and a quality assurance program 4. Data reporting and research, e.g. audit and feedback to multidisciplinary teams, reporting outcomes to enhance international research into LDCT screening 5. Incorporation of smoking cessation interventions, e.g. specific programs designed for LDCT screening or referral to existing community or hospital-based services that deliver cessation interventions. Most original studies are single-institution evaluations that contain descriptive data about the processes required to establish and implement a high-risk population-based screening program. Across all studies there is a consistent message as to the challenges and complexities of establishing LDCT screening programs to attract people at high risk who will receive the greatest benefits from participation. With regards to smoking cessation, evidence from one systematic review indicates the optimal strategy for incorporating smoking cessation interventions into a LDCT screening program is unclear. There is widespread agreement that LDCT screening attendance presents a ‘teachable moment’ for cessation advice, especially among those people who receive a positive scan result. Smoking cessation is an area of significant research investment; for instance, eight US-based clinical trials are now underway that aim to address how best to design and deliver cessation programs within large-scale LDCT screening programs.(9) Question 4: What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Assessing the value or cost-effectiveness of LDCT screening involves a complex interplay of factors including data on effectiveness and costs, and institutional context. A key input is data about the effectiveness of potential and current screening programs with respect to case detection, and the likely outcomes of treating those cases sooner (in the presence of LDCT screening) as opposed to later (in the absence of LDCT screening). Evidence about the cost-effectiveness of LDCT screening programs has been summarised in two systematic reviews. We identified a further 13 studies—five modelling studies, one discrete choice experiment and seven articles—that used a variety of methods to assess cost-effectiveness. Three modelling studies indicated LDCT screening was cost-effective in the settings of the US and Europe. Two studies—one from Australia and one from New Zealand—reported LDCT screening would not be cost-effective using NLST-like protocols. We anticipate that, following the full publication of the NELSON trial, cost-effectiveness studies will likely be updated with new data that reduce uncertainty about factors that influence modelling outcomes, including the findings of indeterminate nodules. Gaps in the evidence There is a large and accessible body of evidence as to the effectiveness (Q1) and harms (Q2) of LDCT screening for lung cancer. Nevertheless, there are significant gaps in the evidence about the program components that are required to implement an effective LDCT screening program (Q3). Questions about LDCT screening acceptability and feasibility were not explicitly included in the scope. However, as the evidence is based primarily on US programs and UK pilot studies, the relevance to the local setting requires careful consideration. The Queensland Lung Cancer Screening Study provides feasibility data about clinical aspects of LDCT screening but little about program design. The International Lung Screening Trial is still in the recruitment phase and findings are not yet available for inclusion in this Evidence Check. The Australian Population Based Screening Framework was developed to “inform decision-makers on the key issues to be considered when assessing potential screening programs in Australia”.(10) As the Framework is specific to population-based, rather than high-risk, screening programs, there is a lack of clarity about transferability of criteria. However, the Framework criteria do stipulate that a screening program must be acceptable to “important subgroups such as target participants who are from culturally and linguistically diverse backgrounds, Aboriginal and Torres Strait Islander people, people from disadvantaged groups and people with a disability”.(10) An extensive search of the literature highlighted that there is very little information about the acceptability of LDCT screening to these population groups in Australia. Yet they are part of the high-risk population.(10) There are also considerable gaps in the evidence about the cost-effectiveness of LDCT screening in different settings, including Australia. The evidence base in this area is rapidly evolving and is likely to include new data from the NELSON trial and incorporate data about the costs of targeted- and immuno-therapies as these treatments become more widely available in Australia.