Intellectual property law has influenced pharmaceutical development and marketing for at least 25 years ago. But it’s not clear whether this is actually the best model for stimulating innovation and addressing the most important global health problems. Closer to home, we also discuss a solution to the jurisdictional conflicts in responding to the pandemic.

The COVID-19 pandemic has stimulated a frenzy of vaccine development never seen before, but also examples of hoarding, price hikes and vaccine nationalism. We discuss where the intellectual property rules have come from and where exceptions are sometimes made for public health emergencies.

During the COVID-19 crisis there has been some criticism of the World Health Organisation as to whether it declared a pandemic soon enough or covered up for China’s failings. In this podcast we examine the role and responsibilities it shares with its member states and where the straining points have been.

Two more case studies from the Essential Ethics podcast tackling the question of when refusal of treatment should or shouldn’t be accepted by a medical team, and how much autonomy does an adolescent have. Featuring clinicians from the oncology department at the Royal Children’s Hospital, Melbourne.

Delirium can be precipirated by a host of environmental triggers that are highly modifiable. Anything that contributes to a person’s disorientation and discomfort can increase the likelihood of a delirium episode. While a lot of these factors are compounded in elderly and frail patients, delirium can be reversed in a majority of patients by non-pharmacological means.

Delirium is an acute disturbance of consciousness, attention, cognition or perception. It’s associated with an increased risk of falls, dementia and high dependency care, and all of this adds up to higher mortality. About a third of patients admitted to ICU or approaching the end of life, experience delirium. But it’s notoriously underdiagnosed, so in this episode we talk about the presentations and detection of delirium. We also go through some of the medical and iatrogenic risk factors.

When can a child be said to have cognitive capacity and bodily autonomy? For those who don’t, where does the guardianship of the parent to give way to that of the medical professionals? These questions and more are discussed in two case studies from the Essential Ethics podcast, produced within the Children's Bioethics Centre in Melbourne.

Almost 500 million Medicare rebates are processed every year and for the most part these are claimed appropriately. But non-compliant billing could be costing the health system over 2 billion dollars annually. The vast majority of this comes down to lack of education about the MBS. Department of Health has an elaborate, and sometimes controversial way of identifying misuse of the system. Government regulation also influences the market for private medical fees as does supply and demand of certain specialties.

COVID-19 has disrupted delivery of routine healthcare in many ways. Consulting patients by video or phone can be a way to keep patients safe, but many doctors are nervous as they adopt it for the first time. In this podcast we go over some of the bureaucratic and tech support questions that clinicians have been asking during the current crisis. We also discuss the art of building trust with new patients, and conducting a physical examination through telehealth.

Australia has one of the best value health systems in the world, but also some of the most complicated health regulation that ties together public and private payers. This creates some traps for well-intentioned providers and loopholes for the less well-intentioned.