Ideas@TheCentre

Ideas@TheCentre brings you ammunition for conversations around the table.  3 short articles from CIS researchers emailed every Friday on the issues of the week.

Year 12 exams must go ahead

Blaise Joseph

09 April 2020 | Ideas@TheCentre

Keep calm and carry on. That should be the clear, consistent message we give Year 12 students at the moment.

And yet education Ministers met earlier this week to discuss the plight of Year 12s amid calls to cancel the ATAR and end-of-year exams, apparently in order to reduce student stress caused by coronavirus developments — as though radically overhauling how students are admitted into universities within one year wouldn’t lead to even more anxiety for Year 12s.

And it is incredibly naïve to think the practical problems of an entirely new university admissions system could magically be resolved between now and the end of 2020.

One proposal is to replace the ATAR with a ‘learner portfolio’ based on extra-curricular activities and subjective assessments.

But the ‘innovative’ thought-bubble alternatives to the ATAR are especially unfair for high-achieving disadvantaged students. Advantaged students tend to have more extra-curricular opportunities and professional networks, so would gain an unfair benefit in competing for places in high-demand university courses. Just imagine the differences in CVs and ‘learner portfolios’ between students from wealthy inner-city suburbs areas and those in low-socioeconomic areas.

Exams may not be enjoyable for students, but they are the great equaliser in education. They assess and rank each student’s academic ability in each subject in the same way at the same time, with transparent and detailed methodology.

In any case, it would be unfair to change the rules for Year 12s at this late stage. After all their hard work in Year 11 and up until now, students deserve to receive a meaningful Year 12 certificate — based on rigorous exams rather than vague superficial indicators — at the end of this year.

Sure, the current situation with many students not attending school makes it harder to prepare, particularly for disadvantaged students who don’t have access to effective learning support online or at home. A simple solution to this is to encourage secondary schools to remain open with normal classes for just their Year 12 students, if they don’t have adequate online classes in place.

Teachers are still working hard to ensure their students are prepared anyway. It’s been inspiring to see teachers so quickly get their heads around less-than-ideal education technology to ensure they can continue teaching and answering student questions.

Thankfully, education Ministers remain adamant that students will receive ATAR scores this year and it appears Year 12 exams will go ahead (but might just be delayed by a month or two). They shouldn’t backdown. Whatever other harm the coronavirus will do to Australia, we should insist it won’t stop Year 12 students from getting the rigorous qualification they need for future life.

Invisible Threats

Monica Wilkie

09 April 2020 | Ideas@TheCentre

While in social isolation, technology has allowed people to work from home and share a virtual salut with friends.

But what happens when the technology fails? We weren’t prepared for the shock of a pandemic. Our now total dependence on technology will make the next shock unbearable, and early signs of network strain are alarming.

A significant increase in Internet usage  — more than 70 percent during business hours — led Telstra CEO Andy Penn, to urge Australians to practice Internet rationing… a near futile request in the age of social isolation.

The crash of the MyGov website showed the real-world damage caused by unprecedented demand surges.

Perhaps such a crash was unavoidable, but this incident highlights the fragility of our virtual dependence and created a potential health hazard.

Although the government’s claims of a cyber-attack causing the crash were unsubstantiated, security concerns — especially as we increasingly live almost entirely online — are not unfounded.

Privacy issues and security problems have plagued the now ubiquitous video conferencing site Zoom. Security experts have warned the platform’s existing encryption technology is insufficient, and defence personnel are now banned from using Zoom.  

Cyber-attacks on the World Health Organisation have doubled during the COVID-19 crisis, and an Italian social security website fell victim to hackers.

Assurances from telcos that they are preparing are meaningless, because the preparation has started after the crisis — which is too late.

Those who can work from home are lucky — for now. But are we prepared for a massive network failure or hack? Given how reliant we are on technology is it possible to be prepared?

We do not notice things when they function well.

We do not praise a secure, and fast internet when our meditation coach seamlessly live-streams our latest mindfulness practices — we only curse it when the video buffers after we were told to breathe in.

COVID-19 is an insidious, invisible force that woke us up to the threat of pandemics. A failure of our technology could wake us up to the fragility of our entire lives.

Bigger health picture

Jessica Borbasi

09 April 2020 | Ideas@TheCentre

There is suddenly a lot of panic over the number of ventilators available in Australia. Likely provoked by headlines around the world proclaiming there are not enough. But is this really the only thing we need to be worrying about?

It may be that people who ‘miss out’ on a ventilator would not have benefited from it — or may not have wanted it in the first place.

The overwhelming focus on the number of ventilators provokes fear as it conjures images of the frail and elderly being forgotten and forced to die alone.

But it doesn’t have to be like this if we ensure national availability of palliative care and advance care planning.

Last week the median age of the Australians who died from COVID-19 was 81 years. A Chinese study has shown that older age is the greatest risk factor for developing respiratory failure and death. Nearly half of the patients who died in Italy had three or more comorbidities, such as hypertension and diabetes. Generally speaking, those who are most effected by COVID-19 also seem to be those who would be the least likely to survive an ICU admission for any reason.

Facing an extraordinary humanitarian and resource crisis, Italian doctors spoke out about rejecting people from ICU based on “potential survival”. Another has said “[Who lives and who dies] is decided by age and by the [patient’s] health conditions. This is how it is in a war.”

These solemn declarations give the impression that those deemed ‘unworthy’ will be left uncared for. It implies that we cannot do everything for everyone and so must do nothing for others.

But this is wrong. Too often doctors speak of there being “nothing left to do” but there is always the opportunity to relieve suffering. We must ensure that palliative care is available for those Australians who would not benefit from a ventilator or who do not wish to be ventilated. Palliative care is well equipped to treat these patients.

Nonetheless, in the best of times, let along during a pandemic, palliative medicine is easily overlooked. Unbelievably, Australians over 80 years of age, dying from non-malignant disease, such as respiratory failure, are currently the least likely to receive palliative care — partly due to a lack of referral.

But it is not just the medical fraternity who need reminding about palliative care.

There has never been a more pertinent time for all Australians to consider what type of medical care they are — and are not — willing to endure.

Many self-actualised 80-year-olds view pneumonia as “an old friend” and upon its arrival entrust me to ensure their dignity and not send them to the cold clinical ICU to suffer a drawn out death. This is an advance care directive.

In an Australian audit of 2,285 patients over 65 years of age, across six states and territories, less than 30% had an advance care directive indicating a person’s preference for care. Even in aged care facilities, less than 50% of residents have a care directive indicating whether, for example — they want to be transferred to the emergency department, be resuscitated or what consequences of medical treatment they would consider unbearable. This is despite evidence demonstrating that advance care directives promote autonomy.

If we don’t ask, we won’t know how people wish to be cared for if their lives are threatened.

The current lack of integrated access to palliative care and responsible advance care planning is something we need to be worrying about. Many older Australians will forgo a ventilator but we will only know this if we ask and if we reassure them that they will always be cared for — ventilated or not.

Dr Jessica Borbasi is a medical doctor and research associate at The Centre for Independent Studies. She is the author of the research report ‘Life Before Death: Improving Palliative Care for Older Australians.’