Doctor and activist


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Category: Justice

Vale Trevor Morling – the Passive Smoking Judgement of 1991, 10/6/20

Judge Trevor Morling has died at the age of 92.

He was the author of the famous ‘Morling Judgement’’’ which sent a shock around the world in 1991 as it stated that ‘passive smoking was potentially lethal’.

This has to be put in context if its significance is to be duly recognised.  The seminal article about smoking causing lung cancer had been written by Doll and Hill in the British Medical Journal in 1950, and many articles followed in the 1950s linking smoking to a great many diseases.

In 1961, the Royal College of physicians, concerned that the UK government had not done anything to curb smoking, commissioned their landmark report ‘Smoking and Health’ in 1962.  The US Surgeon-General did the same, resulting in a similar report in 1964.

The tobacco industry had to decide whether it would scale down its production, or tough it out and take the money.  It did secret research which confirmed that burning tobacco produced carcinogens and other harmful products which could not actually be removed.  There was a change of personnel and ethos.  Prior to 1950, tobacco was a legitimate product like anything else.  After the research was confirmed, the decision to keep selling and to deny the effects and hinder government action was the strategy that everyone working at the top of the tobacco industry had to accept.

Tobacco use was mainstream.  45% of all US adults smoked in 1954 (Statistica- Gallup) and consumption peaked in Australia in 1963.  People smoked everywhere. There were no smoke-free areas in bars, restaurants or anywhere else.  It was normal for house guests to light up and then ask ‘where is the ash tray?  The Tobacco industry was keen to maintain this situation and talked of the need for ‘courtesy and tolerance’ between smokers and non-smokers, which was code for ‘doing nothing political’.  Smokers all ‘chose to smoke’, which of course meant that they had voluntarily (and knowingly) assumed the risk and consequences of their behaviour.  The tobacco industry also gave money to political parties, just asking for a secret promise that there would be no legislation against them before the next election.  The medical industry were unaccustomed to this, and kept giving advice that was ignored, with a few significant voices such as Dr Nigel Gray of the Victorian Anti-Cancer Council and Dr Cotter Harvey of the Thoracic Society doing what advocacy they could. 

Non-Smokers Rights groups were the main driving force for change in the US in the 1960s and 1970s  arguing that people had a right not to breathe smoke.  The health charities, Cancer Councils, Heart Foundations were very keen to be non-political as their core business was raising research funds. Real activists soon discovered that their opponents were not the smokers, but the industry, who claimed that there was no proof that passive smoking was harmful, and that courtesy and consideration was all that was needed.  Their public stance was referred to as the ‘tightrope policy’.  They had to admit that many people believed that tobacco was harmful, as they had to contend that the smokers knew the risk that they were taking and hence could not sue them for deceiving them. But they also had to claim that they did not know that smoking was harmful, so that they were no liable for selling unsafe goods.  It was absurd, but it continued. 

The tobacco industry as well as being very politically active were the major advertiser, tobacco being second only to food.  This meant that the media were more reluctant to run stories that would affect their advertising revenue.  Outdoor advertising was also ubiquitous with over 50% of billboards being for tobacco, reminding people to smoke, and especially plastered all over convenience stores where cigarettes were sold.

In 1981 Prof Takeshi Hirayami published a seminal paper showing that non-smoking wives of smoking husbands got more cancer than wives of non-smokers (Br Med J (Clin Res Ed) 1981;282:183).  At last there was substantial medical evidence of the harm of passive smoking.

In Australia the medical groups had done quite good advocacy and in NSW a Transport Minister, Pat Hills, simply banned smoking on buses and trains in 1977, but pubs and clubs knew that smokers drank and gambled more than non-smokers, so they took the money from the tobacco industry and lobbied hard against smoke-free indoor air.  The restaurant industry followed them, somewhat lamely.

But a breakthrough came in 1979 when 3 activists, Bill Snow, Ric Bolzan and Geoff Coleman formed BUGA UP (Billboard Utilising Graffitists Against Unhealthy Promotions).  Coleman had studied political economy, and saw the issue as the tobacco industry killing people for money.  BUGA UP saw irresponsible and misleading advertising as the major vehicle for the promotion of products that had no intrinsic worth, tobacco being the leading example.  They wrote on billboards, changing the wordings in satiric and humorous ways, and signed their work, BUGA UP, which was an invitation for all to copy.  They also did street theatre, often concerned with disrupting tobacco promotion activities in supermarkets or malls.  This had an immense direct effect as the billboard posters were only being changed every 3 months and the leaflets and street theatre were amusing.  There was a lot of popular support as most people saw that smoking was harmful, and governments were too craven to act.  There was also a lot of publicity when Coleman and Neville Biffin were arrested in 1981 and charged with defacing a billboard.  They were convicted in 1982 and fined, but praised by the judge (Daily Telegraph 26/2/82) and given a light penalty, which sent a strong message.  It also sent a shot around the world by making all other tobacco activism seem moderate by comparison.  Australia’s activism was seen as more direct with a ‘Robin Hood’ flavour, but was also more conspicuous because it was against the ubiquitous tobacco billboards, and targeted the industry directly, rather than the more subtle and legalistic approach of the non-smokers’ right groups who had previously been the front line against the industry.  It might be noted that at the 5th World Conference on Smoking and Health  in 1983 there were no scheduled sessions on political action or advocacy, and the first meeting was convened by renowned Californian activist Prof Stan Glantz.  The presentation on BUGA UP had to be repeated as the room was not large enough for the people who had wanted to attend.  The medical system was becoming energised.

The tobacco industry was very demoralised by this.  They had set up a lobby group, pretentiously called the ‘Tobacco Institute.’  But this was re-energised by John Dollisson who was there from 1983-87. 

In 1983 the Western Australian lower house supported a private member’s bill by Dr Tom Dadour to ban tobacco sponsorship of sport, but an energetic campaign led by Dollisson and using sporting bodies who received money from tobacco, defeated this in the upper house (Musk, BMJ Vol 290 25/5/85). 

After his successful Industry fight against the WA Dadour bill, Dollisson’s feisty style set the tone for the tobacco struggles of the 1980s.  He was physically strong and in debate would cram a number of aggressive arguments into each sentence, such as,  ‘You are treating the smoking causes disease hypothesis as fact, then want to even say that passive smoking is harmful, and smoking is addictive and the advertising get the kids and then you want to tell people how to live their lives and trample on their rights and then you want the government to enforce a nanny state for you.’  (This is not a direct quote, but an example of how his speech was structured).  Assuming that he was interrupted at this point, as he would not stop if he were not, the tobacco control advocate would then be able to only answer one of the points already raised.  But Dollisson’s aggressive style eventually got him into trouble, with the Trade Practices Commission, prohibition of ‘misleading and deceptive conduct’ being used against one of his advocacy ads. Then the Australian Federation of Consumer Organisations bravely took him on.  The story is told by Stacey Carter (Tobacco Control- BMJ Issue 12 Suppl 3):

In July 1986 he [Dollisson as CEO of the Tobacco Institute (TIA)] placed an advertisement in the national press entitled “A message from those who do…to those who don’t”29 in which he claimed “there is little evidence and nothing which proves scientifically that cigarette smoke causes disease in non-smokers”.30 Early in 1987, Dollisson placed a “followup” ad for the TIA, as demanded by the Trade Practices Commission, which among other things stated that the TIA did not accept that their original advertisement was misleading.31 This action triggered a six year legal war between TIA and the Australian Federation of Consumer Organisations (AFCO), at substantial cost to the TIA.

On 7 February 1991 Justice Morling decided that the TIA “had engaged in conduct that was misleading or deceptive” and banned the TIA from speaking publicly on ETS.40,41 On appeal the injunction was lifted, but the court granted a declaration that the advertisement was misleading and deceptive contrary to the Act and the TIA were ordered to pay a large proportion of AFCO’s costs.

The ‘Morling Judgement’ as it was termed was the first time in the world that passive smoking had been held by a court to be harmful, and this rang around the world.

Dollisson left the Tobacco Institute and went to Philip Morris where he helped the campaign against the Victorian Government’s Tobacco Act of 1987, which raised the State tobacco tax and replaced tobacco sponsorship money as well as promoting health (which replaced tobacco advertising from the advertisers point of view) and also funded medical research.  The Victorian legislation, effectively paid off the tobacco industry’s bought acolytes, and the aggressive approach to advocacy by Dollisson in Australia was seen as backfiring. 

The decision also set the precedent for the test case Scholem v NSW Dept of Health, where a psychological counsellor successfully sued for workplace tobacco smoke exposure in May 1992.

Australia has been drifting in its tobacco control endeavours of late, but Trevor Morling will be remembered for his contribution, as well for the many other achievements cited below.

www.smh.com.au/national/chamberlain-royal-commission-judge-was-a-lawyer-s-lawyer-20201006-p562hk.html

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Domestic Violence Becomes a Workers Comp Issue 8/6/20

The NSW Supreme Court has held that the children of a worker killed at home by her mentally ill partner in a domestic violence incident can have compensation.

It is good that the issue of domestic violence gets publicity and that the children get compensation. But it raises the issue of whether employers are seriously able to assess the domestic situation of all employees and then whether they can ever hope to intervene in them.  Employers ran a long campaign not to have to pay for journey accidents, people injured on the way to work, on the basis that it was not a risk that they could control, yet which potentially might cause a big change in their insurance premiums and thus costs.  If we want our employers to be concentrating on making their businesses efficient and looking for hazards in the workplaces that they do control, it is slightly dubious public policy to have them sniffing around about employees’ home life.  This case is slightly unusual in that the employer was effectively a partnership bet ween the couple rather than having a distant employer, and the company had been deregistered which suggests some dysfunction  But the money accessed was Workers Compensation insurance and this will affect premiums and potentially other work situations.

It is true that a lot needs to be done about the discovery and action on domestic violence.  It is also true that mentally ill people need to live somewhere and that their carers are at risk.  Judges faced with people in dire need of help such as the children in this situation search for answers, and the Workers Compensation insurance scheme is a source of such funds. But the precedent set is not a good one.

The same principle applies when a baby gets into trouble at birth and has long-term adverse effects. If the obstetrician is found to have erred, there is a lot of money to give the unfortunate infant.  If he or she is not found to have erred, there is no money for the infant.  So now the premiums for obstetricians are very high and some retire in consequence.  4 Corners ran a show on this issue some time ago and it turned out that one doctor was responsible for about 60% of the problem births in Western Australia and had declined to speak to the show. Wow- go after him!  Who was he?  The Professor at the biggest teaching hospital of course.  Most of the difficult cases in the State were admitted under his name, and the staff of the hospital did their best with these cases. 

What is needed is a compensation system that is no fault.  Sometimes bad things happen.  Sometimes people make mistakes. Sometimes big mistakes have small consequences and sometimes little mistakes have big consequences.  With systems, it is not usually one person who makes a mistake, there are miscommunications, lack of clarity who was responsible, lack of availability of something or someone.  Accident causation theory is now an academic discipline, but the legal profession has not really caught up, let alone the political system.

A lot needs to be done about domestic violence, but I am not sure that making it a workers compensation issue will do anything more than push it into the public eye and help these children.  Employers and insurers will run a successful political campaign to change the law to exclude it.  I am not often on the side of Workers Compensation insurers, but a better solution has to be found.

www.smh.com.au/business/workplace/no-longer-a-private-matter-employer-held-responsible-for-family-violence-20200605-p54zy1.html

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Aboriginal Deaths in Custody are not far from the US situation. 5/6/20

Australians looking at the riots happening in the US may be tempted to feel smug that it does not happen here. The riots don’t, but there has been a long history of Aboriginal deaths in custody, seemingly unchanged by a number of Royal Commissions. This is long overdue to be addressed, and is the peak of the tendency to criminalise our social problems.

You might argue that the policeman who tripped a 16 year old to arrest him did so because the youth threatened to break his jaw, but you cannot argue with the many deaths and inquiries’ findings.

We need to put our own house in order.

www.theguardian.com/australia-news/2020/jun/04/morrison-says-australia-should-not-import-black-lives-matter-protests-after-deaths-in-custody-rally?CMP=share_btn_fb

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Housing Stimulus: More Middle Class Welfare 5/6/20

Successive governments have used the building industry to pump up the economy on credit.  How so?  For decades the tax deduction on negatively geared real estate has made housing a favoured investment. It has been the no-brainer way to make money. You borrow to own a property, and as long as it is your, all the capital gain is yours.  So the lesser fraction that you own, the greater the percentage rise in your total assets.  And since you save on tax and gain rent, it is far better than shares or other assets. If you ask to borrow 90% to buy shares, no bank would lend you 90%. They would fall about laughing, and you would be taking a big risk.  If you wanted to borrow 90% of real estate, no problem- all perceived as low risk.  How come?  Because Australia’s private debt is rising and is now the highest in the world.  This little Ponzi scheme has a cost. We have the best houses, which are the most expensive relative to our incomes, and we have a huge national private debt, which means that we pay interest to foreign banks and have no money to develop and own our own country.  Like all Ponzi schemes, it is OK as long as you sell out before the bubble pops.  The older generation are doing this, cashing out as the younger generation takes up the huge loans that are now necessary.

The tax department got less money to create this mess, so public housing was not built, and there is a huge shortage of public housing.  Because prices are so high there is also a problem in affordable housing as wages in the real world have stagnated as globalisation allows jobs to go offshore to be done more cheaply by third world people.  The negative gearing thing amounts to middle class welfare, where those who had one house were able to buy more, and those that did not merely saw rents and prices rise.  Labor tried to address this and lost the election.

Now we have a recession, worsened by the COVID-19 crisis and the taxpayer has to step in, making more debt for the future.  So what projects to spend the money on?  More middle class welfare! Those who already have $150,000 to improve their house get another $25,000 from the future taxpayer, the young people of today.

It is merely another example of the Morrison government’s lack of commitment to a fair go for all. This could be a huge opportunity to build social housing to help those who have been left behind.  Is the excuse that the projects are not ‘shovel-ready’?  The government could pay for the huge outstanding renovations and repair bill on the public housing, which has been neglected for 30 years.  Surely these repair lists on yellowed paper could be found and actioned.

Morrison governs for his voters, not for the country as a whole. His policies increase inequality, which stores discord for the future.  This last effort will further the Matthew Effect, named after the biblical quote, ‘For to every one who has will more be given, and he will have abundance; but from him who has not, even what he has will be taken away’.

— Matthew 25:29, RSV.

www.theguardian.com/australia-news/2020/jun/03/morrison-government-to-offer-25000-grants-to-help-build-and-renovate-homes

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Crimeless Victims 22/12/19

We hear of ‘victimless crimes’ like urinating in a park when all the toilets are shut, or jaywalking.  Every now and then a politician wants kudos for actually stating that they are not going to prosecute (and they are going to save on legal system time). But more important are ‘crimeless victims’ where the neglect […]

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Secret Trial of Witness K- East Timor Whistleblower

25 March 2020 The trial of Witness K, the whistleblower who told of Australia’s bugging of the East Timorese Cabinet room during the maritime border negotiations has been going on in secret in Canberra. What has Australia come to? This is what we heard Russia did during the Cold War. The government does dirty deals […]

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Power, Injury and Awards

26 November 2016 Power, Injury and Awards.  I work in medicine, treating mostly third party motor vehicle injuries and workers compensation injuries.  There are much fewer of the latter because there are less employees.  Many people working as couriers are ‘self employed’ contractors.  One man had to pay $75,000 for the right to deliver parcels […]

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