The ethical questions that come up in paediatrics can appear overwhelming to begin with. 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? When might treating one child have implications for the resources available to others? And what about not treating or vaccinating a child, if that’s what the parents want?

All of these issues are tackled in the Essential Ethics podcast, produced within the Children's Bioethics Centre at the Royal Children’s Hospital, Melbourne. The Centre was established to promote the rights of young patients and to support families and clinicians facing some vexing ethical questions. The Essential Ethics podcast takes a case-based approach to demonstrate how dilemmas in clinical ethics can be worked through in a systematic way. A couple of these are presented here as part of the RACP Congress digital program.

In the first story discussed, a child with autism spectrum disorder is suspected of having COVID-19, but the mother refuses testing as it will distress him for little gain. The second, real life case, is that of a 16 month old boy born with a developmental abnormality of the lower leg. In the most severe cases the recommended clinical management involves amputation, but this boy’s deformity can be corrected through a number of involved surgeries. Orthopaedic surgeon Chris Harris describes the confronting course he had to take. He is interviewed by paediatric respiratory physician John Massie and clinical ethicist Lynn Gillam. They are respectively the Clinical Lead and Academic Director of the Children's Bioethics Centre, and both have Professorial appointments at the University of Melbourne.

Guests
Prof Lynn Gillam (Academic Director, Children’s Bioethics Centre, University of Melbourne)
Prof John Massie FRACP (Royal Children’s Hospital Melbourne, University of Melbourne)
Dr Chris Harris FRACS (Royal Children’s Hospital Melbourne)

Production
Written and produced by Mic Cavazzini. Music courtesy of Free Music Archive includes ‘Vodka’ by Transient, ‘Linger’ by David Szesztay and ‘Celeste’ by Adam Fitch. Image licenced from Shutterstock. 

Editorial feedback for this episode was kindly provided by members of the RACP’s Podcast Editorial Group; Saion Chaterjee, Jenae Valk, Michael Herd, Phillipa Wormald and Lisa Mounsey.

Please visit the RACP website for a transcript embedded with citations. Fellows of the College can claim CPD credits for listening and additional reading.