In this podcast we explore the ethical underpinnings of deciding with children when providing medical care. We recognise that children of all ages have varying levels of capacity to understand and participate in medical decisions that affect their own bodies. We cover the following ethical principles in our exploration of deciding with children: the intrinsic and instrumental value of asking and considering the child’s view; respect for personhood, bodily sovereignty and liberty; the child’s right to a view; truth-telling and children’s best interests. Host: Prof John Massie. Guests: Prof Lynn Gillam and Prof Clare Delany, Children's Bioethics Centre, RCH.

Speakers: Prof David Archard - Chair Nuffield Council on Bioethics, UK and Dr Joe Brierley - Chair, Clinical Ethics Service and Intensivist, Great Ormond Street Hospital for Children, London.

This session is a fascinating debate in which Prof Archard advocates for the immediate needs of the sick child in intensive care now, while Dr Brierley insists that medical care for children, even if they are desperately sick, can only advance if we collect and publish data. Whose argument sways you the most?

The session is moderated from London by Dr Sarah Aylett - Clinical Ethics Service and Neurologist, Great Ormond Street Hospital for Children, London and from Melbourne by Prof Lynn Gillam, Children's Bioethics Centre, RCH.

Speakers: Prof David Archard - Chair Nuffield Council on Bioethics, UK; Dr Joe Brierley - Chair, Clinical Ethics Service and Intensivist, Great Ormond Street Hospital for Children, London; Dr Sarah Aylett - Clinical Ethics Service and Neurologist Great Ormond Street Hospital for Children, London.

In this session we discuss how innovative therapies should be considered for use in the COVID-19 pandemic. The ethics team from GOSH London and the Nuffield Council on Bioethics take into account the clinical needs of sick children and the imperative to 'do something', against the scarcity of solid scientific evidence about proposed treatments. The session is moderated by Prof Lynn Gillam, Children's Bioethics Centre, RCH.

Speakers: Professors Lynn Gillam and Clare Delany, Children’s Bioethics Centre, RCH and Associate Professor Helen Irving, Clinical Lead for Children Health Ethics and Law, Queensland Children’s Hospital.

In this session, the initial consideration is safety to hospital staff in the COVID-19 pandemic, and what might constitute acceptable risk to those staff of becoming infected at work. This opens the way for a more general discussion about an ethical approach to staff safety when parents or patients threaten staff.

Speakers: Professors Dominic Wilkinson and Julian Savulescu, from the Uehiro Centre for Practical Ethics at Oxford University, UK. Moderator: Professor David Isaacs, Clinician-ethicist and infectious diseases physician, Children’s Hospital, Westmead, Australia.

In this session, Prof Savulescu accepts the premise that a safe COVID-19 vaccine is developed and brings a consequentialist approach to justify mandatory vaccination. Prof Wilkinson rebuts this, indicating mandatory vaccination is unjustified coercion.

Speakers: Professor Dominic Wilkinson and Professor Julian Savulescu, both from the Uehiro Centre for Practical Ethics at Oxford University, UK. Moderator: Professor David Isaacs, Clinician-ethicist and infectious diseases physician from the Children’s Hospital, Westmead, Australia.

In this session Prof Wilkinson presents arguments in favour of COVID-19 challenge trials, arguing that we have an obligation to know all we can, and that such trials would guide vaccination research. Prof Savulescu presents the case against challenge trials, on the basis that children are the wrong candidates, given their low infection and mortality rates.

Professor John Lantos, Bioethicist and Neonatologist at Mercy Hospital for Children, Kansas City Missouri considers the many ethical dilemmas in clinical care raised by the COVID-19 pandemic and how we can learn from these for post-pandemic times. This is a far-ranging session considering surge management, staff infection, innovative therapies and research.

The Ethics Toolkit is a series within Essential Ethics designed to give clinicians a clear understanding of the tools that bioethicists use to think through complex problems. In this episode we explore the ethical foundations of child and family centred care. The conversation considers the obligations of healthcare providers to involve patients and families in their own healthcare and in designing healthcare systems. Host, Prof John Massie, is joined by: Prof Catherine Crock AM, physician at The Royal Children's Hospital, Melbourne (RCH), Co-founder of the Hush Foundation and Gathering of Kindness; and Prof Lynn Gillam, Academic Director of the RCH Children’s Bioethics Centre and Professor, University of Melbourne School of Population and Global Health.

The Ethics Toolkit is a series within Essential Ethics designed to give clinicians a clear understanding of the tools that bioethicists use to think through complex problems. In this episode we discuss what shared decision-making means and consider the ethical principles that underpin it. We then consider how this should include children and adolescents as emerging decision-makers. Host, Prof John Massie, is joined by Dr Giuliana Antolovich, Paediatrician with Developmental Medicine at The Royal Children's Hospital, Melbourne (RCH), and Prof Clare Delany, Senior Ethicist with the Children’s Bioethics Centre at RCH and Professor at the University of Melbourne School of Population and Global Health.