Essential Ethics

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. This episode examines different ways to consider bioethics, beyond the commonly used framework of the four principles. Virtue ethics, consequentialism and rule-based ethics all get a road test to see how they might add value to bioethical discourse in various situations. Host: Prof John Massie, Clinical Director, Children’s Bioethics Centre. Guest: Dr Ros McDougall, Senior Lecturer, 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 explore the origin of the four principles of bioethics, namely, respect for autonomy, beneficence, non-maleficence and justice. The four principles provide an easy framework for ethical analysis and have gained prominence as the main framework that is used for clinical ethics consultation. Host: Prof John Massie, Clinical Director, Children’s Bioethics Centre. Guest: Prof Lynn Gillam: Academic Director, RCH Children’s Bioethics Centre and Professor, University of Melbourne School of Population and Global Health.

In the closing plenary session of the 2019 National Children's Bioethics Conference, two senior clinical ethicists lead a discussion on the ethical dimensions of respect: Professor Lynn Gillam and Professor Clare Delany, both from the Children’s Bioethics Centre at The Royal Children's Hospital, Melbourne.

What happens when the medical team and parents have divergent views about the best interests of the infant? Dr Sid Vemuri, Consultant in Paediatric Palliative Medicine, Victorian Paediatric Palliative Care Program, and Dr Bennett Sheridan, Paediatric Cardiologist, Cardiac Intensivist, RCH, and Nurse Emelina Finnegan present a case of an infant with an inoperable congenital heart malformation whose life is prolonged by prostin infusion.

Sometimes newborn infants have multiple congenital abnormalities. Each of them may be treatable on its own. However, the overall prognosis can mean that it's unclear whether embarking on active treatment is in the best interests of the child. This is the ‘twilight zone’ where the gap between harm and best interests is hard to determine. The twilight zone can take its toll on parents and clinicians, as Dr Trisha Prentice, Neonatologist at The Royal Children's Hospital, Melbourne explained at the 2019 National Children's Bioethics Conference at RCH.

The RCH Nutrition and Food Services Team presents the risks and benefits of blended food for tube feeding of children. It's an option that's often practised by parents but not endorsed by the RCH home enteral nutrition program. This is followed by a lively discussion considering the ethically important issues of patient (parent) autonomy and fair process (justice) at RCH. Presenters: Dr Heather Gilbertson, Manager, Nutrition and Food Services, RCH; Ms Keryn Coster and Ms Rachael Martin, Dieticians, Nutrition and Food Services, RCH. Commentators: Ms Bernadette O’Connor, Director, Allied Health, RCH and Prof John Massie, Clinical Lead, Children’s Bioethics Centre, RCH.

Professor Avraham Steinberg, from the Shaare Zedek Medical Center in Israel, presents this keynote talk given at the 2019 National Paediatric Bioethics Conference held at The Royal Children's Hospital, Melbourne. Combining warmth and honesty with wisdom and pragmatism, he navigates medical ethics across the ages and cultures of modern Israel.

Before the Covid crisis curtailed travel, Professor John Massie roped in an expert for the US take on screening for inherited diseases. Recorded in Seattle in 2019, here he is face to face with Professor Benjamin Wilfond MD, Director of the Treuman Katz Center for Pediatric Bioethics, University of Washington, and Pulmonologist at Seattle Children’s Hospital.

Just imagine: You had testing in pregnancy to make sure everything was OK with the baby. You had Down syndrome screening and foetal ultrasounds. You even asked your obstetrician, “are there any other tests we could do to have a healthy baby?” You were told, "that’s it". Only that's not it.

Turns out, there's a test for spinal muscular atrophy. And your baby is born with SMA. You learn that you and your partner are carriers of the gene mutation that causes SMA. It doesn't change the love you have for your new baby, but why weren't you offered the test? To help us consider the ethics of this, John Massie is joined by Ainsley Newson, Professor of Bioethics, University of Sydney and Deputy Director at Sydney Health Ethics, Sydney School of Public Health.