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. In this episode Prof Doug Diekema explains the origins of the Harm Principle and how it sets a threshold for state intervention when children risk being harmed. Prof Diekema outlines the necessary conditions that must be met...

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...

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 ga...

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...

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...

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 Gi...

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...

How do we ration limited healthcare resources without discriminating against people with disabilities? Host, Professor John Massie enlists Dr Giuliana Antolovich, a paediatrician working in Developmental Medicine at the RCH, to shed light on this important topic. Zooming in to the conversation is ethicist Professor Lynn Gillam.

A 5-year-old boy is brought to the ED with high fever, lethargy, cough and breathing difficulties. There is no contact with a COVID-19 case or overseas travel. The boy has moderately severe autistic spectrum disorder associated with a fear of medical procedures. His mother refuses a COVID-19 nasal and throat swab on the basis that it will severely upset him and set his ASD treatment back. Is it ac...

The SARS-Co2 coronavirus has caused the pandemic that many suspected would come, but which has still caught health services by surprise. Medical resources are never infinite, even in wealthy countries with well-developed healthcare systems like Australia. Host, Professor John Massie explores with guest, Professor Lynn Gillam some of the ethical issues around allocation of resources to children dur...

The COVID-19 pandemic has created pressure on healthcare services and healthcare workers like never before. Essential Ethics host Professor John Massie is joined by Prof Lynn Gillam and Prof Clare Delany of the Children’s Bioethics Centre to consider the ethical principles that should be the bedrock of the institutional and individual healthcare worker response to the pandemic.

When parents advocated for early leg amputation and prosthesis fitting for their child, rather than go through a lengthy series of leg salvaging operations and rehabilitation, orthopaedic surgeon Dr Chris Harris faced an ethical dilemma. Should he acquiesce to the parents' request? Or should he steer them to a pathway they don’t want to take? Thank goodness we have Prof Lynn Gillam back in the cha...

Left ventricular assist devices have made it possible to keep children with heart failure alive while waiting for a heart transplant, yet at a significant risk of strokes and prolonged hospitalisation. But what do you do when the number of children waiting for a heart transplant is much greater than the number of hearts that become available? Dr Jacob Mathew can deal with almost any cardiac emerge...

Jade is a 14-year-old girl with a high grade medulloblastoma (brain tumour). She presented with headaches but no evidence of neurological impairment. She is an otherwise healthy year eight student. Primary surgical resection with post-operative radiotherapy is the recommended treatment. There is a 30 percent chance of responding. But it's likely she will have side-effects (intellectual disability,...

Your patient is a young adult, but still under 18 years. He doesn’t want cancer treatment that will affect his appearance. But this will put him at risk of a less certain cure. Dr Diane Hanna is not fazed as to what to say, but how to make the best outcome happen is her dilemma. Professor Clare Delaney helps us consider the rights of the child to make a decision about their healthcare, but also, w...

What do you do when parents demand investigations and treatments for their children, that you think are unnecessary? Dr Giuliana Antolovich, experienced paediatrician and straight-talker, along with clear-thinking academic director Professor Lynn Gillam, tackle this one with host, Professor John Massie.