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.

Essential Ethics

The Ethics Toolkit - Patient and Family Centred Care

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.

The Ethics Toolkit - Shared Decision Making

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 looks at the Zone of Parental Discretion (ZPD) which is a protected space in which parents can make medical decisions for their children that may not be optimal (best interests) but are not substantially harmful (Harm Principle) to the interests of their child. It recognises parents as natural, and legal, decision-makers for their children and acts to preserve the parent-child-doctor relationship. Host: Prof John Massie, Clinical Director, Children’s Bioethics Centre, RCH. Guest: Prof Lynn Gillam, Academic Director, Children’s Bioethics Centre, RCH, and Professor, University of Melbourne School of Population and Global Health.

The Ethics Toolkit - The Zone of Parental Discretion

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 under the Harm Principle. Host: Prof John Massie, Clinical Director, Children’s Bioethics Centre, RCH.Guest: Prof Doug Diekema, Treuman Katz Center for Pediatric Bioethics, University of Washington.

The Ethics Toolkit - The Harm Principle

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 - Beyond Principles: other ways to consider bioethics

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.

The Ethics Toolkit - Principles

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.

Respect - a Socratic Dialogue

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.

Respecting families' cultural and religious beliefs and practices - going too far or not far enough?

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 Twilight Zone

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.

Blended food for tube feeding a child: ethical considerations

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.

Negotiating diverse cultural and religious differences in a paediatric hospital

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.

Screening for inherited diseases: the North American perspective

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.

Screening for inherited diseases: Should all couples be offered all tests?

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.

Special: Pandemic Ethics in a Children's Hospital - Disability in the time of Covid-19

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 acceptable to accede to mother’s wishes and not do a COVID swab? Professor John Massie navigates the issue with Professor Lynn Gillam.

Special: Pandemic Ethics in a Children's Hospital - Refusal of Covid-19 Testing

Essential Ethics, from the Children’s Bioethics Centre at The Royal Children’s Hospital (Melbourne, Australia) presents discussion of challenging cases that come up when treating children. Hear the most up-to-date thinking and draw knowledge from the ethics toolkit. After a decade or more of experience our team of world-recognised ethicists take on the hardest cases. Essential Ethics is informative, interesting and always relevant. Hosted by Professor John Massie, a clinician and bioethicist at The Royal Children’s Hospital, Melbourne.

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Essential Ethics

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