The Melbourne Clinical Ethics Group (MCEG) comprises three experienced clinical ethicists who have joint positions at Melbourne University and major tertiary public hospitals in Melbourne. They are also co-authors of the book, When Doctors and Parents Disagree (The Federation Press, 2016).
Professor Lynn Gillam (MSPGH) is an experienced clinical ethicist, who founded and continues to lead the clinical ethics service provided by the Children’s Bioethics Centre at the Royal Children’s Hospital.
Professor Clare Delany is a clinical ethicist at the Children’s Bioethics Centre at the Royal Children’s Hospital and a consultant clinical ethicist at Peter MacCallum Cancer Centre in Melbourne.
Associate Professor Rosalind McDougall (MSPGH) has been involved in providing clinical ethics support in hospitals since 2008, and co-founded the Australasian Clinical Ethics Network. She is a consultant clinical ethicist at Austin Health.
What is Clinical Ethics?
Clinical ethics is about making good decisions in ethically complex situations.
In our work with clinicians and families in hospital settings, ethical complexity arises when people disagree or misunderstand each others’ values and priorities about health, quality of life, and benefits, burdens of clinical care.
These differences arise frequently, are often emotionally fraught, and involve high stakes for the patient and their family.
Some typical examples of ethically complex situations involve:
- a patient disagreeing with clinically recommended treatment
- a patient or their family requesting treatments or testing which a clinicians believes is unnecessary, burdensome or not clinically indicated
- clinicians within a multidisciplinary teams disagreeing about a recommended pathway
- uncertainty about when to begin end of life planning and involve palliative care
- uncertainty about a patient’s capacity to give their informed consent
- deciding whether to implement experimental treatment requested by a patient based on internet searching
Conflicts about what matters ethically can derail good quality of care and cause moral distress and burnout in clinicians.
MCEG offers following four services
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Consultations
The ethics case consultation process helps clinicians to ensure that they have carefully and thoroughly considered all moral aspects of cases. In the uncommon situations where clinicians feel they cannot fully achieve what they believe to be the best outcome for a patient, ethics consultations and discussion can assist in alleviating and giving staff tools to address moral distress.
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De-brief
A clinical ethics de-brief involves an ethicist leading and facilitating a discussion about a past ethics challenge. The goal is to assist staff to process, reflect on and address moral distress arising from a past experience or to identify and analyse ethical dimensions of the experience.
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Education and Training
Assist clinicians, to build capacity and embed clinical ethics expertise within health institutions.
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Policy Advice
Consultation based advice to health professional bodies and government, including: advance directives for patients, withdrawal and withholding of life-sustaining medical treatment, COVID-19 related ethical challenges.
To read more download MCEG brochure
MCEG brochure (PDF 1.2 MB)
If you have any question please email us at c.delany@unimelb.edu.au
What do clinicians say?
“I would still be waking up in the night otherwise. This was a really difficult one for me. I found it incredibly helpful to go through the ethics service” - neonatologist.
“It’s a support - you’re not alone making a difficult decision that could blow up... one’s not standing alone.” - paediatrician
“It was a very therapeutic meeting as a team. The room was full of people involved in the case, everyone was involved in the discussion - they had an opportunity to air their views.” - physician
“It was very clear how to proceed after the meeting. Up until then everyone was giving different unconscious messages.....We all communicated - there was recognition of how difficult it was. When the team comes together it’s very powerful”. - nurse
“The turnout was phenomenal. Sharing of ideas was very helpful” - paediatrician
(de-identified quotes from Clinical Ethics service evaluation interviews conducted at the Royal Children's Hospital.)
If you have any question please feel free to contact us
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