The Clinical Ethics Service provides:

• Ethics case consultations for current clinical cases
• Ethical reviews of past clinical cases
• Facilitated departmental discussions that can foster communication, mediation and practical problem solving

Who can use the clinical ethics service? 

• Any RCH, MCRI or University of Melbourne Department of Paediatrics staff member

How quickly can the clinical ethics service respond?

• Within 24 - 48 hours

How can I refer a case?

Initial contact with the Clinical Ethics Service can be made by:

1. PHONE: Bioethics intake: 0478 281 449, OR call Academic Director, Prof Lynn Gillam on 9345 4368
2. PAGE: Clinical Ethics Consult on 4056, OR page Clinical Director Prof John Massie on 6427 (or mobile via switch) 
3. EMAIL: bioethics@rch.org.au. Please feel free to also copy in the RCH Clinical Ethicists;
   georgina.hall@rch.org.au
   jenny.oneill@rch.org.au
   sharon.feldman@rch.org.au.
   Please complete, scan & attach the appropriate Referral Form (see below)
   
   Referral Form 1 (Standard)
   Referral Form 2 (Disorder of Sex Development)
   Referral Form 3A (Fertility Preservation Pre-pubertal)
   Referral Form 3B (Fertility Preservation Post-pubertal)
   
   If requested, a formal clinical ethics case meeting will be organised. This meeting is attended by the clinical ethicist, the referring clinician, representatives of the multidisciplinary team involved in the patient's care, and members of the Clinical Ethics Response Group. Written notes from the meeting are provided to the referring clinician within 24 hours.

        Clinical ethics issues

       Areas to consider for case review, education, facilitated discussions or input into policy development:

• Informed consent
• End of life decision making including advanced treatment plans and withdrawal and withholding treatment
• Withholding information from children (children/families rights)
• Children's participation in decision making
• Cultural dissonance/cross cultural care
• Use of interpreters
• Prenatal screening/diagnosis
• Predictive genetic testing including carrier status in minors
• Genetic counseling
• Children's participation in research- competence, opt out consent, children's assent to treatment
• Vaccination practice
• Allocation of resources
• Professional practice- including communication/confidentiality between providers

Resources

• Withholding or Withdrawal of Life-Sustaining Treatment- clinical resources
• Withholding or Withdrawal of Life-Sustaining Treatment- policy document
• American Academy of Pediatrics Bioethics policy statements
• Making law practical for families and paediatricians
• Law, Ethics and Communication: A guide for giving information and obtaining informed consent for central venous access devices