Reconciling ethics and law in the clinical context

Vicki Xafis1, Patsi Michalson2

1 Sydney Children’s Hospitals Network, Children’s Hospital at Westmead, Corner Hawkesbury Rd & Hainsworth St, Westmead, NSW 2145 
2 Sydney Children’s Hospitals Network, Sydney Children’s Hospital, High Street, Randwick, NSW 2031

Medical decision-making can be complex as parents of patients in the paediatric context weigh up the treatment choices they have available for their child. In the majority of cases, parents and the clinicians involved in the care of their child come to a consensus view about the most appropriate treatment option(s) for the paediatric patient. There are, however, occasions when divergent views strongly held by both parties cannot easily be reconciled and where legal and ethical considerations provide the only structure for resolving the impasse. Such cases can sometimes result in legal experts becoming involved to the exclusion of organisational ethics experts.

The workshop will commence with the proposition that discussions exploring the ethical issues that arise in paediatric medical decision-making must be embedded in considerations of lawful practice but that early discussions involving ethics can often prevent their escalation to purely legal considerations and improve the quality of the decision-making both in and out of Court. The role that the inclusion of ethical deliberations can have in courts of law will be highlighted and insight from a range of healthcare professionals with whom this has been discussed will be provided. The proposition will be further considered by workshop participants.

Other workshop themes include:

  • practical issues involved in the provision of advice from the areas of ethics and law in the clinical context
  • perceptions around the merit of involving the two disciplines in the conversations health providers have with parents
  • impediments to involving the two disciplines in discussions with parents
  • an exploration of how the two disciplines can work side by side to provide the best outcome for patients, families, and clinicians.

Based on the presenters’ experience and input from workshop participants, practical suggestions on how the two disciplines can work together effectively to produce optimal outcomes will be summarised.


Biography

Vicki Xafis is the Sydney Children’s Hospitals Network Clinical Ethics Coordinator. She is a founding member of the Australasian Clinical Ethics Network and co-stream leader of the Clinical Ethics Stream, AABHL; a founding member and Secretary of the PSANZ Perinatal Palliative Care Subcommittee; and affiliated with VELiM, University of Sydney.

Patsi Michalson  is a South African- born  former Barrister and Senior Counsel who  practised extensively in the areas of Family Law and Medical Law before  recently moving to Australia where she now oversees Medico-Legal matters  for the Sydney Children’s Hospitals Network, which includes the two largest children’s hospitals in NSW.