Remember when health ethics seemed simple

A/Prof. Clare Delany1

1Children’s Bioethics Centre, Royal Children’s Hospital, Melbourne , West Brunswick , Australia

In simpler times (1767), doctors informed patients so they could take courage for whatever the doctor deemed necessary.  Doctors’ ethical obligations seemed simple; decide necessary and appropriate treatment and administer it. Patients’ separate or differing values were a likely hindrance to good care.  This was especially so for children, where clinical goals trumped all other interests.

‘Taking courage’ was overtaken in 1914 by the more enlightened view that patients should determine what is done to their body.  But even with this progress, the decision-making, mode of communicating and overall authority remained clearly and simply, with and determined by the doctor.

Fast forward to 2018. Children have rights and interests.  Parents have moral authority to decide what is best for their child.  A clinician’s advice concerning treatment is now only one component of the information informing parents and children. Social media, crowdfunding and “dr google” make ethical responses by doctors anything but simple.  The discharge by doctors of their ethical roles and obligations can only be described as complex. Some question whether doctors are needed at all.  In this talk I discuss how ethical goals and standards developed for simpler times might be used for today’s complex times.


Associate Professor Clare Delany, PhD, Master Hlth and Med Law, Master of Physio, BApp Sci (Physio)

Clare Delany is a clinical ethicist at the Royal Children’s Hospital Children’s Bioethics Centre in Melbourne.  She is also an Associate Professor at the University of Melbourne, Department of Medical Education, where she is responsible for coordination of research higher degrees and the masters year of the EXCITE (Excellence in Clinical Teaching) program. Clare is Chair of the University of Melbourne ‘Education, Fine Arts, Music and Business’ Human Research Ethics Committee.  Clare’s research expertise is in the area of qualitative methodology and methods and this is applied across broad subject areas of clinical ethics, clinical education and paediatric bioethics.

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