Published by The Royal Children's Hospital, Melbourne
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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 takes 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.
2025 National Paediatric Bioethics Conference: Ethics of children with rare diseases and the resulting disability participating in commercially sponsored advanced therapy clinical trials
In this episode of Essential Ethics, recorded at the 2025 National Paediatric Bioethics Conference, research nurse coordinator Cat Wood from the Murdoch Children’s Research Institute explores the ethical challenges of advanced therapy clinical trials for children with rare genetic conditions. Focusing on gene therapy trials for inherited epilepsy, she examines issues of consent, disability, risk, and equity in research involving children with severe neurodisability. Cat highlights the importance of meaningful engagement with patients and families, offering thoughtful insights into the ethical complexities of developing potentially life-changing therapies.
2025 National Paediatric Bioethics Conference: “The Squeaky Wheel,” an ethical approach to finding the balance between addressing parental concerns and managing excessive demands
In this episode of Essential Ethics, recorded at the 2025 National Paediatric Bioethics Conference, Dr Ciara Earley explores the ethical challenges that arise when parental advocacy becomes increasingly demanding. Drawing on a real-world case, she examines how clinicians can balance responding to parental concerns with maintaining focus on the child’s best interests. Dr Earley presents a practical ethical framework to help healthcare teams navigate complex family dynamics while supporting both parents and clinicians in delivering high-quality paediatric care.
2025 National Paediatric Bioethics Conference: SickTok - Adolescent illness identity, privacy, and the role of the clinician
In this episode of Essential Ethics, recorded at the 2025 National Paediatric Bioethics Conference, nurse Elise Burn explores the impact of social media on young people living with illness. In SickTok: Adolescent Illness, Identity, Privacy and the Role of the Clinician, she examines how online platforms can shape illness identity, influence health behaviours, and create new ethical challenges for clinicians. This thought-provoking presentation highlights the complexities of supporting adolescents in an increasingly digital world.
2025 National Paediatric Bioethics Conference: Talking with children about illness and dying
In this episode of Essential Ethics, recorded at the 2025 National Paediatric Bioethics Conference, Emeritus Professor Myra Bluebond-Langner and Professor Lynn Gillam explore the ethical importance of talking with children about serious illness and dying. Drawing on decades of research and clinical experience, they examine truth-telling, the changing role of parents, and how conversations can be centred on a child’s lived experience rather than age alone. Their presentations and discussion offer compassionate, practical insights into supporting children, families, and clinicians through some of healthcare’s most challenging conversations.
2025 National Paediatric Bioethics Conference: If you hit someone with a frying pan, it’s not cooking!!!
In this episode of Essential Ethics, recorded at the 2025 National Paediatric Bioethics Conference, social workers Dani Gold and Anna Lucia examine the ethical consequences of how family violence is documented in healthcare records. In If you hit someone with a frying pan, it’s not cooking, they argue that softened or minimising language can obscure harm and undermine patient dignity. Drawing on their expertise in family violence and child safety, they offer practical strategies for more accurate, respectful documentation and highlight why every response to violence carries ethical significance.
2025 National Paediatric Bioethics Conference: How can we make better ethical decisions in practice?
In this episode of Essential Ethics, recorded at the 2025 National Paediatric Bioethics Conference, Associate Professor Rosalind McDougall explores how we can make better ethical decisions in clinical practice. Drawing on a real case, she examines the strengths and limitations of ethical theory in time-pressured healthcare settings and argues for the importance of practical wisdom, collaboration, and decision-making. Central to her presentation is the concept of epistemic humility—an openness to learning from others and recognising the limits of one’s own knowledge—as a key ingredient for effective clinical ethics deliberation.
2025 National Paediatric Bioethics Conference: Socrates in the clinic
In this opening keynote of the 2025 National Paediatric Bioethics Conference, Professor John McMillan from the Bioethics Centre at the University of Otago explores how clinical ethicists can be most useful in healthcare. In Socrates in the clinic: the role of ethical analysis in healthcare, he challenges the dominance of ethical theories and principles, arguing that good ethics is not always good philosophy. Through practical examples and thought-provoking insights, McMillan offers a fresh perspective on ethical analysis and decision-making in clinical practice.
2024 National Paediatric Bioethics Conference: Disentangling perspectives
Moral distress is a pervasive phenomenon in healthcare and contributes to healthcare worker burnout, turnover, and withdrawal from patient care. Dr Morley provides a brief overview of the concept of moral distress and, through a series of cases, disentangles stakeholders' perspectives and concepts related to moral distress. She argues that moral compromise is central to alleviating the negative effects of moral distress and successful moral compromise requires a willingness to understand others' perspectives and values. Presenter: Dr Georgina Morley, Nurse Ethicist and Director of the Nursing Ethics Program at the Cleveland Clinic, Ohio, USA. Host: Prof John Massie, Children's Bioethics Centre, The Royal Children's Hospital, Melbourne.
Getting your heart dirty
Caring for children with severe neurological impairments presents multiple challenges. As medical technology advances, the choices for clinicians and families grow in complexity. From life-prolonging interventions to deeply personal decisions, tensions and disagreements often arise, with emotions running high. In this episode, we explore the ethical considerations across this high-stakes area of paediatric care and offer a practical toolkit to help clinicians navigate difficult decisions with confidence, compassion and clarity. Host: Prof John Massie Guests: Dr Zoë McCallum, Paediatrician, Department of Neurodevelopment & Disability at The Royal Children's Hospital Melbourne . Clinical Associate Professor Giuliana Antolovich, Paediatrician and Clinical Stream Leader, Physical Disability, Neurodevelopment & Disability at The Royal Children's Hospital, Melbourne.
How should we conceptualise suffering in children's healthcare?
Suffering is an important concept in medical practice, but it can be hard to be certain just what suffering is. This is amplified in paediatric practice when it can be hard to know when a child is suffering, especially if that child is a newborn, is pre-verbal or has severe developmental delay. In this episode we explore a new account of suffering that helps clinicians towards a consistent approach to the sick child and their family. Host: Prof John Massie Guests: Clin Assoc Prof Tyler Tate, Palliative Care Physician at Lucille Packard Children’s Hospital, California and the Center for Biomedical Ethics at Stanford University Dr Georgina Hall, Clinical Ethicist - Children’s Bioethics Centre at The Royal Children's Hospital, Melbourne
Love your patient
Tyler Tate has co-authored a wonderful paper, "Love Your Patient", which explores the lost heart of medicine that is now driven by scientific and financial imperatives. In this podcast, Tyler explains his paper and makes a call to all clinicians to orient their practice towards regarding their patients as people and thereby accept the obligation to truly care for them. To "love your patient" is not just a riff on Jesus' injunction to "love thy neighbour as thyself" but a deep philosophical enquiry that should animate clinical practice. Host: Prof John Massie Guests: Clin Assoc Prof Tyler Tate, Palliative Care Physician at Lucille Packard Children’s Hospital, California and the Center for Biomedical Ethics at Stanford University
Moral distress
Moral distress was first defined in the nursing literature (Jameton, 1984) as "the experience of knowing the right thing to do while being in a situation in which it is nearly impossible to do it". This was seen as a departure from the somewhat academic philosophical concepts of bioethical principles of the time by placing value on emotions and compassion in guiding moral action. Since then, there has been considerable work in unpacking the elements of moral distress and thinking about the implications for staff and healthcare systems and, importantly, how we might go about tackling the problem.
2024 National Paediatric Bioethics Conference: Hope within despair
Music as a therapeutic intervention is often used to transcend deficits and medical acuity, shifting instead to a strengths-based approach. Here, moments of joy are celebrated, and even the smallest positive responses offer parents an opportunity to connect with their child beyond the diagnosis. But is it ethical to foster hope in the face of end-of-life care? Music therapist Jack Thomas relates a life-changing story––with a song in his heart. Presenter: Jack Thomas, Music Therapist, The Royal Children's Hospital, Melbourne. Host: Prof John Massie, Children's Bioethics Centre, RCH Melbourne.
2024 National Paediatric Bioethics Conference: When words fail
Talking about stressful situations can give rise to euphemisms. Coded language can help smooth harsh realities or create a bond when it’s shared by a team. But in healthcare, when it stigmatises the patient, does it have the potential to undermine their quality of care? And if the patient overhears their clinicians referring to them in this way, how are they affected? Clinical Nurse Consultant Tania Ramos encounters a critical moment in her patient care experience. Presenter: Tania Ramos, Clinical Nurse Consultant, The Royal Children's Hospital, Melbourne. Host: Prof John Massie, Children's Bioethics Centre, RCH Melbourne. If this program has raised concerns for you or someone you know, the following services are available: Lifeline 13 11 14 or lifeline.org.au Kids Helpline 1800 551 800 or kidshelpline.com.au
2024 National Paediatric Bioethics Conference: Beyond distress and dilemma
Bioethics, as an applied form of ethics, is concerned with clinical problems and decision-making. This makes sense because healthcare takes action to resolve challenges in preventing and treating illness. But by focusing on dilemmas and moral distress, we sometimes lose sight of patients––and their stories––and fail to see the moral richness that permeates illness, dying and death, and by association, the moral richness of life. This does a disservice to morality, as it’s often these small epiphanies that make healthcare––and ethics––so meaningful. Presenter: Prof Ian Kerridge, Haematologist/Bone Marrow Transplant physician, Royal Northshore Hospital, Professor of Bioethics and Medicine, University of Sydney. Host: Prof John Massie, Children's Bioethics Centre, The Royal Children's Hospital, Melbourne.
2023 National Paediatric Bioethics Conference: High cost and novel therapies
Associate Professor Tom Connell speaks about the challenges faced by large children's hospitals with the availability of high cost new drugs. Speaker: Associate Professor Tom Connell, RCH Chief of Medicine. Host: Professor John Massie, Children's Bioethics Centre, The Royal Children's Hospital Melbourne.
2023 National Paediatric Bioethics Conference: Gender affirming care
Dr Daniel Wright explores innovation in the light of gender affirming care for children with gender dysphoria. Daniel shows us how philosophy can help de-pathologise issues such as gender dysphoria, yet still leave room for treatment, innovative or routine. Speaker: Daniel Wright, Clinical Psychologist and PhD candidate, Children's Bioethics Centre. Host: Professor John Massie, Children's Bioethics Centre, The Royal Children's Hospital Melbourne.
2023 National Paediatric Bioethics Conference: Hope, Humility and Innovation
One of Australia's leading clinical ethicists, Professor Ian Kerridge, brings together storytelling, clinical experience and philosophy to help us navigate a path through the complexity of innovation in health care. Speaker: Professor Ian Kerridge, haematologist and specialist in bone marrow transplantation, Royal North Shore Hospital, Sydney and Professor of Bioethics and Medicine, University of Sydney. Host: Professor John Massie, Children's Bioethics Centre, The Royal Children's Hospital Melbourne.
2023 National Paediatric Bioethics Conference: Rethinking innovation
The 2023 conference was unified by the theme of innovation. Between 2023 and 2030, there will be at least ten new and expensive therapies approved every year. But in Australia and many other nations, these won't necessarily be funded. Furthermore, there will be off-licence requests to use these innovations and other emerging therapies, along with new devices and surgical developments. How should clinicians, hospitals and health services approach this issue? How should bioethics be positioned to support these requests and the introduction of new and emerging treatments? This is a recording of the opening plenary of the 2023 conference. Speaker: Assistant Professor Bryanna Moore, Department of Bioethics and Health Humanities at the University of Texas Medical Branch and chair, American Society for Bioethics and Humanities, Paediatric Ethics Affinity Group. Host: Professor John Massie, Children's Bioethics Centre, The Royal Children's Hospital Melbourne.
Parents vs clinicians: a path to resolution
Parent-clinician conflict is a common reason that clinical ethicists become involved in children’s care. The genesis of the conflict is often quite early in the course of the child’s illness and the situation builds to a crisis when there is a difficult decision to be made. Clinicians and ethicists have a traditional way of considering the problem confronting the child. In this podcast Bry Moore and Ros McDougall offer a different lens through which to see the problem and, ideally, find a fresh way to consider the conflict and manage a path to resolution. Guests: Associate Professor Bryanna Moore, Dept of Bioethics & Health Humanities, University of Texas Medical Branch, USA, and Associate Professor Rosalind McDougall, Health Ethics at the Melbourne School of Population and Global Health, University of Melbourne. Host: Professor John Massie, Children's Bioethics Centre, The Royal Children's Hospital Melbourne.
