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Paediatric clinical ethics in Australia and New Zealand: a survey
  1. Emma Cottle1,
  2. Melanie Jansen2,
  3. Helen Irving2,
  4. Ben Mathews3
  1. 1 School of Medicine, Griffith University, Gold Coast, Queensland, Australia
  2. 2 Centre for Children’s Health Ethics and Law, Children’s Health Queensland, Brisbane, Queensland, Australia
  3. 3 Australian Centre for Health Law Research, Queensland University of Technology, Brisbane, Queensland, Australia
  1. Correspondence to Dr Emma Cottle; emma.cottle{at}


Objectives To quantify the presence, purpose, function, governance and funding of clinical ethics services (CES) in tertiary paediatric hospitals in Australia and New Zealand.

Design, setting and participants A descriptive, quantitative survey was conducted across eight paediatric hospitals.

Main outcome measures Responses from survey questions on the presence, purpose, function, governance and funding of the CES.

Results Seven of eight tertiary paediatric hospitals identified access to CES. Regarding purpose and function, all CES provided clinical case consultation, six of seven provided education and training, six of seven assisted with organisational policy and guideline development and four of seven undertook original ethics research. There was wide variation in how case consultations were conducted, reported and documented. With respect to governance and funding, all CES reported to their hospital executive and only one CES reported having a dedicated, although small, budget.

Conclusions Heterogeneity in the process of case consultation and CES policy content exists across the organisations studied. There is consistency with the broader values that underpin CES such as their multidisciplinary nature and level of training required for key staff. There is an apparent lack of formal budgetary support from health services for CES activities, with support derived mostly from staff who contribute their time in addition to their primary roles.

  • clinical ethics services
  • clinical ethics
  • clinical ethics response group
  • clinical ethics advisory group
  • paediatric
  • health service

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  • Contributors EC and MJ were responsible for a literature review, drafting and editing of the research protocol, drafting and editing of the survey instrument, recruiting participating facilities, and drafting and editing of the final article. HI and BM were responsible for editing the research protocol, the survey instrument and the final article. This study was undertaken by a final year MD student, supervised and coauthored by members of CCHEL in compliance with the ICMJE Recommendations. All authors had access to all of the data.

  • Funding Funding of this study fell under the remit of CCHEL. All authors had full access to all of the data.

  • Competing interests None declared.

  • Ethics approval Ethics approval was granted by the following HRECs: Sydney Children’s Hospitals Network (LNR/15/SCHN/428, 18/11/2015), Women’s and Children’s Hospital Network (HREC/15/WCHN/194, 11/03/2016), Queensland University of Technology (1500000971, 13/11/2015), Children’s Health Queensland (HREC/15/QRCH/171, 15/09/2015). Formal HREC approval was not required by Monash Health, Royal Children’s Hospital or Princess Margaret Hospital for Children.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement There are no additional unpublished data from this study.

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