Paediatric clinical ethics in Australia and New Zealand: a survey

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.