Synopsis

This Grand Round will feature two presentations on the ethical complexities of decision-making for children with life-limiting conditions. While shared decision-making is the accepted ethical approach, the devil is in the detail.

Dr Sid Vemuri will discuss different ways in which physicians go about shared decision-making.  Based on data from a qualitative study of 25 paediatricians, Sid will describe four distinct approaches, with ethically significant differences in the role for parents in each. Which of these approaches is ethically acceptable, for what reasons and in what situations?

Dr Giuliana Antolovich will discuss information-sharing, a crucial aspect of shared decision-making that is often not given due ethical attention, even though it shapes the way in which decision-making plays out.  Her analysis will focus on the ethics of answering a question that parents sometimes ask when their child has a life-limiting condition – “Doctor, isn’t there anything else you can do?”.

Discussion of the ideas arising from these two presentations will be facilitated by Lynn Gillam.

Speakers

Dr Sid Vemuri is a paediatric palliative care physician with the Victorian Paediatric Palliative Care Program, and PhD candidate in the Department of Paediatrics, University of Melbourne.

Dr Giuliana Antolovich is paediatrician in the Department of Neurodevelopment and Disability at RCH.

Professor Lynn Gillam is a clinical ethicist at the Children’s Bioethics Centre, RCH and Professor of Health Ethics in the Department of Paediatrics, University of Melbourne.