Clinical Ethics and Mediation Services
Providing services for clinicians, welfare staff, patients and families.
Professor Clare Delany provides a Clinical Ethics Consultation Service for individual clinicians and health organisations and services who do not have their own embedded clinical ethicists. The consultancy service is committed to being deliberative, respectful and inclusive of diverse perspectives, and collaborative.
Requests for clinical ethics consultations may come from individual practitioners within hospitals or health institutions or from institutions concerned with patient welfare such as Departments of Health and Human Services.
(PhD, BAppSc (Physio), Masters of Hlth and Med Law, Masters of Physio, Nationally Accredited Mediator)
Professor Clare Delany
Professor Clare Delany is a clinical ethicist at the Children’s Bioethics Centre at the Royal Children’s Hospital and a consultant clinical ethicist at Peter MacCallum Cancer Centre in Melbourne.
In the Department of Medical Education, Melbourne Medical School, Clare works closely with health professionals from a variety of disciplines to conduct education research relevant to their clinical contexts.
Clare is the chair of University of Melbourne, Central Human Research Ethics Committee.
What is involved in a clinical ethics consultation?
A clinical ethics case consultation is a facilitative process where a clinical ethicist supports clinicians to think systematically and thoroughly about ethical concerns. Ethically available options will be proposed and advice given in some circumstances, but the resulting decisions and actions about patient care remain the responsibility of the clinicians or other staff involved in welfare decisions for others.
What are the benefits of clinical ethics?
Clinical ethics is about making good decisions in ethically complex situations. Clinical ethics discussions draw from ethical principles and related concepts and aim to identify and analyse individual patient/client care scenarios where there are dilemmas, uncertainties or disagreements about the ‘right’ action for a patient and/or families or carers. Clinical ethics consultations and discussions help clinicians and patients to recognise, to better understand and to more consistently make good ethical decisions.
The ethics case consultation process helps clinicians to ensure that they have carefully and thoroughly considered all moral aspects of cases. In the uncommon situations where clinicians feel they cannot fully achieve what they believe to be the best outcome for a patient, ethics consultations and discussion can assist in alleviating and giving staff tools to address moral distress.
Research shows that clinical ethics:
Decreases moral distress in staff, and associated burn out and staff attrition¹
Introduces productive and collaborative models conflict management. In healthcare²³
Assists clinicians to identify and analyse ethical complexity¹
Establishes a safe space to discuss high stakes, and ethically and emotionally challenging cases¹²
Improves the quality of health care outcomes⁴
Services
Clare provides a Clinical Ethics Mediation Service for clinicians or welfare staff and patients and families to address conflict, arising from significant differences in values and positions regarding goals of care, or the best ways to achieve those goals. Importantly, any resolution or outcome from a clinical ethics mediation needs to fit within the scope of what is ethically acceptable.
The mediation process is facilitative in approach. This means Clare will focus the parties on their interests, facilitate and encourage discussion between them, and assist them to identify common interests and ethically available options in the interests of a patient or client.
As a mediator using the facilitative model, Clare will not suggest solutions or be directive in the development of options. The aim is to enable clinicians and parents/patients/families to have problem-solving conversations with the goal of finding common ground leading to a mutually acceptable plan of action in the interests of a child, patient or client.
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Laura Guidry-Grimes, Marika Warren, Hannah I. Lipman, Kelly Kent, Kaarkuzhali Babu Krishnamurthy, Arlene M. Davis, Tho- mas May, Marycon Chin Jiro, and Jane Jankowski, “Clarifying a Clinical Ethics Service’s Value, the Visible and the Hidden,” The Journal of Clinical Ethics 30, no. 3 (Fall 2019): 251-61.
Newson, A. The value of Clinical Ethics Support in Australian Healthcare. MJA 202 (11) 15 June 2015.
McDougall,R, Delany C and Gillam, L "Collaboration in clinical ethics consultation: a method for achieving “balanced accountability”." The American Journal of Bioethics 14.6 (2014): 47-48.
Sine, David M., and Virginia A. Sharpe. "Ethics, risk, and patient‐centered care: How collaboration between clinical ethicists and risk management leads to respectful patient care." Journal of Healthcare Risk Management 31.1 (2011): 32-37.