Clinical Ethics Support Service (CESS)
Contact us or refer a case
Enquiries: SCHN-ClinicalEthicsSupport@health.nsw.gov.au
Phone: 02 7825 0810
About our service
The Clinical Ethics Support Service (CESS) aims to improve children's welfare by promoting the best interests, and agency of children and their families in healthcare.
The Clinical Ethics Support Service is a Network-wide service and provides support to healthcare professionals experiencing ethical dilemmas in practice and aims to embed clinical ethics principles and capacity across all areas of the Network.
The service is consultative and non-adjudicative, and provides:
- Ethics case consultations for current clinical cases in a structured and confidential manner
- Informal ethics discussion regarding an ethical concern or query
- Ethical reviews of past clinical cases to assist learning
- Ethics Rounds
- Facilitated departmental discussions to encourage communication and practical problem-solving
- Support where conflict arises, or challenging behaviours occur with decision makers
- Regular ethics discussion groups
Consideration of and involvement in clinical ethics have a long-standing tradition at both the Sydney Children’s Hospital, Randwick, The Children’s Hospital at Westmead and Bear Cottage Hospice.
We acknowledge the important legacy of Professor David Isaacs and A/Professor Henry Kilham in establishing and developing the CESS.
Service information
Issues we consider during consultations
- Informed consent, including capacity and confidentiality
- End-of-life decision making (including advanced treatment plans and withdrawal and withholding treatment)
- Disagreement between stakeholders and decision makers
- Truth telling and disclosure to children (children/families rights)
- Children's participation in decision-making
- Parent’s role as proxy decision makers
- Management of conflict between stakeholders and challenging behaviours
- Cultural issues and values/cross cultural care including Aboriginal and Torres Strait Islander peoples
- Accommodation of conscience
- LGBTQI+ ethics
- Genetic testing and counselling
- Children's participation in research- competence, opt out consent, children's assent to treatment
- Clinical research and novel therapies
- Just distribution of health resources
- Use of interpreters
- Vaccination practice
- Professional practice, including communication/confidentiality between providers
Who can access the service
The service can consult with any Sydney Children's Hospitals Network member of a clinical team or SCHN affiliated teams.
Families and external clinicians can access the service for information or direction to resources or pathways.
Clinical ethics service response time
The clinical ethics service responds to cases and enquiries within 48 hours.
What happens in a clinical ethics consultation
An initial confidential discussion will be scheduled to consider the issue raised and decide on the level of involvement and ethical question of the service with the referrer.
A formal clinical ethics consultation generally includes the clinical ethicist, and or Fellow, the referring clinician, and representatives of the relevant team involved in the child’s care.
Clinical Ethics Response Group (CERG)
The Clinical Ethics Response Group (CERG) is a group of engaged and experienced clinicians with an interest or training in ethics who attend consultations, assist with ethics input to policy, and meet 5 times per year for service evaluation, development and discussion of ethical themes and issues.
Meet the team
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Anne Preisz, Clinical Ethicist
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Dr Philip Britton, HOD Infectious Diseases, Clinical Ethics Acting Medical Lead, Head of CPIR
