Clinical Ethics Support Service (CESS)

Contact us or refer a case


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

Anne Preisz

Anne Preisz, Clinical Ethicist

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Anne leads the CESS and holds a postgraduate Masters degree in Bioethics from the University of Sydney. Her clinical background is as a specialist physiotherapist in neuromuscular and neonatal care. Anne interned at the RCH Children’s Bioethics Centre and is an NMAS accredited Mediator and an Honorary Associate at Sydney Health Ethics, University of Sydney and a Senior Lecturer at the University of Notre Dame, Bioethics department.
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Dr Philip Britton

Dr Philip Britton, HOD Infectious Diseases, Clinical Ethics Acting Medical Lead, Head of CPIR

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Dr Britton is a paediatrician, infectious diseases physician and Associate Professor in child and adolescent health at the University of Sydney. He is completing his Master's degree in Bioethics from the University of Notre Dame. Dr Britton has expertise in surveillance of severe childhood infectious disease and neurological infections. He co-leads the Commonwealth department of the PAEDS network and collaborates on inpatient clinical trials.
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Melissa Drinkwater

Melissa Drinkwater, Clinical Ethics Fellow

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Melissa has a Masters in Bioethics from the University of Sydney. She is a General Practitioner (GP) based in Sydney, with a special interest in children and young people's health. Melissa's care approach is strong, holistic and collaborative for patients and families. Prior to her GP training, Melissa was a paediatric trainee at the Sydney Children's Hospital Network.
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Last updated Wednesday 17th July 2024