Ethics and the Internet - Going to the source

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In 2009, this column, in a two-part series, contained information about web-based resources on ethics, bioethics, research and clinical ethics. The information was offered to assist readers to find readily accessible and reliable sources of information and guidance for their ethical practice. Some seven years later, it is perhaps time to revisit and update that information.

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Professional ethics
The ethics of health professions emerged as those professions sought to identify themselves and what they wished to make distinctive about their membership. The codes of professional ethics continue to serve this purpose and, in Australia, have become increasingly linked to statutory registration and regulation of the conduct of these professions.
The World Medical Association, the Australian Medical Association, the International Council of Nurses and the Australian Nursing and Midwifery Council have published codes of ethics, available, respectively, at:
www.wma.net/en/30publications/10policies/c8/
www.ama.com.au/tas/ama-code-ethics-2004-editorially-revised-2006
www.icn.ch/ethics.htm www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Codes-Guidelines.aspx#codeofethics
More recently, the Australian Medical Council, whose functions include education of overseas trained doctors and accreditation of Australian medical schools, developed and published a code of good medical practice. The Medical Board of Australia has adopted the code and, as a result, it can be relied upon as evidence of relevant standards of professional practice in proceedings involving doctors. The code is available at www.medicalboard.gov. au/Codes-Guidelines-Policies/Code-of-conduct.aspx.
Bioethics
Since the emergence, about fifty years ago, of bioethics, its importance for national policies in health and its growth as an academic discipline are reflected in the establishment of national advisory bodies, of academic centres.
National bioethics advisory bodies
Many nations have established national bioethics advisory bodies that serve a range of functions, including advice on government policy, response to citizens’ requests for information and advice and the development of guidelines on clinical practice and research. The World Health Organization provides a useful list of contact details for many of these bodies:
www.apps.who.int/ethics/nationalcommittees/
In Australia, the closest equivalent is the Australian Health Ethics Committee, a principal committee of the National Health and Medical Research Council (NHMRC). It advises the Chief Executive Officer of the NHMRC on ethical issues in health and develops ethical guidelines on human research:
www.nhmrc.gov.au/about/nhmrccommittees/australian-health-ethics-committee-ahec.
Bioethics centres
These centres are typically established independently or by universities. A representative list with associated websites can be found at aabhl.org/page/bioethics_centres.html.
Australian academic centres include the Centre for Human Bioethics at Monash University arts.monash.edu.au/bioethics and the Centre for Values, Ethics and the Law in Medicine at the University of Sydney http://sydney.edu.au/medicine/velim/ and independent centres such as the Ethics Centre (formerly known as the St. James Ethics Centre) http://www.ethics.org.au and the Adelaide Centre for Bioethics and Culture http://www.bioethics.org.au.
Internationally, prominent academic centres include those at the University of Pennsylvania www.bioethics.upenn.edu, the Kennedy Institute of Ethics at Georgetown University kennedyinstitute.georgetown.edu, the University of Toronto www.jointcentreforbioethics.ca and the Ethox Centre www.ndph.ox.ac.uk/research/ethox-centre and the Oxford Uehiro Centre for Practical Ethics, www.practicalethics.ox.ac.uk/home both at Oxford University. Independent centres include the Hastings Centre www.thehastingscenter.org and the Nuffield Council on Bioethics www.nuffieldbioethics.org.
Research ethics
The ethics of research involving human participants has been the subject of extensive development of guidelines, legislation and advisory bodies. The common pattern of governance is the reliance on research ethics committees, usually established in universities, hospitals and research institutions, to subject research proposals to prior review in order to decide if they meet the requirements of national and international guidelines such as the Declaration of Helsinki, issued by the World Medical Association.
Websites include www.wma.net/en/30publications/10policies/b3/index.html owww.wma.net/en/30publications/10policies/b3/index.htmlr the International Ethical Guidelines for Biomedical Research Involving Human Subjects (currently under review) issued by the Council for International Organizations of Medical Sciences www.cioms.ch/final_draft_CIOMS_guidelines-10_september_2015-WITH_WATERMARKS.pdf
The Office for Human Research Protections, the United States of America federal agency that oversights compliance with federal regulations, publishes an compilation of national human research governance that is updated annually:
www.hhs.gov/ohrp/international.
In Australia, the relevant national guidelines are contained in the National Statement on Ethical Conduct in Human Research, 2007 (updated 2015), issued by the National Health and Medical Research Council, the Australian Research Council and Universities Australia: www.nhmrc.gov.au/publications/synopses/e72syn.htm. This provides for the institutional establishment of human research ethics committees of which more than 200 are known in Australia.
Clinical ethics
The ethics of clinical practice has more recently been the subject of specific guidance, because the ethics codes of the relevant professions, particularly doctors and nurses, were seen to cover this territory. However, especially in the United States, the practice of using ethics committees to advise and assist health professionals has developed.
Australian examples of this recent attention include those at the New South Wales Department of Health: www.health.nsw.gov.au/clinicalethics/pages/default.aspx, ACT Health http://www.health.act.gov.au/about-us/clinical-ethics-committee and the clinical ethics service at the Royal Children’s’ Hospital in Melbourne: www.rch.org.au/bioethics/clinical.cfm?doc_id=12222.
Lastly, as a valuable, regular and free service, Ethics and Health Law News - www.ehln.org - provides weekly bulletins of current information and links to sources.

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“Many nations have established national bioethics advisory bodies that serve a range of functions, including advice on government policy, response to citizens’ requests for information and advice and the development of guidelines on clinical practice and research.”

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Colin Thomson
BA, LLB, LLM (Sydney) www.ehealthinfo.gov.au
Colin Thomson, BA, LLM (Sydney) is Professor of Law at the University of Wollongong and Academic Leader for Health Law and Ethics in the Graduate School of Medicine. He also works as a consultant.
He was a member of the Medical Research Ethics Committee (1988-91) of the National Health and Medical Research Council and, from 1998-2002 a member, and from 2006-2009, chair of the Australian Health Ethics Committee. As a consultant, he has advised NHMRC, FaHCSIA, Health Departments of NSW, Qld and Vic and several universities. He is a Senior Consultant with Australasian Human Research Ethics Consultancy Services (www.ahrecs.com).
Colin has provided training to human research ethics committees, chairs the CSIRO Social Science HREC and is a member of HRECs at Department of Health and Ageing and University of Wollongong/Illawarra Shoalhaven LHD.
He is a joint author of Good Medical Practice: professionalism, ethics and law, 2010, Cambridge University Press.