Web based resources on ethics in practice

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The arenas of ethics in health care continue to develop as experience and new situations refine deliberation. As a result, the available resources proliferate.

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To inform readers of international and national activity in these arenas, this issue’s column provides information about web-based resources on ethics in practice. The information, although not totally inclusive, is offered to assist readers to find readily accessible and reliable sources of information and guidance for their ethical practice.
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/
ama.com.au/codeofethics
www.icn.ch/ethics.htm
www.nursingmidwiferyboard.gov.au/Codes-Guidelines- Statements/Codes-Guidelines.aspx#codeofethics
The Australian Medical Council, a body that accredits Australian medical schools, has published a national code of good medical practice to be used in relation to the national medical registration system. The final code is available at goodmedicalpractice.org.au/.
Bioethics
Since the emergence, about 40 years ago, of bioethics as a distinct area of ethics, 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 and academic journals.
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:
apps.who.int/ethics/nationalcommittees/nec.aspx
In Australia, the closest equivalent is the Australian Health Ethics Committee (AHEC), a principal committee of the National Health and Medical Research Council. AHEC advises the Chief Executive Officer on ethical issues in health and develops ethical guidelines on human research:
www.nhmrc.gov.au/about/committeesnhmrc/australian-health-ethicscommittee- ahec
Bioethics centres
These centres are either established independently or by universities. A list with associated websites of Australian, New Zealand and international centres can be found at aabhl.org/page/bioethics_centres.html
These include Australian academic centres such as 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 www.cvelim.org/ and independent centres such as the Adelaide Centre for Bioethics and Culture www.bioethics. org.au/ and the St James Ethics Centre www.ethics.org.au/
Internationally, prominent academic centres include those at the University of Pennsylvania www.bioethics.upenn.edu/ and the University Toronto http://www.jointcentreforbioethics.ca/ Prominent among the independent centres are the Hastings Centre http://www.thehastingscenter.org/, established in 1969 and the Nuffield Council on Bioethics http://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. (In Australia, research involving animals is governed by legislation at a State and Territory level.) The common pattern of governance is the reliance on research ethics committees, usually established in research institutions, to subject research proposals to prior review to decide if they meet the requirements of national, and international guidelines such as the Declaration of Helsinki, issued by the World Medical Association www.wma.net/en/30publications/10policies/b3/index.html
The Office for Human Research Protections, the United States of America federal agency that oversights compliance with federal regulations, publishes an international 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, issued by the National Health and Medical Research Council, the Australian Research Council and Universities Australia and updated last year:www.nhmrc.gov.au/publications/synopses/e72syn.htm. This provides for the institutional establishment of human research ethics committees.
A list of those registered with the NHMRC is available at: www.nhmrc.gov.au/health-ethics/human-researchethics- committees-hrecs/list-humanresearch- ethics-committees.
Clinical ethics
The ethics of clinical practice has not been as much the subject of specific guidelines as research, because the ethics codes of the relevant professionals, particularly doctors and nurses, cover this territory.
However, especially in the United States, the practice of using ethics committees or consultants to advise and assist health professionals has developed. Australian examples include the Clinical ethics Advisory Panel at the New South Wales Department of Health: www.health.nsw.gov.au/clinicalethics/Pages/clinical-ethics-advisory-panel.aspx and at the Royal Children’s’ Hospital in Melbourne: www.rch.org.au/bioethics/clinical.cfm?doc_id=12222.
A useful resource for clinicians on these issues is the Clinical Ethics resource at: clinicalethics.info/.
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, Cambridg University Press.