Ethics of Clinical Practice - How to Apply

The SLHD Ethics Review Committee has two Sub-committees that consider ethical issues relating to clinical practice.
1. Ethics of Clinical Practice Sub-committee
This Sub-committee considers primarily policy issues in areas relevant to clinical practice.
Issues can be referred from:

• SLHD Ethics Review Committee
• Hospital administration
• Medical Board
• Other committees (e.g. Patient Care Committee, Drug Committee, Quality Assurance Committee, Infection Control Committee, Data Security Committee, etc.)
• Any individual associated with SLHD.

The issues which the Sub-committee is available to review include:

• Assisted reproductive technologies (IVF, surrogacy, donor insemination, etc.)
• Care of the terminally ill
• Not-for-resuscitation policies
• Withdrawal of life-support
• Pregnancy termination
• Consent for post-mortem examinations & use of tissues
• Innovative therapies (see below for full details)
• Resource allocation
• Ethical issues in postgraduate teaching
• Relationship between health care professionals and the pharmaceutical industry
• Innovative therapies

Most proposals for the introduction of new techniques and the use of approved / listed devices in new settings are considered by the Ethics of Clinical Practice Sub-committee once support in principle has been obtained at facility level. See the SLHD Policy Directive SLHD_PD2015_022 "New Interventional Procedures: The Safe Introduction of New Interventional Procedures and Clinical Innovations into Clinical Practice". Where the new intervention has any commercial involvement, a standard protocol and / or a patient outcomes register, or where the device has not been approved / listed for use in Australia, consideration by the Clinical Trials Sub-committee and the Ethics Review Committee will be required as an alternative pathway, ie Study protocol / Registry > Clinical Trials Sub-committee / Ethics Review Committee > notification to the Therapeutic Goods Administration (TGA) under the CTN Scheme.

Implementation of a new intervention on the basis of individual patient need using an unapproved device > application via the Ethics Review Committee to the TGA under the SAS or for the clinician to become an Authorised Prescriber of the product.The Sub-committee's Terms of Reference and membership are available elsewhere on this website. The Sub-committee meets monthly, and reports via the SLHD Ethics Review Committee. Meetings are relatively informal. Relevant individuals are often invited to attend meetings to discuss issues or provide expert advice to the Sub-committee.

Contact with the Sub-committee can be made through the Executive Officer (Ms Sanaa Thomas) or the Chairman (Dr Rob Loblay, 0417 210 085).

2. Clinical Ethics Advisory Panel
A Panel derived from the membership of the Ethics of Clinical Practice Sub-committee can provide advice about individual cases or specific circumstances where there are ethical issues of significant concern. Any member of staff can seek the Sub-committee's advice and, if necessary, a Panel can be convened at short notice (24-48 hours). The Sub-committee's services can be requested in any situation where there is:

• an ethical dilemma which cannot be easily resolved;
• a highly sensitive or controversial ethical issue;
• a serious difference of ethical opinion amongst stakeholders in a particular situation.
• The Panel meets on an ad hoc basis. Its core membership is drawn from the Ethics of Clinical Practice Sub-committee, but other individuals with relevant expertise can be co-opted according to the circumstances. Normally, the applicant(s) and (where appropriate) other relevant stakeholders are invited to meet with the Panel to present the problem and exchange opinions about the issues.

The role of the Panel is an advisory one and the final responsibility for decisions rests with the senior clinician or administrator. As indicated above, the Sub-committee can be contacted 24 hours per day, 7 days per week. 
Working hours: Executive Officer: Ms Sanaa Thomas sanaa.thomas@health.nsw.gov.au
Convenor: Professor David Cook 0419 195 535
After hours: Contact the Convenor by mobile phone or through the RPAH switchboard.