1. Clinical ethics........................is everyone’s business ! Alastair Macdonald HQSC September 25 th 2012

2. Key stakeholders A working party - stock take of clinical ethics in NZ ? Short/medium term goals Clinical ethics network Website / Report

3. On being a patient Empowered? Fully autonomous ?

4. On being a patient Empowered? Fully autonomous ? Sick, dazed, weak, possibly confused? A need to trust?

5. We all need to take time to make the difficult decisions.........

7. ..........usually as part of a team!

8. What if you need an ethics opinion?

12. The problem...........?.......we don’t have a clinical ethics network.

13. The United Nations Educational, Scientific and Cultural Organisation (UNESCO) Universal Declaration on Bioethics and Human Rights in October 2005 –Article 19 “Independent, multidisciplinary ethics committees should be established, promoted and supported” –Article 23 “.......foster debate, education and public awareness of and engagement in bioethics at all levels

14. Clinical ethics committees/groups in NZ Auckland hospital CEAG 15 years Waitemata Lakes Bay of Plenty Mid-Central Wellington 27/10/09 –Includes Hutt and Wairarapa Taranaki March 2012

15. Having a network means..............We can talk to each other !!

16. Having a network means..............We can talk to each other !! –National reporting of referrals from individual CEAGs –Determination of referral patterns –Development of educational resources/training programmes –Achievement of many of the goals of the UNESCO declaration on bioethics.

17. Having a network means...... A mature basis for discussion of ethical issues –Limited resources –Increasing demands upon those services –New technology –Aging population –DNAR or AND –Advance directives –Euthanasia

18. Patients - can we do better ?

19. Yes we can !

20. Key stakeholders A working party - stock take of clinical ethics in NZ Clinical Ethics Network For New Zealand Short/medium term goals Clinical ethics network Website / Report

22. “Clinical ethics is everyone’s business”