HOW does an aged-care worker navigate the rights of a dementia patient who refuses to shower?
How does a doctor decide when a patient can really consent to a procedure?
Health workers are constantly called on to make critical decisions, yet they cannot always look to the law for answers.
“Good law is very important, but being able to make ethical decisions in spite of not knowing exactly what will happen requires a level of ethical thinking that is much more nuanced than simply appealing to the relevant law,” the new Queensland Bioethics Centre director Dr David Kirchhoffer said.
The centre is a joint venture between the Australian Catholic University, the Archdiocese of Brisbane and several Queensland Catholic health care organisations, recognising the need to combine university research, health care experience and religious intellectual tradition to enable the best ethical decision-making in Catholic health care settings.
Based at the ACU campus at Banyo, Dr Kirchhoffer will provide research, advice and training to help doctors, nurses, aged-care workers, bishops and priests make ethical decisions.
Within the health care sector, Catholic Health Australia is the largest non-government provider of health, community and aged-care services with 75 hospitals and 550 aged-care services.
There are three Catholic hospitals and 22 aged-care homes in Brisbane alone.
Dr Kirchhoffer said many health workers made decisions daily about life and death, and often did not have extensive formal training to understand how to make a bioethical decision.
“Bioethics is often seen as a place for people talking about abortion and euthanasia. But there are so many other issues,” he said.
“Questions of autonomy are very important, particularly for human research ethics.
“We have a standard model of informed consent. But what about populations that are unable to consent – people with dementia, children below the legal age of consent, infants, people whose autonomy is compromised because of issues such as addiction or psychological issues?
“What about people in prisons or asylum seekers shut on an island where if a doctor with a white coat asks them to do something they are not in a position to say no?
“Often these are under-researched populations because of the difficulties around obtaining informed consent, and that’s an ethical problem too.
“Autonomy is a piece of the puzzle but it should not be treated as the only relevant criterion.”
Dr Kirchhoffer said bioethics research was also needed to keep up with changing science.
For instance, how will a priest know what to say when the first parishioner asks about getting a chip implanted to enhance athletic ability?
“New technology is setting up questions about what it is to be human,” Dr Kirchhoffer said.
“With genetic modification and nanotechnology, we are already moving towards the realm of human-machine hybridisation.
“People are already walking around with technological devices tracking their every move.
“It’s only a step to those chips being implanted in our bodies.”
The capacity for human enhancement through chemical, genetic or technological means will create more questions.
“If medicine is traditionally about curing, what happens when we are actually moving beyond the norm through enhancement – particularly when that is associated with weaponisation?” Dr Kirchhoffer said.
He said the bioethics centre would be able to provide health workers with training and advice using contemporary research methods and the wide range of Catholic thinking.
“Catholic bioethics is often presented as monolithic. It’s not,” Dr Kirchhoffer said. “Catholic bioethicists are debating these issues themselves.
“The need for a centre like this is because there’s a value in having a place where ethics and ethical methodologies interact with religious thought in systematic ways so that people come to understand the nuances and can make a decision in good conscience.
“Ultimately ethics is about giving people the tools to make decisions themselves.
“It’s a problem if people come to me expecting me to make decisions for them because then they are not taking personal responsibility.”
The Queensland Bioethics Centre, situated at ACU’s Banyo Campus, Brisbane, will be launched at noon on May 25 at St Stephen’s Cathedral.