After the huge success of last year’s St David’s Day Conference, I was very much looking forward to this year’s event, and Abby Parish and her team once again certainly did not disappoint!
Nestled in the heart of Wales’ vibrant capital city, a stone’s throw away from the iconic sites of Cardiff Castle and the Millenium Stadium, Park Inn provided a classy, yet relaxed setting for an exciting day of learning ahead. Greeted with a lovely warm beverage and a selection of delicious pastries on arrival, there followed an opportunity to catch-up with paediatric colleagues both old and new before the opening lecture of the day.
The programme itself was particularly attractive this year, focusing on Ethics as the principal theme. On a personal note, I felt my knowledge of Ethics in Paediatrics was somewhat lacking, with minimal educational opportunities available previously to explore this complex but fascinating topic. I therefore jumped at the opportunity to attend this year’s St David’s Day Conference to broaden my knowledge and experiences.
The introductory lecture was provided by the President of the RCPCH, Professor Neena Modi. This fascinating lecture on the ethical issues in neonatal research emphasised the importance of the positive relationship between parents/patients and the medical profession, to enhance understanding about science and research methodology, whilst simultaneously strengthening trust between both parties. Professor Modi also discussed the concepts of ‘opt-out’ consent and mention of a possible ‘inclusion benefit’ in order to improve recruitment and efficiency of Randomised Controlled Trials.
The next lecture was one of three of the day by Dr Richard Hain, Consultant and all-Wales Clinical Lead in Paediatric Palliative Medicine. His ‘Introduction to Parental Authority’ talk gave an excellent insight into the difficulties often faced concerning parents’ influence on treatment and care decisions. He talked about the concept of “best interest,” discussing the differences between objective and subjective interests, and their importance in helping parents choose ‘the path of least regret’ with regards to treatment decisions.
Before morning coffee there was a case presentation session led by Wales Neonatal GRID Trainees Kate Burke and Zoe Howard. Their experiences of the management of three different babies born with Trisomy 18 highlighted the variability of genetic diagnoses, the postnatal role of perinatal palliative care, and the central role of the parents.
The final session of the morning featured a lecture on prenatal screening and the associated ethical dilemmas, by Professor Angus Clarke, Clinical Geneticist in Wales. He discussed the goals of antenatal screening programmes, particularly focusing on the permission of informed reproductive decisions, conveying ‘reproductive autonomy,’ whilst considering the balance of health economic assessments.
Dr Hain brought the morning session to a close with his lecture on ‘the value of a short life, who decides?’ This was an extremely thought-provoking session discussing the rights of the fetus, and the value of a child, particularly focusing on the views of the parents and that of the law.
The afternoon session, entitled ‘Costly care – because you’re worth it,’ focussed on the legal aspects of a number of ethical dilemmas, including reference to the relevant articles of the European Convention on Human Rights. The legal concepts were presented by Dr Rim Al-Samsam, Consultant in Paediatric Critical Care Medicine, who has a special interest in law in the context of healthcare. Dr Richard Hain then chaired an open session alongside Dr Al-Samsam, encouraging audience participation to discuss potential treatment dilemmas faced in a hypothetical case.
Following an incredibly profound and inspiring day, the CEO of the RCPCH hosted an interactive ‘road-show’ to discuss some of the topical issues faced by the RCPCH and their potential plans to improve them. Also discussed was the exciting new RCPCH curriculum, due to be launched over the coming weeks.
If you are yet to attend a St David’s Day Conference I could not recommend it more. I very much look forward to next year’s instalment already!
Dr Annabel Greenwood