Core and affiliated staff in the Monash Bioethics Centre undertake groundbreaking research in traditional and emerging areas of bioethics. In our research, we strive for academic excellence while undertaking research that influences policy and regulation, and has impact within delivery systems for health and wellbeing.
In the latest Excellence in Research in Australia (ERA) exercise, Monash University was the only university in Australia to be awarded the top rating of ‘5’ for the area of Applied Ethics, to which the Monash Bioethics Centre is a key contributor. Additionally, Monash University was one of only two universities to receive the top rating across all criteria in the recent ERA Engagement and Impact exercise for Philosophy, including Bioethics.
Our research informs international and national scholarly debate, policy development and implementation and public understanding of the ethical dimensions of health, technology and society. We integrate our research into the Centre’s teaching and leadership programs; it is also the foundation for broad social and community engagement.
Our staff are heavily involved in social impact and community engagement activities, including media interviews, public lectures, contributions to public inquiries and the development of practice-specific guidelines in their areas of expertise.
Current research in the Centre is shaped by three programs:
Reproductive Biomedicine and Technology
Leader: Professor Catherine Mills
Associated personnel: Dr Liz Sutton (Research Fellow), Dr Molly Johnston (Postdoctoral Fellow/Associate Lecturer), Dr Alissar El-Murr (Postdoctoral Fellow), Dr Giuliana Fuscaldo (Research Fellow)
In recent decades, the experience of making a family has been fundamentally transformed by innovations in embryology, reproductive medicine and human genomics. From in vitro fertilisation to the emerging technologies of mitochondrial replacement techniques and genome editing, this research program explores the ethical, social and regulatory issues raised by new and emerging practices and technologies in reproductive biomedicine. It addresses foundational philosophical questions about ethical concepts such as responsibility and reproductive freedom, in tandem with in-depth empirical research. The core aims of the program are to understand and improve the reproductive experiences of women and their partners, and to contribute to the consistent and fair regulation of reproductive technologies, in Australia.
Funder: Australian Research Council, Discovery Projects Scheme. Investigators: A. Whittaker (Monash); C. Mills (Monash); S. Rudrappa (U. Texas at Austin); A. Marren (Sydney).
This socio-cultural study aims to undertake a comparative study of the new Australian Uterine Transplant (UTx) trial with established and emerging UTx programs in the US and India. Expected outcomes of this project include: enhanced understandings of the experiences and meanings of uterine transplant for women donors, recipients and staff involved in UTx trials; an exploration of the ethical issues raised by this technology; and a comparison of social responses to uterine transplants across different societies.This study is anticipated to provide theoretical insights on the social and ethical impacts of this technology for improved public policy responses.
Funder: National Health and Medical Research Council. Investigators: Wendy Lipworth (Sydney U.); I. Kerridge (Sydney U.); W. Ledger (UNSW); R. Norman (U. Adelaide); A. Newson (Sydney U.); C. Stewart (Sydney U.); I. Karpin (UTS); C. Mills (Monah U.); C. Waldby (ANU); C. Mayes (Deakin U.)
Funder: Australian Research Council Discovery Projects Scheme. Investigators: C. Mills (Monash); R. Sparrow (Monash); K. Ludlow (Monash); N. Warren (Monash).
The aim of this interdisciplinary project is to investigate the legal and ethical implications of technologies that allow inheritable modifications of the human genome. The use of these technologies in human embryos is fast becoming an international reality, and this project examines the implications of this in the Australian context. The clarifies the current legal status of inheritable genetic modification technologies in Australia, provides a comprehensive analysis of the ethics of these new technologies, and, building on this, proposes a set of recommendations for regulatory reform to guide Australia’s response to international scientific and legal developments.
Funder: Australian Research Council Future Fellowship Scheme. Investigator: C. Mills (Monash)
Prenatal testing technologies and medical interventions are transforming the experience of pregnancy, especially the relationship between the pregnant woman and the fetus. In doing so, these increasingly routine technologies raise difﬁcult ethical questions for prospective parents. This philosophical project addresses ethical questions raised by these technologies to generate a new approach to reproductive responsibility that accounts for the ethical signiﬁcance of the maternal-fetal relationship.
Full title: Ultrasound, embodiment and abortion: An analysis of foetal imaging and the ethics of the selective termination of pregnancy.
Funder: Australian Research Council Discovery Projects Scheme. Investigators: C. Mills (Monash); N. Stephenson (UNSW).
Obstetric ultrasound screening is a routine aspect of pregnancy, and foetal images are a familiar part of our cultural landscape. Using multi-dimensional social research and philosophical analysis, this project investigates the ways ultrasound screening shapes the experience of pregnancy and impacts on the continuation or termination of pregnancy following diagnosis of foetal abnormalities. It will lead to an innovative theoretical framework for understanding the ethics of abortion that takes into account women's experience in undergoing obstetric ultrasound prental testing.
Values and Virtues in Healthcare
Leader: Professor Justin Oakley
Associated personnel: Dr Lauren Notini (Research Fellow)
Virtue ethics evaluates a person’s actions by considering what character-traits or virtues are the most relevant to act on in their situation. So virtue ethics is distinctive in looking at the psychology of human decision-making, and at the moral motivations behind what people do – in other words, the ‘human factors’ which contribute to good and bad outcomes. These human factors can play a critical role in good and bad health outcomes for patients, and for the community. Virtue ethics enables us to probe these human factors in innovative and fruitful ways. However, virtue ethics is often seen as very individualistic, and as not always very evidence-based.
This research program understands virtues within broader institutional contexts. The research program has two core aims. First, to provide more empirically-informed accounts of healthcare professional virtues, and of how virtuous dispositions can succeed or fail. And second, to transform our understanding of how institutions and policymakers can enable and support virtuous behaviour by practitioners.
Funder: Australian Research Council Discovery Projects Scheme. Investigators: J. Oakley (Monash), S. Clarke (Charles Sturt U.), C.A.J. Coady (U. of Melbourne), J. Savelescu (Oxford) and D. Wilkinson (Oxford).
This project aims to develop a systematic approach to accommodating religious values and practices in healthcare. Current approaches are ad hoc and discriminatory, and in an increasingly religiously diverse contemporary Australia, a systematic approach is needed. This project will consider and provide policy advice on how healthcare could be reformed so that the issue of accommodation of religious values and practices is treated in a consistent and ethical manner. The benefit of the project will be a better, cost effective, model for healthcare management that reduces disparities for disadvantaged and vulnerable groups.
This project aims to improve patient care by devising new approaches for policymakers, healthcare organisations, and healthcare professionals to developing and maintaining practically intelligent professional virtues and virtuous clinical practice. A key aim of this project is to translate research on empirically-informed virtuous professional practice into the development of policy across a range of professions – and, in turn, to use these practical and policy applications to provide further insights into the moral psychology of professional virtues themselves.
This project understands virtues within broader institutional contexts. It draws on robust evidence both on individual strategies to build and strengthen practitioner virtues, and institutional strategies to support practitioner virtues. The project has developed an innovative virtue ethics regulatory model, which I have applied to the regulation of direct-to-consumer pharmaceutical advertising, doctors’ prescribing decisions, medical conflicts of interest, end of life decisions, research ethics, and other areas.
Another innovative feature of this project is its emphasis on the reciprocal interdependence of moral psychology and ethical theory on practice and policy, as I use ethical theory and empirical work in moral psychology to inform practice and policy, while also drawing on these policy and practice applications to refine ethical theory and concepts in moral psychology. This project also considers the nature of secular and religious medical virtues, and the extent to which religious virtues should be accommodated in health care practice and policy.
This research on policy applications of virtue ethics has recently informed the Ethical guidance on allocation of critical care during COVID-19 document, developed for Safer Care Victoria (in the Department of Health and Human Services) by a research team led by Prof Justin Oakley.
Additionally, Justin Oakley is currently working on a book-length project on policy applications of virtue ethics in professional practice, tentatively titled Virtue ethics from the inside out and back again: moral psychology to policy and return.
Infectious Disease Ethics
Leader: Professor Michael Selgelid
Associated personnel: Dr Euzebiusz (“Zeb”) Jamrozik
Infectious disease ethics is a central topic of public health ethics, which has been one of the fastest growing subdisciplines of bioethics during recent decades. It is concerned with a wide range of ethical issues associated with infectious diseases and their control, including questions regarding the obligation of individuals to avoid infection of others; relevant professional obligations of healthcare and public health professionals; infectious disease control policy matters; infectious disease research and surveillance; and global health.
Core aims of this research program are to provide philosophically-rigorous, empirically-informed, practically-relevant guidance regarding the ethical conduct of infectious disease research and ethically sound infectious disease control policy-making in particular.
Funder: The Wellcome Trust. Investigator: M Selgelid
Human infection challenge studies involve the intentional infection of human research participants with pathogens — often with the ultimate aim of facilitating vaccine research and development. The purpose of this research project was to investigate the key ethical and regulatory considerations regarding human infection challenge studies in endemic settings (especially in low- and middle-income countries), and to examine the ethical processes (e.g. in the design, review, and conduct) involved in such studies to date.
The final peport of this project was published as a book by Springer-Nature: Human Challenge Studies in Endemic Settings.
Funder: US National Institutes of Health. Investigator: M Selgelid
Gain-of-function (GOF) research involves experimentation that aims or is expected to (and/or, perhaps, actually does) increase the transmissibility and/or virulence of pathogens. The ultimate objective of such research, when conducted by responsible scientists, is to better inform public health and preparedness efforts and/or development of medical countermeasures. Despite these important potential benefits, GOF research (GOFR) can pose risks regarding biosecurity and biosafety.
In 2014 the administration of US President Barack Obama called for a “pause” on funding (and relevant research with existing US Government funding) of GOF experiments involving influenza, SARS, and MERS viruses in particular. With announcement of this pause, the US Government launched a “deliberative process” regarding risks and benefits of GOFR to inform future funding decisions — and the US National Science Advisory Board for Biosecurity (NSABB) was tasked with making recommendations to the US Government on this matter.
As part of this deliberative process, the National Institutes of Health (NIH) commissioned this research project to provide
- review and summary of ethical literature on GOFR
- identification and analysis of existing ethical and decision-making frameworks relevant to (i) the evaluation of risks and benefits of GOFR, (ii) decision-making about the conduct of GOF studies, and (iii) the development of US policy regarding GOFR (especially with respect to funding of GOFR), and
- development of an ethical and decision-making framework that may be considered by NSABB when analyzing information provided by GOFR risk-benefit assessment, and when crafting its final recommendations (especially regarding GOFR funding policy decisions in particular).
The White Paper resulting from this project was published in Science and Engineering Ethics.
Funder: The Wellcome Trust. Investigators: M Dando, S Whitby, J Whitman, B Rappert, A Kelle, J Sture, M Selgelid.
This project involved collaboration on research into the use of the products of biological research in warfare and bioterrorism. It aimed to enable more bioethical research into so-called ‘dual-use’ of the life sciences, and help develop policies and practices that will prevent the misuse of knowledge generated through biomedical research. It is an emerging research area, and the Enhancement Award helped to provide career opportunities for young researchers including several doctoral students, increase long-term capacity, engage practising life scientists with these issues, and provide a basis for developing effective policies in the future.
Outputs from this project included a book On the Dual Uses of Science and Ethics.
Funder: Australian Research Council. Investigators: C Enemark and M Selgelid
The emergence and spread of deadly infectious diseases increasingly pose health, economic, security, and ethical challenges for Australia and the world. This project investigated links between infectious diseases, national security and human ethics. The project aimed:
- To identify and analyse national security and ethical issues associated with government responses to five infectious disease challenges (pandemic influenza, SARS, plague, TB and HIV/AIDS);
- To develop ethically acceptable policy recommendations for control of diseases with security implications.
Among other outputs, this project culminated in a book on Ethics and Security Aspects of Infectious Disease Control.