ACU’s exploration of advance care planning, which enables patient wishes to inform decisions made by families and medical professionals and to respect patient autonomy and dignity, has led to the development of further research into other areas of medical ethics around aged care issues.

The ACU Plunkett Centre for Ethics research on the subject has significantly improved awareness, policy and practice in the Catholic healthcare system and beyond. It has contributed to new national guidelines for Catholic Health Australia, and policies, procedures and capability development in an acute public teaching hospital and a major aged care provider.

Dr Bernadette Tobin AO, Reader in Philosophy and Director of the Plunkett Centre for Ethics at St Vincent’s Hospital in Sydney, and Dr Steve Matthews, Senior Research Fellow at the Plunkett Centre, collaborated on the research, which has since been applied to questions of end-of-life care in aged care and healthcare settings and decision-making by and for people living with dementia.

Dr Tobin said it had been a significant project over the years for those who clarify healthcare ethics, particularly as it is understood in the Catholic tradition.

“It provides a chance to reflect on ethical practices and work out ways of enacting them for health practitioners,” Dr Tobin said.

“Victoria’s introduction of doctor-assisted suicide impacts the context of how some people think of advance care planning. What is the proper treatment and care for people at the end of their life? How can people with a cognitive impairment ensure that the treatment and care they receive towards the end of their life is consistent with their hopes and priorities? How can individuals and institutions ensure that their commitment to medicine’s traditional healing ethic (a much broader concept than just curing people of illnesses) is not undermined by the new social context in which healthcare is delivered?

“Once you change one element of that context, it affects everything else.”

Dr Matthews’ current ARC-funded research builds on the foundation of his thinking about advance care planning. Entitled Dementia, Moral Agency and Identity: Respecting the Vulnerable, it aims to examine the ethical issues raised by dementia and the care of those living with it.

"The development of increased understandings of the relevant ethical considerations for treatment, and recommendations for new and ethical approaches to policy on dementia, will deliver more humane healthcare, and it will augment the well-being not only of those living with dementia, but also their families and friends, as well as the professionals who care for them"
Dr Steve Matthews
Senior Research Fellow at the Plunkett Centre for Ethics and ACU’s Faculty of Theology and Philosophy

Impacts of this research


Change that improves health and well-being outcomes in society

  • Provision of more just care for large numbers of patients.
  • Advance care plans based on this ACU research bring medicine's traditional respect for the decision of the individual patient and the benefit of the sick person into the 21st century context.
  • These principles make the wishes of the individual sick person, insofar as it is possible, central to the plan and treatment.


Change in professional behaviour and standards within a sector.

  • Strengthened democratic commitment to the respect and protection of all human lives.
  • Enabling respect for patients’ deeply-held beliefs in the healthcare sector.
  • The guidelines influenced by this research embed behavioural change in incoming health professionals.


Change in policy, organisational structure and formal processes.

  • Changes to advance care policies, guidelines and practice at Calvary Health, and St Vincent’s Hospital, Sydney and in other hospitals and organisations.
  • Clinical ethics workshops related to end-of-life care and planning have increased awareness of new approaches to addressing these issues.


The person, people or organisations directly impacted by this research.

  • Catholic Health Australia
  • Calvary Health. Melbourne
  • St Vincent’s Hospital, Sydney and affiliates
  • Patients and their families
  • Medical professionals
  • Palliative care providers

2018 ARC Engagement and Impact Assessment

ACU submitted this research as an impact study in the 2018 ARC Engagement and Impact Assessment. The research received the rank of 'Medium', meaning the impact made a significant contribution to economy, society, environment, or culture, beyond the contribution to academic research.

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Lead researchers

Dr Bernadette Tobin AO
Reader in Philosophy and Director of the Plunkett Centre for Ethics at St Vincent’s Hospital in Sydney.

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Dr Steve Matthews
Senior Research Fellow at the Plunkett Centre for Ethics and in ACU’s Faculty of Theology and Philosophy.

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Plunkett Centre for Ethics

The Plunkett Centre for Ethics is a joint centre of Australian Catholic University, St. Vincent's Health Australia, NSW Facilities and Calvary Health Care. It is devoted to the study and teaching of ethics in clinical practice and biomedical research.

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