Professor David Isaacs, who was the Editor-in-Chief (EIC) of the Journal of Paediatrics and Child Health (JPCH) for 14 years, passed away peacefully in August 2025, after a prolonged period of ill health. His death has left a significant void for his family, friends, colleagues and academia, and yet his life's legacy is immense. Socrates said ‘the unexamined life is not worth living’. David's life was the antithesis; suffused with critical analysis, curiosity and philosophical and academic reflection. Renowned in Australia and globally, David's many accomplishments, awards and acknowledgements defy encapsulating. He hailed from the United Kingdom, having trained at Cambridge and Oxford before being invited to head the first Department of Immunology he had foresight and vision. In the early 1990s, the infectious diseases paediatricians were but a small and nascent bunch, called ‘ASPID’ (Australasian Society Paediatric Interest Group). David gathered the flock at ASPID meetings to impress upon the group the importance of coming together to champion and advance the sub-speciality, by having a stronger, unified voice. Hence the birth of ANZPID (the Australian they were identical. I loved being Editor-in-Chief of the Journal of Paediatrics and Child Health. One of the Objectives was to brighten up the journal. We did this by sourcing artworks and photographs by children, those who contributed to Joanna Capon's Art Express but also children's art competitions run by the Art Department in our hospital. Wiley Blackwell added colour to what had previously been a black-and-white journal. I decided to write editorials every month on varied topics relevant to paediatrics and paediatricians. I used a photograph to accompany each of my editorials. My friend and deputy Editor-in-Chief, Mike South educated me that I could use any photograph in Wikimedia Commons: Images without infringing copyright. That was a Godsend. I was Editor-in-Chief for 14 years until forced to step down by illness, so I wrote over 150 editorials. My first editorial in 2009 was to thank the previous Editor-in-Chief, Frank Oberklaid (although I still regret pointing out that his secret nickname was Frankly Overpaid). My second was on “Humour in Paediatrics”. The last in 2023 was on “Control and Stoicism”. With great kindness and generosity, our social media editor Chris Elliot had all my editorials bound in a book as a gift when I was no longer Editor-in-Chief. My good friend the late Henry Kilham was a prolific cartoonist, and I was able to use several of his best cartoons in the journal. I don't remember all of the Objectives, but we more than doubled the Impact Factor, a measure of how often a journal's papers are referred to by other journals. Improving the Impact Factor was certainly one of the 5 Key Objectives. David's memoir, An Accidental Activist. An Accidental Activist | Ligature, pp. 156–157. Reproduced with permission from the Isaacs family. Incidentally, I am a believer in evidence-based medicine, but it had become something of a mantra and there was some push-back about situations when it was difficult to obtain high-grade evidence. In 1999, a friend and colleague Dominic Fitzgerald and I published a satirical paper in the British Medical Journal (BMJ) called ‘Seven Alternatives to Evidence-Based Medicine’. In the paper we pointed out, with examples, that some people practised eminence-based medicine, some vehemence-based medicine, some eloquence-based medicine, some providence based, some diffidence-based, some nervousness-based and some confidence-based medicine. Of all the over 500 papers I have had published, this BMJ paper is the most quoted. David's memoir, An Accidental Activist, pp. 154. Reproduced with permission from the Isaacs family. David was a humanitarian. He was a leader in paediatric clinical ethics and, along with his colleague and friend Henry Killham, established and led the Children's Hospital at Westmead Clinical Ethics Support Service (CESS) as the Medical Lead until his retirement in 2021. He believed deeply in the value of clinical ethics to support clinicians experiencing complex clinical dilemmas, risk and uncertainty. And to reflect on questions like—what are we doing for rather than to this child? And what matters to this child and family? David loved a ‘chat’ and was known for his easy manner and ‘corridor consultations’ with those he encountered. He knew everyone, and they knew and trusted him. Although we often joked that if Discretion was his middle name—his first name should have been ‘In-’… as the ‘chat’ sometimes tipped into gossip … it was always with kindness and good humour. David was incredibly thoughtful and spent hours when I (AP) first arrived in the Network in 2018 introducing me to everyone he knew, and pointing out all the artwork he admired at CHW. He was instrumental in funding a full-time Ethicist in 2015 and a Fellow in 2020. The CESS is now thriving and growing network wide, in large part due to David's advocacy and legacy. Henry Kilham and I both had a long-standing interest in clinical ethics, not the Research Ethics Committee which considers whether or not research studies are ethical, but the ethics of everyday clinical work in a children's hospital. Henry enrolled to do a Masters course in Bioethics … I enrolled for the same course. …It was fascinating but challenging to have to read the often-dense writing of ethicists and philosophers and to have to write academic essays for the first time since university. Henry and I enjoyed discussing topics and comparing each other's essays. One unexpected effect of the bioethics course was that I became pescatarian. I had become increasingly concerned by the practice of feeding antibiotics to animals merely to increase yield, not for the animals' sake, and by the practice of feeding sheep offal to cows, for economic reasons, which resulted in mad cow disease. We studied the writing of Peter Singer, who is a strict vegetarian, and makes a strong case for vegetarianism. I promptly became a vegetarian. David's memoir, An Accidental Activist, pp. 172. Reproduced with permission from the Isaacs family. After 2 years of Clinical Ethics, Henry and I both acquired a Postgraduate Diploma in Bioethics. We were too exhausted to face writing a long thesis for a Master's degree. Armed with our qualifications, we started the first ever Clinical Ethics service at The Children's Hospital at Westmead. We offered our colleagues ethics consultations in situations that were ethically complex. We arranged to give Clinical Ethics Grand Rounds presentations three times a year, with Bernadette Tobin from St Vincent's Hospital as a visiting ethicist to provide an expert commentary on the cases presented. Clinical Ethics Grand Rounds soon became the best attended of all Grand Rounds. Henry and I also arranged monthly Clinical Ethics meetings where we or a colleague would present a child whose management was causing ethical problems, then open up the case for general discussion. … Henry and I taught on the Masters of Bioethics course for the University of Sydney and I co-supervised a successful PhD student. Henry and I had clinical demands on our time competing with clinical ethics. Henry made a strong case for the Sydney Children's Hospital Network (The Children's Hospital at Westmead and Sydney Children's Hospital, Randwick) to fund a full-time ethicist (in 2015). Eventually the hospital paid attention. Anne Preisz was appointed as Clinical Ethicist and is now Lead for the CESS (2018). She works across two hospitals and is extremely busy. Henry and I worked with her as clinician ethicists until we retired. Associate Professor Phil Britton is now the lead clinician supporting Anne. Anne has succeeded in persuading the Network to fund a Fellow in Clinical Ethics to help cope with the burgeoning demand for ethical advice. David's memoir, An Accidental Activist, pp. 173–174. Reproduced with permission from the Isaacs family. David was profoundly respected for his clinical work and advocacy in refugee and asylum seeker child health. With like-minded colleagues, he recognised the endemic health inequities for refugee and asylum seeker children and set up the Health Assessment for Refugee Kids (HARK) clinic at CHW with Nick Wood and inspired and engaged others like Hasantha Gunasakera. David was a leading voice in witnessing and highlighting to the public the trauma being imposed on children through immigration detention. After visiting Nauru with his son Mark Isaacs and seeing for himself the harms of detention and suffering of refugee children, he consulted widely on children being held in immigration detention in Nauru and became, in his own words, “an Accidental Activist” and prominent in the Kids off Nauru campaign: https://aran.net.au/actions/actions-rallies/kids-off-nauru-campaign/. David further served the national health community through his tenure on the Pharmaceutical Benefits Advisory Committee (PBAC), the Australian Technical Advisory Group on Immunisation (ATAGI) and the Polio Expert Panel in support of the Global Polio Eradication Initiative. Even more outstanding than his exemplary professional contribution was David's kindness, humility, love of the arts (himself an accomplished violinist and member of his local orchestra) and his sense of humour. Anyone who knew David will recall his huge capacity for enjoying life and celebrations and being regaled with many stories told with self-deprecative humour. He was most proud of his family and their numerous accomplishments both in the UK and Australia, and to whom we express our deepest condolences. He adored his wife Carmel, daughter Anna and sons Mark, Tom, and Ben (who sadly died in 2021), and was deeply committed to them and his five beautiful grandchildren. David Isaacs (23/09/1950–02/08/2025). Henry Killam and David were firm friends and enjoyed life and work to the fullest. Henry‘s cartoon of Dave (circa 1995) attests to the fun they had, akin to many Shakespearean plays, a pastime they shared. Vale David Isaacs The authors thank Simon Goudie and Louise Young-Wilson, Journal of Paediatrics and Child Health, for their support.
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