Practical Ethics for General Practice
General practice provides the first point of contact to medical care for patients across the world. GPs have obligations to patients in their care, to the government for responsible use of resources, and to communities for the standard of health services provided. Ethics is at the heart of health services, dealing with fundamental questions about what ought to be valued, and why. The two disciplines inevitably impact upon each other, and this book brings them together to focus on practical ethics for general practitioners. In this update of a successful first edition, the authors aim to: help GPs appreciate the ethically significant nature of general practice, drawing attention to the ethical complexity of apparently mundane and everyday experience; present a thoughtful and thought-provoking account of the moral foundations of general practice, exploring how moral concepts such as trust, beneficence, respect for autonomy, and fairness take on unique meanings in the general practice setting; and to discuss some specific ethical issues in detail, offering solutions that are practical as well as ethically sound. The focus is on practice throughout, ensuring through real cases and discussions with practitioners that the book is not abstract and esoteric in its discussion of philosophical principles, but that it is applicable in the real world of the doctor's surgery. The authors guide their readers through basic approaches to ethical reasoning and use of a practical ethics analysis framework suitable for use in all ethical dilemmas in medicine. Themes covered include the authors' research-based account of trust and the doctor-patient relationship, acting in the patient's best interests, confidentiality, making decisions with patients, beginning and end of life issues, treating children and adolescents, and role conflicts in general practice.
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1 General practice and ethics
2 Ethical reasoning and general practice
3 Trust and the doctorpatient relationship
4 Difficult relationships with patients
5 Confidentiality in general practice
6 Beneficence or does the doctor know best?
7 Justice and resource allocation in general practice
patient autonomy in general practice
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abortion acceptable actions antenatal screening assisted suicide behaviour benefits bioethics British Medical British Medical Association Chapter child circumcision clinical compassion competent concerned conflicts of interest consultation contraception decision-making decisions diagnosis Diane Pretty discussion disease doctor–patient relationship doctors Dr Buchan Dr Carter Dr Chu Dr Day Dr Grainger Dr Mackenzie Dr McDonald Dr McFarlane Dr Morrow Dr Schroeder Dr Singh drug duty ethical issues evidence-based medicine example feel foetus Gillick competence GP’s harm healthcare illness important informed consent involves Lisa Lisa’s Medical Council medical ethics Medical Journal medicine moral obligation Oxford parents paternalism paternalistic patient autonomy patient’s best interests person potential practice practitioners pregnancy preventive problem professional QALY reasons refuse relevant request requires resource allocation respect responsibility risk role sexual Shawlands situation social suffering surgery tion treat treatment trust understand virtue virtue ethics virtue theory